The possibility of a significant forward step in the management of heroin-dependent persons is indicated by the report of Jaffe et al (p 1834) on a pilot test with the drug acetylmethadol (d1-α-acetylmethadol), a synthetic congener of methadone.
The work of Jaffe and his associates points to the eventuality of overcoming one of the troublesome aspects of existing maintenance programs. Because addicts in such programs need to take methadone at least once every day to avoid symptoms of withdrawal, they either have to visit the clinic daily or be given an extended supply. Daily visits work a hardship on some patients with family and vocational responsibilities. Extended supplies of methadone, on the other hand, are subject to abuses, including illegal sale in the streets.
Acetylmethadol apparently can be used as a substitute for methadone in maintenance, and duration of action is at least three times longer. Conceivably this could