Drug replacement and maintenance therapy have a long history of providing individuals struggling with problematic drug use with legal access to drugs that would otherwise be obtained through illegal means.
The Centers for Disease Control and Prevention, the Institute of Medicine, the Substance Abuse and Mental Health Service Administration (SAMHSA), the National Institute on Drug Abuse (NIDA), the World Health Organization and over four decades of government-funded, peer-reviewed medical research have unequivocally and repeatedly proven that replacement therapies like methadone maintenance are the most effective treatments for opioid dependence.
Methadone and Buprenorphine
Methadone is the most widely-used maintenance treatment. Used properly, methadone reduces drug use and related crime, death, and disease among heroin users. But methadone has been handicapped by restrictive government regulations, by misinformation - among treatment providers and drug users alike - and by prejudice against methadone treatment.
Methadone is the most tightly restricted drug in the U.S. Doctors in general medical practice can't prescribe methadone, and regular pharmacies don't distribute it.
Buprenorphine is a newer medication that has also been shown to be effective and it can be prescribed by physicians who have gone through special training.
The Drug Policy Alliance advocates for making both methadone and buprenorphine more accessible, through changing attitudes, laws, regulations, and health insurance policies. Funding must be increased for access to methadone and buprenorphine through the public health system for those who cannot afford it otherwise.
Heroin-Assisted Treatment (HAT)
For drug users who have not found success with methadone, the most dramatic developments in drug substitution therapies have been in the field of Heroin-Assisted Treatment (HAT). HAT programs, as part of comprehensive treatment strategies, provide substantial benefits to long-term heroin users who have not been responsive to other treatment.
Studies have shown that those enrolled in HAT demonstrate a reduction in drug use and an improvement in overall physical and mental health. Additionally, several studies have found that individuals who participated in these programs significantly reduced their involvement in criminal activities, generating large cost savings.
Heroin maintenance may be a feasible, effective and cost-effective strategy for reducing drug use and drug-related harm among long-term heroin users for whom other treatment programs have failed.
Under HAT, pharmacological heroin is administered under strict controls in a clinical setting to those who have failed in other treatments like methadone. Every published evaluation of HAT has shown extremely positive outcomes: major reductions in illicit drug use, crime, disease and overdose; and improvements in health, wellbeing, social reintegration and treatment retention. More than a half dozen countries in Europe and Canada have implemented heroin-assisted treatment (HAT) programs.
There is an extensive body of literature documenting the stigma associated with alcohol and other drug problems. No physical or psychiatric condition is more associated with social disapproval and discrimination than substance dependence. For people who use drugs, or are recovering from problematic drug use, stigma can be a barrier to a wide range of opportunities and rights.
Drug Policy Alliance, American Civil Liberties Union
The Affordable Care Act (ACA) represents a remarkable opportunity for criminal justice and drug policy reform advocates to advance efforts to enact policy changes that promote safe and healthy communities, without excessively relying on criminal justice solutions that have become so prevalent under the war on drugs, and which fall so disproportionately on low-income communities and communities of color.
New Mexico will join 30 other states in offering Medicaid Coverage for Methadone Maintenance Therapy
The State Finally Recognizes Methadone Maintenance Therapy as one of the Most Effective Treatments for Opioid Dependence and a Proven Way to Reduce Overdose Deaths
(SANTA FE, NM) – Starting September 1, the state of New Mexico’s Medicaid Program will begin to reimburse for outpatient Methadone Maintenance Therapy (MMT). New Mexico will join approximately 30 other states in offering Medicaid coverage for MMT.
The U.S. refuses to adopt an evidence-based HIV/AIDS prevention strategy, costing us hundreds of thousands of lives and hundreds of millions of dollars. However, in countries where addiction is treated as a health issue, the fight against HIV/AIDS is being won. Newly diagnosed HIV infections in many countries have been nearly eliminated among people who use drugs, just as mother-to-child transmission of HIV has been eliminated in countries that make medicines for pregnant women accessible.
The Global Commission, whose members include Kofi Annan and four former presidents, calls the drug war a failure and advocates a paradigm shift in global drug policy. The commission's bold recommendations include encouraging governments to experiment with legalization of drugs, particularly marijuana; putting an end to drug policies being driven by ideology and politics; and directing resources away from arresting and incarcerating so many people for drug law violations.
Legislators appreciate hearing from their constituents, and they are elected to represent our views. Always give your legislator your name, address, and telephone number so that they know you are one of their constituents. Be sure to include this information whether you visit in person, call, or write.
When you contact your legislators, a short sentence or two about why you personally support or oppose a certain proposal is fine.
Most importantly, always be courteous and clear when communicating with your legislators. Remember, legislators are people, too!
This volume includes a variety of perspectives on harm reduction approaches, together with an analysis of the concept's role within drug policies, both in Europe and beyond. Readers may not necessarily agree with all of the arguments made or the conclusiondrawn, but we hope it is perceived as a valuable contribution to the ongoing debate on how to respond to contemporary drug problems in Europe.
The International Centre for Science in Drug Policy (ICSDP) is an international network of scientists, academics, and health practitioners committed to improving the health and safety of communities and individuals affected by illicit drugs.