Patients in heroin maintenance programs used less illicit heroin than those on methadone

Urine testing showed 50% illicit heroin co-use in heroin maintenance patients versus 71% in methadone patients, while cannabis use remained high in both groups during treatment.

Musshoff, Frank et al.·International journal of legal medicine·2010·Preliminary EvidenceObservational
RTHC-00436ObservationalPreliminary Evidence2010RETHINKTHC RESEARCH DATABASErethinkthc.com/research

Quick Facts

Study Type
Observational
Evidence
Preliminary Evidence
Sample
Not reported

What This Study Found

Researchers analyzed urine samples from patients in a heroin maintenance program (HMP) and a methadone maintenance program (MMP) at one month before and 6 and 12 months into treatment.

Illicit heroin co-use was detected in 50% of HMP patients, significantly lower than the 71% rate in MMP patients. This higher detection rate compared to previous reports resulted from testing for multiple markers of illicit heroin beyond just acetylcodeine.

Cocaine use was similar between groups and decreased during treatment. Benzodiazepine use also decreased over time. Cannabis use remained high in both groups throughout treatment. Amphetamine use was minimal in both programs.

Key Numbers

Illicit heroin co-use: 50% in HMP vs 71% in MMP (significant difference). Cocaine and benzodiazepine use decreased during treatment in both groups. Cannabis use remained high in both groups.

How They Did This

Observational comparison study analyzing urine samples chromatographically for heroin markers and immunochemically for cannabinoids, cocaine metabolites, amphetamines, MDMA-type substances, and benzodiazepines. Samples collected at 1 month pre-treatment, 6 months, and 12 months.

Why This Research Matters

The finding that cannabis use remained persistently high during opioid addiction treatment raised questions about whether cannabis serves a functional role for patients in these programs.

The Bigger Picture

This study contributed to harm reduction research by comparing supervised heroin programs to methadone maintenance, while also documenting persistent cannabis use as a common feature of both treatment approaches.

What This Study Doesn't Tell Us

Observational comparison between programs without randomization. Differences between programs may reflect patient selection rather than treatment effects. Single center study.

Questions This Raises

  • ?Why did cannabis use remain high during opioid treatment?
  • ?Does concurrent cannabis use help or hinder opioid addiction recovery?

Trust & Context

Key Stat:
50% illicit heroin co-use in HMP vs 71% in MMP
Evidence Grade:
Observational comparison study with objective urine testing but without randomization between programs.
Study Age:
Published in 2010. Harm reduction approaches to opioid addiction have evolved significantly since.
Original Title:
Comparison of urine results concerning co-consumption of illicit heroin and other drugs in heroin and methadone maintenance programs.
Published In:
International journal of legal medicine, 124(5), 499-503 (2010)
Database ID:
RTHC-00436

Evidence Hierarchy

Meta-Analysis / Systematic Review
Randomized Controlled Trial
Cohort / Case-Control
Cross-Sectional / ObservationalSnapshot without intervening
This study
Case Report / Animal Study

Watches what happens naturally without intervening.

What do these levels mean? →

Frequently Asked Questions

What is a heroin maintenance program?

A supervised program where patients receive pharmaceutical-grade heroin under medical supervision as an alternative to methadone, aimed at reducing illicit drug use and associated harms.

Why was cannabis use so persistent during treatment?

The study documented high cannabis use in both programs but did not investigate reasons. Cannabis may serve different functions for patients in opioid treatment that warrant separate study.

Read More on RethinkTHC

Cite This Study

RTHC-00436·https://rethinkthc.com/research/RTHC-00436

APA

Musshoff, Frank; Trafkowski, Jens; Lichtermann, Dirk; Madea, Burkhard. (2010). Comparison of urine results concerning co-consumption of illicit heroin and other drugs in heroin and methadone maintenance programs.. International journal of legal medicine, 124(5), 499-503. https://doi.org/10.1007/s00414-009-0361-8

MLA

Musshoff, Frank, et al. "Comparison of urine results concerning co-consumption of illicit heroin and other drugs in heroin and methadone maintenance programs.." International journal of legal medicine, 2010. https://doi.org/10.1007/s00414-009-0361-8

RethinkTHC

RethinkTHC Research Database. "Comparison of urine results concerning co-consumption of ill..." RTHC-00436. Retrieved from https://rethinkthc.com/research/musshoff-2010-comparison-of-urine-results

Access the Original Study

Study data sourced from PubMed, a service of the U.S. National Library of Medicine, National Institutes of Health.

This study breakdown was produced by the RethinkTHC research team. We analyze and report published research findings without making health recommendations. All interpretations are based solely on the published abstract and study data.