This paper presents Polish methadone maintenance treatment (MMT) against the background of the dominant therapeutic community approach. The perspectives of various stakeholders-supporters and opponents-are examined as well as the barriers, facilitators, ideological conflicts, and financial interests influencing MMT policy and practice. In-depths interviews were carried out with 18 major stakeholders around 2012, almost two decades after the first MMT was launched. The interviews shed light on stakeholders' inter- and intragroup conflicts as well as on their official and hidden agendas, but they also show the relevant wider international and national, economic, and political contexts.