Methadone and It's Effectiveness
METHADONE AND IT’S EFFECTIVENESS
INTRODUCTION
Methadone occupies a position of huge prominence in drug misuse treatment to date. It is estimated there are around 650,000 illicit drug users receiving treatment globally (WHO 2008). Historically it was the earliest form of opioid replacement therapy and continues to be the most widely used form in the United States, Europe and Australia (Ward et al 1998). The most recent figures for Scotland show approximately 22,224 people are receiving methadone for drug misuse (Scottish Exec 2007). The effectiveness of methadone treatment is however questioned by some critics. This paper aims to describe methadone intervention treatment, look at the evidence surrounding it and discuss its effectiveness. For the purpose of this essay the history and treatment goals of methadone will be identified. The paper will then go on to discuss 4 main areas of debate in treatment, namely:
Reduction in criminal activity
Dosage of prescribed heroin.
Methadone maintenance treatment and HIV, Hep B and C.
Support services.
Finally an overview of all of the evidence presented in the paper will be given and the future for methadone in drug misuse treatment discussed.
HISTORY AND DESCRIPTION OF METHADONE TREATMENT
In the USA in the early 1960’s Dole and Nyswander introduced orally administered maintenance doses of the synthetic opioid methadone as a drug substitution treatment for opioid dependence. The main aims of the introduction of this treatment were to reduce illicit drug use and criminal acts. The treatment was devised for established opiate addicts and was based on the principal that, prolonged opiate use caused certain physiological changes within the body which required effective treatment indefinitely (Ward et al 1998). The fundamental aspect of methadone treatment was that it blocked any effect the intake of heroin would cause and the person would fail to experience the euphoria effects. The person would
INTRODUCTION
Methadone occupies a position of huge prominence in drug misuse treatment to date. It is estimated there are around 650,000 illicit drug users receiving treatment globally (WHO 2008). Historically it was the earliest form of opioid replacement therapy and continues to be the most widely used form in the United States, Europe and Australia (Ward et al 1998). The most recent figures for Scotland show approximately 22,224 people are receiving methadone for drug misuse (Scottish Exec 2007). The effectiveness of methadone treatment is however questioned by some critics. This paper aims to describe methadone intervention treatment, look at the evidence surrounding it and discuss its effectiveness. For the purpose of this essay the history and treatment goals of methadone will be identified. The paper will then go on to discuss 4 main areas of debate in treatment, namely:
Reduction in criminal activity
Dosage of prescribed heroin.
Methadone maintenance treatment and HIV, Hep B and C.
Support services.
Finally an overview of all of the evidence presented in the paper will be given and the future for methadone in drug misuse treatment discussed.
HISTORY AND DESCRIPTION OF METHADONE TREATMENT
In the USA in the early 1960’s Dole and Nyswander introduced orally administered maintenance doses of the synthetic opioid methadone as a drug substitution treatment for opioid dependence. The main aims of the introduction of this treatment were to reduce illicit drug use and criminal acts. The treatment was devised for established opiate addicts and was based on the principal that, prolonged opiate use caused certain physiological changes within the body which required effective treatment indefinitely (Ward et al 1998). The fundamental aspect of methadone treatment was that it blocked any effect the intake of heroin would cause and the person would fail to experience the euphoria effects. The person would