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STUDY 2010 HTM file
A survey of community drug team prescribing policies and client views
Contrary to national guidelines, in the mid-2000s in England and Wales, prescribed doses of the heroin substitute methadone were generally low, and often even new patients were not required to take it under supervision at the pharmacy. Patients in Essex also generally favoured low doses and opposed supervised consumption.
What happens when opiate-addicted patients are suddenly no longer required to take their methadone under supervision but can take it away from the pharmacy? In Scotland this was tried in the first UK randomised trial; patients stayed longer in treatment and there was no dramatic escalation in heroin use.
Introduced in Scotland and England in the mid-late 1990s to prevent overdose, did supervised consumption of methadone really make methadone maintenance safer? After accounting for increased prescribing, this analysis concludes that it did curb methadone-related deaths.
An expert committee responds to the Scottish government’s concerns over the role of methadone prescribing in helping patients along the Road to Recovery signposted in the national strategy. On the ground, that road was often barely constructed but methadone was not the problem, rather the failure to optimise programmes for recovery.
DOCUMENT 2014 HTM file
Time limiting opioid substitution therapy
Rather than being ‘parked’ on methadone, generally Britain’s heroin-addicted patients leave too soon to fully benefit, argue official government advisers on drug policy. Their report unambiguously countered concerns within the current UK government over methadone maintenance.
STUDY 2014 HTM file
Treatment retention, drug use and social functioning outcomes in those receiving 3 months versus 1 month of supervised opioid maintenance treatment. Results from the Super C randomized controlled trial
A randomised trial conducted in England found that the (at the time) recommended three months of supervised consumption of prescribed opioid substitutes like methadone conferred no significant advantages over supervising only for up to the first four weeks of treatment, but the findings applied only to the minority of patients for whom random allocation was thought feasible and safe.
HOT TOPIC 2015 HTM file
Prescribing opiate-type drugs to opiate addicts: good sense or nonsense?
One of our hot topics offering background and analysis on important issues which sometimes generate heated debate. For decades deeply felt and at times intemperate debate has surrounded a treatment which achieves unparalleled success by going with the grain of addiction, prescribing the same type of drug which opiate-dependent patients used illegally – a substitution castigated as surrender or hailed as an enlightened lifesaver.
Buprenorphine may be associated with a lower risk of mortality than methadone among people engaged in opioid substitution treatment – but is the pattern of short treatment duration in the UK preventing maximal impact at a population level?
Analysis which informed new UK guidelines on the maintenance treatment of opiate dependence concludes that buprenorphine has slightly less 'holding power' than methadone but equivalent suppression of opiate use.
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.
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