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

Abstract

National Addiction Centre, Institute of Psychiatry and Maudsley Hospital, London SE5 8AF National Drug and Alcohol Research Centre, University of New South Wales, Sydney NSW 2033 Centre for Research on Drugs and Health Behaviour, London SW7 1RQ Beth Israel Medical Centre, New York, NY 10003, USA Correspondence to: Dr Farrell. This paper examines the changes and advances in research and clinical practice and examines the role of treatment structure and programme characteristics in the delivery of methadone maintenance. Methadone prescribing has become much more available over the past decade, both in countries with a history of its use, such as the United Kingdom and Australia, and in countries around the world which previously had not endorsed substitute prescribing.1 There is a need to examine closely the framework in which this treatment is delivered to ensure that the modes of delivery most effective from both cost and benefit perspectives are utilised. This review focuses entirely on methadone maintenance because this is the most extensively evaluated and most used treatment, with about a quarter of a million drug misusers receiving methadone treatment globally. A small number of experimental diamorphine and buprenorphine substitute programmes are . . . [Full text of this article