Edges is grateful to the National Treatment Agency for this information. What is methadone? Methadone is a long-acting synthetic painkiller that mimics the effects of heroin, but is less addictive. It is widely used as a substitute for patients who are attempting to combat addiction to heroin. Like heroin, it produces feelings of euphoria and sedation, but to a lesser degree. The drug is usually provided to addicts under the supervision of a pharmacist. It comes in the form of a green liquid, like cough mixture, poured into a plastic cup. Can it be dangerous? When methadone is taken in large amounts it produces side effects similar to heroin. These include drowsiness, apathy, confusion, nausea, vomiting, suppression of breathing reflexes and constricted pupils. In excessive quantities it will lead to coma and eventually to death. How do methadone substitute programmes work? Doctors must first issue a prescription for the dose, specifying the amount, the days on which it can be administered, and restricting the person who can collect the methadone to the addict him or herself. Initially, a drug abuser is prescribed slowly increasing amounts of methadone to increase tolerance to the drug. Then the amount is slowly decreased until they are cured of the need for the drug altogether. However, some addicts are controversially kept on a steady dose of the drug to avoid a return to heroin once the dosage drops. Do methadone programmes go wrong? Some addicts become as reliant on methadone as they were on heroin. Department of Health figures show that methadone was responsible for the deaths of 421 people in 1997. Heroin addicts have created a vast methadone black market by selling on their doses for as little as £2. What is being done to combat this problem? Department of Health guidelines are being drawn up to control the availability of methadone, chiefly by ensuring that the dose is taken under medical supervision. The National Treatment Agency (NTA) is a special health authority, created by the Government in 2001, with a remit to increase the availability, capacity and effectiveness of treatment for drug misuse in England. The overall purpose of the NTA is to: double the number of people in effective, well-managed treatment from 1998 to 2008; and to increase the proportion of people completing or appropriately continuing treatment, year on year. This is in line with the UK drugs strategy targets. This guidance has been developed by the NTA in consultation with experts in the field. It provides initial guidance for drug treatment practitioners on the potential role of injectable heroin and injectable methadone substitute maintenance prescribing in local drug treatment systems. The guidance is designed to complement with the current Department of Health clinical guidelines – Drug misuse and dependence: guidelines on clinical management (Department of Health, 1999). |
