About special guests Drs. William Santoro and Olapeju Simoyan
Dr. William Santoro is a board-certified addiction medicine specialist with over three decades of experience integrating addiction care into primary and community health. He serves as Section Chief of Addiction Medicine at Tower Health and is an active faculty member for several addiction medicine fellowships, including those at St. Luke’s, Caron Foundation, and Drexel University College of Medicine.
Dr. Olapeju Simoyan is a physician, board certified in family medicine and addiction medicine who strongly believes in the integration of the arts and sciences in healthcare and education. She writes on a variety of subjects, including healthcare, personal development and education, using photography to reinforce her writing in a compelling way.
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In a recent conversation hosted by Train for Change, Dr. William Santoro and Dr. Olapeju Simoyan — co-authors of their book Navigating the Methadone Maze — sat down to dismantle myths, share insights and offer clear guidance around methadone maintenance.
The most common myth may be that methadone is “just replacing one drug with another.”
However, in reality, methadone offers stability and a sense of “normalcy” so patients can focus fully on recovery. “The patient is not getting euphoric effect,” Dr. Santoro said. They're feeling normal. And we don't want the patient on such a dose that they're craving and in withdrawal.”
They also addressed myths around hygiene, nutrition and dental health — concerns that often show up in treatment. In regards to weight gain that’s often falsely attributed to methadone use, Dr. Simoyan noted this is because the patient is taking care of themselves and their health again, now that they’re not using.
Dr. Santoro put it simply: “My philosophy, as far as taking care of patients crossed over into both fields, is that I'm not the boss. I'm a teacher.”
Drs. Santoro and Simoyan emphasized that care should be collaborative. That means making space for questions, inviting patients into decisions, and honoring different learning and communication styles.
“At the end of the day, you, the patient, you are the most important person in this process because it's your choices and your decisions that are going to determine to a significant extent how successful the recovery process is,” Dr. Simoyan often tells her patients. “We’re there to help and support.”
A common concern is “How long will I have to be on this?”
Dr. Simoyan explained that many people come in with a timeline in mind — “just six months,” or “until the end of the year.” But recovery isn’t a set-it-and-forget-it kind of process. “There's no fixed time. We just have to take one day at a time, one step at a time.”
People also worry about stigma, transportation, family pressure and — even now — misunderstanding from parole officers or employers. In rural areas, that stigma can be even stronger. “Everyone knows everyone,” Dr. Santoro said. “It’s a different kind of challenge.”
Yes — with some key notes. In the early days of treatment, or when doses are changing, it’s best to avoid driving or operating heavy machinery until the person feels stable. Mixing methadone with alcohol or other sedating substances is what becomes dangerous.
The bigger issue, Dr. Santoro noted, is misunderstanding. If methadone is shown in a toxicology report, blame is often placed on methadone. Whereas in reality, the patient has benzodiazepines, alcohol or other CNS depressants that are present in the toxicology report as well.
Dr. Santoro talked about the tension between two extremes: mandating counseling for everyone on medication, or saying counseling isn’t needed at all. “If you look at each patient as an individual and figure out what that patient needs — what dose of counseling and what level of group they need. Be honest with yourself, be honest with the patient,” he said. “And that more middle-of-the-road is probably going to get you a lot further than taking it to either extreme.”
Instead of a one-size-fits-all approach, the goal should be to meet people where they are — and offer the kind of care that makes space for healing, not just checkboxes.
Want to learn more?
Dr. Santoro and Dr. Simoyan’s book, Navigating the Methadone Maze, offers practical answers, patient stories and a clear-eyed guide to what methadone maintenance can look like — when it’s done right.
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