FORTY YEARS AND COUNTLESS Political firestorms after it was first introduced, methadone maintenance for the treatment of opioid ad- diction remains a standard therapy in the field of addiction treatment.
The publication on August 23, 1965, of positive results from a small clinical trial of methadone as a treatment for heroin addiction in JAMA marked a sea change in the treatment of addiction (Dole and Nyswander. JAMA. 1965;
193:646-650). The study, conducted at Rockefeller University in New York City by Vincent P. Dole, MD, and the late Marie E. Nyswander, MD, suggested that a medication could be used to control the cravings and withdrawal that often lead to relapse in individuals with opioid addiction who attempt to quit. The work, along with subsequent re- search by Dole, an endocrinologist, Nyswander, a psychiatrist, and col- leagues established the concept of opioid addiction as a chronic disease, similar to diabetes, that as such required long-term treatment. The researchers also emphasized the need for psycho- therapy in combination with methadone treatment.
The research has had a tremendous impact on the treatment of individuals addicted to opioids and on the larger field of addiction treatment, said Thomas Kosten, MD, professor of psychiatry at Yale University, New Haven, Conn, in an interview. “It may be equivalent to the kind of impact penicillin had on infectious diseases,” Kosten said.