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Few data exist on the prevalence and consequences of cannabis use among methadone maintenance patients. Weekly urine toxicology data from 70 patients in a methadone program were analyzed for evidence of cannabis as well as cocaine and benzodiazepines, and the relationship between use of these drugs and opiate use was examined. Patients who were positive for both cocaine and benzodiazepine, but not those positive for cannabis, were more likely also to test positive for opiates. Related literature is reviewed, and the issue of illicit drug use among such patients is discussed in the context of harm reduction.