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:
- 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
- Society needs to make a commitment to offer effective treatment for heroin
addiction for all who need it.
- Opiate-addicted persons under legal supervision need to have access to
methadone maintenance treatment.
- The training of physicians and other health care professionals need
improvement regarding the diagnosis and treatment of opiate addiction.
- The unwarranted over regulation of methadone maintenance treatment and all
opiate agonist treatment programs needs to be reduced.
- 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.
- 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.
- 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.
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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