Despite numerous studies documenting its success, methadone maintenance is an often misunderstood and frequently maligned treatment approach for heroin addiction. By taking 40 to 60 mg of methadone orally every day, heroin addicts are able to achieve a degree of stability in their lives allowing them to pursue productive goals while decreasing risky behaviors such as needle sharing and street drug use. Strict admission criteria for methadone maintenance are spelled out in Food and Drug Administration regulations, and those ineligible for methadone maintenance must avail themselves of other forms of treatment. The emergence of Narcotics Anonymous is an encouraging development for heroin addicts who achieve abstinence through a variety of new pharmacotherapeutic options.