New Books Network How Do We Treat Opioid Addiction?
Jan 19, 2026
Mark Parrino, a veteran addiction-treatment leader and president of the American Association for the Treatment of Opioid Dependence, shares critical insights on opioid addiction. He discusses the evolution of methadone maintenance treatment and the stigma surrounding medication-assisted treatment (MAT). Parrino highlights the troubling history of opioid prescriptions that fueled the addiction epidemic and the need for better public education. He also presents findings from a national census of opioid treatment programs, revealing the current landscape of addiction treatment in America.
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Methadone's Pharmacologic Breakthrough
- Methadone maintenance created a pharmacologic barrier preventing heroin's effects and stabilized patients.
- This 1960s breakthrough shifted treatment from ineffective abstinence methods to effective medication-based care.
Regulatory Siloing Of Methadone Care
- Federal rulemaking in 1972–75 created a closed-panel system requiring dual federal registration for methadone programs.
- That regulatory isolation helped silo treatment outside mainstream medicine for decades.
Early Clinic Realities In The 1970s
- Mark Parrino entered methadone treatment work in 1974 at a lower Manhattan clinic with little clinical structure.
- He witnessed expansion amid doubt, culminating in hostile coverage like the 1980s Florida
