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INTRODUCTION: Continuation of drug use refers to any use of drugs among patients receiving methadone treatment in health clinics. Methadone maintenance treatment is provided for people with addiction to opioids as a part of harm reduction programme, especially reduction in transmission of HIV. OBJECTIVES: This study is to determine the prevalence of continuation of illicit drug use and its associated factors among patients attending methadone clinics. METHODS: A cross-sectional study was conducted in August 2018 involving patients attending methadone clinics in Kota Bharu, Kelantan. Multistage stratified cluster sampling was employed. The data were collected using the questionnaires for demographic data, Hatta Islamic Religiosity Score (HIRS) 96, WHOQOL-BREF (Malay version) and also from patients- clinic files. Data were analysed by single and multiple logistic regressions using SPSS version 24. RESULTS: A total of 150 patients were involved with a response rate of 94.3%. The prevalence of continuation of drug-use was 38.7% (n=58) and 40.7% (n=61), as measured by self-reported drug use within the last 30 days and by urine test positive for drugs, respectively. Multiple logistic regression analysis showed that being Hepatitis C-infected [OR (95% CI: 0.45 (0.21, 0.95)] and higher quality of life score in the domain of psychological health [OR (95% CI: 0.98 (0.95, 1.00)] were associated with reduced continuation of drug use by self-reported use. While for urine positive for drugs, being Hepatitis C-infected [OR (95% CI: 0.27 (0.12, 0.62)] and higher quality of life score in the domain of physical health [OR (95% CI: 0.97 (0.94, 0.99)] were associated with reduced continuation of drug use. CONCLUSION: The prevalence of continuation of drug use among patients attending methadone clinics in Kelantan was high. Those with positive Hepatitis C status and those who scored higher in quality of life in the domain of physical and psychological health, were found to have reduced risk for continuation of illicit drug use.