Phases of treatment: a practical approach to methadone maintenance treatment

There has been an on-going controversy in the United States as to whether methadone should be used in the treatment of opiate addiction as a long-term pharmacological treatment or as a short-term medical intervention to help addicts attain an opiate-free state. This article describes a practical treatment approach which resolves this dichotomy and presents a clinical framework for the variable use of methadone to effectively meet the needs of each individual patient. The therapeutic process is highly structured and is divided into several phases of treatment for opiate addiction. The article describes each of these phases and illustrates how they can be translated into clinical/medical practice. Some of the issues regarding medical maintenance, as well as methadone tapering and maintaining subsequent abstinence, are also addressed.