對海洛因成癮者，Methadone 維持療法（Methadone Maintenance Therapy；MMT）是最 普遍且具成本效益的治療方法，但針對 MMT  所作研究，多著重於減少海洛因使用及降低 愛滋病新增個案數等，而少有對其臨床安全性及死亡個案的探討與研究分析。本個案為 39 歲男性毒癮患者，伴隨有糖尿病、腎衰竭、肝炎及肺結核等病史，於接受 MMT 一個月後， 因胸痛及咳嗽住院治療，住院期間因 lung carvernoma 進行胸廓切開術，除手術期間外，住 院時仍持續服用 methadone，但因該個案免疫功能不佳，於術後一週併發黴菌感染及肺炎， 最後因敗血症合併呼吸衰竭死亡。接受 MMT  治療者，多數並非只有海洛因依賴之單一診 斷，其不穩定的身體狀態、持續存在物質濫用問題及藥物間交互作用等因素，皆會影響 methadone 在患者體內之代謝與蓄積，徒增治療困難與危險。因此，如何使減害計劃之推展 更為安全而無害，實為實施 Methadone 維持療法之重大隱憂與不容忽視之課題。

Methadone Maintenance Therapy (MMT) is the common and cost-effective method for heroin addictive patients. In terms of MMT study, most studies emphasize the reduction of heroin abusers and new HIV infected cases. However, rare studies evaluate the clinical safety and discuss dead cases. We hope to remind the clinical safety by this case when medical groups implement MMT. We reported a drug-addicted case of a thirty-nine year-old man who had multiple problems including diabetes mellitus, renal dysfunction, hepatitis and old pulmonary TB before entering the MMT. After receiving MMT therapy for a month, he suffered from right chest pain and cough with blood tinged yellowish sputum. He was admitted to our surgery ward for lung cavernoma by thoracotomy but died two weeks later. Except the surgery period, this case still continued to receive MMT. His poor immune function with fungus infection and pneumonia became severe one week after the operation. Finally, sepsis with respiration failure led him to death. Unstable physical condition and drug-drug interactions during MMT could increase the risk of overdose and mortality due to drug accumulation by altering the normal metabolism pathway and its excretion. Thus, it is important for us to execute a safer harm reduction program when MMT is implemented.