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March 14, 1966

The Treatment of Heroin Addiction

JAMA. 1966;195(11):972. doi:10.1001/jama.1966.03100110140055

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To the Editor:—  We were distressed to learn that an authority in the field of addiction, publishing on methadone treatment (see p 949), could have so little understanding of the pharmacology of methadone or of our motives. Clarification of our position surely is needed if his research on the subject has persuaded him "that Dole and Nyswander are not directed toward withdrawal therapy but toward the permanent induction of methadone-induced euphoria." No statement could be farther from the truth. We have no desire to substitute legal euphoria for the kind purchased on the street, and indeed could not do this with our regimen. Anyone familiar with the pharmacology of methadone knows that giving this agent in constant daily dosage (as we give it) induces a state of narcotic tolerance that diminishes the euphorigenic action of all opiatetype drugs. Pharmacologically, our treatment is one of narcotic blockade; by maintenance of sufficient

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