Treatment and Rehabilitation Provided to Patients at the Six Programs in 1985 &amp; 1986

Ball, John C.; Ross, Alan O.

doi:10.1007/978-1-4613-9089-3_6

Cited by 45 publications

(66 citation statements)

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“…The widespread disregard of the opportunities for interval dispensing (especially for tablets and ampoules, which have a greater potential for misuse) indicates a failure to appreciate the abuse potential and the substantial value on the black market of injectable forms of methadone. With the prescribing of methadone increasing so rapidly15 and with the above evidence of the instability of this feature of Britain's drug policy, policymakers and planners must find improved methods of harnessing the benefits of methadone prescribing 16 17 18…”

Section: Discussionmentioning

confidence: 99%

Prescribing injectable and oral methadone to opiate addicts: results from the 1995 national postal survey of community pharmacies in England and Wales

Strang

Sheridan

Barber³

1996

BMJ

140

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Objective-To establish the extent of prescribing injectable and oral methadone to opiate addicts and the practice characteristics and dispensing arrangements attached to these prescriptions.Design-National survey of25% random sample of community (high street) pharmacies through postal questionnaire, with four mailings.Setting-England and Wales. Subjects-i in 4 sample of all 10 616 community pharmacies, stratified by family health services authority.Main outcome measures-Data were collected on each prescription for controlled drugs currently being dispensed by pharmacies to misusers, describing the drug, form, dose, source (general practice or hospital; and NHS or private), and numbers of dispensing pick ups a week.Results-Methadone was the opiate most commonly dispensed to misusers (96.0% of 3846 opiate prescriptions). 79.6% of methadone prescriptions were for the oral liquid form, 11.0% for tablet, and 9.3% for injectable ampoules. More than one third of all methadone prescriptions were for weekly or fortnightly pick up, with a further third being for daily pick up. Tablets and ampoules were even less likely to be dispensed on a daily basis. Private prescriptions were significantly more likely than NHS ones to be for tablets or ampoules, to be for substantially higher daily doses, and to be collected on a weekly or fortnightly basis.Conclusions-The distinctively British practice ofprescribing injectable methadone was found to be widespread and, contrary to guidance, to be as prevalent in non-specialist as specialist settings. In view of the frequent crushing and injecting of methadone tablets, clearer more authoritative guidance is needed on the contexts in which injectable methadone (tablets as well as ampoules) should be prescribed and on the responsibilities for monitoring and supervision which should be attached.

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Section: Discussionmentioning

confidence: 99%

Prescribing injectable and oral methadone to opiate addicts: results from the 1995 national postal survey of community pharmacies in England and Wales

Strang

Sheridan

Barber³

1996

BMJ

140

View full text Add to dashboard Cite

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“…Criminality continues, albeit at dramatically reduced rates. Ball and Ross noted the variation of programmes' impact on criminal behaviour and pointed out that methadone maintenance programmes have not specifically focused on patients' criminality 12. There is scope for developing the crime reduction elements of methadone maintenance programmes.…”

Section: Opioid Use and Crimementioning

confidence: 99%

“…This may be due to characteristics of the patients of the programme. Ball and Ross have highlighted the importance of the organisation and the characteristics of the treatment being delivered 12. Treatment variation will be subtantially influenced by overall national policy on the management of opiate addiction 18,36,37…”

Section: Factors Affecting Response To Methadone Maintenancementioning

confidence: 99%

“…In a study of six methadone clinics in the United States, ongoing use of injecting drugs varied from 10-25% in patients in the two most effective clinics to 56% in the least effective 12. The more effective clinics were characterised by prescribing higher doses of methadone, having a treatment goal of successful ongoing maintenance rather than abstinence, and having better quality counselling, more medical services, better staff-patient relationships, low staff turnover rates, and better management.…”

Section: Programme Characteristicsmentioning

confidence: 99%

“…Ball and Ross found that the most successful clinics had successful maintenance on methadone rather than abstinence as their goal of treatment 12. Longer stays in treatment are associated with better outcomes overall,*RF 12,14,15,19-24* and the reason for ending treatment is highly predictive of subsequent functioning, with patients who end treatment with staff approval doing much better than those who leave for other reasons.…”

Section: Maintenance Versus Abstinencementioning

confidence: 99%

See 2 more Smart Citations

Fortnightly Review: Methadone maintenance treatment in opiate dependence: a review

Farrell¹,

Ward²,

Mattick³

et al. 1994

BMJ

360

178

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Predictors of methadone treatment retention from a multi-site study: A survival analysis

Kelly

O’Grady

Mitchell

et al. 2011

Drug and Alcohol Dependence

121

104

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Background Longer tenure in methadone treatment has been associated with positive outcomes such as reductions in drug use and crime, HIV seroconversion, and overdose death. Methods Retention in treatment was examined for 351 opioid-dependent individuals who had been newly admitted to one of six methadone programs in Baltimore, Maryland. Cox proportional hazards regression was used to predict number of days retained in treatment to 90 days from baseline ASI Composite scores and Treatment Motivation scales. A second analysis predicted days in treatment to 365 days using the same baseline variables plus 3-month Motivation scales, Patient Satisfaction scales, and methadone dose in the 248 individuals who had remained in treatment at least 3 months. Analyses held constant gender, race, age, whether participants had a history of regularly smoking cocaine, whether participants were on parole/probation, and program site. Results Retention at 90 days was predicted by female gender, and greater baseline Treatment Readiness (p=.005) but lower Desire for Help (p=.010). Retention at 365 days was predicted by higher baseline ASI Medical Composite scores (p=.037) and lower Legal Composite scores (p=.039), higher 3-month Treatment Satisfaction scores (p=.008), and higher dose (p=.046). Conclusions Greater satisfaction with treatment at 3 months was a significant predictor of retention at 12 months, indicating the importance of understanding the role satisfaction plays in determining retention. Greater severity of legal problems was associated with shorter retention, suggesting that program efforts to increase services to criminal justice patients (e.g., legal counseling) may constitute a useful addition to treatment.

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Treatment and Rehabilitation Provided to Patients at the Six Programs in 1985 & 1986

Cited by 45 publications

References 0 publications

Prescribing injectable and oral methadone to opiate addicts: results from the 1995 national postal survey of community pharmacies in England and Wales

Prescribing injectable and oral methadone to opiate addicts: results from the 1995 national postal survey of community pharmacies in England and Wales

Fortnightly Review: Methadone maintenance treatment in opiate dependence: a review

Predictors of methadone treatment retention from a multi-site study: A survival analysis

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