The abuse of heroin and other opiates is a serious and growing public health problem. According to the 2004 National Survey on Drug Use and Health, an estimated 166,000 Americans use heroin. In addition, 4.4 million use opiate pain relievers (including Vicodin, Percodan, Percocet, and OxyContin) without a prescription. Abuse of legal pain relievers represents a growing category: in 2004, approximately 2.4 million Americans abused prescription pain relievers for the first time. In total, about 1.9% of Americans are abusing illegal or legal opiates. Furthermore, opiate dependence is increasing worldwide, and significantly exacerbating the HIV/AIDS pandemic.
Methadone maintenance treatment (MMT) has been the primary form of treatment for opiate dependence in the U.S. for over 40 years. It involves providing drug abusers with a less addictive opiate (methadone) in a clinical setting, and then gradually tapering the methadone dosage. While on methadone, patients receive counseling and other medical treatments (i.e. hepatitis screening) as needed. The ability to provide all of these treatments in one location has made MMT the most effective treatment for opiate dependence to date. In the United States alone, there are more than 1,200 MMT programs, with an estimated staff of 20,000, serving more than 200,000 patients annually yet, to date, there has been no comprehensive, user-friendly professional reference book on these programs.
This book fills the gap. It is written for a diverse audience, including clinicians, program administrators, substance abuse treatment researchers, and other health service professionals who want to learn about all aspects of MMT. Policy makers interested in establishing new programs, domestically and internationally, will find the information useful. The book offers insights into the effectiveness of methadone, and the characteristics of successful methadone treatment programs (budgets, services, staff, etc.), as well as regulation and accreditation issues. The information presented is based on a study of nearly 150 MMT programs in 15 states.
About RTI International
RTI International is dedicated to conducting research and development that improves the human condition by turning knowledge into practice. With a staff of more than 2,500, RTI offers innovative research and technical solutions to governments and businesses worldwide in the areas of heatlh and pharmaceuticals, education and training, surveys and statistics, demographic governance, economic and social development, advanced technology, energy, and the environment.
The second largest independent nonprofit research organization in the United States, RTI maintains nine offices in the U.S., five internationally, and one international subsidiary, as well as project offices around the world. This book fills the gap. It is written for a diverse audience, including clinicians, program administrators, substance abuse treatment researchers, and other health service professionals who want to learn about all aspects of MMT. Policy makers interested in establishing new programs, domestically and internationally, will find the information useful. The book offers insights into the effectiveness of methadone, and the characteristics of successful methadone treatment programs (budgets, services, staff, etc.), as well as regulation and accreditation issues. The information presented is based on a study of nearly 150 MMT programs in 15 states.
|Publisher:||Springer Publishing Company|
|Edition description:||New Edition|
|Product dimensions:||6.00(w) x 9.00(h) x 0.45(d)|
About the Author
Dr. Wendee Wechsberg, PhD, is the director of the Substance Abuse Treatment Evaluations and Interventions Research Program at RTI International. Dr. Wechsberg has more than two decades of clinical experience and she has directed outpatient drug-free, methadone, and residential substance abuse treatment programs. She is currently conducting intervention research in the United States and South Africa to help women who abuse substances to reduce violence and victimization, and to decrease the spread of HIV. She has published in the areas of methadone treatment, outreach, HIV risk behaviors, and gender and intervention effectiveness.
Jennifer Kasten, PhD, is a senior health policy analyst in the Substance Abuse Treatment Evaluations and Interventions Research Program at RTI International. Dr. Kasten has conducted extensive substance abuse treatment research, and she is an experienced substance abuse treatment counselor. Currently, she is examining the impact of institutional and market forces on organizational change through federal regulations, and she is working on a SAMHSA project to facilitate data collection and analysis of national outcome measures by states for substance abuse treatment. Dr. Kasten recently received her doctorate in Public Administration.
Table of Contents
- The Effectiveness of Methadone and the History of Regulation
- The Accreditation Evaluation Study
- Methadone Maintenance Treatment Program Characteristics
- Core and Ancillary Methadone Maintenance Treatment Services
- Dosing Practices in Methadone Maintenance Treatment Programs
- The Costs and Funding of Methadone Maintenance Treatment
- Direct Care Staff and Their Activities
- Methadone Maintenance Treatment Patients
- Accreditation Outcomes
- Regulation of Methadone Maintenance Treatment
- Summary and Future Challenges
List of Acronyms and and Abbreviations
Appendix A: Opiates and Opioids
What People are Saying About This
"Methadone maintenance is probably the most highly regulated, most misunderstood, and most effective treatment for heroin addiction. The U.S. system arose through a combination of brilliant science, clinical compassion, and continuing sitgmatization of the patients, and it is now moving toward greater integration with the health care system as a whole. This book provides a clear, thorough, and use-friendly description of the U.S. system as it undergoes that transition."
--Dr. Don C. Des Jarlais, , Director of Research, Baron Edmond De Rothschild Chemical Dependency Institute, Beth Israel Medical Center
"This book is highly recommended for treatment program managers, substance abuse treatment professionals, policy makers, and anyone who is genuinely interested in getting a better understanding of methadone maintenance treatment programs at the present time. It's the kind of much-needed reference guide for the opioid dependence treatment field that should be within easy reach on the shelf for quick access to a wealth of practical information."
-Mark Parrino, President, American Association for the Treatment of Opioid Dependence