A recent review of the literature throws these assumptions into question. The review, analyzed and shared by the folks at Drug and Alcohol Findings, found "no evidence that supervising consumption meant patients were better safeguarded or that the treatment more effectively reduced illegal drug use." Instead, these policies tend to be quite costly to programs and burdensome to patients. They reinforce negative stereotypes about MMT patients and have prevented people from seeking potentially lifesaving treatment.
Here at Alltyr Clinic, we routinely hear from patients that the ability to receive a monthly prescription of Suboxone has meant they could keep their job or maintain their role within the family. With all the national attention being given to the recent spike in overdose statistics, maybe it's time the feds re-visit these burdensome regulations and increase access to the highly effective treatments.
From the Findings UK article:
Supervised dosing with a long-acting opioid medication in the management of opioid dependence
From summary and commentary
Guidelines recommend making opioid-dependent patients take their methadone or other opioid substitutes at the clinic or pharmacy to safeguard the patient and prevent medication being ‘diverted’ to other people.
Randomised trials and studies study which monitored patients in routine treatment afforded no evidence that supervising consumption meant patients were better safeguarded or that the treatment more effectively reduced illegal drug use.
However, introduction of supervision to UK treatment services was associated with fewer methadone-related overdose deaths.
Findings and expert opinion support initial supervised consumption and its relaxation on an individual basis, depending on assessment of the patient.