Download Methadone matters : evolving community methadone treatment by John Strang, Gillian Tober PDF

By John Strang, Gillian Tober

content material: part A: advent, historical past and Scope --
Methadone: panacea or poison? / J. Strang and G. Tober --
The heritage of methadone and methadone prescribing / A. Preston and G. Bennett --
Methadone prescribing within the uk: what will we study from neighborhood pharmacy surveys? / J. Sheridan --
part B: points of scientific perform and adaptations --
Negotiating a script: the dynamics of staff/client relationships / A. Quirk ... [et al.] --
Linking psychology and pharmacology / D. Raistrick --
evaluation and consequence tracking / J. Marsden, M. Gossop and D. Stewart --
Plasma methadone tracking: an reduction to dose overview, tracking compliance and exploration of drug interactions / ok. Wolff --
Withdrawal from methadone and methadone for withdrawal / N. Seivewright and O. Lagundoye --
part C: The distinctive Case of Injectables --
Injectable methadone: a unusual British perform / J. Strang and J. Sheridan --
Prescribing injectable methadone: to who and for what objective? / L. promote --
The supervised injecting sanatorium: a drug clinic's adventure of supervising the intravenous self-administration of prescribed methadone / M. Cummins --
part D: the dangers --
Dependence on methadone: the risk lurking in the back of the prescription / G. Tober --
'Using on best' and the issues it brings: extra drug use through methadone remedy sufferers / D. most sensible and G. Ridge --
Methadone and opioid-related deaths: altering incidence through the years / M. Farrell and W. corridor --
The play, the plot and the gamers: the illicit industry in methadone / J. Fountain and J. Strang --
part E: carrier supply --
a first-rate care established professional provider / S. Lawrence --
A critical evaluation carrier with extensively disseminated supply in basic care / F. Watson, L. Mays and J. Bury --
A centrally co-ordinated urban strategic method / R. Watson, J. Jay and L. Gruer --
Supervised intake of methadone in a neighborhood pharmacy / okay. Roberts --
part F: designated instances --
A methadone programme for substance-misusing pregnant girls / A. Walker and J. Walker --
Methadone use in kids / E. gilvarry, J. McCambridge and J. Witton --
Sectin G: Methadone stories --
Methadone therapy: results and version in remedy reaction with NTORS / D. Stewart, M. Gossop and J. Marsden --
swift gain, yet what thereafter?: the push and trickle of make the most of methadone therapy / E. Finch --
Methadone upkeep and aid remedies: the necessity for readability of ambitions and approaches / M. Gossop, J. Marsden and D. Stewart --
part H: In end --
Methadone: attaining the stability / G. Tober and J. Strang.

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Additional resources for Methadone matters : evolving community methadone treatment of opiate addiction

Example text

A small increase to around 90% in the proportion of mixture in 2000 is noted, with the proportions of prescriptions for tablets and ampoules falling off to around 5% each. It is possible that the majority of tablet prescriptions are for the management of analgesia, but national data collected through community pharmacies in 1995 indicate that tablet prescribing for opiate dependence comprised 11% of methadone prescriptions at that time (Strang et al. 1996). Furthermore, comparison of data for 1995 and 1997 for South East England, one year after the government’s ‘Task Force’ report (Department of Health 1996), also indicated little change (Strang and Sheridan 1998a).

Our findings show that dose negotiation, and methadone decision-making more generally, is best understood in relation to the specific organizational context in which it is embedded. This is important because at the time of the fieldwork we found both of the DDUs to be undergoing organizational change, which was affecting staff–client interaction and limiting the scope for negotiation. The emergent picture was that the clinics were becoming ‘stricter’, more ‘boundaried’ and harder for clients to gain access to.

Staff were generally well aware of such concerns, and would seek to discuss them with clients when appropriate. But they also led some staff to regard shorter-acting drugs, such as diamorphine, as possibly more efficacious for clients undergoing detoxification. Indeed, both of the NHS DDUs involved in the research were increasingly using alternatives to methadone treatment 4 Such concerns are well-founded in the sense that withdrawal symptoms of methadone take longer to subside than those of heroin (Department of Health 1999).

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