Skip to main content
NCBI home page
Canadian Medical Association Journal logoLink to Canadian Medical Association Journal
. 1973 Oct 6;109(7):615–619.

Methadone

S K Sim
PMCID: PMC1946949  PMID: 4599599

Abstract

Methadone and acetylmethadol, although possessing almost all of morphine's pharmacological properties, differ from other morphine-like drugs in their longer action, more gradual and less intense withdrawal syndrome, and blockade of euphoric effect of other opiates in addicts. A high percentage of patients maintained on methadone are better able to hold employment or to be otherwise socially productive than when dependent on heroin or morphine.

A review of published results and procedures used in methadone maintenance treatment programs for heroin dependence is presented. Former heroin addicts are usually maintained on 80 to 120 mg. (high dose) or 20 to 60 mg. (low dose) oral methadone daily. Some programs are reported to have produced 80% success (patients employed or otherwise socially productive). Selection of patients, availability of allied therapeutic and rehabilitative facilities, strict control of supply, record keeping and periodic evaluation are considered essential.

Different criteria (“drug-free” vs. “socially productive”) for judging “success” of treatment of heroin-dependent persons by methadone maintenance and administrative problems in large-scale treatment programs constitute the principal aspects of controversy.

Full text

PDF
615

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Aronow R., Paul S. D., Woolley P. V. Childhood poisoning. An unfortunate consequence of methadone availability. JAMA. 1972 Jan 17;219(3):321–324. doi: 10.1001/jama.219.3.321. [DOI] [PubMed] [Google Scholar]
  2. BECKETT A. H. Analgesics and their antagonists: some steric and chemical considerations. I. The dissociation constants of some tertiary amines and synthetic analgesics, the conformations of methadone-type compounds. J Pharm Pharmacol. 1956 Nov;8(11):848–859. doi: 10.1111/j.2042-7158.1956.tb12215.x. [DOI] [PubMed] [Google Scholar]
  3. Bazell R. J. Drug abuse: methadone becomes the solution and the problem. Science. 1973 Feb 23;179(4075):772–775. doi: 10.1126/science.179.4075.772. [DOI] [PubMed] [Google Scholar]
  4. Beckett A. H., Taylor J. F., Casy A. F., Hassan M. M. The biotransformation of methadone in man: synthesis and identification of a major metabolite. J Pharm Pharmacol. 1968 Oct;20(10):754–762. doi: 10.1111/j.2042-7158.1968.tb09634.x. [DOI] [PubMed] [Google Scholar]
  5. Berry G. J. Oral methadone maintenance. JAMA. 1972 Jun 19;220(12):1617–1618. doi: 10.1001/jama.1972.03200120065026. [DOI] [PubMed] [Google Scholar]
  6. Bild S. G. Letter to the editor. Science. 1973 Mar 16;179(4078):1076–1078. doi: 10.1126/science.179.4078.1076. [DOI] [PubMed] [Google Scholar]
  7. Billings R. E., Booher R., Smits S., Pohland A., McMahon R. E. Metabolism of acetylmethadol. A sensitive assay for noracetylmethadol and the identification of a new active metabolite. J Med Chem. 1973 Mar;16(3):305–306. doi: 10.1021/jm00261a037. [DOI] [PubMed] [Google Scholar]
  8. Brill H. Methadone maintenance: a problem in delivery of service. JAMA. 1971 Feb 15;215(7):1148–1150. doi: 10.1001/jama.1971.03180200070020. [DOI] [PubMed] [Google Scholar]
  9. Buchner L. H., Cimino J. A., Raybin H. W., Stewart B. Naloxone reversal of methadone poisoning. N Y State J Med. 1972 Sep 15;72(18):2305–2309. [PubMed] [Google Scholar]
  10. DOLE V. P., NYSWANDER M. A MEDICAL TREATMENT FOR DIACETYLMORPHINE (HEROIN) ADDICTION. A CLINICAL TRIAL WITH METHADONE HYDROCHLORIDE. JAMA. 1965 Aug 23;193:646–650. doi: 10.1001/jama.1965.03090080008002. [DOI] [PubMed] [Google Scholar]
  11. Dobbs W. H. Methadone treatment of heroin addicts. Early results provide more questions than answers. JAMA. 1971 Dec 6;218(10):1536–1541. [PubMed] [Google Scholar]
  12. Dole V. P., Nyswander M. E., Kreek M. J. Narcotic blockade. Arch Intern Med. 1966 Oct;118(4):304–309. [PubMed] [Google Scholar]
