||National Institute on Drug Abuse
|NIDA News Release
||Contact: Beverly Jackson
|FOR RELEASE, Tuesday, March 7, 2000
New Study Underscores
Effectiveness of Methadone Maintenance as Treatment for Heroin Addiction
New research clearly shows that longer-term methadone maintenance therapy
(MMT), combined with some psychosocial counseling, is a far more effective
treatment for heroin addiction than is simply the temporary use of methadone
to detoxify patients and reduce drug craving, even when the detoxification
is coupled with much more intensive psychosocial therapy. The study is
published in this week's Journal of the American Medical Association,
by a research team from the University of California, San Francisco, and
the San Francisco Veteran Affairs Medical Center. The National Institute
on Drug Abuse (NIDA), National Institutes of Health, provided funding
for the research.
"The findings from this study clearly indicate that methadone maintenance
is an effective treatment for heroin addiction," says Dr. Alan I. Leshner,
NIDA Director. "This is yet another indication that MMT should be used
more widely as a treatment option for heroin addicts. Currently, only
about 20 percent of the 810,000* diagnosed heroin addicts in the U.S.
receive this treatment."
Study director Dr. Sharon Hall says, "The goal of this study was to determine
whether short-term methadone-assisted detoxification, when enriched with
intensive psychosocial services and aftercare, could provide an effective
alternative to MMT. Our results show that no matter how ideologically
attractive the notion of a time-limited methadone treatment for heroin
abusers, longer-term methadone maintenance treatment is far more effective."
The researchers interviewed 179 heroin- or cocaine-dependent volunteers
monthly, for 12 months after their admission to the study. The volunteers
were randomly divided into two groupsÑa methadone maintenance treatment
group and a methadone detoxification group. The MMT group was eligible
for 14 months of methadone maintenance, followed by a 2-month detoxification.
Participants in this group were required to attend substance abuse group
therapy 1 hour per week for the first 6 months of maintenance, and 1 hour
per month of individual therapy.
Patients in the detoxification group received methadone only for the
first 180 days of their treatment. During their first 6 months of treatment,
the detoxification group was required to attend 2 hours per week of substance
abuse group therapy; 1 hour per week of cocaine group therapy (if they
had tested positive for cocaine when admitted to the study); a series
of 14 1-hour, weekly substance abuse education classes; and 4 weekly individual
therapy sessions. This group also received 6 months of aftercare services
that included weekly individual and group psychotherapy and liaison services
with the criminal justice system, medical clinics, and social service
agencies, but no additional methadone after the first 180 days of their
Study results showed that more patients in the MMT group remained in
treatment for longer periods of time (438.5 days vs. 174 days) and had
lower heroin use rates than did shorter-term methadone detoxification
patients. Of the MMT group, 77 out of 91 patients were still in the study
at the 12-month mark, while only 57 of 88 methadone detoxification patients
were still in the study. MMT also resulted in a lower rate of drug use-related
HIV-risk behaviors and a lower level of criminal activity.
Note to Reporters: The full text of the article, "Methadone Maintenance
versus 180-day Psychosocially-Enriched Detoxification for Treatment of
Opioid Dependence: A Randomized, Controlled Trial," can be found in the
March 8, 2000, issue of The Journal of the American Medical Association
(JAMA.2000;283:1303-1310). The article is available on JAMA's website
at: http://www.jama.com/ or by calling the Science
News Department at 312-464-5374.
*Figure from The White House Office of National Drug Control Policy.
The National Institute on Drug Abuse is a component of the National Institutes
of Health, U.S. Department of Health and Human Services. NIDA supports
more than 85 percent of the world's research on the health aspects of
drug abuse and addiction. The Institute carries out a large variety of
programs to ensure the rapid dissemination of research information and
its implementation in policy and practice. Fact sheets on the health effects
of drugs of abuse and other topics can be ordered free of charge in English
and Spanish by calling NIDA Infofax
at 1-888-NIH-NIDA (644-6432) or 1-888-TTY-NIDA (889-6432) for the deaf.
These fact sheets and further information on NIDA research and other activities
can be found on the NIDA home page at http://www.drugabuse.gov/.
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