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June 19, 1972

Oral Methadone Maintenance

JAMA. 1972;220(12):1617-1618. doi:10.1001/jama.1972.03200120065026

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To the Editor.—  With one exception, I concur with the position taken by the AMA Council on Mental Health in their explication, "Oral Methadone Maintenance Techniques in the Management of Morphine—Type Dependence." That position perpetuates the impression that, in general, addicts must be maintained at a daily dose level of between 80 and 120 mg. And, occasionally, a daily dose as high as 160 mg and above is required to attain the intended effect.Double-blind studies done in our clinic, and a similar study by Goldstein, demonstrate that most addicts can be successfully maintained with much smaller doses—as low as 30 mg/day. We were unable to demonstrate a significant difference in the behavior of groups of patients maintained continuously with 30, 50, and 100 mg of methadone hydrochloride daily when compared with retention in the program, attendance, employment, illegal activities, and involvement with their families. The one exception was a