NAMA Calls for An End To Using The Term Substitution Treatment Asking That Governments and Their Agencies and Organizations End Its’ Use

National Alliance of Methadone Advocates
Press Release

Contact:
Joycelyn Woods MA-CMA (212) 595-NAMA/6262


For Release:
May 4, 2007


The National Alliance of Methadone Advocates, our international affiliates and chapters in the United States call on all governments, governmental agencies and international organizations to end the use of “Substitution Treatment” when referring to medication assisted treatment (MAT) for opiate addiction.

The term “Substitution Treatment” infers that any medication used in the treatment of opiate dependence is a substitute. No other medication is referred to in this manner creating significant misunderstandings towards the medication and especially the patients. The use of “Substitution Treatment” stigmatizes patients receiving treatment for the opiate dependence, promotes ignorance and pollutes the development and growth of this life saving medication for those needing help for their opiate dependence.

Governments have rejected buprenorphine and particularly methadone because they it is viewed as merely a substitute for heroin or other illicit drugs. Officials in rejecting these medications have expressed the belief that their citizens should have the right to an effective treatment. Thus hundreds of thousands of opiate dependent individuals “are being denied” the most effective treatment because “Substitution Treatment” is misleading and confusing.

In the United States the term Substitute and Substitution Treatment is only used to denigrate both methadone and buprenorphine treatments. Calling these medications a substitute has been used to hurt Patients by denying them opportunities and other benefits that they deserve and have worked for. Thus, in the United States only those against methadone and buprenorphine call them a Substitute.

At Bratislava in 2006 Dr. Icro Maremmani, the President of Europad called for his European colleagues to end the use of “Substitution Treatment. He asked his colleagues to follow the philosophy and principles of Drs. Dole and Nyswander who believed that opioid dependence and addiction was a medical condition and conceptualized the drug dependent person as a person with a brain metabolic disorder.

The last years of Dr. Dole’s life were spent working to resolve the stigma and prejudice that affects patients in medication assisted treatment. Dr. Dole was acutely aware of the stigma that terms like “Substitution Treatment” create towards patients. He always spoke out against any inference that medication assisted treatment was a substitute. In his experience, methadone and more recently buprenorphine were medications that stabilize the endogenous opioid system damaged by narcotics.

We, at the National Alliance of Methadone Advocates believe that the use of Substitute or Substitution Treatment denigrates this treatment. And that by denigrating this treatment patients receiving medication assisted treatment are injured.

As patients we reserve the right to define ourselves and our treatment. It is therefore the spirit of our own self identity we ask governments and their agencies, organizations and professionals to cease using “Substitution Treatment. Methadone and buprenorphine are medical treatments and should be defined as “Medication Assisted Treatment” or “Opiate Agonist Therapy”.



It is therefore in the spirit of our own self identity we ask governments and their agencies, organizations and professionals to cease using “Substitution Treatment. Methadone and buprenorphine are "medical treatments" and should be defined as such. However if you must put a name to addiction treatment then we suggest “Medication Assisted Treatment” or “Opiate Agonist Therapy”.