Document 0348
 DOCN  M9610348
 TI    The demedicalization of methadone maintenance.
 DT    9601
 AU    Rosenbaum M; Institute for Scientific Analysis, San Francisco,
       California; 94123, USA.
 SO    J Psychoactive Drugs. 1995 Apr-Jun;27(2):145-9. Unique Identifier :
       AIDSLINE MED/96053691
 AB    The institution of methadone maintenance as a treatment modality for
       heroin addiction in the mid-1960s was part of the growing medicalization
       of social problems in the United States. The definition of deviance as
       sickness rather than badness set the stage for America's first
       harm-reduction strategy. By the 1970s methadone maintenance was seen as
       a way to reduce drug-related crime, and federally funded programs
       proliferated. Accompanying methadone's phenomenal expansion was
       increased regulation, bureaucratization, and criticism. The early 1980s
       brought the Reagan era, fiscal austerity, the new just say no abstinence
       morality, and demedicalization of methadone maintenance. By the time
       needle-sharing was recognized as a major contributing factor in the
       spread of HIV, methadone had been transformed into a largely
       fee-for-service, short-term, begrudgingly tolerated treatment modality.
       Ironically, while other countries were able to use methadone to curb the
       spread of AIDS, the United States refused to facilitate its expansion,
       and in fact impeded it. To the frustration of proponents and consumers,
       this original harm-reduction tool, with the potential to impact the
       epidemic, was demedicalized and remains marginalized.
 DE    Health Policy  Heroin Dependence/HISTORY/*REHABILITATION  History of
       Medicine, 20th Cent.  Human  Legislation, Medical
       Methadone/HISTORY/*THERAPEUTIC USE  Support, U.S. Gov't, P.H.S.  United
       States  HISTORICAL ARTICLE  JOURNAL ARTICLE  REVIEW  REVIEW, TUTORIAL

       SOURCE: National Library of Medicine.  NOTICE: This material may be
       protected by Copyright Law (Title 17, U.S.Code).