Treatment as harm reduction, defunding as harm maximization: The case of methadone maintenance

Marsha Rosenbaum, Allyson Washbum, Kelly Knight, Margaret Kelley, Jeanette Irwin

Research output: Contribution to journalArticlepeer-review


Despite numerous research studies demonstrating the efficacy of methadone maintenance treatment (MMT) in general and the value of retention in particular, the increasing defunding of this modality has compromised its potential. From 1990 to 1995 the lead author conducted a longitudinal research project to determine the impact of the cost of treatment on 233 San Francisco Bay Area study participants seeking, enrolled in, or defunded from MMT. This paper reports on selected findings from that study. Using variables of drug use, crime, gender and HIV risk, qualitative and quantitative results comparing those seeking treatment with those enrolled in treatment indicated that MMT functioned as a harm-reduction tool. When clients were defunded, however, drug use, crime and HIV risk increased and harm was maximized.

Original languageEnglish (US)
Pages (from-to)241-249
Number of pages9
JournalJournal of Psychoactive Drugs
Issue number3
StatePublished - 1996
Externally publishedYes


  • Defunding
  • Drug policy
  • Harm maximization
  • Harm reduction
  • Methadone maintenance treatment

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • General Psychology


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