Towards a rehabilitation of methadone maintenance: integration of relapse prevention and aftercare.

Methadone maintenance was originally proposed as a long-term treatment modality for opiate addiction. However, most clients leave methadone maintenance rather than take methadone indefinitely and subsequently relapse to opiate use. In this article, the author examines relapse to opiate use by clients during and after methadone maintenance treatment in the United States. He reviews models of relapse prevention and aftercare which may be applicable to clients in methadone treatment. There now exist structured and psychotherapeutic relapse prevention methods which may be integrated into methadone maintenance treatment and could serve, in addition, to revitalize methadone maintenance treatment.