Commentary on the NIH Consensus Development Statement

Policy Statement

Number 8

December 1, 1997

The National Alliance of Methadone Advocates supports the NIH Consensus

Statement on Effective Treatment of Heroin Addiction that was facilitated by the

National Institute on Drug Abuse and the National Institute of Health.

The imprecate of this special statement should be understood in order to

realize the impact that it can have on methadone maintenance treatment. The

Consensus Statements are prepared by a special committee who are comprised of

individuals who are typically professionals from the disciplines involved in the

issue (i.e. doctors, lawyers, etc.) but they have no connections to the field

being examined. In this respect their conclusions are independent and thus

greater influence. The prepared statement is based on the (1) presentations from

panels consisting of professionals working in the field and relevant areas; (2)

questions and statements from conference attendees during open discussion

periods that are part of the public session; and (3) closed deliberations by The

Committee. Thus the statement is an independent report of the consensus panel

and is not a policy statement of the NIH or the Federal Government.

A Summary of the Recommendations are:

1. Strong leadership is necessary in educating the public that addiction is

   not self inflicted but is a medical disorder that includes a spectrum of

   brain and medical conditions that can be effectively treated with benefits

   to society.

2. Society needs to make a commitment to offer effective treatment for heroin

   addiction for all who need it.

3. Opiate-addicted persons under legal supervision need to have access to

   methadone maintenance treatment.

4. The training of physicians and other health care professionals need

   improvement regarding the diagnosis and treatment of opiate addiction.

5. The unwarranted over regulation of methadone maintenance treatment and all

   opiate agonist treatment programs needs to be reduced.

6. Funding for methadone maintenance treatment needs to be increased and

   required as a benefit for public and private insurance programs equivalent

   to the coverage for all medical and mental disorders.

7. Chemically dependent pregnant women need to receive special consideration

   and methadone maintenance treatment must be culturally sensitive to enhance

   favorable outcomes for participating African American and Hispanic persons.

8. Patients, underrepresented minorities, and consumers should be included in

   bodies charged with policy development guiding opiate addiction treatment.

   Methadone maintenance treatment needs to be expanded within States and

   regions where programs where it is currently unavailable.

Summary

The Consensus Committee in their full statement emphasized the rigorous

scientific studies that methadone maintenance had undergone over the past 30

years that demonstrate its effectiveness in significantly lowering illicit

opiate drug use, reducing illness and death from illicit opiate drug use,

reducing crime, and by enhancing social productivity. And that in order for

methadone maintenance treatment to receive adequate funding and it’s expansion

be supported it will be necessary to undertake a campaign to educate

politicians, policy makers and society that opiate addiction is a medical

disorder and methadone is effective in treating it.

To replace the regulations The Committee recommended alternatives such as

physician accreditation and certification and to improve education that

physicians, nurses and other health professionals receive. While reducing

regulations will help to promote expansion of methadone maintenance treatment

increased funding is necessary to ensure expansion in all states including those

that do not currently provide it. The Committee strongly recommended that

legislators and regulators recognize the cost effectiveness of methadone

maintenance treatment and that benefits for treatment be part of public and

private insurance programs.

Bodies charged with policy The Committee urged should be include

misrepresented minorities and patients. The Committee stressed that methadone

treatment must be culturally sensitive and that risk groups, such as pregnant

women should be targeted.

What Can Advocates Do?

It is now important for us to ensure that the conclusion of this Consensus

Statement become known by politicians and policy makers. Patients and the family

members of patients should write to their representatives and tell them that

methadone maintenance treatment does work and most important that it saves ad

restores lives. Do not stop at the federal and national level continue writing

and talking with state and local politicians and policy makers. Because

methadone maintenance treatment has been politicized it is at that level that

must first be education. This Consensus Statements give us the chance to promote

and influence the medicalization of methadone maintenance treatment.

1. Effective Medical Treatment of Heroin Addiction. NIH Consensus Statement 1997 November 17-19;15(6). Available from the National Clearinghouse for Alcohol and Drug Information NCADI

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