HEROIN ADDICTS ON METHADONE

Q: How long do heroin addicts stay on methadone treatment before
they're finally weaned away from it? Or are they on it forever?

A: Methadone is a synthetic drug widely used as a substitute tor
heroin and medicinal opiates, such as morphine, in treating opiate
dependencies. Opiates are drugs that come from the opium poppy.

The treatment is usually conducted in combination with counselling.
"The length of time someone should receive methadone depends on how
badly their drug dependence has interrupted the rest of their life,
psychological and social functioning," said Dr. David Marsh, clinical
director of the addiction medicine program at the Centre tor Addiction
and Mental Health in Toronto.

"It also sometimes depends on what other illness or conditions they
have. Some mental health conditions or physical conditions, like HIV
(and) hepatitis C, are more common in people with opium
dependence."

He said it should be for the patient and doctor to decide when to
start tapering off methadone treatment, ideally when the patient's
physical health and social adjustment have improved and he or she has
been off any other drugs for some time.

"What we know from controlled studies (is), if someone has been on
methadone for at least two years, has had at least a year without
using any other drugs and is in a good social environment, maybe back
at work or in school, and wants to taper off methadone, then about 45
per cent of them will be able to stay off methadone long-term and
maintain their good quality of life," Marsh said.

The other 55 per cent might end up going back on methadone or
relapsing into drug use.

To be approved for methadone in Ontario, an addict must have tried and
failed to get off heroin using other treatments, such as residential
programs. Marsh said methadone is just one of a range of treatments
available. "But it is the one that has the largest scientific evidence
in favour of its effectiveness."