Methadone Maintenance Treatment

What are the benefits of methadone maintenance treatment?

Although there are some side effects associated with the use of methadone--as there can be with any medication--there are many good reasons to provide people who are dependent on opioids with access to methadone maintenance treatment.

Research indicates that methadone maintenance treatment is effective in reducing:

• the use of other opioids;
• the use of other substances, e.g. cocaine;
• criminal activity;
• mortality;
• injection-related risk behaviours;
• other risk behaviours for transmission of HIV and STDs; and
• transmission of HIV (and potentially the transmission of HCV and other blood-borne pathogens).

Methadone maintenance treatment has also been found to improve:

• physical and mental health;
• social functioning;
• quality of life; and
• pregnancy outcomes.

Methadone maintenance treatment is associated with increased retention in treatment.

Methadone maintenance treatment has the potential to benefit, not only people receiving treatment, but also those who are involved in delivering treatment, as well as the wider community and society as a whole.

For people who are dependent on opioids, methadone maintenance treatment provides access to a stable supply of a legal, pharmaceutical grade medication. As a result, people receiving treatment achieve respite from the stress of maintaining a constant supply of illicit opioids often involving criminal activities and high risk sexual practices. Rather than experiencing a constant cycle of highs and lows--as the result of repeated injections of heroin, for example--their mood and functional state become stabilized. Overall, research indicates that people receiving methadone maintenance treatment will:

• spend less time using narcotics daily;¹²
• reduce their use of illicitly obtained opioids (and continue this pattern as long as they stay in treatment);¹³
• reduce their use of other substances including cocaine, marijuana and alcohol;¹⁴
• spend less time dealing drugs;¹⁵
• spend less time involved in criminal activities;¹⁶
• spend less time incarcerated;¹⁷
• have much lower death rates than individuals who are dependent on opioids and not receiving treatment (the death rate for those not receiving treatment is more than three times higher than for those engaged in treatment);¹⁸
• reduce injecting¹⁹, and injection related risk behaviours;²⁰
• reduce other risk behaviours for transmission of HIV and STDs;²¹
• reduce their risk of acquiring HIV infection;²²
• potentially reduce their risk of acquiring HCV²³ or other blood-borne pathogens;
• improve their physical and mental health;²⁴
• improve their social functioning;²⁵
• increase their likelihood of being employed full-time;²⁶ and
• improve their quality of life.²⁷

For pregnant women who are dependent on opioids, receiving methadone maintenance treatment, combined with adequate prenatal care, decreases obstetrical and fetal complications.²⁸ Methadone protects the fetus from erratic opioid levels and frequent opioid withdrawal symptoms, which are common among pregnant women who do not receive treatment for their opioid dependence.²⁹

The longer people who are dependent on opioids remain in methadone maintenance treatment, the more likely they are to remain crime-free, to avoid injecting, and to reduce their use of heroin.³⁰

For practitioners involved in treatment delivery, methadone maintenance treatment is an opportunity to:

• provide an important component of medical and public health care;
• develop partnerships and linkages with other service providers and provide clients/patients with a range of services and supports;
• establish positive, supportive therapeutic relationships with--and learn from--people who are dependent on opioids; and
• contribute to an educational and therapeutic process that can lead people who are dependent on opioids to gain a new perspective on themselves and their use of drugs, and make changes in their lives.

For the wider community, the potential benefits of methadone maintenance treatment include:

• reduced drug-related criminal activity;
• reduced prostitution; and
• reduced numbers of discarded used needles in the community.

For society as a whole, methadone maintenance treatment may result in:

• reduced crime; and
• decreased public health risks.