While stabilized patients appear to do well after switching to office-based treatment, international research shows that new patients also can successfully initiate treatment in such settings. However, research investigating the effectiveness of office-based treatment for new patients has been restricted in the United States.
Having established that office-based programs are effective for stabilized patients, a key issue for researchers and policy makers is whether they would be suitable entry points for new patients seeking methadone for addiction treatment.
There is evidence from abroad that if given proper support, primary care physicians can successfully participate in methadone treatment programs on a large scale and safely initiate methadone treatment (Weinrich and Stuart, 2000). Research also shows that expanding methadone treatment options to include a large number of private physicians doesnt simply prompt patients to choose office-based services over traditional clinics. Rather, the change allows more of those in need to receive treatment by offering services to those who were unable to get help through existing programs (Brands et al., 2002).
But while U.S. researchers explore the risks and benefits of office-based methadone treatment, existing regulations make it difficult for them to extend the evidence to include patients new to methadone treatment. Thus, methadone medical maintenance remains available only to the minority of patients who have proven to be successful in treatmentnot to new patients (Merrill, 2002).