FRANÇAIS :
L'usage de méthadone est depuis toujours contesté pour le traitement des toxicomanes. Face à la propagation du virus du sida, la maintenance peut trouver une place plus importante. On étudie l'usage illicite de drogues chez 229 patients sous méthadone (pendant une durée de 3 mois à 10 ans). La consommation de cocaïne reste un réel problème et ne dépend pas de la durée du programme, mais elle ne conduit pas à l'escalade vers les opiacés. L'usage d'opiacés diminue significativement au cours du traitement (pour 35% des patients sur 3 mois à 85% sur 10 ans)

ENGLISH :
In the twenty-five years since its introduction as a treatment for opiate addiction, methadone maintenance has generated considerable controversy. Regarding the spread of HIV amongst IV drug abusers, the role of methadone maintenance may be more important than ever. The present study was designed to examine continued illicit substance abuse by 229 patients enrolled in methadone treatment as a function of time in treatment (three months to over 10 years). Patients' urinalysis results (a) cocaine use is a problem amongst methadone maintained individuals and does not appear to be related to length of time on the program, (b) cocaine use did not lead to escalated opiate and other illicit drug abuse, and (c) opiate abuse decreased significantly with time in treatment. While 35% of the patients enrolled for less than 12 months were opiate free for the 3 month period, that value increased to 71% for patients enrolled for more than 4 years, and 85% for patients remaining in treatment for over 10 years.