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May 1, 1991

Criteria for Judging Methadone Maintenance Programs-Reply

Author Affiliations

US General Accounting Office Washington, DC

US General Accounting Office Washington, DC

JAMA. 1991;265(17):2191. doi:10.1001/jama.1991.03460170044022

In Reply.—  We are pleased that Drs Newman and Des Jarlais agree with us on the need to develop result-oriented performance standards for these programs, and we share their concerns regarding the difficulty in identifying criteria and developing regulatory policies. Our use of the 20% criterion to distinguish between programs that were effective in achieving the benefits of methadone treatment and those that were not was based on consultation with various methadone maintenance treatment experts. We did not advocate in our report that this criterion be regarded as the only or the best one. In fact, we recommended that the Secretary of Health and Human Services direct the National Institute on Drug Abuse and the Food and Drug Administration, the two federal agencies responsible for overseeing and regulating methadone treatment, to develop the most appropriate result-oriented performance standards.The authors' calculated correlations between dosage and outcome run the risk of