[Treatment of heroin addicts with methadone. Concept of a polarization of therapy (author's transl)].

The article describes the initiation of a permanent treatment with methadone of 14 heroin addicts in whom despite long years of therapeutical efforts and care, chronic addiction had developed, leading to health and social breakdown and eventually to a breaking-off of the therapeutic contacts. A concept of polarization of therapy was evolved in order to implement the methadone treatment, according to which the therapeutic relationship was divided into a conflict-free sphere of methadone administration as basis of the therapeutic working agreement on the one hand, and a conflict-oriented sphere of psychotherapeutic discussion and further therapeutic efforts (ergotherapy, work therapy, social therapy) on the other. The experiences collected during the first 9 months of treatment are communicated, taking into consideration the special dynamics of the doctor-patient relationship.