Methadone Matters: Evolving Community Methadone Treatment of Opiate Addiction

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John Strang, Gillian Tober
CRC Press, 2003 M04 3 - 320 páginas
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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UnReal
Pitiful excuse for a sample of a book. Dont bother downloading it. All you get to read is the biographies of the shrinks that wrote it.

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Contenido

Methadone panacea or poison?
3
The history of methadone and methadone prescribing
13
Negotiating a script the dynamics of staffclient relationships
33
Linking psychology and pharmacology
45
Assessment and outcome monitoring
55
Plasma methadone monitoring an aid to dose assessment monitoring compliance and exploration of drug interactions
67
Withdrawal from methadone and methadone for withdrawal
79
Injectable methadone a peculiar British practice
91
The play the plot and the players the illicit market in methadone
167
A primary care based specialist service
179
A central assessment service with widely disseminated delivery in primary care
189
A centrally coordinated city strategic approach
199
Supervised consumption of methadone in a community pharmacy
211
A methadone programme for substancemisusing pregnant women
225
Methadone use in young people
235
Methadone treatment outcomes and variation in treatment response within NTORS
249

Prescribing injectable methadone to whom and for what purpose?
107
The supervised injecting clinic a drug clinics experience of supervising the intravenous selfadministration of prescribed injectable methadone
119
Dependence on methadone the danger lurking behind the prescription
131
Using on top and the problems it brings additional drug use by methadone treatment patients
141
Methadone and opioidrelated deaths changing prevalence over time
155
Rapid benefit but what thereafter? The rush and trickle of benefit from methadone treatments
259
Methadone achieving the balance
285
Index
293
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Acerca del autor (2003)

Dr Gillian Tober's research is in the process of treatment delivery, the effectiveness of addiction treatment and the nature and measurement of substance dependence. Her clinical work includes development of and supervision in the use of treatment manuals.

Professor John Strang's involvement with the Department of Health has covered the period of the introduction of harm reduction initiatives, and also the preparation of the 'Orange Guidelines'; in both, a more competent use of methadone treatment is charted.

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