Pubdate: Tue, 05 Jan 1999 Date: 01/05/1999 Source: The New York Times Author: Robert L. Cohen, M.D. Authors: Robert L. Cohen, M.D. Note: The NYT feature article, 'Days on Methadone, Bound by Its Lifeline' is posted at: http://www.mapinc.org/drugnews/v99.n006.a04.html To the Editor: A Jan. 2 front-page article on methadone maintenance neglects a critical failure of the treatment. Methadone does not completely block a patient's craving for heroin. Required drug testing in methadone maintenance programs identifies those who continue to use heroin and dispenses punishment in the form of humiliation and daily pickups. Why punish people who seek treatment for heroin use for using heroin? The only significant differences between heroin and methadone are the length of action (methadone stays in the body longer) and the legal status. People who use methadone to help control their heroin use and to avoid entrapment by the police should not be punished for seeking heroin. Heroin and methadone should be dispensed in supportive settings on a monthly basis. ROBERT L. COHEN, M.D. New York