It has worked decently well in parts of Europe, and a new experiment in Canada lends support to the idea. I’d like to see it tried here. On the other hand, I’d also like to see methadone freed of the restrictions imposed by the Narcotic Addict Treatment Act.
I’d also like to see the New York Times experiment with requiring scientific literacy in its columnists. John Tierney cites NYT reporter Benedict Carey for the claim that ” treating hard-core heroin addicts with their drug of choice seems to work better than treating them with methadone.” But neither Carey nor the paper Carey reports on makes any such claim. The study wasn’t among “hard-core heroin addicts” generally, but among addicts who had already failed on methadone treatment. Carey reports that crucial fact in his lead, but apparently Tierney couldn’t be bothered to read either his colleague’s story or the original paper, which is also crystal-clear on this crucial point..
The finding that some people who do poorly on methadone do better on heroin is valuable, but it’s not the same as finding that heroin beats methadone overall.