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same way that thyroid medication restores thyroid function.
Methadone is a relatively inexpensive medication. Much of the costs
are associated with compliance with a complex set of regulations. It is
likely that the costs of indefinite maintenance on methadone will be
significantly reduced as research continues to clarify the pace at which
psychosocial services can be reduced, and as regulations are
simplified. Current models support the view that well-functioning
patients can be transitioned to physicians in office-based practice.
This is called “medical maintenance” and is supported by 20 years’
research evidence. Federal and state regulatory barriers currently
prevent full implementation of these findings, but efforts are underway
to update regulations in the light of scientific findings.

Reduction of Illict Drug Use and Drug-Associated Crime

One of the most striking benefits of methadone treatment is a dramatic
reduction in both illicit drug use and drug-associated crime (Ball &
Ross, 1991). A variety of studies have documented rapid drops at the
outset of methadone treatment, with continuing improvement over a
period of several years. Some important “natural experiments”
occurred during the 1980’s, when methadone treatment was abruptly
discontinued in several California counties. Thanks to the adeptness
of UCLA researchers, it was shown that the relatively low crime rates
of patients in treatment jumped immediately for those unable to find a
means of continuing to receive methadone. It remained low for those
able to find a way to stay in treatment. Many other studies show a
drop in crime within the first few months of entering methadone
treatment.

It is important to understand that much benefit is obtained by relieving
drug craving, but coping patterns take time to undo. Patients who do
not extricate themselves from networks of drug users involved in
criminal activity are at higher risk of relapse, and also are more likely
to avoid learning prosocial behaviors. For example, lying is a
ubiquitous pattern in those who are currently using drugs. It is
common for drug use to be discontinued, but lying remains tempting
as a way of dealing with conflict with one’s partner, friends, or
employers. Participation in counseling and self help groups makes it