TEN YEARS ago in The Journal, we reported on the use of methadone hydrochloride to treat a small group of intractable heroin addicts. The encouraging results of this pilot experiment suggested that larger-scale maintenance programs might provide a treatment alternative for a significant number of heroin addicts.
To some extent this expectation has been supported by the experience of clinicians using methadone in treatment programs throughout the United States and abroad. Many thousands of former heroin addicts have been rehabilitated, but on balance today, it must be recognized that the projections of ten years ago were overly optimistic. The great majority of heroin addicts in our cities remain on the streets, and the programs have lost their ability to attract them to treatment.
An unfortunate consequence of the early enthusiasm for methadone treatment is today's general disenchantment with chemotherapy for addicts. What was not anticipated at the onset was the
Dole VP, Nyswander ME. Methadone Maintenance Treatment: A Ten-Year Perspective. JAMA. 1976;235(19):2117–2119. doi:10.1001/jama.1976.03260450029025
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