**Conflict of interest**

a positive emotional support on behalf of the people close to them and inability to prevent from not using drugs. Even if they have not restarted all of a sudden (with heroin) they have used NPS (such as Magic/Supergold, Pure). Three patients who gave up the substitution treatment were hospitalized at Psychiatric Hospitals. The evaluations which maintain or change the methadone doses are made in accordance with the clinical behavior, psychological and paraclinical monitoring. We state that, an important proportion of the patients have confessed self-medication with methadone, before their onset in the program. The methadone was used in order to stop the state of withdrawal with heroin (a short term detoxification), and also, as

All the patients in the group have been included in the program for years, because of their relapses. Their periods of abstinence have lasted for only several days, months, but not years. For instance, one patient had repeated attempts of abstinence during a year, as follows: four times of 1–7 days, two times of about 1 month, and one time (but interrupted) of approxi-

In spite of monitoring the treatment carefully, there are relapses which impede the personal and social reintegration. Current literature data indicate that sustained remission occurs in a significant minority of heroin users and the treatment does not cure this addiction, but it can

The results of the study show that the complex correlative, clinical, laboratory, and psychological evaluation is essential to start and supervise the methadone substitution maintenance. This is in line with the recent data from the literature emphasizing the need for multidisciplinary evaluation of candidates for opioid agonist therapy, including a careful medical history, physical and psychiatric examination, psychosocial evaluation, as well as the deter-

• Most of the population using the medical assistance with MMT is represented by male persons, with low level of education, predominantly without any occupation or with a temporary one. The average age of the patients is approximately 30 years; they have a long history of consumption of opiates (approximately 11 years); they predominantly use heroin injections, in most cases associated with other drugs (polyconsumption, i.e., high frequency of association with NPS); most of the patients present somatic comorbidities (HCV or HIV infections), and have several previous hospitalizations and lengths of treatment. The average age of the patients at the onset of the study is significantly different from the age of the patients at the onset of their drug consumption. The total duration of the consumption is statistically different from the duration of the

contribute to prevent the heroin use and reduce its adverse effects [22].

mination of the patient's readiness to change [23].

The study has revealed the following aspects:

consumption, previous to the first MMT.

an agent for long term substitution.

mately 4 months.

130 Drug Addiction

**5. Conclusions**

The authors declare no conflict of interest.
