Methadone and buprenorphine maintenance 1
Running head: METHADONE AND BUPERNORPHINE MAINTENANCE
Public Policy: Methadone and buprenorphine maintenance
Dana Clark
University of Central Florida
Since the mid-1970’s harm reduction strategies such as methadone maintenance programs has been effectively used in America. The literature on methadone maintenance shows that the programs reduce heroin use and needle sharing. Methadone blocks the narcotic effect of heroin and prevents withdrawal symptoms through a varied daily dose, depending on the addicts need. Although these programs have been shown to be successful, regulations are so stringent that very few substance abusers have access to the help they need.
One requirement methadone maintenance programs have is that methadone can only be prescribed by “comprehensive treatment programs”. This excludes hospital clinics, health centers in the community, and private doctor’s offices. Dosage level is also a matter of policy, as many clinics are only regulated to give out low dosages of methadone to clients. What this policy does not take into account is the individual need of the client, opting rather for set dosage levels. Research has shown that higher doses of methadone are more effective in the reduction of heroin use. Removing restrictions from methadone maintenance programs will benefit the high number of heroin users and give them access to proper dosages.
The Drug Addiction Treatment Act of 2000 is a piece of legislature that helps substance abusers gain access to resources. This legislation allows qualified physicians to prescribe schedule III, IV, and V narcotic drugs for the detoxification or maintenance of addiction to opiates. These addicts can be treated outside of the tightly restricted methadone maintenance programs. This program has the potential to change treatment methods forever, and increases the access to treatment for clients anywhere in the United States.
Buprenorphine was the first medication approved for use under this act in 2002. Physicians can prescribed this treatment to as many as thirty patients, and an evaluation of the program has shown that buprenorphine is an effective clinical treatment. The use of this treatment has increased availability of medication for opiate-addicted clients, and has shown to be effective in promoting positive long-term outcomes. Some insurance-funded treatment programs are pushing buprenorphine us, but many feel that the limit as to the number of clients that can be treated is a hindrance on success.
Social workers play an important role in referring clients who have opiate addictions to receive the proper medical treatment. Referrals to qualified physicians who are knowledgeable about opiate addictions and the stigmas that come along with it are appropriate for clients. The way social workers handle referrals in this area is important, as it will shape treatment processes in the future, and places importance on the treatment of clients with these specific needs.
Opiate addiction has become a widely overlooked issue in this country. More and more people are experiencing the addictive properties of opiates such as heroin, and treatment methods are far from perfected. The shared use of needles has also brought about a new surge of HIV and AIDS in the drug using population. Heroin has devastating social, psychological and physical effects. By placing stringent regulations on methadone clinics, clients may not get the proper dosage or treatment they need, but the fact that methadone is still a synthetic opiate must be considered. If strict regulations are not placed on the drug, potential for abuse may increase, only rather than using heroin addicts will turn to methadone and buprenorphine.
References
Van Wormer, K. & Davis, D.R. (2008). Addiction Treatment: A Strengths Perspective.
Belmont, CA: Thomson-Brooks/Cole.