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British guidelines suggest electrocardiogram screening of methadone patients at heightened risk of a form of possibly methadone-aggravated cardiac disorder which can result in sudden death. But a London clinic found this would still mean testing most patients, with huge resource implications yet uncertain benefits.
Addicts attending a clinic twice a day to take prescribed heroin seems like a recipe for an unwelcome increase in local drug-related disorder and nuisance, but in London the effect was to remove rather than add people to the troubling street-drinking population.
Addicts attending a clinic twice a day to take prescribed heroin seems like a recipe for an unwelcome increase in local drug-related disorder and nuisance, but given (as there usually will be) small numbers, experience in London was that not much changed.
REVIEW 2011 HTM file
Heroin maintenance for chronic heroin-dependent individuals
Update of the first authoritative review to combine results from all trials to date of long-term heroin prescribing for the management of heroin addiction finds important advantages for seemingly intractable patients previously failed by methadone, including reduced illegal drug use.
Survey responses from clinicians prescribing methadone at Scottish addiction treatment clinics show how the requirement that patients be observed taking the medication involves striking a balance between safety, individualising treatment, and attracting and retaining patients.
Compromised by an inability to interest enough patients, the only randomised UK trial of cognitive-behavioural therapy for methadone patients was unable to be definitive but did find some signs of benefit and that the therapy had pulled some of the intended psychological levers.
STUDY 2011 HTM file
What is the role of harm reduction when drug users say they want abstinence?
A team including one of the researchers responsible for the original finding have queried the interpretation of the highly influential report from a national Scottish study that most drug users starting treatment wanted to become abstinent. On the basis of in-depth interviews, they caution that it is just not that simple.
On several measures, the few drug dependent patients who accessed aftercare after treatment in Scotland in the early 2000s did better than the majority who chose to or were left to fend on their own – but could this be attributed to the aftercare, or would they have done well anyway?
Evidence-based guidance for British GPs on how to withdraw heroin and other opioid addicts from opiate-type drugs or to maintain them by long-term prescribing of legal substitutes, with a focus on the use methadone and buprenorphine, the main medications used for these purposes in the UK.
STUDY 2010 HTM file
The National Drug Related Deaths Database (Scotland) report 2009
New database offering in-depth information on drug deaths in Scotland reveals that 60% of cases had been in contact with drug treatment services, nearly 40% in the past six months, suggesting that there had been chances to intervene which for these patients had been insufficient to avoid death.
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