Pathways to Recovery is a 12-step-based self-help group program that is peer-led and facilitated by staff. It was developed to meet the needs of clients in the Methadone Treatment Program (MTP) at the Bellevue Hospital Center in New York City. The program was designed to add more structure to typical methadone treatment and to include women undergoing methadone treatment in a male-dominated population. Data were obtained from a sample of 26 MTP and Pathways to Recovery clients who were recruited via flyers and from a sample of 26 MTP clients who were not Pathways to Recovery clients. Participants completed a series of questionnaires measuring their demographic characteristics, substance use history, depression, anxiety, spiritual orientation, and 12-step beliefs. Results of comparative analysis indicate that there is a population within the methadone treatment population that can respond to a spiritually oriented approach within a methadone treatment clinic setting. In particular, female Pathways to Recovery clients were characterized as having high levels of depression and high levels of spiritual orientation and endorsement of 12-step programs. Similar findings were not found in the male population comparisons. Understanding the differences in subgroups of women and men may facilitate the development of peer-led programs that better address the needs of the population. Table, references