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In the late 1950s and the 1960s, efforts were made to find alternative methods to treat heroin addicts that today would be classified as “harm reduction” in intent and result. One of the most successful, yet controversial, was methadone maintenance. This is a “substitution” technique that involves substituting a longer-acting opioid, methadone, which is dispensed under medical supervision, for the short-acting street drug, heroin. Though generally successful, this mode of treatment is not a universal panacea and has attracted criticism from hard-line drug warriors for “sending the wrong message on drugs.” Much information, however, about drug addiction and withdrawal has been garnered from drug testing of in-program addicts and those in aftercare. This entry provides a background of methadone maintenance before examining the importance ...

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