TREATMENT AS HARM REDUCTION, DEFUNDING AS HARM MAXIMIZATION - THE CASE OF METHADONE-MAINTENANCE

Despite numerous research studies demonstrating the efficacy of methad one maintenance treatment (MMT) in general and the value of retention in particular, the increasing defunding of this modality has compromis ed its potential. From 1990 to 1995 the lead author conducted a longit udinal research project to determine the impact of the cost of treatme nt on 233 San Francisco Bay Area study participants seeking, enrolled in, or defunded from MMT. This paper reports on selected findings from that study. Using variables of drug use, crime, gender and HIV risk, qualitative and quantitative results comparing those seeking treatment with those enrolled in treatment indicated that MMT functioned as a h arm-reduction tool. When clients were defunded, however, drug use, cri me and HIV risk increased and harm was maximized.