  13. Dole V. P., Nyswander M. E., Warner A. Successful treatment of 750 criminal addicts. JAMA. 1968 Dec 16;206(12):2708–2711. [PubMed] [Google Scholar]
  14. Fraser D. W. Methadone overdose. Illicit use of pharmaceutically prepared parenteral narcotics. JAMA. 1971 Sep 6;217(10):1387–1389. doi: 10.1001/jama.217.10.1387. [DOI] [PubMed] [Google Scholar]
  15. Gordon E. Treatment of methadone poisoning. JAMA. 1972 May 1;220(5):728–731. doi: 10.1001/jama.1972.03200050066028. [DOI] [PubMed] [Google Scholar]
  16. Hammond A. L. Narcotic antagonists: new methods to treat heroin addiction. Science. 1971 Aug 6;173(3996):503–506. doi: 10.1126/science.173.3996.503. [DOI] [PubMed] [Google Scholar]
  17. Holden C. Methadone: new FDA guidelines would tighten distribution. Science. 1972 Aug 11;177(4048):502–504. doi: 10.1126/science.177.4048.502. [DOI] [PubMed] [Google Scholar]
  18. Inturrisi C. E., Verebely K. Disposition of methadone in man after a single oral dose. Clin Pharmacol Ther. 1972 Nov-Dec;13(6):923–930. doi: 10.1002/cpt1972136923. [DOI] [PubMed] [Google Scholar]
  19. Jaffe J. H. Further experience with methadone in the treatment of narcotics users. Int J Addict. 1970 Sep;5(3):375–389. doi: 10.3109/10826087009057006. [DOI] [PubMed] [Google Scholar]
  20. Jaffe J. H., Senay E. C. Methadone and l-methadyl acetate. Use in management of narcotics addicts. JAMA. 1971 May 24;216(8):1303–1305. [PubMed] [Google Scholar]
  21. Jaffe J. H., Senay E. C., Schuster C. R., Renault P. R., Smith B., DiMenza S. Methadyl acetate vs methadone. A double-blind study in heroin users. JAMA. 1972 Oct;222(4):437–442. [PubMed] [Google Scholar]
  22. Kramer J. C. Methadone maintenance for opiate dependence. Calif Med. 1970 Dec;113(6):6–11. [PMC free article] [PubMed] [Google Scholar]
  23. Kreek M. J. Medical safety and side effects of methadone in tolerant individuals. JAMA. 1973 Feb 5;223(6):665–668. [PubMed] [Google Scholar]
  24. Lennard H. L., Epstein L. J., Rosenthal M. S. The methadone illusion. Science. 1972 May 26;176(4037):881–884. doi: 10.1126/science.176.4037.881. [DOI] [PubMed] [Google Scholar]
  25. Lewis E., Jr A heroin maintenance program in the United States? JAMA. 1973 Jan 29;223(5):539–546. [PubMed] [Google Scholar]
  26. Lipkowitz M. H., Schwartz D. W., Lazarus R. J. Abrupt withdrawal of maintenance methadone. JAMA. 1971 Sep 27;217(13):1860–1861. [PubMed] [Google Scholar]
  27. Maugh T. H., 2nd Narcotic antagonists: the search accelerates. Science. 1972 Jul 21;177(4045):249–250. doi: 10.1126/science.177.4045.249. [DOI] [PubMed] [Google Scholar]
  28. Olsen G. D. Methadone binding to human plasma albumin. Science. 1972 May 5;176(4034):525–526. doi: 10.1126/science.176.4034.525. [DOI] [PubMed] [Google Scholar]
  29. Pohland A., Boaz H. E., Sullivan H. R. Synthesis and identification of metabolites resulting from the biotransformation of DL-methadone in man and in the rat. J Med Chem. 1971 Mar;14(3):194–197. doi: 10.1021/jm00285a004. [DOI] [PubMed] [Google Scholar]
  30. Rigg W. D., Brawley P. Methadone: an alternative to the "official view". Can Med Assoc J. 1972 Aug 5;107(3):198–201. [PMC free article] [PubMed] [Google Scholar]
  31. Rosenberg C. M., Patch V. D. Methadone use in adolescent heroin addicts. JAMA. 1972 May 15;220(7):991–993. [PubMed] [Google Scholar]
  32. Tice A. D., Pascarelli E. F. Methadone maintenance withdrawal. JAMA. 1972 Jan;219(1):87–87. doi: 10.1001/jama.1972.03190270057020. [DOI] [PubMed] [Google Scholar]
  33. VEATCH R. M., ADLER T. K., WAY E. L. THE IMPORTANCE OF STERIC CONFIGUA. ION IN CERTAIN MORPHINNE-MIMETIC ACTIONS OF SYNTHETIC ANALGETICS. J Pharmacol Exp Ther. 1964 Jul;145:11–19. [PubMed] [Google Scholar]
  34. Zaks A., Feldman M. Private methadone maintenance. Analysis of a program after one year. JAMA. 1972 Dec 4;222(10):1279–1280. doi: 10.1001/jama.222.10.1279. [DOI] [PubMed] [Google Scholar]
  35. Zaks A., Fink M., Freedman A. M. Levomethadyl in maintenance treatment of opiate dependence. JAMA. 1972 May 8;220(6):811–813. [PubMed] [Google Scholar]

Articles from Canadian Medical Association Journal are provided here courtesy of Canadian Medical Association

RESOURCES