It has been estimated that 1.35 million people are heroin users in European countries. Heroin dependence is a chronic disease characterized by compulsive drug-taking behavior despite serious negative consequences and, specifically, injection drug users have high prevalence of infectious diseases, drug overdose, and psychiatric disorders. Approximately 90,000 patients receive methadone treatment in Spain.
Treatment with methadone has been shown to reduce the risk of death as compared to no treatment
In a recent study located in Badalona (Spain), we aimed to analyze the survival of heroin users and predictors of death in 1.678 patients admitted to a methadone treatment program in the CAS-Delta (1992-2010).  The CAS-Delta is a primary care center for outpatient addiction treatment, and serves an area with ​​400,000 inhabitants over five municipalities, including Badalona.
At the end of study, 441 (26.3%) patients had died and 14 (3.2%) of deaths occurred within one month of first entry to treatment.
The results of this study shows that MTP patient mortality decreased sharply for two decades and that HIV/AIDS is the main predictor of death among this population. However, that mortality has recently slightly increased among HIV-infected women.
Adapting treatment delivery to patients’ life conditions and improving the coordination of different health care levels is essential to improve survival of HIV-positive women.

Muga R, Rivas I, Faure E, Fuster D, Zuluaga P, Rubio M, Muñoz T, Torrens M, Tor J, Sanvisens A.

BMC Infect Dis. 2014 Sep 17;14:504.