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Biomedical understanding of methadone as a magic-bullet pharmacologicalblock to the euphoric effects of heroin is inconsistent with epidemiologicaland clinical data. An ethnographic perspective on the ways street-basedheroin addicts experience methadone reveals the quagmire of powerrelations that shape drug treatment in the United States. The phenomenonof the methadone clinic is an unhappy compromise between competingdiscourses: A criminalizing morality versus a medicalizing model ofaddiction-as-a-brain-disease. Treatment in this context becomes a hostileexercise in disciplining the unruly misuses of pleasure and in controllingeconomically unproductive bodies. Most of the biomedical andepidemiological research literature on methadone obscures these powerdynamics by technocratically debating dosage titrations in a socialvacuum. A foucaultian critique of the interplay between power …