The increasing use of methadone maintenance (substitution) programs1-3 in the treatment of adult heroin addiction has created situations for children which require the attention of pediatricians. Methadone is an analgesic drug. In urban areas, thousands of heroin addicts are now receiving high dosage of methadone, usually 80 to 120 mg daily. This approach to heroin addiction has met with greater success than any other form of treatment. It is expected that increasing numbers of heroin addicts will be treated in the near future by this method throughout the United States and Canada.4 Pediatricians should focus on three aspects of the problem as follows: