Thursday, May 20, 2010

Protecting Patient Confidentiality:

Protecting patient confidentiality - in the interest of the public as well. A May 5th editorial entitled "Patient safety first, doctor" in the Southland Times (New Zealand) commends a physician for reporting one of his methadone patients, who worked in a nursing home, to her employer. What the editors fail to understand is that inability to guarantee strict adherence to privacy will be a powerful disincentive for those who want and need help for their dependency - and particularly those who are employed in "sensitive" settings. Discouraging those needing help from getting it poses an enormous threat to the entire community.

Thursday, May 13, 2010

Quotable Quote, and Just As Relevant 13 years Later:

"Although recent scientific research supports our understanding of opioid dependence as a chronic disease, methadone maintenance treatment has not yet gained universal acceptance as a normal therapy for a bonafide medical condition ... [and] its effectiveness in improving quality of life is limited by the continuing stigmatization and social disengagement of patients." (emphasis in original, Can Med Assoc J 1997; 157:395-398)

Tuesday, May 11, 2010

Dramatic Efficacy of Methadone Treatment in Maine:

a state of Maine study of more than 1000 patients has found an “astronomical” drop in use of of pre-treatment drug of choice, with “broad impact not only on patients, but on their families as well.” Story appeared 7 May and can be found by clicking here,

Monday, May 03, 2010

Proposed Cap on Duration Methadone Treatment in Wisconsin

It is reported (Wisconsin State Journal May 1) that Deborah Powers, who regulates methadone clinics for the state of Wisconsin, has suggested “limits on how long people can be in [methadone] treatment” as a response to substantially increased need and demand for care. This makes as much sense as a demand that those lucky enough to cram into one of the Titanic lifeboats be required to give up their places every few minutes to unfortunate survivors still in the water. Or to use a medical analogy: to proclaim a pre-natal clinic is “at capacity” and thus limiting each pregnant woman’s care to no more than three months.

Opiate dependence is a chronic, notoriously relapsing, potentially fatal medical condition. Many different treatment approaches exist and all deserve support. None, however - whether long-term or short-term, with medication or without, in-patient or ambulatory – has ever been able to make a credible claim that it is a cure. As for methadone maintenance in particular, no treatment has been shown to be more effective in attracting and retaining patients and in helping them resume healthy, productive lives. Furthermore, experience throughout the world for more than four decades has demonstrated that it can be expanded rapidly and at a modest cost, with enormous benefits not only to patients but to the community as a whole.

Wisconsin, and every other state in the nation, should focus on providing prompt care for all opiate dependent people who want and need it – and with tragic frequency die without it. No public officials should be more committed to this goal than those who, like Ms. Powers, are given the authority and responsibility to “regulate” treatment services.