Ward J, Hall W, Mattick R P
Division of Psychology, Australian National University, Canberra.
Lancet. 1999 Jan 16;353(9148):221-6. doi: 10.1016/S0140-6736(98)05356-2.
Methadone maintenance treatment (MMT) involves the daily administration of the oral opioid agonist methadone as a treatment for opioid dependence-a persistent disorder with a substantial risk of premature death. MMT improves health and reduces illicit heroin use, infectious-disease transmission, and overdose death. However, its effectiveness is compromised if low maintenance doses of methadone (<60 mg) are used and patients are pressured to become prematurely abstinent from methadone. Pregnancy and psychiatric comorbidity are not contraindications for MMT. As an alternative to MMT, other oral opioid agents (eg, naltrexone, buprenorphine) may increase patient choice and avoid some of the more unpleasant aspects of MMT. The public-health challenge for the future is to develop and continue to deliver safe and effective forms of opioid maintenance treatment to as many opioid-dependent individuals as can benefit from them.
美沙酮维持治疗（MMT）包括每日口服阿片类激动剂美沙酮，用于治疗阿片类药物依赖——一种存在过早死亡重大风险的持续性疾病。MMT可改善健康状况，减少非法海洛因使用、传染病传播和过量用药死亡。然而，如果使用低维持剂量的美沙酮（<60毫克）且迫使患者过早停用美沙酮，其有效性会受到影响。怀孕和合并精神疾病并非MMT的禁忌证。作为MMT的替代方法，其他口服阿片类药物（如纳曲酮、丁丙诺啡）可能会增加患者的选择，并避免MMT一些更令人不适的方面。未来公共卫生面临的挑战是开发并持续为尽可能多能从中受益的阿片类药物依赖个体提供安全有效的阿片类药物维持治疗形式。
