Methadone Matters: Evolving Community Methadone Treatment of Opiate Addiction
Methadone heals, but methadone kills. Methadone is a life-saving treatment, but methadone is also a life-threatening poison. The challenge is how to confer the benefit without incurring the harm. And that is what this book is all about. Methadone is by far the most widely prescribed drug in the treatment of heroin addiction, and yet, all too often, we are clumsy in our use of this powerful drug. So how much of the observed benefit is to do with methadone itself? Does dose matter? How important is the psychosocial component of care? How can problems of poor compliance be addressed? Is supervised consumption feasible, and, if so, is it justifiable and beneficial? And what is injectable methadone all about? When is it ever prescribed, and for whom, and how? And what about the dangers? Methadone itself can be the actual drug of overdose. How successful have efforts been made to re-structure methadone treatment to prevent overdose deaths? and how can the problems of diversion to the illicit market be kept to a minimum?
This multi-authored book, comprising chapters from the best of clinicians, researchers and policymakers, is the essential guide to increasing the relevance and effectiveness of methadone treatment. Like it or loathe it, Methadone Matters.
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Methadone panacea or poison?
The history of methadone and methadone prescribing
Negotiating a script the dynamics of staffclient relationships
Linking psychology and pharmacology
Assessment and outcome monitoring
Plasma methadone monitoring an aid to dose assessment monitoring compliance and exploration of drug interactions
Withdrawal from methadone and methadone for withdrawal
Injectable methadone a peculiar British practice
The play the plot and the players the illicit market in methadone
A primary care based specialist service
A central assessment service with widely disseminated delivery in primary care
A centrally coordinated city strategic approach
Supervised consumption of methadone in a community pharmacy
A methadone programme for substancemisusing pregnant women
Methadone use in young people
Methadone treatment outcomes and variation in treatment response within NTORS
Prescribing injectable methadone to whom and for what purpose?
The supervised injecting clinic a drug clinics experience of supervising the intravenous selfadministration of prescribed injectable methadone
Dependence on methadone the danger lurking behind the prescription
Using on top and the problems it brings additional drug use by methadone treatment patients
Methadone and opioidrelated deaths changing prevalence over time
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abstinence Addiction Service Alcohol Dependence assessment behaviour benefits benzodiazepines British Journal British Medical Journal buprenorphine clinicians cocaine community pharmacies Department of Health detoxification diamorphine diazepam dispensing diversion doctors dosage dose of methadone Drug Abuse Drug and Alcohol Drug Misuse drug users Farrell follow-up Gossop Greater Glasgow harm reduction heroin heroin addicts illicit drug illicit market improvements increase individual initial injectable methadone intravenous involved Journal of Addiction lofexidine London Marsden ment methadone ampoules methadone dose methadone maintenance methadone maintenance treatment methadone prescribing methadone programmes methadone reduction methadone treatment Misuse of Drugs monitoring months National Treatment Outcome NTORS opiate addicts oral methadone Outcome Research Study overdose deaths pharmacists practice practitioners prescribed methadone prescriptions primary problems Psychiatry reported risk Sheridan social specialist staff Strang Substance Misuse supervised consumption temazepam therapist therapy Treatment Outcome Research treatment programmes treatment services withdrawal symptoms