Addiction Vol. 102; No. 5: P. 771-777 (05..07) - Friday,
"Diversion of methadone outside treatment programs occurs, yet
reasons for use of 'street methadone' are characterized
poorly. Self-medication for withdrawal symptoms is one
plausible hypothesis. Among HIV-infected drug users, some
antiretroviral medications can reduce potency of methadone,
yet any association between such effects and the use of
supplemental methadone sources remains undetermined,"
explained the study authors, who sought to estimate the
frequency and risk factors for use of street methadone.
The researchers followed injection drug users (IDUs) recruited
through extensive community outreach in 1988-89 and 1994,
using semi-annual questionnaires about health history, use of
licit and illicit drugs such as methadone, and HIV-related
assays. Analyses were conducted using generalized estimating
equation logistic regression.
Analysis of 2,811 eligible and enrolled IDUs found 493
reported use of street methadone over 12,315 person-years of
follow-up (4.0/100 person-years). According to multivariate
analyses, street methadone use was more common among women,
whites, those ages 40-59, those who reported withdrawal
symptoms, past methadone program attendance (6-12 months prior
to visit), recent heroin injection with or without cocaine
(but not cocaine alone), smoking or sniffing heroin and
reported trading sex. HIV infection or treatment was not
associated with street methadone.
"The results suggest that older IDUs still using heroin may be
using street methadone to treat signs of withdrawal. The
absence of a higher rate of street methadone use in HIV
seropositive IDUs reveals that antiretroviral/methadone
interactions are not a primary determinant of use outside of
treatment settings," the authors concluded.