First Scotland now Australia: Politicians against Methadone

Australian Health Minister Abbott announced his intention of encouraging "the growing number of people in long-term treatment with methadone ... to kick their drug addiction completely" (Dec 3, Sydney Morning Herald): Anarray of treatment options helps to enhance and extend life for those who are opiate-dependent. One of the most effective treatments is methadone maintenance; one of the least effective, to date, has been naltrexone. But one thing these two medications and all other therapeutic approaches to opiate addiction have in common: they do not offer "cure," any more than Alcoholics Anonymous pretends to cure alcoholism, cardiac medications cure coronary artery disease, etc.

Given the costs in dollars and in human suffering associated with illicit heroin use, treatment is a great bargain, and community leaders should applaud the steady increase in the number of Australians receiving care. All efforts for which evidence of effectiveness exists should be supported maximally, but none has been shown more effective, for more people, than methadone maintenance. An "exit strategy," however, while a useful metaphor when applied to wars, is not a useful concept when it implies termination of effective medication for a chronic medical condition.