Methadone Medical Maintenance: An Early 21st-Century Perspective

Abstract

Methadone medical maintenance is the treatment of stable methadone-maintained patients in primary care physicians' offices under an exemption from federal methadone regulations. Reports from seven such programs in six states show high retention and low frequencies of illicit drug use. Patients and physicians indicate high levels of satisfaction. Although methadone maintenance has a long history of safety and efficacy, most methadone medical maintenance programs are no longer operating or accepting new patients. Federal regulations for standard methadone clinics allow some features of methadone medical maintenance, and advocacy for state approval of these changes is strongly recommended.

KEYWORDS:

• Review
• methadone
• primary care
• opioid
• addiction
• pharmacotherapy
• buprenorphine
• heroin

ACKNOWLEDGMENTS

The authors would like to thank Gregory James and Belinda Greenfield of the New York State Office of Alcohol and Substance Abuse Services for help in compiling information on the New York State Programs, and Margaret Chappell for the literature searches for this article.