For 2 years, two drug dependency units have been prescribing smokable methadone or heroin to opiate injectors to encourage them to move away from injecting. Smokable cocaine or amphetamine are also prescribed. The aim is to help clients switch away from injecting the drugs because of the greater risks of that mode of administration, particularly HIV infection. Issues to be considered in a treatment program involving smokable drugs include: (1) Who should receive such a prescription: long-term opiate injectors who wish to try to stop injecting or short-term injectors who may be weaned off injection by more conventional means, although both groups are at risk of HIV infection? (2) Even in smokable form, heroin is for many people easier to withdraw from than oral methadone. Although methadone withdrawal symptoms are less severe than heroin, the half-life of methadone is much greater; (3) Passive smoking - possible risks for persons near an opiate smoker; and (4) risks of smoking-related diseases. References