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Abstract: The emergence of intravenous drug users as a major group suffering from AIDS has the side effect of attracting top-flight medical researchers to methadone maintenance programs in which medical care had not been heretofore emphasized. This case describes the ways in which one drug treatment program in New York struggles to adapt to its new mission. It looks specifically at the clash of cultures which ensues when drug counselors, physicians, and researchers converge. The funding and regulatory complications surrounding the care of AIDS patients is also explored.