Methadone Maintenance Treatment-A Reply

Abstract

In 1965, Dole and Nyswander published the results of their initial experiences with using the drug methadone as a maintenance treatment for chronic heroin addicts [1]. The results were very encouraging and set off a tide of both medical and public expectations as to the ability to successfully treat what had been seen as an almost untreatable problem. Ten years or so later the authors reviewed what had transpired and concluded that the original hopes had not been realized [2]. Following a hugh expansion in the availability of methadone treatment in the 1970s, numbers seeking admission were now dropping, retention rates had substantially dropped, and both addicts and the public viewed methadone programs with cynicism and alarm rather than hope. The authors attribute these gloomy results to interference with treatment programs by excessive, unreasonable, and rigid governmental rules and regulations. “It is mainly the programs rather than the addicts that have changed.”