Methadone, an opioid¹ agonist medication, is recognized by the American Medical Association, which affirmed "the proven public health and patient health benefits of methadone maintenance and other similar opioid replacement programs in reducing the use of heroin."² This 1999 declaration followed a report from The Institute of Medicine (IOM) in 1995 and the conclusions of a 1997 National Institutes of Health (NIH) Consensus Development Panel. Both IOM and the NIH Consensus Panel recommended that opioid addiction be treated more like other medical conditions and that efforts be made to reform the methadone treatment system. To modernize the treatment system, the Secretary of the U.S. Department of Health and Human Services promulgated regulations that became effective May 18, 2001, to transfer oversight of opioid treatment programs from the Food and Drug Administration to the Substance Abuse and Mental Health Services Administration (SAMHSA). One of the key requirements of the regulations (42 CFR Part 8) is that opioid treatment programs become accredited, just like the process required for other mainstream health care facilities.

What does this requirement mean for patients, programs and the community?

	Accreditation demands a higher standard of care for people receiving opiate agonist3 treatment for addiction to heroin and other opiates, by shifting responsibility for treatment decisions from regulators to clinicians.
	Accreditation allows for greater clinical discretion and medical judgment in determining appropriate individualized treatment, particularly in managing methadone/LAAM doses.
	Accreditation ensures that patients are appropriately assessed and matched to the right treatment, that treatment is individualized, and that the need for ongoing care is professionally assessed and monitored for quality.
	Accreditation provides patients and the community with the assurance that quality treatment is being provided to those who are addicted to heroin and similar opioids.
	Accreditation's focus on quality of care integrates opiate agonist treatment into the mainstream of the nation's health care system and helps reduce the stigma associated with that treatment.
	Accreditation promotes state-of-the-art treatment services, with emphasis on outcome measures, especially those pertaining to reductions in crime and drug use, and engagement in productive employment. These changes enhance patient rights as well as outlines patients' responsibilities.
	Additionally, opioid treatment programs are regulated by the U.S. Department of Justice, Drug Enforcement Administration for their security and accounting their medications, and by individual state authorities for compliance with state program standards.

¹Drugs that activate receptors in the brain are termed agonists. Agonists occupy receptors and switch them on. As a result, they produce an effect in the brain and body. Therefore, opioid agonists switch on one or more opioid receptors.

²The American Medical Association, "Reduction of the Medical and Public Health Consequences of Drug Abuse: Update," Adopted as AMA policy, 1999 AMA Annual Meeting.

³At proper doses, agonist therapy relieves the physiological craving for opioids, blocks the euphoric effects of opioids and normalizes the physiology of the body impaired by opioid dependence.