Long-term methadone maintenance treatment: some clinical examples.

After 27 years methadone maintenance remains perhaps the most controversial form of available opiate addiction treatment. Recognizing that many patients choose to remain in methadone treatment for extended periods of time the authors have wondered whether such patients might actually be harmed by long-term involvement. A review of the records of 3 patients who had been in continuous treatment for 15 years or more revealed that all of their lives had improved over the course of their treatment involvement. They varied in the length of time required before they showed improvement and all three indicated that they wished to remain on methadone because previously they had resumed drug use when they tried detoxing either alone or in treatment. There were periods during their treatment involvement when these patients were not doing well and could have been regarded as treatment failures. Continuing on in treatment, however, all three had made positive changes in their lives, changes which were of benefit to the society as well as the individual.