Methadone treatment: experiment and experience

FRANÇAIS :
L'article traite des relations entre politique publique et recherches scientifiques, et donne l'exemple du large programme de traitement à la méthadone des toxicomanes, qui avait été mis en place à Hong Kong dans les années 70 alors qu'aucun support scientifique n'en avait encore réellement prouvé l'efficacité et qu'aux Etats-Unis l'inverse se produisait. Les décisions gouvernementales ne sont pas toujours influencées par la découverte scientifique, les chercheurs doivent le savoir s'ils veulent jouer un rôle dans la politique de santé publique.
ENGLISH :
The relationship between public policy and scientific investigation is explored by a review of the experience with methadone maintenance treatment for narcotic addiction. The implementation of a widespread treatment effort in Hong Kong in the 1970s is contrasted with recent policies in regard to methadone treatment expansion in the United States. In neither case did research findings form the basis for public policy. In Hong Kong, rapid expansion of methadone treatment was initiated before scientific evidence was available to support this course, and in the United States treatment expansion has been rejected despite extensive evidence of its utility and safety. Decisions by government officials and health care providers, as in the case of addiction treatment, may be influenced more by philosophy and intuition than by scientific evidence. Scientists must recognize and address this reality if they are to play a meaningful role in shaping public health policy. (Author's abstract)