Providing interim doses of methadone reduced both heroin use and criminal activity, according to researchers. "Although the original drug treatment programs in the United States emphasized the importance of counseling and other services with the methadone, our data suggest that when you cannot provide all of those services, just providing the methadone can make a tremendous improvement in the lives of heroin-addicted individuals," said lead researcher Robert P. Schwartz of Friends Research Institute, Inc. and the University of Maryland School of Medicine.

Schwartz and colleagues found that of 194 patients who received the interim treatment, only 16 percent dropped out within four months. And 76 percent of those who stayed with the interim treatment program later entered a comprehensive methadone program, compared to just 21 percent of those who were on waiting lists without medication.

Positive urine tests for heroin among interim patients ran at 60 percent, compared to 79 percent for waiting-list members. "We are planning to conduct a cost-benefit analysis to determine the extent to which savings from differential rates of arrests, incarcerations, emergency-room visits, and inpatient hospitalizations offset the cost of both comprehensive and interim treatment," Schwartz said.

He noted, however, that current federal law presents barriers to implementing an interim heroin program. "First, interim methadone treatment is restricted to a maximum of 120 days, after which time interim patients must be transferred to comprehensive treatment," he said. "This requirement sharply limits the ability of interim programs to admit heroin-addicted applicants, because programs must be certain that they will have a comprehensive treatment slot at the end of the interim period."

"Second, programs must remain open on Sundays and major holidays (including Christmas Day)," he continued. "In Baltimore, this requirement prohibits half of the city's treatment programs (which are open six days per week) from providing interim methadone treatment, thus limiting treatment capacity."

The study was published in the January 2006 issue of the Archives of General Psychiatry.

Schwartz, R. P., et al. (2006) A Randomized Controlled Trial of Interim Methadone Maintenance. Arch Gen Psychiatry, 63:102-109.

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