Integrating primary care and methadone maintenance treatment: Implementation issues

Merrill Herman, Marc N. Gourevitch

Research output: Contribution to journalArticle

28 Scopus citations

Abstract

Linking primary medical care with methadone maintenance treatment brings critical services to drug users, many with HIV/AIDS, tuberculosis and other illnesses. However, a variety of important philosophical, ethical, and systems issues may impede the process of implementing a 'linked' service delivery model. Conflicting paradigms, such as the traditional 'doctor-patient' relationship with its emphasis on continuity of care and the substance abuse treatment model of limit-setting and behavioral consequences, create tension in the treatment system. This article describes these tensions and uses clinical vignettes to demonstrate how to address these implementation issues. In conclusion, solutions are proposed for successful integrating services for medically ill substance abusers.

Original languageEnglish (US)
Pages (from-to)91-102
Number of pages12
JournalJournal of Addictive Diseases
Volume16
Issue number1
DOIs
StatePublished - Mar 15 1997

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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