BMJ  2003;327:321-322 (9 August), doi:10.1136/bmj.327.7410.321

Paper

Effect of national guidelines on prescription of methadone: analysis of NHS prescription data, England 1990-2001

John Strang, professor of the addictions1, Janie Sheridan, research worker in the addictions1

1 National Addiction Centre (Maudsley/Institute of Psychiatry), London SE5 8AF

Correspondence to: J Strang j.strang@iop.kcl.ac.uk

The first 150 words of the full text of this article appear below.

Introduction

Though there is strong evidence to support the use of methadone maintenance for opiate addiction1 it is often delivered poorly. Evidence based guidelines were developed in 1996 and 1999 (see www.doh.gov.uk/drugdep.htm and further details on bmj.com) and widely publicised in the United Kingdom.2 3 In 1998 we found scant evidence of any impact4 and concluded that "if planners are awaiting major change in methadone prescribing as a result of central exhortation, they should not hold their breath." However, perhaps guidelines may have a slower cumulative effect.

Method and results

We examined data on all NHS methadone prescriptions dispensed by community pharmacists in England. These account for 98% of methadone prescriptions in England.5 Unpublished commercial data indicate that 95% of methadone prescriptions from general practitioners are for addiction treatment (IMS Health).

To investigate the impact of the guidelines we used two specific recommendations from the Department of Health (the 1996 taskforce report and the . . . [Full text of this article]

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