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highly regulated, clinic-based structure (Jaffe and O’Keefe 2003; “NIH Consensus” 1998;
Institute of Medicine 1995), although buprenorphine has recently been approved for use in an
office-based setting by trained physicians (Jaffe and O’Keefe 2003).
It is important to examine patient perspectives on medication-assisted substance abuse
treatment for a variety of reasons. Because of the regulated structure of methadone clinics
(patients must generally go to the clinic daily for medication), this treatment modality can have a
significant impact on an individual’s life. The examination of patient views can also be useful in
assessing how well the treatment meets patient needs. Until recently, however, the ideas and
attitudes of patients in drug treatment were not considered in research (Montagne 2002; el-
Guebaly 2002). There have been a handful of quantitative studies on patient attitudes on specific
issues such as supervised consumption and withdrawal (Stone 2003; Lenne 2001; Gold 1988),
but studies employing qualitative methodologies have been in short supply (for three exceptions,
see Hunt, et al. 1985-1986, Koester et al.1999, and Fischer et al. 2002). Many of the existing
studies on patient views towards treatment were conducted in other countries whose substance
abuse treatment programs differ greatly from that of the U.S. in terms of structure and
implementation. Getting the perspective of the patient can lead to new insights on how to
develop, organize, and carry out more effective treatment for drug abuse. In a study on patient
perceptions of the change process, Lovejoy, et al. write, “Taking seriously what these hard-to-
reach patients say about what works for them is an important and often overlooked step in
designing treatment strategies that will motivate and engage them” (1995:281).
Although the research on patient perspectives on methadone treatment is limited, there
are some studies which should be considered. It is important to differentiate between the
Convention