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Methadone Maintenance Patients in General Medical PracticeA Preliminary Report
David M. Novick, MD;
Emil F. Pascarelli, MD;
Herman Joseph;
Edwin A. Salsitz, MD;
Beverly L. Richman, MD;
Don C. Des Jarlais, PhD;
Mary Anderson, MS;
Vincent P. Dole, MD;
Marie E. Nyswander, MD
JAMA. 1988;259(22):3299-3302.
Abstract
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Medical maintenance is the treatment by primary care physicians of rehabilitated methadone maintenance patients who are stable, employed, not abusing drugs, and not in need of supportive services. In this research project, physicians with experience in drug abuse treatment provided both the pharmacologic treatment of addiction as well as therapy for other medical problems, as needed. Decisions regarding treatment were based on the individual needs of the patient and on currently accepted medical practice rather than on explicit regulations. We studied the first 40 former heroin addicts who were transferred to this program from more conventional methadone clinics. At a follow-up visit at 12 to 55 months, 33 (82.5%) of 40 patients had remained in treatment; five (12.5%) had been discharged because of cocaine abuse and two (5%) had been voluntarily discharged. Personal benefits of medical maintenance include the dignity of a standard professional atmosphere and a more flexible reporting schedule. This program has the potential for improving treatment of selected methadone maintenance patients.
(JAMA 1988;259:3299-3302)
Author Affiliations
From the Department of Medicine (Drs Novick and Salsitz) and the Methadone Maintenance Treatment Program (Dr Richman), Beth Israel Medical Center and Mount Sinai School of Medicine of the City University of New York; the Division of Ambulatory Care, St Luke's— Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons (Dr Pascarelli and Ms Anderson); New York State Division of Substance Abuse Services (Mr Joseph and Dr Des Jarlais); and The Rockefeller University (Drs Dole and Nyswander), New York.
Footnotes
Dr Nyswander died in 1986.
Reprint requests to Division of Chemical Dependency, Beth Israel Medical Center, First Avenue at 16th Street, New York, NY 10003 (Dr Novick).
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