Prevalence of illicit methadone use as shown in new patients entering a methadone maintenance treatment program

Background: While there are significant harms and dangers associated with illicit methadone use, the exact scope of the problem is largely unknown. However, we do know that annual deaths from methadone are rising and the literature indicates that a significant number of these deaths are directly related to illicit methadone use. Given this, methadone diversion should be a primary concern for all methadone providers and treatment programs. Methods: We conducted a medical record review of consecutive admissions to a large methadone maintenance treatment program over a 4-year period to determine the prevalence of confirmed methadone use prior to methadone treatment initiation. Results: 5805 records were examined; a total of 5144 met the criteria as a "new initiate" on mmtp. Of these 5144 new initiates 1062 (20.6%) were identified via urinalysis to have illicit methadone present. Conclusions: Our study shows the prevalence of illicit methadone use in patients initiated on methadone maintenance over a 4-years period to be at least 20.6%.