2002 The New York Academy of Medicine Beliefs About Methadone in an Inner-City Methadone Clinic

ABSTRACT Despite being considered both the most effective treatment for heroin addic-tion and an essential tool in the prevention of human immunodeficiency virus (HIV), methadone maintenance (MM) is often held in low esteem by heroin addicts—even those in MM treatment. This survey examined current beliefs and attitudes about MM of patients at an inner-city clinic, and the personal experience and attitudes of these patients with this treatment. Consenting patients in a methadone clinic serving a poor population with high rates of human immunodeficiency virus infection were queried about their attitudes toward and beliefs about methadone using a 16-item question-naire. Over 2 days, 315 questionnaires were completed (acceptance rate 40%), total-ing 32 % of the 1000 clinic patients. Nearly 80 % believed that methadone had a posi-tive effect on his or her life, but 80 % were certain or unsure as to whether methadone is bad for one’s health, and a similar percentage (80%) believed that discontinuing methadone was an important goal. Patients continue to have strongly negative atti-tudes toward and beliefs about methadone despite their acknowledgement that metha-done has been very positive for them as individuals. As a result, many patients leave MM treatment prematurely, and there are usually unfilled slots in MM programs in New York City, even while continued need exists (e.g., less than 25 % of the heroin addicts in the city are in treatment). The restrictive nature of many MM programs may account for these attitudes and beliefs