Abstract
To the Editor.— Dr Dole 1 proposes that opiate addiction is related to a persistent derangement of the endogenous ligand-receptor complex system. This theory seems to have some merit but if we conclude, as Dr Dole does, that the defect is best compensated by methadone we must ignore a lot of conflicting data. The facts show that even when taking methadone, a large percentage of addicts continue to abuse illegal drugs and alcohol; now that cocaine is as prevalent as it is, the situation seems to be getting worse. 2 In fact, most of the people who do well in methadone maintenance programs have the same demographic variables as people who do well in drug-free treatment programs. 3 Fortunately, there is an effective form of treatment for many opiate addicts that seems to allow the receptor complex to normalize. It consists of a program of abstinence from all mood
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