Methadone Control Act

[Page 509]The Methadone Control Act, originally introduced in 1973 as the Methadone Diversion Control Act, was passed by the U.S. Congress along with other bills in 1974 as the Narcotic Addict Treatment Act. An amendment to the 1970 Controlled Substances Act, the Methadone Control Act established federally funded methadone clinics and regulatory guidelines for licensing and dispensing methadone. This entry examines the use of methadone to treat opiate addiction, the history of opiate substitution therapies and concerns about methadone diversion that led to the passage of the Methadone Control Act, the legal content of the act, and reactions to the act after it was passed.

Methadone hydrochloride, commonly known as methadone, was originally approved by the Food and Drug Administration (FDA) in 1947 for analgesic and antitussive uses. In 1972 the FDA approved methadone for use in treating opiate addiction. Methadone had been prescribed by doctors for this use since the mid-1960s because, as a weak-acting opiate agonist, it imitates the chemical effects of opiates without producing the addictive euphoria of opiates such as heroin. It was found to be effective in treating opiate addiction by minimizing the painful symptoms of opiate withdrawal.

Opiates were widely used for medicinal purposes in the United States during the 19th century, but by the late 19th century the dangers of opiate addiction began to be recognized by the medical community. Around 1920, some cities had established clinics to dispense morphine to treat opiate addiction, but these were promptly closed because of opposition from law enforcement agencies. For the next 40 years the Federal Bureau of Narcotics held an anti-addiction maintenance position until opiate substitution therapy using methadone was found to be effective in the mid-1960s.

The Methadone Control Act instituted regulations for the already-established practice of doctors prescribing methadone for the treatment of opiate addiction during the decade before its passage. Under the 1970 Controlled Substances Act methadone was classified as a Schedule II controlled substance, meaning that while it has an acceptable medical use, it has a high potential for abuse by both opiate addicts and nonaddicts. The Methadone Control Act was introduced as an amendment to the Controlled Substances Act out of particular concern for controlling the diversion of methadone to the underground drug market where it could be abused by nonaddict individuals.

The Bureau of Narcotics and Dangerous Drugs (BNDD) presented the results of scientific research and undercover operations in a series of Senate and House hearings in 1972 and 1973 on several bills, including the Methadone Control Act that became the Narcotic Addict Treatment Act of 1974. The BNDD identified methadone diversion as a serious problem, particularly when and where the heroin supply was low and in large cities. Emergency room visits and drug-related deaths due to methadone were found to be on the rise as reports of heroin-related hospitalizations and deaths declined. The BNDD identified this public health issue as the result of illicit methadone diversion. Four main sources of methadone diversion were identified: (1) “unscrupulous practitioners” who wrote illegal prescriptions, (2) negligent operations of legitimate programs that resulted in unaccounted for shortages in methadone, (3) diversion by patients enrolled in methadone maintenance programs, and (4) robberies of methadone clinics and the hijacking of trucks transporting methadone.

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