Tapering from methadone maintenance: attitudes of clients and staff.

To investigate the barriers to tapering from methadone and to generate ideas for clinical services, 60 clients on methadone maintenance and 30 staff members in five methadone maintenance clinics were interviewed. The interview format combined quantitative and qualitative response options and assessed subjects' experience with tapering from methadone, ideas about barriers to tapering, suggestions about services that would aid them in getting off methadone, and aftercare services that would help them to remain drug-free. Both staff and patients noted significant barriers to methadone detoxification, estimating the likelihood of completing a successful taper at 10% and 14%, respectively. Patients reported psychological symptoms of withdrawal discomfort, but they emphasized physical problems of withdrawal much more than did staff. Both groups noted the need for counseling, role models of detoxified former addicts, and a wide array of available services.