Reports in American newspapers in April 1994 warned of the possibility of a new heroin epidemic in the United States. This warning follows relatively closely warnings from the nation's medical community that governmental policy is hobbling the ability of health professionals to effectively deal with heroin addicts already present in American society (Dole, 1992, pp. 2234 2235). Conflict surrounds the treatment for heroin addiction because of the relapse rate of heroin addicts receiving such treatment, and because recidivism in behaviors associated with heroin addiction (Glass, 1993, pp. 1995 1996).
Relapse prevention, thus, should be the key goal of any treatment for heroin addiction (Chang, Carroll, Behr, and Kosten, 1992, pp. 327 330). Unfortunately, relapse prevention frequently is not the primary goal of treatment programs for heroin addition (Glass, 1993, pp. 1995 1996). In the United States, a process approach as opposed to an outcome approach to the treatment of heroin addiction often dictates that social and political dictums assume precedence over medical outcomes as objectives in treatment programs for heroin addiction (Dole, 1992, pp. 2234 2235). As an example, methadone maintenance has been confirmed by research as the most effective treatment for heroin addiction within the context of relapse prevention (Glass, 1993, pp. 1995 1996). Methadone maintenance as a treatment for heroin addiction in the United States is widely opposed, however, by a large and influential body of politicians, bureaucrats, and
health care professionals who claim that such treatment is "wrong" because the effect is to substitute one addiction for another addiction (Glass, 1993, pp. 1995 1996). This opposition chooses to ignore the facts that methadone maintenance is the most effective means known to preclude relapse in heroin addicts, and that subjects for whom methadone maintenance is successful do not tend to engage in the criminal b...