We examined the feasibility of hepatitis C treatment in patients on opioid maintenance. One hundred patients with chronic hepatitis C, 50 on methadone maintenance, and 50 with no intravenous drug use or opioid maintenance for at least 5 years were prospectively matched for sex, age, hepatitis C virus (HCV) genotype and HCV RNA. The primary end point was undetectable HCV RNA at 24 weeks posttreatment. Treatment with peginterferon alfa-2b (1.5 g/kg per week) and ribavirin (1000-1200 mg /day) was initiated for 24 weeks (HCV genotype 2, 3) or 48 weeks (HCV genotype 1, 4). Within the first 8 weeks of therapy, discontinuation due to noncompliance or patient request was observed in 22% (11/50) in the methadone group versus 4% (2/50) in the control group (P ‫؍‬ .02). After 8 weeks, there was no significant difference in discontinuation due to noncompliance or patient request I ntravenous drug use is currently the main transmission route of hepatitis C virus (HCV) infection in the Western world. [1][2][3][4][5] The prevalence in intravenous drug users varies between 35% and 95%. 6 Thus, intravenous drug users with HCV represent a relevant public health problem. Combination therapy with pegylated interferon ␣ and ribavirin induces sustained viral responses in treatment-naive patients of 35% to 85%, depending on HCV genotype and HCV viral load. 7,8 Due to these success rates and the convenience of a once weekly injection of pegylated interferons, the acceptance of interferon based therapies has grown with physicians and patients, despite significant treatment-related adverse events. However, individuals with active substance abuse are generally not considered eligible for interferon-based therapy because of poor compliance and the priority of treating the addiction first. Yet some physicians treat patients on opioid maintenance therapy with interferon-based therapies despite the unavailability of clinical trial data to support this practice. Consequently, the present study examines, in a prospective controlled setting, the efficacy and tolerability of pegylated interferon ␣ plus ribavirin in patients with or without methadone maintenance. Patients and MethodsBecause a randomized trial in a setting comparing patients on opioid maintenance with patients not on opioid maintenance as controls is not feasible, we chose a prospectively matched population study design. To be included in the methadone maintenance group, patients had to have been on stable methadone maintenance without the concomitant use of illicit drugs for 6 months. To be enrolled in the control group, patients had to have no history of intravenous drug use, illicit drug use, or opioid

In a case of suicide in a depressive 19-year-old man with considerable ingestion of new leaves, resorption of yew ingredients could be demonstrated. The main substance could be identified as 3,5-dimethoxyphenol, the aglycone of taxicatine, which is a typical ingredient of yew leaves. 3,5-dimethoxyphenol was demonstrated in harvested yew leaves, stomach content and cardiac blood of the victim. Structure confirmation was achieved by means of HPLC, UV, GC-MS, IR and 1H-NMR spectroscopy. None of the Taxus alkoids could be identified. The components detected by TLC have not yet been identified. The results demonstrate that 3,5-dimethoxyphenol can be used as a marker in cases of intoxication by yew ingredients.

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