Report of the Council on Scientific Affairs

@article{Yoast2001ReportOT,
  title={Report of the Council on Scientific Affairs},
  author={Richard A. Yoast and Michael A. Williams and Scott D. Deitchman and Hunter C. Champion},
  journal={Journal of Addictive Diseases},
  year={2001},
  volume={20},
  pages={15 - 40}
}
Abstract Extensive evaluation studies show that methadone maintenance therapy (MMT) reduces heroin use and associated problems in a cost-effective manner, without negative public health impact. MMT is limited by inadequate funding and understanding of relevant research, extensive regulation, and limits on the freedom of physicians to provide methadone in a variety of medical settings. Broad-based medical, public health, and scientific support exists for expansion of MMT with greater emphasis on… 

Pharmacological Treatment of Substance Abuse in Correctional Facilities: Prospects and Barriers to Expanding Access to Evidence-Based Therapy

While the high rates of drug-related arrests, recidivism, and the large numbers of substance abusers within the correctional system are alarming, they also represent Chapter 23 of the US criminal justice system.

Growing Implications for Primary Care

Mainstreaming opioid addiction treatment has many advantages; its success will depend on resolution of ethical and delivery system issues as well as improved and expanded training of physicians in addiction medicine.

A pilot survey of attitudes and knowledge about opioid substitution therapy for HIV-infected prisoners.

It is found that more education of individuals treating and caring for HIV-infected opioid dependent prisoners is needed.

Methadone Dosage and Retention

While controlling for a number of client and organizational variables, a daily methadone dose of 60 mg/day or above was found to be associated with longer retention in treatment, and exploring factors affecting the utilization of the recommended daily methADone dose remains an important issue in effective delivery of methadon treatment.

Research Note — Review of Corrections-Based Therapy for Opiate-Dependent Patients: Implications for Buprenorphine Treatment among Correctional Populations

The pharmacological treatment options for opiate-dependent inmates, along with potential application for community-to-correctional approaches are reviewed, and the recent approval by the Food and Drug Administration of physician-prescribed buprenorphine and the new opportunities it presents to corrections-based treatment are explored in depth.

Evidence-Based Treatment of Opioid-Dependent Patients

Effective treatments are available to stabilize patients and reduce harm, thereby increasing life expectancy and quality of life, and both clinical experience and neurobiological evidence indicate that opioid dependence is a chronic relapsing disorder.

Treating opioid dependence. Growing implications for primary care.

Mainstreaming opioid addiction treatment has many advantages; its success will depend on resolution of ethical and delivery system issues as well as improved and expanded training of physicians in addiction medicine.

Reducing the Risk of HIV Infection Associated With Illicit Drug Use

There is an urgent need for more substance-abuse prevention and treatment programs, legislation that facilitates unencumbered access to sterile syringes, and expedient availability of reproductive health care services for sexually active youth, including voluntary HIV-1 counseling and testing.

Innovations in agonist maintenance treatment of opioid-dependent patients

Agonist maintenance treatment has become the first-line treatment for chronic opioid dependence and is very effective in stabilizing the health condition and social situation, while also reducing harm, thereby increasing life expectancy and quality of life.

Societal Perception and Support for Methadone Maintenance Treatment in a Chinese Province with High HIV Prevalence

The support was the strongest amongst the police and medical professionals but the lowest in drug users, and a considerable proportion of the respondents viewed MMT as contradictory to China's drug control policies and this factor was negatively associated with support for MMT.
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References

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The Scottish experience indicates that prescription of methadone in office-based settings can expand access to an important treatment modality, and primary care physicians safely prescribed methad one for maintenance treatment when provided with adequate support.

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Data from major program evaluation studies of existing substance abuse treatment programs are presented, followed by reviews of controlled studies of opiate, cocaine, and marijuana abuse and dependence; particular attention is given to studies that have standardized treatment through the use of treatment manuals.

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Federal Regulation of Methadone Treatment examines current Department of Health and Human Services standards for narcotic addiction treatment and the regulation of methadone treatment programs pursuant to those standards.

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Findings from a longitudinal research project to determine the impact of the cost of treatment on 233 San Francisco Bay Area study participants seeking, enrolled in, or defunded from MMT indicated that MMT functioned as a harm-reduction tool.

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In this research project, physicians with experience in drug abuse treatment provided both the pharmacologic treatment of addiction as well as therapy for other medical problems, as needed, for rehabilitated methadone maintenance patients.

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With implementation of the NIH Consensus Statement on Effective Medical Treatment of Heroin Addiction, including training of primary care physicians, methadone maintenance treatment could reach many more patients, achieve higher success rates, and substantially reduce the deleterious effects of opioid addiction in the U.S.

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