JOURNAL OF DRUG ISSUES 0022-0426102102 523-542

This article describes the history of the heated legal controversy in Germany about prescribing medicinal narcotics. The professional corporations of medical doctors have claimed a right to govem the interpretation and definition of legal terms and for a long time resisted the clinical insights and practical experience about maintenance treatment that had been gathered from abroad. The next logical step was to prescnibe heroin- also formerly a licensed medication- in cases where methadone was not accepted or physically tolerated by patients. Slowly the social and political taboos against providing narcotic maintenance to addicts have been removed. The authoraddresses the question of whetherprescribing heroin to addicts can reduce health and social problems and improve the client's quality of life. THE GERMAN DISCUSSION REGARDING THE PRESCRiPTION OF MEDICINAL NARCOTICS After more than ten years of controversial discussions in Germany about medical prescription of opioids, a group of interested cities, German states (Laender), and the Federal Ministry of Health began a cooperative effort in the spring of 1999 to address the issue. The newly elected government declared its support for the initiatio