Literature Review - Methadone Maintenance Treatment

9. Conclusions

The overall effectiveness of methadone maintenance treatment is established in the literature. There is clear evidence that methadone maintenance treatment offers a range of benefits which far outweigh the costs of delivering treatment.

Research has identified specific program-related factors that are likely to improve the effectiveness of methadone maintenance treatment programs. In particular, treatment programs that focus on retaining individuals in treatment are those most likely to enhance the likelihood of achieving positive outcomes. This includes programs that adopt a client/patient-centred approach and that employ a comprehensive service model which addresses the multiple needs of individuals who are dependent on opioids. Other important factors - such as admission criteria, assessment, adequate individualized dosage, unlimited duration of treatment, therapeutic monitoring of drug use during treatment, and a client/patient-centred approach to tapering - also play a role in improving retention and treatment outcomes. Staff training and program environments are critical areas that contribute to the therapeutic process and the achievement of positive treatment outcomes.

In conclusion, there are good, evidence-based reasons to focus on improving access to effective MMT treatment. Ongoing research and evaluation that compares the effectiveness of various program modalities, and delineates the range of access points, settings, and delivery modes will be important to further improve outcomes.