Vincent Dole (1913–2006), Marie Nyswander (1919–1986)
Among the substitutes for morphine synthesized by German scientists before and during World War II was methadone. After the war, all German patents were expropriated by the Allies and confiscated by the U.S. Department of State. Eli Lilly acquired the rights to methadone in 1947 and marketed it as an analgesic (painkiller) and cough suppressant under the trade name Dolophine. Two decades later, it was the most widely used drug for the treatment of heroin addiction—a use that has been derided by some.
Methadone does not resemble morphine chemically but produces many of the same effects, including addiction. However, unlike morphine, it is very effective when taken by mouth and acts for extended periods. In the mid-1960s, Vincent Dole and his wife Marie Nyswander, working at the Rockefeller Institute (now Rockefeller University), introduced methadone for the treatment of heroin addiction.
Daily doses of methadone reduce the craving addicts have for heroin and prevent the withdrawal symptoms in physically dependent individuals. Those who quit using heroin and remain in the methadone maintenance treatment (MMT) program engage in fewer criminal activities (as they are obtaining methadone legally) and are more likely to assume family responsibilities and gainful employment. Moreover, because methadone is taken by mouth, the transmission of hepatitis and HIV by contaminated needles is reduced.
SUBSTITUTE ADDICTION: GOOD OR BAD? MMT is not without detractors or problems. Because methadone is often used for extended periods—for some, a lifetime—methadone addiction often replaces heroin addiction. Loose control of methadone distribution at some clinics has led to accidental overdoses and deaths. In addition, numerous private methadone clinics in the United States may charge clients $50–300/week. Without insurance, methadone is, thus, unaffordable for many users, and even well-motivated addicts may face long waits before entering programs. Although methadone offers hope for the heroin addict, it is not the final solution to this intractable societal problem.
SEE ALSO Morphine (1806), Heroin (1898), Opioids (1973), OxyContin (1996).
For those unable or unwilling to go “cold turkey,” methadone provides a weapon to break the shackles of heroin addiction. Not infrequently, individuals may need the persuasion of a significant other to enroll in a methadone maintenance program; in other instances, courts may offer an addict the option of either incarceration for heroin-related offenses or successful participation in a methadone program.