HEROIN USE DURING METHADONE-MAINTENANCE TREATMENT - THE IMPORTANCE OFMETHADONE DOSE AND COCAINE USE

Objectives. The purpose of this study was to examine factors associate d with heroin use during methadone maintenance treatment. Methods. Log istic regression statistical models were used to examine data obtained in a cross-sectional sample of 652 methadone patients. Results. Heroi n use during the 3 months prior to interview was shown to be greatest among (1) patients maintained on methadone dosages of less than 70 mg/ day (adjusted odds ratio [OR] = 2.1, 95% confidence interval [CI]= 1 3 , 3.4) and (2) patients who used cocaine during treatment (adjusted OR = 5.9, 95% CI = 3.8, 9.1). These results were independent of treatmen t duration, treatment compliance, alcohol use, and socioeconomic facto rs. Cocaine users were more likely than nonusers of cocaine to use her oin at all methadone dosage levels. Conclusions. This study confirms a nd extends past research showing high-dose methadone maintenance to be important to heroin abstinence. Further investigation of the independ ent association between heroin use and cocaine use is needed.