DO METHADONE PATIENTS SUBSTITUTE OTHER DRUGS FOR HEROIN - PREDICTING SUBSTANCE USE AT 1-YEAR FOLLOW-UP

Data were analyzed from the nationwide Treatment Outcome Prospective S tudy (TOPS) to assess whether current and former methadone patients su bstitute other drugs for heroin. The sample comprised 513 heroin users who were admitted to methadone programs in 10 cities across the Unite d States and followed for at least 1 year. Structured face-to-face int erviews were administered at admission and at follow-up to assess use of six substances: cocaine, amphetamines, illegal methadone, tranquili zers, marijuana, and alcohol. The study found a decline in the use of all substances except alcohol. Patients who substantially reduced or e liminated their use of heroin during the follow-up year were more like ly to decrease their use of other drugs than were patients who continu ed to use heroin on a weekly or more frequent basis. These findings su ggest that methadone programs indirectly reduce patients' use of cocai ne, amphetamines, illegal methadone, tranquilizers, and marijuana, ins ofar as they are successful in eliminating or decreasing heroin use. S imilar reductions in drug use were found among patients who were not e nrolled in methadone programs during the follow-up year. These finding s do not support the commonly held belief that heroin addicts substitu te other drugs for heroin.