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THERAPEUTIC EFFECTIVENESS OF METHADONE MAINTENANCE PROGRAMS IN THE MANAGEMENT OF DRUG DEPENDENCE OF MORPHINE TYPE IN THE USA

NCJ Number
27072
Author(s)
S S WILMARTH; A GOLDSTEIN
Date Published
1974
Length
53 pages
Annotation
THIS DOCUMENT PROVIDES AN OVERVIEW OF THE HISTORY AND PHARMACOLOGICAL EFFECTS OF METHADONE, DISCUSSES THE RATIONALE OF METHADONE MAINTENANCE, AND DESCRIBES THE FEATURES AND OUTCOMES OF THREE METHADONE PROGRAMS.
Abstract
THE PHARMACOLOGIC ADVANTAGES OF METHADONE RELEVANT TO ITS USE IN A MAINTENANCE PROGRAM ARE DISCUSSED. THESE INCLUDE: ITS EFFECTIVENESS BY ORAL ADMINISTRATION AND THE 24-48 HOUR DURATION OF ACTION; THE ABILITY TO SUSTAIN PHYSICAL DEPENDENCE WHILE RECEIVING HEROIN WITHDRAWAL SYMPTOMS; THE ABILITY OF METHADONE TO PRODUCE GROSSTOLERANCE TO HEROIN, THEREBY ATTENUATING THE EUPHORIC EFFECTS OF HEROIN; AND THE VERY MILD EURHORIC EFFECTS OF METHADONE WHEN GIVEN IN DAILY ORAL DOSES. GOVERNMENTAL REGULATIONS OVER METHADONE MAINTENANCE AND THE PROBLEMS THIS MAY CAUSE FOR METHADONE MAINTENANCE PROGRAMS ARE OUTLINED. THE LOCATION, TREATMENT PROGRAM GOALS, AND ADMISSION CRITERIA OF THREE MAINTENANCE PROGRAMS ARE DESCRIBED. THESE PROGRAMS ARE THE METHADONE MAINTENANCE TREATMENT PROGRAM (MMTP) OF NEW YORK CITY, THE ILLINOIS DRUG ABUSE PROGRAM (IDAP) OF CHICAGO, AND THE SANTA CLARA COUNTY METHADONE PROGRAM (SCCMP) IN CALIFORNIA. THE PERFORMANCE OF EACH PROGRAM ON SUCH OUTCOME FACTORS AS RETENTION RATES, DROP-OUT RATES, CRIMINALITY OF PATIENTS, POST-TREATMENT EMPLOYMENT RATES, DRUG ABUSE OF CLIENTS, THE REPORTED EFFECTS OF METHADONE ON CLIENTS' PHYSICAL AND MENTAL HEALTH, AND EVENTUAL WITHDRAWAL FROM MEHTADONE.

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