User views on supervised methadone consumption

Abstract

To assess the views of opiate-dependent individuals about supervised methadone consumption. Three groups of opinions were sought: (i). new patients referred for assessment and treatment, using rating scales; (ii). the consensus view of the Methadone Alliance (a national users' forum); and (iii). the consensus view of a local service users' forum. All three groups expressed the view that supervised consumption has an important place in methadone treatments. Users understand the need for daily supervision of methadone and are generally willing to accept it. Users' views provide support for the introduction of flexible methadone prescribing regimes incorporating supervised consumption. Privacy in pharmacies and the possibility of moving away from supervision are important elements in an acceptable programme. Supervised consumption is an important component of safe, effective and responsible methadone prescribing.

Regaining control: The patient experience of supervised compared with unsupervised consumption in opiate substitution treatment

“…An existing UK study of supervision had already suggested that the possibility of moving away from supervision might be important for patients [12]. However, this study collected patients' views prior to entering treatment, and thus did not assess actual treatment experiences.…”

“…It was suggested that there should be adequate privacy for supervised consumption services [11]. A UK study identified that patients understood the need for supervised consumption but considered privacy within pharmacies and the possibility of moving away from supervision to be important [12]. A further study also found a generally positive response to supervision and agreement that supervision reduced the amount of street methadone [13].…”

Consumer satisfaction with opioid treatment services at community pharmacies in Australia

“…Participants gave less favourable ratings of the privacy afforded during supervised dosing, which may reflect that many pharmacies do not have a private, separate area in the pharmacy for administering methadone and buprenorphine, often due to space limitations. The issue of privacy has been cited as an issue of concern by both clients and other customers of the pharmacy [11][12][13]20]. However, some pharmacists cite that wherever possible they try to dose clients discreetly, at less busy times, or when other customers are not in the pharmacy [11,21].…”

“…In addition, the treatment experiences of community pharmacy clients have received some attention. Studies in the UK and Australia have explored client perceptions of treatment and issues relating to staff attitudes, privacy during supervised dosing, flexibility regarding takeaway dosing, the cost of treatment and being treated differently from other customers [3,[9][10][11][12][13]. A recent study of 432 clients receiving methadone and buprenorphine treatment at public clinics in NSW found that while clients were generally satisfied with treatment, they were dissatisfied with the frequency of clinic attendance for dosing, inflexible dosing hours, and a lack of takeaway doses [14].…”

The effect of an electronic medicine dispenser on diversion of buprenorphine-naloxone—experience from a medium-sized Finnish city

“…Retention in treatment is similar (Fiellin et al, 2006;Bell et al, 2007;Moore et al, 2012) or even improved (Holland et al, 2012) in comparison with observed dosing. OST patients value unobserved dosing and consider it as an essential part of OST (Stone & Fletcher, 2003;Treloar, Fraser, & Valentine, 2007;Madden, Lea, Bath, & Winstock, 2008).…”