Page 52 - 1
P. 52
52
Figure 5
More recently, Payte (2002) noted, "Arbitrary dose ceilings have no
foundation in science or clinical medicine. Programs with ‘dose caps'
can expect problems with accreditation." Furthermore, the U.S. federal
regulations or addiction medicine associations do not endorse such
“caps”.
In terms of safety, a meta-analysis of methadone dosing studies found
that patients having access to "high-dose maintenance" were actually
at a greater reduced risk of fatal heroin overdose during treatment
compared with those at lower doses. Remember, the goal of
methadone is to stabilize the opioid addicted person so that withdrawal
pain and drug craving behaviors are suspended. The optimal dose
amount to initiate and maintain stabilization depends on individual
patient needs.
A Chronic, Relapsing Disorder
According to Alan Leshner, past President for the National Institute of
Drug Abuse, “Addiction is rarely an acute illness. For most people, it
is a chronic, relapsing disorder. Total abstinence for the rest of one's
life is a relatively rare outcome from a single treatment episode.
Relapses are more the norm. Thus, addiction must be approached more
