[Evolution of patients with long-term methadone substitution].

The Drop-in in Neuchâtel (Switzerland) offers methadone substitution treatments since 1975. In the present research, we analyze the progress of 119 patients in treatment over a period of ten years. Our results confirm that substitution treatments do often last long (56% over ten years) and that they can be stopped successfully by some patients (29%). Among patients who maintain in the long-term the methadone, we do observe a global stabili zation of their medico-psycho-social situation. The results are convincing concerning the diminution of the heroin consumption and criminality. However, the professional reintegration rate is small and we observe for 30% of them a slow deterioration of their physical health, mainly bond with chronic illnesses (HIV, HCV) and life habits (not appropriate alcohol consumption, nicotine addiction...).