[3] In the United States, there are approximately 1,500 methadone clinics that are federally certified opioid treatment programs.
[4] Before the 1960s, abstinence-based detox was the only option for opioid addicts in the United States and produced high relapse rates.
However, in 1965 clinicians at Rockefeller University published a report in the Journal of the American Medical Association of the successful treatment of 22 men addicted to heroin with the use of orally administered methadone.
In September 1969 the first methadone maintenance treatment program was created in Washington, D.C by Robert DuPont, M.D, that oversaw 25 parolees.
[7] Currently methadone must be provided through opioid treatment programs (OTP) in the United States and can not be prescribed in office settings.
CBT is an individualized treatment plan that allow therapists to explore patterns of maladaptive substance use to help generate alternative behavior skills.
It is generally accepted that the more intensive the counseling contacts the individual is willing to submit to, the higher the success rate of the program.
Clinics should be able to provide or refer patients to various services: community resources, vocational rehabilitation, education, employment, and prenatal-care.
[9] The epidemic of HIV/AIDS in Ukraine is quickly growing and was the reason for research into opioid agonist therapies (OAT) in the country as a means to curb the spread of HIV.
[10] Kyrgyzstan has a similar HIV/AIDS problem as Ukraine and to try and combat this, started a trial methadone program within prisons.
It is estimated that half of incarcerated individuals in Kyrgyzstan inject drugs and the use of unsterilized needles and transfer of HIV is higher in the prison setting.
[12] However, one study by the University of Maryland School of Medicine found that crime rates do not increase when a methadone clinic is opened.
The efforts of patients who are seeking rehabilitation, and clinic professionals who serve them, are significantly undermined by this criminal activity that surrounds them.
[15] The high relapse rate may be partially due to the severity of cases seen at methadone clinics, as well as the long-term effects of opioid use.
Supporters argue that the clinics aim not just to eliminate narcotic addictions, but also to help people function in their lives.
[17] However, the bulk of the current research supports the hypothesis that methadone clinics do in fact reduce overdose and substance-related crime.