Sentences to ponder

November 11, 2015November 10, 2015 ~ Jason Schwartz

From a meta-analysis on retention in medication assisted treatment:

Notably, only a single study examined retention for longer than one year, even though the National Institute on Drug Abuse (NIDA) recommends a minimum of one year in methadone maintenance treatment for best outcomes.⁷³ Indeed, despite extensive and prolonged use of methadone to treat heroin addiction since the mid-1960s, little is known about its effects over the long-term.

You should ask, “What medication was used in the study where they looked at outcomes for longer than a year?” The “medication” they studied is heroin.

Published by Jason Schwartz

I have been an addiction professional and social worker since 1994. I started blogging in 2005 as the Clinical Director at Dawn Farm. I no longer work at Dawn Farm and am now the Director of Behavioral Medicine at a community hospital, and a lecturer at Eastern Michigan University’s School of Social Work. Views expressed here are my own. Keep in mind that the field, the contexts in which the field operates, and my views have changed over time. View all posts by Jason Schwartz

2 thoughts on “Sentences to ponder”

Ed Dagnes says:

November 11, 2015 at 1:25 pm

Dear Jason:
In my limited experience with supporting the recovery of heroin addicts, I read NIDA, SAMHSA, Science Today etc. I would like to read about your therapy experiences which form your opinion. Here you seem to question a public health statement from NIDA, with your understanding of a meta-study. Is that a pursuasive argument that opiate-replacement modalities do NOT have better outcomes than abstinence alone?
1. Jason Schwartz says:
  
  November 11, 2015 at 1:44 pm
  
  I have no interest in eliminating options. My only interest is in challenging the frequently made statement that MAT is the MOST effective treatment with the implication that other forms of treatment may approach malpractice.
  
  The info of on the effectiveness of MAT is much muddier than is generally presented. They often don’t report on the kinds of outcomes people care about and they often don’t report on a meaningful duration of care.