On Federal Regulation of Methadone Treatment

A RECENT report from the Institute of Medicine (an affiliate of the National Academy of Sciences) provides an authoritative review of the history and consequences of federal regulation of methadone treatment.¹It examines the assumptions that justified imposition of special restrictions on prescription of methadone and the effects of enforced guidelines on the function of treatment programs. Since the Narcotic Addict Treatment Act (1974) authorized an unprecedented restriction of the right of physicians to prescribe an approved drug, the experience of the past 20 years can be seen as a major experiment in governmental regulation of medical practice. Given the controversial nature of the subject, both the government and the medical profession in general are fortunate to have had the results of this experiment evaluated at the highest scientific level. Quite properly, I was not included in the deliberations for the Institute of Medicine report. My views on the