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Five-year treatment outcome follow-up was conducted on 56 methadone maintenance patients originally assessed for detoxification fear. Three fear measures were associated with treatment outcome variables by canonical correlation, representing 40% shared variance between predictor and predicted variables. Detoxification fear was associated with longer treatment, fewer treatment episodes, fewer methadone detoxification attempts, and fewer successful methadone detoxifications. These findings suggest that detoxification fear is a significant factor that may affect methadone maintenance outcome. Other variables related to treatment outcome and implications for future research are discussed.