The hypotheses of this study was that entry into methadone treatment would be associated with duration of drug use and current injection practices; and the same variables associated with treatment entry would be associated with treatment requests. Data pertaining to demographics and drug user were collected from Baltimore NEP participants upon registration between August 1994 and February 1997. Participants were made aware that referrals to off-site methadone maintenance were available upon request. Odds ratios and multiple logistic regression models were used to compare those that requested treatment to those that did not and those that entered treatment to those that did not. Results show that 28 percent of participants from the NEP site that received a methadone treatment referral during the study period subsequently entered a program offering methadone maintenance. Obtaining a referral for off-site drug user treatment was associated with female gender, older age, use of speedballs, and older age at first injection. Entering drug user treatment was associated with male gender only. Despite using drugs at similar rates, women were twice as likely as men to request drug user treatment referrals from sites of NEP, but less than half as likely to enter off-site treatment. Barriers to using treatment referrals are important issues to resolve, especially for women that use community needle exchange programs. 2 tables, 33 references