Methadone Maintenance: A Problem in Delivery of Service

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Abstract
Virtually every issue which relates to drug dependence is suffused with emotion that turns differences of opinion into controversy and leads to distortions, exaggerations, and misunderstandings. In methadone maintenance one can see an excellent example of the process. The drug has been known for years as a synthetic capable of producing addiction (full morphine-type drug dependence)1but very useful as a transitional drug in withdrawal from heroin.2It remained for Dole and Nyswander to show that methadone could be used in a radically different way and that addicts could be maintained on it in such a way as to promote their rehabilitation. The initial series of six cases was started in January 1964, and by December 1970 an estimated 10,000 US addicts in more than 60 programs across the country were receiving methadone maintenance. The development of these programs has been accompanied by active controversy. The method, on the

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