OBJECTIVE: This paper examines the sociodemographic and psychiatric characteristics of patients taking methadone who continue to share needles. METHOD: Three hundred twenty-three patients were recruited from four methadone programs. Data were collected by using questionnaires and interviews. Psychiatric symptoms were measured with the SCL-90, the Beck Depression Inventory, and the Addiction Severity Index. RESULTS: Twenty percent of these subjects reported sharing needles within the previous 6 months. Those who shared reported greater difficulty in acquiring new needles, more legal difficulties, more severe drug problems, and higher levels of psychiatric symptoms. CONCLUSIONS: These data suggest that patients who continue to share needles are a more disturbed subgroup of the methadone maintenance population. Efforts designed to reduce needle sharing may need to be more sharply focused on patients who are at greatest risk of infection, and these patients may require more intensive psychiatric services.Abstract Teaser