Methadone matters : evolving community methadone treatment of opiate addiction

Title:

Methadone matters : evolving community methadone treatment of opiate addiction

Author:

Tober, Gillian.

ISBN:

9781841843650

9781841841595

Publication Information:

London : Martin Dunitz ; Independence, KY : Distributed in the USA by Fulfilment Center, Taylor & Francis, 2003.

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Material Type	Library	Call Number	Suggested Age	Status
Book	Searching... West Huntington Public Library	362.293 M	Adult	Searching... Unknown

Methadone heals, but methadone kills. Methadone is a life-saving treatment, but methadone is also a life-threatening poison. The challenge is how to confer the benefit without incurring the harm. And that is what this book is all about. Methadone is by far the most widely prescribed drug in the treatment of heroin addiction, and yet, all too often, we are clumsy in our use of this powerful drug. So how much of the observed benefit is to do with methadone itself? Does dose matter? How important is the psychosocial component of care? How can problems of poor compliance be addressed? Is supervised consumption feasible, and, if so, is it justifiable and beneficial? And what is injectable methadone all about? When is it ever prescribed, and for whom, and how? And what about the dangers? Methadone itself can be the actual drug of overdose. How successful have efforts been made to re-structure methadone treatment to prevent overdose deaths? and how can the problems of diversion to the illicit market be kept to a minimum?
This multi-authored book, comprising chapters from the best of clinicians, researchers and policymakers, is the essential guide to increasing the relevance and effectiveness of methadone treatment. Like it or loathe it, Methadone Matters.

Author Notes

Dr Gillian Tober'sresearch is in the process of treatment delivery, the effectiveness of addiction treatment and the nature and measurement of substance dependence. Her clinical work includes development of and supervision in the use of treatment manuals.

Professor John Strang'sinvolvement with the Department of Health has covered the period of the introduction of harm reduction initiatives, and also the preparation of the 'Orange Guidelines'; in both, a more competent use of methadone treatment is charted.

John Strang and Gillian ToberAndrew Preston and Gerald BennettJanie SheridanAlan Quirk and Robert Lilly and Tim Rhodes and Gerry StimsonDuncan RaistrickJohn Marsden and Michael Gossop and Duncan StewartKim WolffNicholas Seivewright and Olawale LagundoyeJohn Strang and Janie SheridanLouise SellMike CumminsGillian ToberDavid Best and Gayle RidgeMichael Farrell and Wayne HallJane Fountain and John StrangSusanna LawrenceFiona Watson and Linda Mays and Judy BuryRichard Watson and Jane Jay and Laurence GruerKay RobertsAnn Walker and James WalkerEilish Gilvarry and Jim McCambridge and John WittonDuncan Stewart and Michael Gossop and John MarsdenEmily FinchMichael Gossop and John Marsden and Duncan StewartGillian Tober and John Strang

Editors	p. vii
Contributors	p. ix
Acknowledgements	p. xiv
Abbreviations used	p. xv
Section A Introduction, background and scope
1 Methadone: panacea or poison?	p. 3
2 The history of methadone and methadone prescribing	p. 13
3 Methadone prescribing in the United Kingdom: what can we learn from community pharmacy surveys?	p. 21
Section B Aspects of clinical practice and variations
4 Negotiating a script: the dynamics of staff/client relationships	p. 33
5 Linking psychology and pharmacology	p. 45
6 Assessment and outcome monitoring	p. 55
7 Plasma methadone monitoring: an aid to dose assessment, monitoring compliance and exploration of drug interactions	p. 67
8 Withdrawal from methadone and methadone for withdrawal	p. 79
Section C The special case of injectables
9 Injectable methadone: a peculiar British practice	p. 91
10 Prescribing injectable methadone: to whom and for what purpose?	p. 107
11 The supervised injecting clinic--a drug clinic's experience of supervising the intravenous self-administration of prescribed methadone	p. 119
Section D The risks
12 Dependence on methadone: the danger lurking behind the prescription	p. 131
13 'Using on top' and the problems it brings: additional drug use by methadone treatment patients	p. 141
14 Methadone and opioid-related deaths: changing prevalence over time	p. 155
15 The play, the plot and the players: the illicit market in methadone	p. 167
Section E Service delivery
16 A primary care based specialist service	p. 179
17 A central assessment service with widely disseminated delivery in primary care	p. 189
18 A centrally co-ordinated city strategic approach	p. 199
19 Supervised consumption of methadone in a community pharmacy	p. 211
Section F Special cases
20 A methadone programme for substance-misusing pregnant women	p. 225
21 Methadone use in young people	p. 235
Section G Methadone studies
22 Methadone treatment: outcomes and variation in treatment response within NTORS	p. 249
23 Rapid benefit, but what thereafter? The rush and trickle of benefit from methadone treatment	p. 259
24 Methadone maintenance and reduction treatments: the need for clarity of goals and procedures	p. 271
Section H In conclusion
25 Methadone: achieving the balance	p. 285
Index	p. 293

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