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Methadone maintenance in the United States is delivered in specially
licensed facilities called Opioid Treatment Programs (OTPs). (Other
names for these programs are Narcotic Treatment Programs, or
methadone clinics.) Because the OTP is strictly regulated, methadone
maintenance is delivered in a particular way that meets Federal and
State regulations, and sometimes has nothing to do with evidence-
based research. There is mandated counseling, and mandated urine
testing, as well as daily observation by nurses while the patient takes
the dose at the window.

What Is A Good Outcome For Opiate Addiction Treatment?

Addiction is a chronic illness, so we don’t have a cure for it. However
good addiction treatment controls the disease and prevents the long-
term ravages to the person’s life. Control of the addiction includes
control of the behaviors that are part of the disease, so when we look
at outcomes we use a broad lens.

In addiction treatment, even such non-medical things such as staying
out of jail, becoming employed, and getting along with one’s spouse
are taken into account as positive outcomes of treatment. Of course,
we also study whether the patient continues to use drugs, or has
reduced or eliminated illicit or harmful use of substances.

Because addiction is chronic, good outcomes come with ongoing care.
If treatment is interrupted, relapse may occur. So one of the measures
of a good outcome is whether the patient has remained in treatment.
This is called treatment retention.

The following table summarizes some of the outcomes we look for in
addiction treatment.

Table 1

Desired outcomes for addiction treatment
Retention in treatment
Reduction or discontinuation of the use of illicit or harmful substances