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Thousands of Lives Saved But Still Controversial

Commentary by Herbert D. Kleber, MD

JAMA. 2008;300(19):2303-2305.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

SUMMARY OF THE ORIGINAL ARTICLE

A Medical Treatment for Diacetylmorphine (Heroin) Addiction: A Clinical Trial With Methadone Hydrochloride

Vincent P. Dole, MD, and Marie Nyswander, MD

JAMA. 1965;193(8):646-650.

Twenty-two male patients, addicted to heroin 9.5 years (median), were stabilized using oral methadone hydrochloride and then observed for approximately 1 to 15 months (median, 3 months). The medication had 2 main effects: (1) relief of narcotic hunger (craving); and (2) induction of sufficient tolerance to block the average illegal dose of heroin.

A combination of the methadone treatment and a comprehensive program of rehabilitation was associated with marked improvement in patient problems such as jobs, returning to school, and family reconciliation. No adverse effect other than constipation was found.

The authors note that "careful medical supervision and many social services" were necessary and stressed that "both the medication and supporting program were essential." The small . . . [Full Text of this Article]

Author Affiliations: Columbia University College of Physicians and Surgeons, Division on Substance Abuse, The New York State Psychiatric Institute, New York.

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