Contrary to the practice of many residential programs, this Phase II of methadone treatment is an ideal time to attend for intensive group treatment.

To recommend the discontinuation of methadone dose prior to program entry - or prior to a client’s demonstrated ability to remain abstinent outside of a treatment setting - seems a common and reckless disservice. 

An extended period of time abstinent and on a stable, moderate dose of methadone seems to allow for gradual readjustment of opiate receptor activity. Common experience suggests that a gradual taper is more easily tolerated after an extended time spent in Phase II of treatment. A bare minimum of one year is the standard recommendation at our facility.

Phase III begins with a taper of methadone dose to gradual discontinua-tion. Many factors will be considered prior to embarking on this course.

These include the length of time in prior treatment, stability of lifestyle and attentiveness to recovery, outstanding issues of chronic pain or concurrent psychiatric disorder, previous history of addiction and intravenous use of opiate drugs.There is no healthy reason for this decision to be pressured.

Methadone should be the last issue of concern if a proper decision has been made to taper at this point. Our facility recommends a background taper of five milligrams once monthly while all other attention is directed to recovery activities and lifestyle satisfaction.

Recovery refers to a process of learning to enjoy life without the use of intoxicating drugs and while minimizing risk of relapsed use. Since relapse risk is never absent, recovery is a lifelong process attended to on a day to day basis.

Not all methadone clients are ready and/or interested to accept the ways of recovery. But just as a methadone program offers easy access to other services - education on recovery and an attitude that recovery from addiction is attainable should be routinely on hand.

Methadone stands its own ground as a harm reduction strategy for severe opiate dependence - and it does so regardless of readiness for recovery.

But Methadone Maintenance Treatment is but one medical strategy in a larger and lifelong context of recovery from addiction.

Decisions about the initiation and duration of methadone treatment are best made from the perspective of recovery - guided by its principles and its integration into daily life.

In the long run a day to day, personal program of recovery provides the only lasting freedom from addiction and its potential for devastating consequences.

And recovery from addiction is of course, the most reliable means of reducing harm.

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