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Methadone maintained heroin-dependent patients in Birmingham (UK) randomised to inpatient v. outpatient lofexidine-based detoxification rarely sustained long-term opioid abstinence; return to maintenance was the typical outcome.
Compared to methadone, buprenorphine is more often chosen in a make-or-break attempt to divorce oneself from illicit opiates found the first large-scale study to compare the drugs in real-life conditions at a British opiate addiction maintenance treatment programme.
NOTES 2010 PDF file 239Kb
Preventing unauthorised use of medications prescribed for the treatment of opiate addiction
Detailed and fully referenced notes on preventing the diversion of maintenance medications like methadone on to the illicit market, with an emphasis on the pros and cons of supervised consumption.
STUDY 2010 HTM file
Problem drug users’ experiences of employment and the benefit system
Substantial barriers to employment were revealed by interviews with problem drug users in England currently or recently in treatment and with staff who worked with drug users. Includes review of relevant international research.
STUDY 2010 HTM file
Supervised injectable heroin or injectable methadone versus optimised oral methadone as treatment for chronic heroin addicts in England after persistent failure in orthodox treatment (RIOTT): a randomised trial
Controversial and expensive it might be, but in the first British randomised trial, a continental-style heroin prescribing programme featuring on-site supervised consumption suppressed illegal heroin use much more effectively than oral methadone.
REVIEW 2009 HTM file
Prescription of heroin for the management of heroin dependence: current status
Should heroin prescribing be a mass treatment entry route or a niche option for the few who have not done well in optimised (but still cheaper) mainstream treatments? With nearly all the latest studies to hand, this review came down firmly on the 'niche' side of the debate.
DOCUMENT 2006 PDF file 1326Kb
The Rolleston legacy
In British drug policy no document has more claim to the term 'classic' than the 1926 Rolleston report, which enshrined doctors' freedom to prescribe opiates to opiate addicts.
STUDY 2005 PDF file 102Kb
More patients drop out after long waits for methadone prescribing
Combined implications of two British studies are that the longer someone waits for methadone treatment, the less likely they are to start it, and even if they do, they will have spent longer at risk from dependent heroin use.
OFFCUT 2005 PDF file 151Kb
Hepatitis C is spreading more rapidly than was thought
From the early 2000s in Britain there was clear evidence from research and routine monitoring that drug policy was failing to contain hepatitis C infection among injectors, and worrying signs of a trend upwards in HIV infection.
STUDY 2009 HTM file
Drug and alcohol services in Scotland
Scotland's national audit body assesses value for money from drug and alcohol services. It found systems poorly informed by the problems to be addressed and what works in addressing them, and in respect of drugs, unclear about what 'value' consists of.
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