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Methadone maintenance treatment has been the subject of hundreds of clinical studies and outcomes assessments.Overall, such studies have found that treatment with methadone is safe and effective for most patients. Experience suggests that most methadone deaths in OTPs occur during the induction period because the initial dose is too high, the dose is increased too rapidly, or the methadone interacts with another drug
The ASAM Methadone Action Group affirms that methadone can be dispensed safely and effectively so long as the potential risks are recognized and appropriate action is taken to prevent problems, where that is possible, and to address them rapidly and effectively if they arise. Careful prescribing,patient education, and intervention at the first sign of toxicity can reduce the risk of overdose.
The Action Group acknowledges that these clinical recommendations present certain implementation challenges.However, members of the group are convinced that the use of careful protocols for methadone induction and stabilization, coupled with increased clinical vigilance, will save lives in this vulnerable patient population.