- “Methadone Treatment: Our Vision for the Future”
Remarks by Barry R. McCaffrey
Director, Office of National Drug Control Policy
April 12, 2000
Part I of speech highlights those who have been visionaries in the methadone field – individuals who informed the discussion on opiate addiction through trailblazing efforts. Part II examines what we know about addiction. Part III looks at the status of drug treatment and what we are doing to make it more available. Part IV provides an update on our past-year progress in implementing a new system of federal oversight for treatment programs, particularly methadone. Part V outlines policy issues that currently define the methadone debate. Finally, Part VI articulates our vision for the future of methadone treatment.
- News From the Front
This is an update of the Notice for Proposed Rule Making (NPRM), which intends to shift federal regulatory oversight authority for methadone treatment away from the FDA to an accreditation process, which will be managed by CSAT. In addition, the implications of the Drug Abuse Treatment Act (S.324) (H.R. 2634) are discussed.
- Association Survey Identifies Greater Numbers in Methadone Treatment
We had been receiving conflicting reports concerning the number of opiate dependent individuals enrolled in methadone maintenance treatment programs. Consequently, The Association decided it was time to find out what the treatment system consisted of and, in response to all the varying reports, we conducted a survey.
The survey requested census and related information from the State Methadone Authorities and the designated State Methadone Provider Contact representatives in the forty-two states, (in addition to the District of Columbia) that provide methadone treatment services. Read more about the findings of the survey.
- 1998 Methadone Maintenance Program and Patient Census in the U.S.
- Notice for Proposed Rule Making – Change in Federal Oversight for Methadone Treatment
This article documents the survey results that our Associated compiled from methadone treatment programs and State Methadone Authorities regarding the direct and indirect costs of accreditation for the Association’s testimony on November 1, 1999 when the federal interagency hearing convened to receive guidance from the field. Also, this provides an in-depth discussion on the Association’s stance on accreditation and recommendations to the federal government in regulating the accreditation process.
- Narcotic Treatment Programs Best Practice Guidelines
- The DEA and our Association is in the final stages of developing the Best Practice Guidelines. This article explicitly states what the upcoming Best Practice Guidelines will encompass.
- Narcotic Treatment Programs Best Practice Guidelines
- Drug Addiction and Treatment Act (S.324) (H.R.2634)
The importance of the legislation would be to make new medications, such as Buprenorphine, available to chronic opiate dependent individuals through physician offices. This would reverse more than 75 years of having physicians prohibited from treating such a disease in their individual medical practices. This article makes reference to some articles regarding the efficacy of buprenorphine as well our Association’s position.
- Association Expands Its Training Course to Physicians and Clinicians in Methadone Treatment Programs
The Association’s Board of Directors authorized an expansion of this opportunity so that we could site such training events in different regions of the United States. This article discusses the results of the first independent training (Atlanta during September 1999) from our National Methadone Conference.
- Patient Recognition Ceremony
The Association has been supporting the broad implementation of patient recognition ceremonies in methadone treatment program. We recently participated in such an experience in Pawtucket, Rhode Island when the Addiction Recovery Institute convened its annual celebration dinner.
- Association Introduces Management Training Symposia
The Association convened the first management-training symposium in Washington, D.C. on December 8, 1998 with the assistance of an educational grant from Glaxo Wellcome, Inc. Read more about the highlights of this event.
- Expanding Access to Medical Maintenance Treatment
These are the criteria for stable patient referral from methadone programs to office-based medical practice settings.
- Imminent Changes for Our Field
This report discusses the most significant issues concerning the transition in federal oversight from the FDA to CSAT, using an accreditation model in place of process oriented regulation.
- New Support for Methadone Maintenance Treatment through a Realistic National Drug Policy
This report expresses how General McCaffrey and ONDCP have taken on an important leadership role, which we believe will lead to a major expansion in methadone treatment throughout the United States.
- Neurobiology of Heroin Addiction and of Methadone Treatment
The following article represents the major text of Dr. Avram Goldstein’s plenary speech during the April 1997 National Conference. It is increasingly important for treatment providers to understand the neurobiology of addiction in order to effectively use the pharmacology of methadone and other pharmacotherapies, such as LAAM and developing treatment agents.
- Policy For Treating Methadone Maintained Patients in Private Medical Settings
This articles focuses on our Association’s criteria for implementing a policy of referring stabilized methadone maintained patients from our treatment programs to off site physician based settings, in advance of the NIH panel recommendations.
- Buprenorphine and the Use of Clinically Effective Medications in Treating Chronic Opiate Dependence
This article displays AATOD’s support for the new medications (LAAM and Buprenorphine) that are being made available to treat chronic opioid dependent individuals as well as some comparisons between Buprenorphine and methadone.
- Ultra Rapid Detoxification
Our office has been contacted frequently about the use and efficacy of Ultra Rapid Opiate Detoxification. AATOD will not take any official position until we have access to studies regarding ultra rapid opiate detoxification. Therefore, AATOD has asked agencies within the federal government to conduct such studies.
- Recommendations for Hepatitis Prevention and Treatment
Our Association’s Policy Committee, Janice Kauffman, (Chair, Massachusetts), Michael McAllister (NY), Paul McLaughlin(CT), Dr. J. Thomas Payte (ASAM), Michael Rizzi (RI) and Dr. George Stavros (AZ), has developed basic recommendations for the prevention and treatment of Hepatitis C in our patient population.
- Increasing Support For Treatment in the Medical Establishment
The National Institutes of Health (NIH) convened a Consensus Development Conference on Effective Medical Treatment of Heroin Addiction during November 1997. The conference was co-sponsored by the National Institute on Drug Abuse (NIDA) in conjunction with the National Institutes of Health Office of Medical Applications of Research and the NIH Office of Research on Women’s Health. This conference represented a landmark opportunity to focus on the efficacy of methadone treatment and to develop a system, which would overcome the barriers of the past three decades. This article describes the panel’s recommendations in further detail.