Official Drug Advisers Reject Time Limit on Methadone Substitution for Addicts

Should the government enforce mandatory limits on the length of methadone substitution treatment? In Britain, at least, the answer is now a resounding “no”. According to a report released in early November by the Advisory Council on the Misuse of Drugs (ACMD), imposing a blanket timeline on methadone substitution treatment “would lead to high rates of relapse and increase HIV infection and death rates.”The Council’s report comes in response to a proposal advocated by senior Tory party officials, including pensions secretary Iain Duncan Smith, who claimed that the methadone maintenance program “has entrenched addiction and sucked investment out of residential rehabilitation programs.” For now, at least, ACMD is holding firm that methadone treatment should not be time restricted.

Methadone Maintenance Programs: Why No Time Limit?

According to ACMD’s research, the majority of individuals in the UK’s program were not “parked” on methadone treatment as Duncan Smith alleged. In fact, ACMD expressed concern that most individuals were receiving treatment for too short a time. ACMD argued that individuals needed longer treatment times to maximize benefits. The council pointed to statistics showing that nearly 40 percent of individuals actually drop out within six months of treatment. Only 10 to 15 percent of program participants receive treatment for more than five years. ACMD argued that the priority should be increasing access to substitution treatment, not restricting this access.“All the evidence suggests that restricting access to substitution treatment leads to an increased risk of people relapsing, turning to crime to fuel their habits – and even dying from an overdose,” said Annette Dale-Perla, the chair of ACMD’s recovery committee.

However, Dale-Perla did stress that a methadone maintenance program will be most effective when the program is offered in conjunction with behavioral therapies and skill classes to help individuals address the root psychological causes for their addictions and begin rebuilding their lives.ACMD chairman, Professor Les Iversen stressed that methadone maintenance should be seen as a stepping stone to recovery. “When a person with a heroin addiction is also given help to deal with their personal, social and economic problems there is a greater chance of a positive outcome,” said Iversen.

What Are the Benefits of Methadone Maintenance?

Methadone maintenance treatment is a comprehensive treatment program in which methadone as prescribed as an alternative opioid to heroin. Methadone is substituted for heroin and other opioids because it blocks the effects of other opioids, a phenomenon known as cross-tolerance.Methadone suppresses opioid withdrawal symptoms, reduces the craving for heroin, reduces the euphoric effects of other opioids, and does not cause intoxication symptoms (e.g., sedation or euphoria) associated with heroin abuse. Prescribing physicians typically work closely with on-site substance abuse counselors and a drug treatment team to make therapeutic decisions for each individual in treatment. Methadone use is closely regulated.

Since tolerance to methadone maintenance develops slowly, individuals can, theoretically, use methadone indefinitely to maintain sobriety. ACMD cited a variety of studies that have found methadone to be effective at not only helping individuals stay sober, but also improving physical and mental health, social function, quality of life, and retention in treatment programs. Methadone maintenance programs also have social benefits: participants are less likely to steal or commit crimes in order to obtain heroin.

Seeking Treatment for Heroin Addiction: Next Steps

If you or a loved one is struggling with heroin abuse, sobriety is possible. A methadone maintenance program is an important part of a comprehensive treatment program. To learn more about the benefits of methadone maintenance, talk to an substance abuse addiction specialist or drug counselor today.

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