Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...

140nance treatment patients showing a constant and accelerated decline in criminalbehavior and the contrast group showing a pattern very similar to the earlierperiod of observation.4. SUPPORTIVE SERVICESPatients on methadone maintenance have available to them on demand oneor more members of the program staff who are ready, willing, and able to respondto their needs whether these needs be medical, psychiatric, vocational,social, or legal.5. PROGRAM PHILOSOPHYTreatment programs for heroin addiction using methadone maintenance haveaccepted the fact that the "hard-core" addicts have a chronic disease, and, therefore,need medication and support over a long period of time, if not for life.This philosophy has resulted in a more permissive attitude toward patientswho show evidence of recurrent abuse of other drugs such as barbiturates andamphetamines or continued chronic alcohol abuse, and every effort is made toassist the patients in handling these problems. Only when this support fails arepatients dropped from the program.CONCLUSIONMethadone maintenance is a valid treatment for those hard-core addicts whoare 18 years or older with a history of at least 2 years of addiction and whohave had difficulties in adjusting to the stringencies of abstinence programs.Among patients selected in this manner methadone maintenance has provedsuccessful in 80 percent of more than 4,000 patients in the New York City methadonemaintenance treatment program. A majority of the patients have completedtheir schooling or increased their skills and have become self-supporting.Their pattern of arrests has decreased substantially. This is in sharp contrastto their own previous experience, as well as their current experience when comparedwith a matched group from the detoxification unit, or when compared withthose patients who have left the program. Less than 1 percent of the patientswho have remained in the program have reverted to regular heroin use. No othertreatment program can demonstrate a better rate of success.Methadone maintenance as a treatment modality was never conceived as a"magic bullet" that would resolve all the problems involved in heroin addiction.For this reason, we believe that any treatment program using methadonemaintenance must be prepared to provide a variety of supportive services to dealwith such problems as mixed drug abuse, chronic alcoholism, as well as psychiatricor behavioral problems and a variety of other social and medical problems.Therefore, methadone maintenance should not be considered as a method oftreatment suitable for use by the private medical practitioner in his office practice,because of the requirements for other program components including socialrehabilitation and vocational guidance.