Ausubel D P
Int J Addict. 1983 Aug;18(6):851-62. doi: 10.3109/10826088309033052.
The psychopharmacological rationale and clinical effectiveness of the methadone maintenance treatment program was subjected to critical theoretical and methodological analysis. It was concluded (1) that the MMTP constitutes and perpetuates an immature coping mechanism; i.e., "subliminal euphoria"--pervasive pharmacological shielding of addicts from the inevitable discomforts attending adaptation to the real world; (2) that it does not satisfy so-called tissue craving for florid euphoria because most "stabilized" clients actively seek and obtain same from heroin, methadone itself, and/or other potentially euphorogenic drugs; (3) that the source of this craving resides in the addict's personality rather than in his tissues; (4) that official evaluation studies of the MMTP grossly exaggerate its clinical effectiveness; and (5) that the MMTP has inadvertently created incomparably more primary methadone addicts than it has cured heroin addicts.
美沙酮维持治疗项目的心理药理学原理及临床疗效受到了批判性的理论和方法分析。研究得出以下结论：（1）美沙酮维持治疗项目构成并延续了一种不成熟的应对机制，即“阈下欣快感”——通过药物普遍保护成瘾者，使其免受适应现实世界时不可避免的不适；（2）它无法满足对强烈欣快感的所谓组织性渴望，因为大多数“病情稳定”的患者会积极从海洛因、美沙酮本身和/或其他可能产生欣快感的药物中寻求并获得这种欣快感；（3）这种渴望的根源在于成瘾者的个性而非其身体组织；（4）对美沙酮维持治疗项目的官方评估研究严重夸大了其临床疗效；（5）美沙酮维持治疗项目无意中造成的原发性美沙酮成瘾者比治愈的海洛因成瘾者多得多。
