Andrew,

Thank you so much for your letter. I enjoy receiving mail from MDs and treatment professionals especially when their humanity and compassion is obvious, but your letter is unique because you also seem comfortable with the quality of care that you are able, and allowed to provide. It is quite refreshing and gives me hope for the future.

The rules and regulations regarding methadone, and the American "War On Drugs"/zero tolerance/abstinence or nothing attitude (which has seriously affected health care, esp. chronic pain pt.s and sub. abuse) has created a restrictive atmosphere where even the best MDs can not always do what is best for their patients. As you may know, MMT is monitored and overseen by a branch of federal law enforcement called the Drug Enforcement Agency (DEA), who also happen to be the main "War-riors On Drugs." Instead of a wholly health care based system, MMT is still in the realm of law enforcement, which often leaves many wondering "who gave the DEA a license to practice medicine?"

Under dosing is a great problem here. It astounds me that some clinics and MDs continue to ignore the findings of 30 years research in their field. Low dosing is also the result of public pressure from War On Drugs hysteria. Doctors and staff at these clinics tend to be abstinence oriented, and consider methadone to be merely a substitute for heroin, hence they don't give patients much, and they try to hurry the patients off methadone and into 12-step programs.

I've heard that the US is the only country that has fallen so heavily for 12 step self help groups. Are 12 steps groups very prevalent in Australia?

NAMA and its affiliates work very hard to change the policies and ideas at the low dose clinics, sometimes with success, but public opinion and the DEA are mostly against us. One of our biggest struggles is to convince people that methadone patients have great potential and deserve quality health care, and stabilized patients deserve an equal place in society along side everyone else.

Thank you again for your letter, and for a chance to sound off on some of the issues. I hope you'll keep in touch.

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