Ten years of methadone maintenance treatment: some clinical observations.

Ten years of methadone maintenance were reviewed in all 547 patients admitted to one clinic in New York City. High retention rates, reduced but still high mortality rates, increased employment, and minor degrees of recognized opiate abuse characterized those remaining in treatment. The treated patients appeared to evolve into a unique social and economic class, partly in the drug subculture and partly outside the drug world. Many were dependent on public assistance for living expenses, methadone treatment, and medical care. An interesting finding was their heavy demands for inpatient hospital care, often for drug-related reasons. A segment of New York City narcotic addicts was sequestered in an open-ended treatment process with considerable benefits to themselves and to society. Only a small fraction appeared to gravitate toward full economic support, to discontinuation of methadone, and to an enduring narcotic-free state.