Improving on Methadone

To many of those involved in the fight against heroin addiction, methadone seems to be the most workable weapon yet devised. A synthetic morphine substitute, it relieves the symptoms of narcotic withdrawal, blocks heroin's euphoric effects and allows an addict to lead a relatively normal life. But methadone also has its drawbacks. It is almost as addictive as the heroin it replaces, and most addicts must indefinitely maintain their new, though less destructive, habit. Because methadone is short-acting, it must be taken daily; addicts starting treatment must either report to a clinic for daily dosages or be given several days' supply at a time, a practice that opens the door to abuse.

The problem posed by methadone's addictive properties remains to be solved. But two doctors at the University of Chicago's Pritzker School of Medicine have experimented with a drug that may resolve the dilemma of distribution. Writing in the A.M.A. Journal, Drs. Jerome Jaffe and Edward Senay report that 1-methadyl acetate, a methadone-like substance, suppresses both withdrawal symptoms and narcotic hunger up to three times as long as ordinary methadone. Therefore it decreases the temptation and the opportunity to cheat on the treatment by selling the heroin substitute for drug money.

Not Available. The pair base their report on a test involving ten addicts already under care in a Chicago drug program. Five of the subjects were given daily doses of methadone. The other five were kept on methadone during the week, but given a single dose of 1-methadyl acetate--plus placebos--to see them through the weekend. None of the ten knew whether he was receiving methadone or the new substance.

Physicians who examined the ten patients were unable to detect any clinical differences between the two groups. Nor were the addicts themselves able to distinguish between the drugs. All ten were equally able to resist the opiates to which they were addicted. For the present, 1-methadyl acetate is being produced only for investigational purposes and is not available for addiction-treatment programs. The Jaffe-Senay results are encouraging enough, however, to stimulate testing on a large scale.

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