Methadone maintenance and recovery.
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Biomedical subjects
Publications and source records attributed to R G Newman.
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Despite the proven effectiveness of methadone maintenance treatment in the management of opiate dependence, methadone maintenance programmes have met with almost universal opposition and controversy in countries all over the world. The unique aspects of methadone treatment are examined, including the stringent restrictions imposed on methadone programmes and the convention of sub-optimal dosing adhered to in many programmes. Finally, some reasons for the under-utilization of this treatment mode are proposed, and the implications of current attitudes towards methadone maintenance programmes are examined.
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In any contractural relationship, legally and ethically, all parties much benefit. Minor concessions to one party can be significant gains for the other. To establish the win/win environment, it is sometimes necessary to make reasonable concessions that preserve the overall objective of the JIT concept. It is good business sense to make those concessions that are inexpensive and guarantee greater control. The concessions discussed strengthen the buyer-seller relationship and aid in reaching the objectives of JIT.
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Considerable evidence indicates that intravenous drug users are emerging as the group at greatest risk for both acquiring and spreading human immunodeficiency virus (HIV) infection. Thus, all possible methods to control the spread of HIV infection in intravenous drug users should be explored. Key recommendations are that HIV antibody testing of intravenous drug users should be voluntary, because mandatory testing is counterproductive; free distribution of needles and syringes to intravenous drug users should occur only in carefully controlled circumstances to determine its effectiveness in decreasing infection rates; and drug-free and methadone maintenance treatment programs should be available on demand to all intravenous drug users as a means of reducing the spread of HIV infection. At present, the primary strategy for prevention must be education resulting in behavioral change. Education is currently the only definitive means for controlling the spread of HIV infection among intravenous drug users, their sex contacts, and to fetuses.
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