BMJ 1996;313:1482 (7 December)

Letters

Clinical judgment is important

EDITOR,--As private providers of oral and injectable methadone maintenance, we read John Strang and colleagues' paper about the prescribing of injectable and oral methadone to opiate addicts with concern but also some irritation at its occasional unrealities.1 Many of our patients have steady and responsible jobs, often in changing locations. For such people, to pick up methadone mixture daily is difficult. Even in the United States, where daily pick up is almost mandatory, some demonstrably stable patients can collect 28 days' supply.2

Furthermore, although 50 mg methadone ampoules retail for as little as £2, private daily dispensing and controlled drug fees can easily reach £25 a week, especially if both oral and injectable methadone are prescribed. In a relatively low cost maintenance programme we have to take this into account. Once patients graduate to less frequent pick up the threat of daily pick up is a useful sanction.

Why is . . . [Full text of this article]


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Relevant Article

Prescribing injectable and oral methadone to opiate addicts: results from the 1995 national postal survey of community pharmacies in England and Wales
John Strang, Janie Sheridan, and Nick Barber
BMJ 1996 313: 270-272. [Abstract] [Full Text]

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