January 16, 2001
Contact: Ivette Torres/SAMHSA Media Phone: 301-443-5052

Fact Sheet: Improving Quality and Oversight
of Methadone Treatment

BACKGROUND: The Department of Health and Human Services (HHS), the Department of Justice (DOJ), and the White House Office of National Drug Control Policy (ONDCP) have agreed to new regulations to improve the quality and oversight of substance abuse treatment programs that use methadone and other medication to treat heroin and similar addictions.

ONDCP estimates that there are 980,000 heroin addicts in the United States. Roughly 20 percent currently receive methadone or Levo-Alpha-Acetyl-Methadol (LAAM) as part of an addiction treatment program. There are approximately 1000 methadone treatment programs in the U.S., including programs approved for LAAM treatment. Methadone treatment has undergone more study than any other anti-addiction drug treatment modality, with uniformly positive results. Methadone treatment has enabled thousands of Americans to lead stable lives. These success stories are similar to those that result from the use of other medications to treat other chronic disorders such as asthma, arthritis, diabetes, heart disease, hypertension and psychiatric disorders.

REFORMING FEDERAL REGULATIONS: Under the rule, federal oversight of narcotic treatment programs would be shifted from direct inspection by the Food and Drug Administration (FDA) to a system administered by the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Substance Abuse Treatment (CSAT). The rule, which was published in the Federal Register on January 17, 2001, relies on accreditation by independent organizations and states, in accordance with standards established by CSAT. These standards emphasize improving the quality of care, such as individualized treatment planning, increased medical supervision, and assessment of patient outcomes. This new program relies on best practice guidelines CSAT has developed over the last 10 years.

IMPROVING THE STANDARD OF CARE: The shift to an accreditation approach is expected to improve the quality of and access to narcotic addiction treatment programs. Accreditation will allow for increased professional discretion and medical judgment in designing a treatment plan based on client needs, particularly in managing methadone/LAAM doses and determining on a case-by-case basis whether and when medically supervised withdrawals from medication might be undertaken. Focusing on quality of care will move methadone treatment closer to the mainstream of the nation's health care system, and help reduce the stigma associated with that treatment. As a result, physician interest in office-based practice may increase, and hospitals and HMO's accustomed to meeting accreditation standards in other areas of medical practice may begin to expand or initiate these narcotic addiction treatment services.

FOCUSING ON OUTCOMES: Development of accreditation standards for narcotic addiction treatment will improve oversight and accountability of these programs. These standards will also serve to promote 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 are expected to enhance patient rights as well as outline patients' responsibilities.

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