Methadone treatment and the acquired immunodeficiency syndrome epidemic
Article Abstract:
The acquired immunodeficiency syndrome (AIDS) can be fatal after only a single exposure to the virus that causes it. The usual modes of transmission are through sexual contact and sharing intravenous needles among persons addicted to narcotics. Although most of the citizenry has no need to fear the disease, it can infect hemophiliacs and other recipients of transfusions and the sexual partners and babies of those infected. History has shown that treating a particular disease during an epidemic has not stopped the infection; reducing transmission of the infection is the only potential method of quelling the AIDS epidemic. A vaccine is not likely to be developed in the near future. Safe sex practices have clearly been demonstrated among the gay community as a means of controlling transmission of the AIDS virus. The contamination of one needle will potentially infect each person who subsequently uses it. Drug addicted AIDS patients continue to share needles with other addicts while politicians attempt to control a public health problem which the medical profession has ignored. The review of methadone treatment underscores this issue and urges physicians to consider the transmission of the AIDS virus through shared needles. Quality methadone programs which consistently provide patients with an adequate dosage of methadone are a safe, reliable and simple way to further limit the spread of the AIDS epidemic. Medical societies should take a more active role of responsibility in judging the quality of methadone treatment facilities and providing public education.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
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Methadone treatment and acquired immunodeficiency syndrome
Article Abstract:
The recent increase in the incidence of AIDS, acquired immunodeficiency syndrome, among intravenous drug users, their sexual partners and children has led to a renewed interest in the use of methadone treatment programs to limit the spread of this fatal disease. The goal of this public health initiative is to decrease needle sharing among narcotic addicts, attract more individuals into treatment and retain them in therapy. Although these measures would decrease the transmission of the AIDS virus, there is on-going controversy about implementing new methadone programs and altering existing ones. Government and public health policies in many areas have been based on using methadone treatment to cure narcotic addicts of their addiction; this must now be addressed from a different perspective. Some programs limit the duration of enrollment and some areas prohibit methadone treatment. In order to further reduce the risk of AIDS transmission among intravenous drug users, their sexual partners and children, quality methadone treatment programs must include education about the potential effects of needle sharing, safe sex, and family planning. These efforts will require the active support and involvement of the medical community at many levels: medical societies, physicians involved in treating addicted patients, medical schools, and psychiatry residencies.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1989
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Hazards of process regulations: the example of methadone maintenance
Article Abstract:
Process control, or regulation, of methadone treatment programs may decrease quality because it creates an atmosphere of inflexibility and insensitivity. The main advantage of process control is that it is easy to administrate and enforce. The Food and Drug Administration (FDA) approved methadone-maintenance for treatment for heroin addiction, and it is now used worldwide. It is the most successful treatment for heroin addiction, and the need for successful treatment has increased with the association between intravenous drug use and AIDS. Yet many people still oppose methadone treatment programs. Many physicians view drug addiction as a moral weakness rather than a medical issue. The medical profession needs to accept the concept that some behavior results from chemical processes in the body, and become more involved in drug addiction treatment programs. Physician participation may help reduce bureaucratic regulation of treatment programs and improve patient treatment.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1992
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