Long Term Methadone Treatment in Denmark

Abstract

The widespread existence of long term methadone treatment in Danish general medical practice is traced historically to the inability of the dominant pedagogical treatment system to define treatment goals that seem both attractive and possible to the patients. The usually poor quality of methadone treatment is seen to be due largely to a combination of physicians' disinclination to take up the treatment of drug abusers at all, and antagonism toward long term methadone treatment rooted in the professional ideologies of personnel in the social services. Contrary to what is commonly claimed by the proponents of the pedagogical model, we contend that the detrimental effects of the existence of long term methadone treatment on the “motivation” of patients in pedagogical institutions are minor. Both the problem of poor quality methadone treatment in general practice and the problem of recruiting patients to the pedagogical system require for their solution a fundamental reformulation of goals and strategies within the pedagogical system itself.