Methadone Maintenance Therapy Works-End of Story

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I hate to be condescending but how the scientific community perceives a phenomena and how the public at large perceive the exact same thing can be starkly different.

For example, there is still a debate over the scientific legitimacy of global warming and climate change. Of course, this flies in the face of reality. In the scientific community, there is no more doubt over climate change than there is over heliocentricity (the theory that states the Earth revolves around the Sun). Study after study comes to the came conclusion, the scientific evidence is overwhelmingly in favor. But I’m not writing to debate climate change.

The same type of dichotomy exists for replacement/maintenance therapies for addiction. Methadone and the related compound buprenorphine (Suboxone, one of its formulations) are still considered controversial or ineffective or “replacing one drug for another.”

Methadone pills. (

In brief, methadone is a compound that acts on the same target as heroin (the mu opioid receptor) but unlike heroin, it acts for a very long time (24hrs). Dr. Vincent Dole, a doctor at the Rockefeller University in New York, and his colleague, Dr. Marie Nyswander, had the brilliant idea of using this very long-acting opioid compound as a way of treating heroin addiction. Indeed, methadone has the advantage of not producing the intense, pleasurable high that heroin produces but is still effective at curbing cravings for heroin and eliminating withdrawal symptoms. Dole and Nyswander published their first study in 1967 and methadone has been an approved—and effective—treatment for heroin addiction worldwide ever since.

However, controversy over the use of methadone exists. Even the opening of a methadone clinic can incite protests. The persistence of negative attitudes towards methadone and the stigma against treating addiction as a medical disease has prevented addicts from receiving proven medical treatments that are effective at curbing cravings and actually keeping them off of heroin and in treatment programs.

So just for a moment, let’s suspend our preconceived notions about what methadone is or how it works and let’s just ask our selves two simple questions:

 Does methadone work?

Does methadone keep addicts off of heroin and in treatment?

The answer is a resounding YES!


Mattick JP et al. Methaodone. 2009 title

Many controlled, clinical studies have examined the effectiveness of methadone. But a comprehensive comparison of methadone versus control, non-medication based treatments has not been considered amongst the various studies.

Researchers at the Cochrane Library performed this type of comprehensive analysis. Data was considered from 14 unique, previous clinical studies conducted over the past 40 years. Researchers compared methadone treatment versus control, non-medication based treatment approaches (placebo medication, withdrawal or detoxification, drug-free rehabilitation clinics, no treatment, or waitlist).

11 studies and 1,969 subjects were included in their final analysis.

 Read the full paper, published in 2009, here.

The results were clear. Methadone was found to keep people off of heroin and in treatment more effectively than control treatments. Urine analysis confirmed methadone-treated addicts were more likely to be heroin-free and regularly seeking treatment.

Of course, as I stated above, this is nothing new. But it’s important to note that abstinence therapies or treatments that encourage addicts to go “cold turkey” don’t really work; inevitably, relapse will occur. A medical treatment exists to help addicts fight their cravings so their brains are not fixated on obtaining heroin and these people are able to regain normal daily functions. And in time, methadone doses can be tapered down as intensity and frequency of cravings decrease.

The debate now should not be on whether methadone works, but on how to use it effectively and how to expand its use so that as many people as possible can benefit from it.

Most importantly, methadone helps an addict to return to normal life. End of story.

Welcome to Dr. Simon Says Science!

(Image from
(Image from

Something I noticed about science/neuroscience blogs, and science writing in general…it’s not done by scientists! That doesn’t mean that quality of the writing or the reporting is of a poor quality—in some instances, they can be phenomenal (Carl Zimmer’s articles come to mind). However, journalists (even the best) are not scientists and their writing is not a scientists’ perspective.

It was this realization, in concert with my passion for science communication and love of writing and thinking about science, that lead me to this little project: a science blog by a scientist.

Above all, I want the public to understand science because I’m an early career scientist that cares about making life better for as many people as possible. And I strongly believe that science, more than nearly any other human endeavor, has consistently improved the lives of people in numerous ways: from health to lifestyle to industry.

A little bit about me first. My name is Derek Simon and I completed by PhD in Cellular and Molecular Biology in August 2012 from the University of Michigan. I have been working in academic research labs for over a decade, since my second semester (January 2004) as an undergraduate at the University of Wisconsin-Madison. My research interests and projects have ranged from Huntington’s disease to the endocrinology of prostate cancer to cancer biology and biology of the adrenal glands. I am currently a Postdoctoral Fellow at the Rockefeller University ( working in the Laboratory of the Neurobiology of Addictive Diseases.

My current scientific passions are neuroscience (brain biology) and specifically, the neuroscience of drug addiction. This blog will largely focus on topics related to drug addiction but since this is a remarkably complex disease (the same as nearly all topics related to the brain) a great deal of basic neuroscience knowledge is needed.

Science is Fun! But there's more to it than fancy glassware. (Image © Derek Simon 2015)
Science is Fun! But there’s more to it than fancy glassware. (Image © Derek Simon 2015)

However, my scientific passions are eclectic so here’s an overly ambitious list of topics I hope to discuss:

  • Drug addiction
    • Basic neuroscience knowledge
    • Important research about the actions of drugs of abuse
    • Experimental techniques in neuroscience and drug addiction research
    • Drug policy and criminal justice issues related to drug abuse in the United States
  • General discussion of science
    • The scientific method and “how do we know what we know?” in science
    • Science policy in the United States
    • Discussion of limitation, flaws, and improvements to be made in the scientific research world
  • Other fun topics in science
    • Hot Topics in science and exciting new research
    • The science of music
    • Consciousness and free will
    • The science of sexuality

Just a quick disclaimer: the views and opinions posted here are mine and mine alone. My writings here do not represent the views or opinions of the Rockefeller University, my boss, or my colleagues.

And I do not claim to be an expert, merely what I would call “a source with professional experience”. An important quality for a scientist to possess is to know what you know. That may seem like a strange statement but is the core of all scientific research. As scientists, we strive to learn as much as we can about how the world works (new discoveries are made all the time) but there are limits to our knowledge. I am simply being honest about my own limitations as a scientist.

I’m also a classically trained pianist, composer, and amateur photographer. The other sections of this  site will be dedicated to these other passions.

Thank you so much and hopefully this will be an educational and enlightening experience for my readers and myself!