[Use of methadone in the treatment of narcotic addiction]

In spite of the 30-year experience in the use of methadone in heroin addicts, there is no consensus about the value of that method. In view of the opinion that resistance to methadone treatment is partly caused by ignorance, the aim of this paper is to improve the knowledge about the method. The paper offers explanation of: (1) metabolic basis of heroin addiction, (2) methadone pharmacology, (3) psychosocial aspects of the addiction, (4) methadone treatment procedure, (5) aims and (6) results of the treatment. A demand for designing the treatment program on the basis of expert knowledge rather than on political and moral judgments is stressed. Topics in program organization are described: indications, daily dosage and its administration, treatment duration, professional job-sharing and control of the treatment. A review of medical goals--individual-oriented and social-oriented goals of the treatment is made. "Therapeutic milieu", as well as treatment dose and treatment duration have been recognized as the main determinants of the outcome. Evaluation criteria and treatment have been elaborated as potential basis for further research.