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To the Editor.—
Cushman and Dole's (226:747, 1973) forceful arguments against arbitrary detoxification of patients in methadone maintenance treatment is timely and far-reaching. Because of the curious psychosocial dimensions of an illness that doesn't fit into the disease paradigm very clearly, we are being compelled to enter into dangerous modifications in treatment.Our experience reinforces the Cushman-Dole observations. They, however, have given statistical security to clinical impressions.The use of pharmacologic substitution therapy in chemical dependency of the morphine type has been the underpinning in the total social rehabilitation of many thousands of patients. We cannot allow a governmental edict to tamper with satisfactory treatment.
Maslansky RA. Methadone Maintenance. JAMA. 1974;227(2):201. doi:10.1001/jama.1974.03230150049019