Letters

Methadone tolerance testing in drug misusers

BMJ 2006; 333 doi: http://dx.doi.org/10.1136/bmj.39045.392928.1F (Published 30 November 2006) Cite this as: BMJ 2006;333:1173

Author's response

  1. Adam Bakker, general practitioner
  1. 1Lisson Grove Health Centre, London NW8 8EG [email protected]

    There would be little reason to perform methadone tolerance testing if it didn't seem to attract difficult to engage addicts and if conventional induction were really safe. Unfortunately, slow titration may actually involve a mortality up to seven times greater than untreated addiction.1 Therefore, even when complying with the guidelines, the risks are not minimal; only the risk of blame is absent. Whether methadone tolerance testing is even riskier remains to be seen. I consider it good practice to discuss overdose risk and its management …

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