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Mei-Hing Ng,1,2 Vincent Chin-Hung Chen,3,4 Hua Ting,1,5 Tsang-Yaw Lin,2 Sheng-Huang Chang,2 Michael Gossop61Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; 2Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nan-Tou County, Taiwan; 3Department of Psychiatry, Chang Gung Medical Foundation, Chiayi Chang Gung Memorial Hospital, Chiayi County, Taiwan; 4Department of Psychiatry, School of Medicine, Chang Gung University, Taoyuan City, Taiwan; 5Department of Physical Medicine and Rehabilitation, Chung-Shan Medical, University Hospital, Chung-Shan Medical University, Taichung, Taiwan; 6National Addiction Center, Institute of Psychiatry, King’s College London, London, UKPurpose: Few empirical studies have investigated hematological parameters among people with a heroin use disorder. This study explores the prevalence of macrocytosis and associated factors among patients with heroin use disorder who were entering methadone maintenance treatment (MMT) in Taiwan.Patients and methods: In this cross-sectional study, hematological parameters were measured and the prevalence of macrocytosis was assessed in a sample of 958 patients with a heroin use disorder entering the MMT program at Tsaotun Psychiatric Center in Taiwan. The demographic characteristics, heroin-related issues, other substance use history, and other clinical variables were analyzed. Univariate analysis was used to assess the association of all variables. Multivariable logistic regression was used to identify the relationship between the significant factors and macrocytosis.Results: The study found that nearly one-fifth (19.5%) of the participants had macrocytosis. Older age, longer duration of heroin use, and more days of alcohol use within the previous month were associated with macrocytosis.Conclusion: We found that concurrent use of alcohol was an important factor related to macrocytosis among people with a heroin use disorder. The prevalence of macrocytosis indicated t