NCJ Number
179031
Journal
Substance Use & Misuse Volume: 34 Issue: 12 Dated: 1999 Pages: 1709-1721
Editor(s)
Stanley Einstein Ph.D
Date Published
1999
Length
13 pages
Annotation
This paper reviews the current state of methadone maintenance programs in the United Kingdom and proposes an injectable methadone prescribing policy based on the authors' clinical practice.
Abstract
Unlike other countries, there is a tradition in the United Kingdom of prescribing injectable methadone to opiate addicts as treatment for their addiction. Along with injectable heroin prescribing, this approach has been labeled as the "British System." It has caused controversy at home and abroad and provided a hot topic for debate among its advocates and critics since 1926. Over the years, intravenous opiate misuse has increased globally due to diverse social, psychological, and political reasons. The United Kingdom has also reflected similar, if not adverse, trends nationally. Following an increase in the number of intravenous opiate misusers, a growing minority of them is being prescribed injectable methadone as treatment. In the absence of comprehensive guidelines or policy from the Home Office and the Department of Health, this practice has serious practical, ethical, and legal implications for the health professionals involved. The authors' proposal for an injectable methadone policy lists its essential features. First, the goals of treatment should be individualized, measurable, and reviewed at regular intervals. Second, the dose of injectable methadone should be in line with current evidence about effectiveness. Third, the patient's injecting technique and disposal of injecting equipment should be safe. Finally, the patient should agree with the general rules and regulations of the prescribing clinic. The proposal also encompasses criteria for patient eligibility and components of the assessment procedure. 32 references