Withdrawal from methadone maintenance. Impact of a tapering network support program.

This study assessed the impact of providing tapering and aftercare assistance to individuals addicted to heroin maintained on methadone. Participants were clients in six outpatient methadone maintenance clinics who expressed a motivation to withdraw from methadone and who met criteria predictive of success. Fifty-eight clients in three clinics had an enriched program available, whereas 56 clients in three matched comparison clinics received written materials only.

Bridges and barriers to recovery: clinical observations from an opiate recovery project.

Clinical issues are described in opiate addicts attempting to taper off methadone maintenance, and techniques are suggested to help this patient population. The observations were generated in an experimental "Tapering Network" project, in which opiate addicts on methadone maintenance had the opportunity to receive individual and group counseling, relapse prevention training, self-help groups, and other services. Vignettes illustrate clinical problems with intimacy and social isolation, identity as a former addict, and a "post methadone syndrome" characterized by vulnerability, dramatic swings in mood, and disordered thinking for a period of up to six months after detoxification.