the program. Also, an integral part of counseling is on preventing the exposure and transmission of HIV. Clinics should be able to provide or refer patients to various services: community resources, vocational rehabilitation, education, employment, and prenatal-care. There is no set guideline for duration of methadone treatment, however, longer treatments are associated with better outcomes. Patients receiving methadone treatment in a closed setting should be assisted when transferring to a community-based setting. Patients who voluntarily decide to stop methadone treatment should speak to their provider to discuss why they want to stop and other treatment options. Effectiveness While methadone clinics are generally considered to be effective treatment options for patients addicted to opioids, especially when other interventions have failed, there is controversy surrounding the placement of methadone clinics. There is a perception that the presence of the clinics attracts crime to surrounding areas. However, one study by the University of Maryland School of Medicine found that is not the case, crime rates do not increase when a methadone clinic is opened. Another study by University of Pennsylvania found within a 200 m radius, the presence of a methadone clinic causes a significant decrease in property and total crime but a significant increase in drug and violent crime. A 2004 GAO study notes that placement of clinics can impede recovery and exacerbate relapse: “Although these clinics are intended to help those in need of rehabilitation, patients who seek treatment must navigate their way to and from the clinics in an environment in which illegal sales of narcotics are daily occurrences. The efforts of patients who are seeking rehabilitation, and clinic professionals who serve them, are significantly undermined by this criminal activity that surrounds them." Between 70-90% of patients who discontinue methadone maintenance will relapse. The high relapse rate may be partially due to the severity of cases seen at methadone clinics, as well as the long-term effects of opioid use. Some patients stay on methadone for the rest of their lives, which generates criticism regarding the effectiveness of the clinics. Supporters argue that the clinics aim not just to eliminate narcotic addictions, but also to help people function in their lives. Methadone clinics may decrease the use of emergency rooms by patients addicted to opioids According to a 2009 Cochrane review, methadone maintenance treatments decreased the likelihood that heroin dependent patients would use heroin, but did not change crime or mortality