The study aimed to determine patterns of use of medical services and prescriptions for pharmaceuticals among 438 heroin users interviewed for the Australian Treatment Outcome Study ( ATOS) at baseline, 12 and 24 months. Drug use declined markedly, and there were significant improvements in health. There were declines in the proportion of participants who had attended a general practitioner ( GP) ( baseline: 60%, 12 months: 53%, 24 months: 52%), who had an ambulance attendance ( 11%, 7%, 5%), and who were treated in an accident and emergency department ( 11%, 6%, 5%). While there was no decrease in the proportion who obtained a prescription ( 47%, 45%, 46%), there was a decrease in the mean number of reported prescriptions obtained ( 2.3, 1.0, 0.9). There were also differences across follow- up in the reported types of medications obtained, with a significant decrease in the proportion obtaining psychotropic medications ( 38%, 21%, 19%). In particular, there were large declines in the proportion who reported benzodiazepines ( 30%, 12%, 10%) or narcotic analgesics ( 8%, 3%, 4%) on prescription. While ATOS participants continued to be frequent users of health services, the cohort reported reduced levels of drug- seeking and risk commensurate with their reductions in drug use.