IN US AND OVERSEAS, BIG TOWNS AND SMALL, WHEN IT COMES TO ADDICTION AND METHADONE THEY JUST DON'T GET IT:

The Clanton (Alabama) Advertiser on 13 Aug reported a local ruling that disallows establishment of a methadone clinic there. Part of the rationale: there's another clinic that is within 30 minutes drive from all parts of the county (i.e., pursuant to "pickup" regulations, every patient would face a one-hour daily roundtrip to be medicated!). The local District Attorney commended the mayor and council for their opposition to the proposed methadone clinic," stating: "If you are going to open a methadone clinic here, you might as well open a clinic next it to that will help get people off methadone."

Meanwhile, new Swiss guidelines and recommendations concerning "substitution" treatment of addiction were attacked in the press because they were interpreted as discouraging "abstinence" as a therapeutic goal (for example, see Tagesanzeiger, Aug 12, http://www.tagesanzeiger.ch/dyn/news/schweiz/780252.html)
In response, the Swiss Society for Addiction Medicine issued a statement noting the obvious: "It's a worldwide reality that only a minority of those who are dependent manage to achieve and maintain abstinence."

Clearly, there's been a very widespread - near-universal - failure of providers, professional organizations and government authorities to achieve an understanding of the chronic disease of opiate addiction and its treatment with methadone.