A recent article discusses "addiction recovery: its definition and conceptual boundaries" (J Subst Ab Treatm 2007; 33:229-241). Among the various perspectives cited is that of ASAM, which defines recovery as a "process of overcoming both physical and psychological dependence on a psychoactive drug with a commitment to abstinence-based sobriety". Also cited is Narcotics Anonymous World Services, whose Board of Trustees "affirms the right of NA meetings to refuse to allow those using medically prescribed methadone as 'drug replacement therapy' to speak at meetings and refers to such individuals as 'under the influence of a drug,' 'still using,' and 'not clean.'" The reference for the ASAM position is 1998, and that of NA's Board is 1996. However, we're unaware of any publicized change of position of either.
Clearly, we have a long way to way to go - still! - before narcotic addiction is recognized as a chronic medical problem for which medication can be not only appropriate but life-saving. The challenge of gaining acceptance for this view, put forth originally 42 years ago by Dole and Nyswander, is greatest among our colleagues in the field of addiction treatment.