Abstract
Aims and MethodSurveys suggest that UK drug services under-prescribe methadone to opiate-dependent patients. This study investigated methadone prescribing for 169 patients on long-term methadone at a specialist drug service.ResultsThe mean methadone dose for patients on maintenance was 65.8 mg, and 67.7% were taking 50 mg or more. Mean doses in relation to methadone formulation varied substantially: mixture 57.4 mg, tablets 81.8 mg and ampoules 113.0 mg. These figures are higher than those reported from national surveys. The proportion of urine screens positive for illicit opiates was inversely related both to methadone dose and length of time in treatment.Clinical ImplicationsThis survey shows the levels of methadone prescribing at an inner-city drug service and gives support to the effectiveness of high-dose methadone maintenance.
Highlights
Surveys suggest that UK drug services under-prescribe methadone to opiate-dependent patients.This study investigated methadone prescribing for 169 patients on long-term methadone at a specialist drug service
Mean doses in relation to methadone formulation varied substantially: mixture 57.4 mg, tablets 81.8 mg and ampoules 113.0 mg. These figures are higher than those reported from national surveys.The proportion of urine screens positive for illicit opiates was inversely related both to methadone dose and length of time in treatment. This survey shows the levels of methadone prescribing at an innercity drug service and gives support to the effectiveness of high-dose methadone maintenance
In 1996, the Department of Health published a review of drug services in England (Department of Health, 1996) and stated that for patients on methadone maintenance, daily doses of over 50 mg were associated with lower rates of heroin use
Summary
These figures are higher than those reported from national surveys.The proportion of urine screens positive for illicit opiates was inversely related both to methadone dose and length of time in treatment. This survey shows the levels of methadone prescribing at an innercity drug service and gives support to the effectiveness of high-dose methadone maintenance. In the National Treatment Outcome Research Study, the mean methadone dose prescribed by specialist drug services in the UK was 48 mg (Gossop et al, 1999).
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