Long-term methadone maintenance treatment: some clinical examples

FRANÇAIS :
Constatant que de nombreux patients choisissent de rester pendant très longtemps sous maintien à la méthadone, les auteurs ont voulu étudier les effets à long terme de ce type de prise en charge. La trajectoire de trois patients restés sous maintien à la méthadone depuis plus de 15 ans est étudiée. La durée du traitement avant l'apparition d'une amélioration est différente pour chaque patient. Aucun des 3 patients ne veut arrêter la méthadone; la raison invoquée étant la rechute lors de précédentes tentatives. Chaque trajectoire comporte des périodes très difficiles pendant lesquelles on aurait pu conclure à un "échec" du traitement. Dans les trois cas néanmoins, le suivi du traitement à très long terme a finalement mené à des modifications positives du style de vie.
ENGLISH :
Recognizing that many patients choose to remain in methadone treatment for extended periods of time the authors have wondered whether such patients might actually be harmed by long-term involvement. A review of the records of 3 patients who had been in continuous treatment for 15 years or more revealed that all of their lives had improved over the course of their treatment involvement. They varied in the length of time required before they showed improvement and all three indicated that they wished to remain on methadone because previously they had resumed drug use when they tried detoxing either alone or in treatment. There were periods during their treatment involvement when these patients were not doing well and could have been regarded as treatment failures. Continuing on in treatment, however, all three had made positive changes in their lives, changes which were of benefit to the society as well as the individual.