Maintaining the viability and safety of the methadone maintenance treatment program.

The purpose of this article is to describe a methadone maintenance treatment (MMT) program and address how such programs can maintain their viability in the community as well as the safety of the clinic environment for patients and staff. The complex nature of the MMT patient is described including social, legal and psychiatric issues. Diversion (selling of methadone) is discussed and examples of how to combat diversion are explored, including monitoring of take-home privileges. The safety of the clinic setting may be ensured through the utilization of toxicology screens and breathalyzers as well as through limit-setting, enforcement of program rules and the maintenance of professional therapeutic boundaries.