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Descriptive study of the effects of altering formulation of prescribed methadone from injectable to oral

  • Tracey Myton and Keron Fletcher (a1)
Abstract
Aims and Method

To describe an enforced but gentle transition from prescribed intravenous methadone to oral methadone in 14 opiate-dependent patients. We examined their case notes looking for ease of transition, evidence of illicit drug use before and during the 6 months following transition and progress 3 years later.

Results

Eight patients immediately stopped injecting, the remainder used intravenous heroin in addition to prescribed oral methadone for some months. There were no serious adverse events. Three years later, four patients had ceased opiate use altogether and six were maintained on oral methadone (five of these without illicit use). Two patients were prescribed oral methadone by their general practitioner and one was no longer in treatment.

Clinical Implications

We show that it is possible to alter the formulation of prescribed methadone without deterioration in clinical stability or losing patients from treatment. This is an important conclusion as it is presumed that one of the aims of treatment with intravenous methadone is to move patients away from injectable to oral use. Offering patients a transition period of 6 months and a choice of the process of transition may be helpful.

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Copyright
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
References
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Department of Health (1999) Drug Misuse and Dependence – Guidelines on Clinical Management. Norwich: The Stationery Office.
FARRELL, M., WARD, J., MATTICK, R., et al (1994) Methadone maintenance treatment in opiate dependence: a review. BMJ, 309, 9971001.
FELDER, C., UEHLINGER, C., BAUMANN, P., et al (1999) Oral and intravenous methadone use: some clinical and pharmacological aspects. Drug and Alcohol Dependence, 55, 137143.
SARFRAZ, A. & ALCORN, R. (1999) Injectable methadone prescribing in the United Kingdom – current practice and future policy guidelines. Substance Use and Misuse, 34, 17091721.
STEELS, M., HAMILTON, M. & MCLEAN, P. (1992) The consequences of a change in formulation of methadone prescribed in a drug clinic. British Journal of Addiction, 87, 15491554.
STRANG, J., SHERIDAN, J. & BARBER, N. (1996) Prescribing injectable and oral methadone to opiate addicts: results from the 1995 national postal survey of community pharmacies in England and Wales. BMJ, 313, 270272.
STRANG, J., MARSDEN, J., CUMMINS, M., et al (2000) Randomised trial of supervised injectable versus oral methadone maintenance: report of feasibility and 6-month outcome. Addiction, 95, 16311645.
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BJPsych Bulletin
  • ISSN: 0955-6036
  • EISSN: 1472-1473
  • URL: /core/journals/bjpsych-bulletin
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Descriptive study of the effects of altering formulation of prescribed methadone from injectable to oral

  • Tracey Myton and Keron Fletcher (a1)
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