DETECTED HEROIN USE IN AN AUSTRALIAN METHADONE-MAINTENANCE PROGRAM

A reanalysis was undertaken of survey and retrospective urinalysis dat a on patients remaining in an abstinence-oriented, public methadone ma intenance program in Sydney, Australia. A comparison of urinalysis res ults with those of previous reports of Australian methadone programs s uggests that the clinic's disciplinary program failed to reduce defect ed heroin use; morphine was detected in 27% of urine specimens. Women, those with a partner in methadone maintenance, and exprisoners were s ignificantly more likely to submit morphine positive urines. When acco unt was taken of subjects' General Health Questionnaire scores in a se cond logistic regression model, the more psychologically disturbed pat ients were one fifth as likely to submit a morphine positive specimen as the less disturbed. This and other findings are interpreted as indi cating that psychologically disturbed patients who continued to use he roin were more likely to be expelled from or otherwise leave treatment than the less psychologically disturbed who continued to use heroin.