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January 3, 1972

Methadone Maintenance Withdrawal

JAMA. 1972;219(1):87. doi:10.1001/jama.1972.03190270057020

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To the Editor.—  The Sept 27 report on abrupt withdrawal of methadone maintenance by Lipkowitz et al (216:1860, 1971) suggested that the withdrawal responses were primarily subjective rather than objective. Because of the potency and the increasing use of methadone, more clinical information about this substance is needed.We do not feel that abrupt withdrawal of any drug can be evaluated under conditions of arrest and imprisonment. Although the authors attempted to confirm complete cessation of narcotic use by analysis of urine sample, data are absent in one case, were obtained only after a week of gradual methadone reduction in another, and were only taken after three weeks in a third. Information about the physical status is mostly retrospective and scanty.Even under close supervision in a hospital, it is difficult to prevent patients from receiving drugs they desire, be they narcotics, alcohol, or other types. Relatives, friends and