Bentham and Beccaria in Methadonia: Justifications of Addiction Professionals for Imposing Sanctions Against Patients Who Violate Rules in Opioid Maintenance Treatment

The daily work of addiction professionals in opioid maintenance treatment (OMT) involves various dual loyalty conflicts; among the most challenging is the conflict between treatment provision and imposition of sanctions. Although not trained to deal with penological issues, addiction professionals participate in judicial processes, which have huge impact on patients’ recovery process. This article presents an excerpt of a staff meeting in an OMT program which deals with the case of a patient who violated a rule. This is accompanied by analysis of various justifications for punishment according to different penological schools of thought. Practical implications are suggested to enrich addiction professionals’ knowledge and understanding of the impact of the sanctions on patients’ recovery process.