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Quality and Access

Bruce J. Rounsaville, MD; Thomas R. Kosten, MD

JAMA. 2000;283:1337-1339.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

A major priority in US medicine is the need to improve quality and access while containing costs. Two articles in this issue of THE JOURNAL address 2 important quality and access issues in opioid stabilization treatment: primary care methadone treatment,¹ which can improve access by broadening the prescriber base, and the abbreviation of methadone therapy,² which might improve access by allowing more patients per year in the available treatment slots. These articles address 2 strategies to enhance quality: directly observed methadone administration in primary care and intensified counseling in brief methadone treatment.

Office-based care can clearly increase access as current methadone maintenance delivery in specially licensed, centralized programs reaches only an estimated 14% of patients with opioid dependence because of limited treatment slots and geographical constraints.^3-4 Greater access is needed to cope with the recent upsurge in heroin use⁵ and the increasing . . . [Full Text of this Article]

Author Affiliations: Department of Psychiatry, Yale University School of Medicine, New Haven, and Veterans Affairs Healthcare Systems, West Haven, Conn.

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