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Center for Alcohol and Addiction Studies

Effective Medical Treatment of Heroin Addiction in Office-Based Practices with A Focus on Methadone Maintenance”

Work-in-progress report
List of participants

April 5, 2001

When the Physician  Leadership on National Drug Policy first met in the summer of 1997, we identified a number of key issues on which we wanted the PLNDP to focus. The attached report relates to the section of our consensus statement that recommends, "It is time for a new emphasis in our national drug policy by substantially refocusing our investment in the prevention and treatment of harmful drug use reallocating resources toward drug treatment and prevention, utilizing criminal justice procedures which are shown to be effective in reducing supply and demand, and REDUCING THE DISABLING REGULATION OF ADDICTION TREATMENT PROGRAMS. "

In our initial discussions at the New York Academy of Medicine, one of our primary concerns was the over-regulation of methadone maintenance treatment. Since that time, through an NIH Consensus Conference (in which PLNDP members Howard Hiatt and Robert Petersdorf participated) and subsequent HHS initiatives, there has been a shift from FDA regulation of methadone maintenance programs to an accreditation style of regulation at the Center for Substance Abuse Treatment. Coincident with these events, several clinical researchers have become active in testing the usefulness of methadone maintenance treatment in office-based practices.

With the recent expansion of methadone maintenance treatment into medical practice settings beyond large clinic settings, several PLNDP members felt that it was time to review the policies that both support and retard this development. Therefore, a PLNDP meeting was assembled at the New York Academy of Medicine on November 6, 2000 with clinicians, researchers and regulators in order to discuss their experiences in expanding methadone treatment. We were surprised to learn that, prior to this meeting, the investigators had never met.

This meeting, initiated by the Physician Leadership on National Drug Policy, was co-sponsored by PLNDP member Dr. Spencer Foreman, MontefioreMedicalCenter and Dr. Robert Newman, Continuum Health Partners, and in cooperation with PLNDP member Dr. Jeremiah Barondess, New York Academy of Medicine. In addition to the PLNDP National Office’s involvement with the project, PLNDP Chair Dr. June Osborn participated in the meeting.

Our ability to convene such groups and to facilitate communication among such leaders in medicine and public health is extremely valuable according to the positive feedback that we received from this meeting.

This "work-in-progress" report is being circulated to the participants of the meeting and is the first of what I hope will be several such PLNDP-sponsored reports on clinical demonstrations and current research that support our consensus and contribute to enlightened policies.

David C. Lewis, MD
Project Director

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