Pharmacotherapy of Opioid Addiction: "Putting a Real Face on a False Demon"

J Med Toxicol. 2016 Mar;12(1):58-63. doi: 10.1007/s13181-015-0517-5.


Methadone maintenance therapy (MMT), a pharmacological treatment for opioid use disorder for the past 50 years, continues to remain controversial. Despite consistent and overwhelming evidence confirming the effectiveness and safety of MMT, misconceptions and myths persist regarding its legitimacy as a treatment for opioid addiction. This often results in the underutilization and limited availability of this treatment modality. Despite successful outcomes, the controversial nature of MMT, and the stigma experienced by the patients on methadone, has been a particularly difficult obstacle to overcome. We present the history of MMT, review the evidence for its efficacy in the treatment of opioid dependence, and explore the origins of the stigma and misconceptions related to MMT.

Keywords: Addiction; Drug dependence; Medication assisted treatment; Methadone; Opioid addiction.

Publication types

  • Historical Article
  • Review

MeSH terms

  • Analgesics, Opioid / adverse effects
  • Analgesics, Opioid / therapeutic use*
  • Attitude of Health Personnel
  • Behavior, Addictive*
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Methadone / adverse effects
  • Methadone / therapeutic use*
  • Opiate Substitution Treatment / adverse effects
  • Opiate Substitution Treatment / history
  • Opiate Substitution Treatment / methods*
  • Opioid-Related Disorders / epidemiology
  • Opioid-Related Disorders / history
  • Opioid-Related Disorders / psychology
  • Opioid-Related Disorders / rehabilitation*
  • Prejudice
  • Risk Factors
  • Social Stigma
  • Substance Abuse Treatment Centers
  • Treatment Outcome


  • Analgesics, Opioid
  • Methadone