One Answer to Heroin

NARCOTICS

A promising new treatment that permits heroin addicts to kick the habit was reported last week by two New York City physicians. It involves switching from heroin, which can cost the addict $25 or more a day--and is almost certain to involve him in crime --to methadone, a relatively harmless drug that costs 10-c- for a daily dose. Methadone's only significant side effect is constipation.

Spiked Orange Juice. In the A.M.A. Journal, Dr. Vincent P. Dole of the Rockefeller Institute and Dr. Marie Nyswander of Manhattan General Hospital report that after considering other drugs as heroin substitutes, they hit upon methadone, a synthetic painkiller made from coal-tar extracts and marketed by Eli Lilly & Co. as Dolophine. A short course of methadone, the doctors knew, would ease the addict's first pangs of withdrawal from heroin. But they also knew that more than 80% of "cured" addicts promptly relapsed, and they wondered whether continued treatment with methadone would keep them off their "horse."

The doctors picked out 22 "mainline" addicts, all with costly, longtime habits, and steadily fed them the drug at Manhattan General. Within a week the patients were behaving normally. Only six weeks later they left the hospital, but returned every day to drink their methadone in orange juice. Now, after only seven months of treatment, almost all the 22 are regularly employed; one is in college, another is preparing for it, and two are rated as fully rehabilitated, except for needing continued doses of methadone.

Rugged Test. "The most dramatic effect of this treatment," report Drs. Dole and Nyswander, "has been the disappearance of narcotic hunger." By some biochemical action that still eludes the medical experts, methadone blocks the usual effects of heroin. While on methadone, the doctors continue, the patients can watch addict friends inject heroin, or even take a test injection themselves, and still resist all temptation because they no longer get any kick or euphoria from heroin. This is true even with massive test doses, far more potent than a street "bag." And if a patient should sneak a shot of heroin, this can be detected surely and easily by urinalysis.

The U.S. Public Health Service in the past has rejected any addiction treatment that leaves the patient dependent on another drug. But the New York doctors believe that their preliminary results certainly justify further trials. City health authorities agree: in a $1,380,000 program, they are extending the methadone treatment to at least 250 more addicts.

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