Abstract
Opioid substitution with oral methadone is the most widely implemented treatment for heroin dependence. In Britain, a complex array of specialist and generic health care services have evolved to deliver this treatment modality. Several minority aspects of British substitution practices receive enduring international interest, including the use of heroin itself as a substitute and the prescribing of methadone in an injectable form. This paper focuses on six linked dimensions that characterize substitution services: (1) treatment providers and settings, (2) prescribing regimes and treatment goals, (3) substitute drugs, (4) dose administration, (5) dose levels, and (6) substitute formulations. Against a background of increasing central and local accountability for the quality and efficiency of specialist providers and critical attention toward their effectiveness, the strengths and weaknesses of the British approach are considered and key issues and future directions are discussed.
| Original language | English |
|---|---|
| Pages (from-to) | 243-263 |
| Number of pages | 21 |
| Journal | Journal of Drug Issues |
| Volume | 28 |
| Issue number | 1 |
| Publication status | Published - 1998 |
Keywords
- METHADONE TREATMENT
- GENERAL-PRACTITIONERS
- DRUG-USERS
- MAINTENANCE
- TRIAL
- BUPRENORPHINE
- CONSEQUENCES
- DEPENDENCE
- PROGRAM
- POLICY