A risk-benefit analysis of methadone maintenance treatment

Drug Saf. 2000 Mar;22(3):179-90. doi: 10.2165/00002018-200022030-00002.


Methadone maintenance treatment for heroin (diamorphine) addiction has been extensively researched. There is consistent evidence that while in treatment, heroin addicts are at a lower risk of death, are less involved in crime, and feel and function better than while using heroin. Despite the research evidence supporting methadone treatment, there remains widespread public scepticism about this form of treatment. This scepticism is frequently expressed in terms of the perceived risks of methadone treatment. The perceived risk that methadone treatment may maintain people in an addicted lifestyle is not supported by research literature. The risks of treatment include an increased risk of death during induction into treatment, and risks of diversion of drugs to the black market. For some patients, adverse effects of methadone pose a problem and the availability of new pharmacotherapies may provide useful options for these patients. Risks can be reduced and benefits increased by directing greater attention to the quality of treatment.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • HIV Infections / prevention & control
  • Heroin Dependence / mortality
  • Heroin Dependence / rehabilitation*
  • Humans
  • Methadone / adverse effects
  • Methadone / therapeutic use*
  • Quality of Life
  • Risk Assessment


  • Analgesics, Opioid
  • Methadone