Best Practices - Methadone Maintenance Treatment

2002
ISBN: 0-662-31812-9
Cat. No.: H49-164/2002E

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Table of Contents

• Preface
• Acknowledgements
• 1. Introduction
  • 1.1 Purpose of this Document
  • 1.2 Who is the Intended Audience for this Document
  • 1.3 Development of this Document
• 2. Background
  • 2.1 What is Substance Dependence?
  • 2.2 What is Opioid Dependence
  • 2.3 Impact of Opioid Dependence
  • 2.4 What is Methadone Maintenance Treatment
  • 2.5 How does Methadone Work
  • 2.6 Brief History of Methadone Maintenance Treatment
  • 2.7 Evolving Regulatory and Administrative Context
  • 2.8 Increasing Access to Methadone Maintenance Treatment in Canada: Overcoming Barriers
  • 2.9 What is the Status Quo - How is Methadone Maintenance Treatment Delivered in Canada and Internationally?
  • 2.10 What Types of MMT Programs are Most Effective?
  • 2.11 Developing a Continuum of MMT Program Delivery
• 3. Rationale
  • 3.1 Potential Benefits of Methadone Maintenance Treatment
  • 3.2 Potential Cost Benefits of Methadone Maintenance Treatment
• 4. Best Practices in MMT - Program Development and Design
  • 4.1 Clear Program Philosophy and Treatment Goals
  • 4.2 Focus on Engagement and Retention
  • 4.3 A Maintenance Orientation
  • 4.4 A Client/Patient-Centred Approach
  • 4.5 Accessibility
  • 4.6 Integrated Comprehensive Services
  • 4.7 Client/Patient Involvement
  • 4.8 Involvement of Wider Community
  • 4.9 Adequate Resources
• 5. Best Practices in MMT - Program Policies
  • 5.1 Open Admission
  • 5.2 Timely Assessment
  • 5.3 Adequate Individualized Dosage
  • 5.4 Methadone Dosage during Pregnancy
  • 5.5 Unlimited Duration of Treatment
  • 5.6 Clear Criteria for Involuntary Discharge from Treatment
  • 5.7 Urine Toxicology Screening and Non-Punitive Approaches to Drug Use During Treatment
  • 5.8 Client/Patient-Centred Tapering
• 6. Best Practices in MMT - Program Team and Environment
  • 6.1 Multidisciplinary Program Team
  • 6.2 Adequate Human Resources
  • 6.3 Competence, Attitudes and Behaviours in Practice
  • 6.4 Relationship Building and Support
  • 6.5 Adequate Ongoing Training
  • 6.6 Program Environment
  • 6.7 Organized, Structured Approach to Treatment
  • 6.8 Safety
  • 6.9 Flexible Routines
  • 6.10 Information Collection And Sharing
• 7. Best Practices in MMT - Meeting the Needs of Specific Groups
  • 7.1 MMT and People with Multiple Substance Use Behaviours
  • 7.2 MMT and People who are Dependent on Oral Opioids
  • 7.3 MMT and Women
  • 7.4 MMT and Pregnant Women
  • 7.5 MMT and Youth
  • 7.6 MMT and People who are Homeless
  • 7.7 MMT and People Living in Rural or Remote Communities
  • 7.8 MMT and First Nations and Inuit
  • 7.9 MMT and People Living with HCV
  • 7.10 MMT and People Living with HIV/AIDS
  • 7.11 MMT and People with Mental Health Disorders
  • 7.12 MMT and Offenders in Correctional Facilities
• 8. Research and Evaluation
  • 8.1 Research Gaps
  • 8.2 Need for Evaluation
• Reference List and Suggested Further Reading