It is now clear that methadone maintenance is not the ultimate answer for heroin addiction.The search for a heroin substitute has been and still is intense. This paper is a preliminary report of a community-based experiment with a non-narcotic, non-addictive, long lasting, inexpensive heroin antagonist named haloperidol.The setting is in a middle-American community, the Triple Cities area of Binghamton, Johnson City, and Endicott in Broome County, New York.Haloperidol is a neuroleptic drug of the butyrophenones class, and is thus quite distinct from tranquilizers, anti-depressants, and other classes of psychotropic drugs. Haloperidol was first introduced in Denmark for use "in states of agitation of any type and origin."1In 1971, Karkalas and Lal at the Rhode Island Institute of Mental Health found haloperidol could relieve severe withdrawal symptoms within twelve to forty-eight hours.2 Half of their ten inpatient subjects experienced significant recovery and did abstain from heroin completely. The abstinence syndrome was considerably diminished in one other case, and the four other high dosage addicts in the 25-30 bag a day range, required some methadone for detoxification. This study, it should be noted, dealt only with detoxification using haloperidol.Our efforts were motivated by the desire to test the effectiveness of haloperidol for both the alleviation of the abstinence syndrome and the therapeutic aspects of the opiate addiction problem, Further, inasmuch as the literature shows a preponderance of clinical inpatient withdrawal studies,3 we desired to see a community-based experiment in keeping with the trends in community health in general, and community mental health in particular.The maintenance emphasis of this experiment marked the first time haloperidol had been tested for this milieu. Our emphasis on maintenance was based on two premises: Karkalas and Lal had shown that haloperidol
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