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November 18, 1988

Methadone Maintenance

JAMA. 1988;260(19):2835-2836. doi:10.1001/jama.1988.03410190083022

To the Editor.—  The June 10 issue of THE JOURNAL contained an article by Novick et al1 entitled "Methadone Maintenance Patients in General Medical Practice," followed by an editorial by Dr Wesson.2 Dr Wesson noted the discrepancies in the reported efficacy of placing highly functioning patients from a traditional psychosocial model methadone clinic into a general medical office setting utilizing methadone diskets and minimal patient-physician contact (up to 28 days between visits). We concur with Dr Wesson's comments concerning the liabilities involved (large supplies of methadone in disket form available for resale) and the observation that a significant portion of previously drug-free patients (20%) returned to drug use while in this setting. On the surface, the comments by Novick et al and Dr Wesson seemed to imply the existence of only two somewhat opposing approaches used for methadone maintenance treatment today. However, it is important to understand that