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January 29, 1973

Methadone Maintenance

Author Affiliations

Martinez, Calif

JAMA. 1973;223(5):557. doi:10.1001/jama.1973.03220050057024

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To the Editor.—  Although much has been written in your journal and others about methadone and methadone maintenance, few clinicians are aware of the range of the drug's effects. One misconception is that patients undergoing methadone maintenance are less susceptible to pain because they are daily ingesting a powerful narcotic analgesic. The following is a memo we have forwarded to physicians that may interest your readers:As you know, methadone is an addicting narcotic. Like heroin and morphine, methadone is a powerful analgesic and also quickly produces in a patient a tolerance to the drug. I use the word tolerance to mean that it takes quantitatively more of a given substance to produce an effect. On methadone maintenance we use progressively larger and larger doses of methadone to "build" a patient up to a maintenance level. At this maintenance level, a patient becomes tolerant to the methadone dose he/she is