Methadone Maintenance: Some Treatment Programs Are Not Effective; Greater Federal Oversight Needed

GAO discussed its evaluation of 24 methadone maintenance treatment programs in eight states. GAO noted that: (1) the methadone maintenance programs' policies and procedures differed widely regarding methadone dosage levels, the frequency of urine testing, patients' dismissal from the programs for continued drug use, and the availability of counseling and vocational training; (2) more than 20 percent of the patients at 10 of the 24 programs continued to use heroin after 6 months of treatment; (3) none of the 24 programs evaluated the effectiveness of their methadone treatment; (4) between 1982 and 1989, the Food and Drug Administration (FDA) and the National Institute on Drug Abuse (NIDA) provided little oversight of methadone programs, although FDA recently found that 62 programs did not meet federal requirements; and (5) a proposed FDA and NIDA interim maintenance program, which would allow access to methadone without counseling or rehabilitation, would not be effective in reducing drug use or the risk of acquired immune deficiency syndrome.