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August 9, 2000

Methadone Maintenance for Opioid Dependence—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthorPhil B.FontanarosaMD, Executive Deputy EditorIndividualAuthor

JAMA. 2000;284(6):694-695. doi:10.1001/jama.284.6.691

In Reply: The comments of Dr Annitto and Ms Kelly aptly illustrate the diversity of views about methadone treatment within the clinical community. Some may find this diversity surprising, given the evidence indicating the clinical efficacy of methadone maintenance for the treatment of opioid dependence.1 Annitto appears to have misconstrued the findings of our study to indicate that there were no differences between treatment conditions on important variables such as heroin use and psychosocial functioning. Our data indicate that patients in the methadone maintenance treatment group showed significantly less heroin use and reported less human immunodeficency virus (HIV) risk–related drug use behavior. In contrast, as far as we could determine, there are no controlled studies of 12-step programs for the treatment of opioid addiction. Therefore, their efficacy for the treatment of this disorder is unknown.