THE OFFICE OF THE CHIEF MEDICAL EXAMINER OF NEW YORK CITY ATTRIBUTED 836 DEATHS FROM JANUARY 1974 TO JUNE 1975 TO METHADONE, EITHER ALONE OR IN COMBINATION WITH OTHER DRUGS. WHILE CIRCUMSTANCES SURROUNDING METHADONE DEATHS CANNOT BE KNOWN WITH CERTAINTY, AVAILABLE RECORDS INDICATE (1) THE COMBINATION OF METHADONE AND OTHER DRUGS WAS FOUND IN MORE DEATHS THAN METHADONE ALONE; (2) METHADONE-RELATED DEATHS MOSTLY INVOLVED PERSONS BETWEEN THE AGES OF 16 AND 30 NOT ENROLLED IN A METHADONE TREATMENT PROGRAM; (3) THE METHADONE INVOLVED IN MOST DEATHS HAD BEEN OBTAINED ILLEGALLY; AND (4) THE DENSITY OF METHADONE TREATMENT PROGRAMS AND PATIENTS IN NEW YORK CITY APPARENTLY CONTRIBUTES SIGNIFICANTLY TO THE LARGE NUMBER OF METHADONE DEATHS. PROBABLY MORE THAN HALF OF THE PATIENTS IN TREATMENT PROGRAMS SELL PART OF THEIR TAKE-HOME SUPPLY, CONTRIBUTING TO THE ILLICIT METHADONE PROBLEM. THEFTS FROM LEGITIMATE SOURCES ALSO CONTRIBUTE TO THE ILLICIT METHADONE TRADE IN NEW YORK CITY. ENDING TAKE-HOME PRIVILEGES FOR METHADONE TREATMENT CLIENTS COULD REDUCE THE ILLICIT USE OF METHADONE AND THE NUMBER OF DEATHS; HOWEVER, THIS MUST BE WEIGHED AGAINST THE WEAKENING OF THE TREATMENT PROGRAM, WHICH COULD LEAD TO RELAPSES INTO DRUG ABUSE AND ADDICTION. A FEDERAL MULTIAGENCY REVIEW BOARD IS CURRENTLY STUDYING THE TAKE-HOME POLICY. WHILE THE FEDERAL DRUG ENFORCEMENT ADMINISTRATION'S INSPECTION OF METHADONE TREATMENT PROGRAMS AS MANDATED UNDER THE NARCOTIC ADDICT TREATMENT ACT OF 1974 BEGAN SLOWLY, INSPECTIONS ARE NOW ALMOST ON SCHEDULE. TABULAR DATA ARE PROVIDED, AND THE APPENDIXES CONTAIN A LETTER FROM THE ASSISTANT ATTORNEY GENERAL FOR ADMINISTRATION OF THE DEPARTMENT OF JUSTICE AND A LIST OF PRINCIPAL OFFICIALS RESPONSIBLE FOR ADMINISTERING ACTIVITIES DISCUSSED IN THE REPORT. (RCB)