By Nicholas Seivewright
Lately, methadone has been the remedy of selection for heroin dependency. This method has had huge good fortune, yet for this reason different healing procedures were overlooked. This booklet attracts at the author's direct scientific adventure and uses overseas study findings to supply a entire and special consultant to carrier provision and therapy for drug misuse, together with methadone and replacement opiate substitutes, cleansing tools, naltrexone and relapse prevention, and attainable techniques with non-opiate clients. assurance locations emphasis on social elements in drug misuse and dependency, and the ensuing therapy concerns and useful problems. Illustrative case reports are featured during the textual content. Combining a hugely useful procedure with a robust examine base, this booklet may be an important source for psychiatrists and different execs enthusiastic about the administration of drug misuse.
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Extra resources for Community Treatment of Drug Misuse: More than Methadone
1969, Gunne & Gronbladh 1981). In many areas polydrug use is the norm in those presenting for treatment, including those accepted for methadone, because of the extent of predominant opiate use (Bell et al. 1990a). Such individuals are likely to differ substantially from those in the original studies in terms of treatment needs and response to standardized methadone treatment. Associated counselling Counselling is one of the main aspects of process which has been examined in studies of methadone treatment.
However, it must be noted that the comparisons were mainly carried out in the early maintenance programmes where patients were observed every day when presenting for their methadone, a far cry from a modern clinic where there may only be contact monthly. In our view urine testing is essential at every appointment, simply because it usually provides the only objective evidence of progress. In the early days ‘random’ urine testing meant that the patient still provided a sample Practical management 37 every day but only some from each week were tested, whereas currently if samples are only taken at some appointments, long periods can go by without any information.
Medical model and substitution model of methadone treatment Rationale Mechanism Explanation for improvements in health and well being Dose Duration Medical model Substitution model To correct metabolic disturbance caused by opiate dependence Reduces craving and blocks effects of other opiates Primary, due to methadone To provide a reasonably satisfying drug effect High Indeﬁnite Reduces need to use other drugs Secondary, due to removal from street drug use Minimum comfortable dose Should be able to gradually withdraw The nature of methadone treatment Speciﬁc treatment or heroin substitute?