Commentary on the NIH Consensus
Development Statement 1

From the Meeting November 17-19, 1997 Effective Medical Treatment of Heroin Addiction

     

Policy Statement
Number 8
December 1, 1997

The National Alliance of Methadone Advocates supports the NIH Consensus Statement on Effective Treatment of Heroin Addiction that was facilitated by the National Institute on Drug Abuse and the National Institute of Health.

The imprecate of this special statement should be understood in order to realize the impact that it can have on methadone maintenance treatment. The Consensus Statements are prepared by a special committee who are comprised of individuals who are typically professionals from the disciplines involved in the issue (i.e. doctors, lawyers, etc.) but they have no connections to the field being examined. In this respect their conclusions are independent and thus greater influence. The prepared statement is based on the (1) presentations from panels consisting of professionals working in the field and relevant areas; (2) questions and statements from conference attendees during open discussion periods that are part of the public session; and (3) closed deliberations by The Committee. Thus the statement is an independent report of the consensus panel and is not a policy statement of the NIH or the Federal Government.

A Summary of the Recommendations are:

  1. Strong leadership is necessary in educating the public that addiction is not self inflicted but is a medical disorder that includes a spectrum of brain and medical conditions that can be effectively treated with benefits to society.
  2. Society needs to make a commitment to offer effective treatment for heroin addiction for all who need it.
  3. Opiate-addicted persons under legal supervision need to have access to methadone maintenance treatment.
  4. The training of physicians and other health care professionals need improvement regarding the diagnosis and treatment of opiate addiction.
  5. The unwarranted over regulation of methadone maintenance treatment and all opiate agonist treatment programs needs to be reduced.
  6. Funding for methadone maintenance treatment needs to be increased and required as a benefit for public and private insurance programs equivalent to the coverage for all medical and mental disorders.
  7. Chemically dependent pregnant women need to receive special consideration and methadone maintenance treatment must be culturally sensitive to enhance favorable outcomes for participating African American and Hispanic persons.
  8. Patients, underrepresented minorities, and consumers should be included in bodies charged with policy development guiding opiate addiction treatment.
    Methadone maintenance treatment needs to be expanded within States and regions where programs where it is currently unavailable.

Summary

The Consensus Committee in their full statement emphasized the rigorous scientific studies that methadone maintenance had undergone over the past 30 years that demonstrate its effectiveness in significantly lowering illicit opiate drug use, reducing illness and death from illicit opiate drug use, reducing crime, and by enhancing social productivity. And that in order for methadone maintenance treatment to receive adequate funding and it's expansion be supported it will be necessary to undertake a campaign to educate politicians, policy makers and society that opiate addiction is a medical disorder and methadone is effective in treating it.

To replace the regulations The Committee recommended alternatives such as physician accreditation and certification and to improve education that physicians, nurses and other health professionals receive. While reducing regulations will help to promote expansion of methadone maintenance treatment increased funding is necessary to ensure expansion in all states including those that do not currently provide it. The Committee strongly recommended that legislators and regulators recognize the cost effectiveness of methadone maintenance treatment and that benefits for treatment be part of public and private insurance programs.

Bodies charged with policy The Committee urged should be include misrepresented minorities and patients. The Committee stressed that methadone treatment must be culturally sensitive and that risk groups, such as pregnant women should be targeted.

What Can Advocates Do?

It is now important for us to ensure that the conclusion of this Consensus Statement become known by politicians and policy makers. Patients and the family members of patients should write to their representatives and tell them that methadone maintenance treatment does work and most important that it saves ad restores lives. Do not stop at the federal and national level continue writing and talking with state and local politicians and policy makers. Because methadone maintenance treatment has been politicized it is at that level that must first be education. This Consensus Statements give us the chance to promote and influence the medicalization of methadone maintenance treatment.

1. Effective Medical Treatment of Heroin Addiction. NIH Consensus Statement 1997 November 17-19;15(6). Available from the National Clearinghouse for Alcohol and Drug Information NCADI
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