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question should be whether he or she is taking an adequate dose, as
that will dominate or undermine other factors in producing
improvement.

The second milestone was the publication of an Institute of Medicine
(IOM) report on the Federal Regulation of Methadone Treatment
(Rettig & Yarmolinsky, 1995). The IOM is chartered by the National
Academy of Sciences. This highly prestigious committee concluded
that the effectiveness of methadone treatment is well established, but
overregulation created barriers to access and implementation of good
practices. They examined the impact of diversion, the issue that
inspired much of the early regulations. After careful study, they
concluded that the risks of diversion and misuse did not warrant the
unusual level of regulation, and that these needed to be modified to
promote better access and good care.

The third milestone was the convening of an NIH Consensus
Development Conference in 1997 (National Consensus Development
Panel on Effective Medical Treatment of Opiate Addiction, 1998).
This process has been crafted by NIH to address controversial topics
in medicine and public health in an unbiased, impartial manner. An
independent panel of non-federal professionals in health fields is
convened to hear reports by experts, who present research on specific
aspects of the topic. After discussion, the panel issues findings and
recommendations. The panel reviewed the existing medical literature
and attended a series of expert presentations, and then strongly
recommended broader access to methadone treatment, through
reduction of regulatory barriers and active leadership in addressing
stigma and other issues.

Conclusion

In summary, methadone treatment has been exhaustively studied from
a variety of perspectives. Although inappropriate policies and
practices can undermine its effectiveness, when properly implemented
it is a powerful tool to bring improvement in measures of public health
and safety.