Detected heroin use in an Australian methadone maintenance program

A reanalysis was undertaken of survey and retrospective urinalysis data on patients remaining in an abstinence-oriented, public methadone maintenance program in Sydney, Australia. A comparison of urinalysis results with those of previous reports of Australian methadone programs suggests that the clinic's disciplinary program failed to reduce detected heroin use; morphine was detected in 27% of urine specimens. Women, those with a partner in methadone maintenance, and exprisoners were significantly more likely to submit morphine positive urines. When account was taken of subjects' General Health Questionnaire scores in a second logistic regression model, the more psychologically disturbed patients were one fifth as likely to submit a morphine positive specimen as the less disturbed. This and other findings are interpreted as indicating that psychologically disturbed patients who continued to use heroin were more likely to be expelled from or otherwise leave treatment than the less psychologically disturbed who continued to use heroin.