A BIT OLD BUT THOUGHT IT WAS INTRESTING,METHADONE DAILY PICKUPS

[froude]

AS the title says,All the best Froude.
Heroin substitute supervision saves lives: official

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Researchers have identified that supervision of methadone prescribing has substantially reduced deaths among users of the heroin substitute, at a time of growing heroin addiction problems and expanded methadone prescribing.

It has long been known that treatment with methadone reduces deaths among heroin addicts but there have been historic concerns about misuse and overdoses of methadone itself.

“We’ve been able to identify, for the first time, dramatically reduced mortality from deaths involving methadone, despite the recognised high risk of early death in this population,” says Professor John Strang of King’s Health Partners. “We are now achieving the positive benefits from this treatment with much lower risk of the negative complications”.

“And the key determinant is the introduction of supervised administration of methadone in controlled doses. That prevents stockpiling, which reduces the opportunity for overdosing or passing on methadone to others who are equally at risk.”

The research found that changes in methadone prescribing practice in the 1990s, particularly the introduction of daily supervision of doses in the early stages of treatment, have been highly effective in making methadone treatment safer – achieving a fourfold reduction in deaths involving methadone across England and Scotland. It also suggests that other changes to treatment could further reduce over-dosing from ‘opioids’ – heroin and synthetic substitutes. Opioids are implicated in over three-quarters of all illicit drug related deaths in the UK.

The findings are published online in the British Medical Journal on Friday, 17 September 2010. The research team developed a new measurement tool ‘OD4’ which measures deaths per million daily doses of methadone prescribed in a year. The study covering 1993 to 2008 looked at the effects of the introduction of supervised dosing of methadone from in Scotland (1995-2000) and England (1999-2005) and found methadone deaths per million doses declined at the same time as there was an 18-fold increase in methadone prescribing in Scotland, and a 7-fold increase in England.

NOTES TO EDITOR

The research was led by the National Addiction Centre (NAC) at King's Health Partners. King’s Health Partners is an Academic Health Sciences Centre (AHSC), bringing together clinical and research expertise across both physical and mental health.

This isnt even a year ago and thought it was intresting hope you do to.

[OP8S]

I think that a lot of GPs are aware of this. I know my one is, he had to argue the case for maintenance to the local CDT who when first set up were very recovery orientated & didn't think a maintenance clinic neccessary ! It is because of him that we now have a maintenance clinic, before it was just a revolving door. People got sick of scoring , getting ill etc. & so approached the CDT who put them on a reduction script. Some only lasting 6 weeks, using DHC. I know countless people who arrived back at their door within a few months needing a script. It's the CDTs & DSPs that rule the roost now. You would think that your GP would have the final say on most issues surrounding your care, but no. It's the people running these organisations that pull most of the strings. An example of this was when a lad that lived a couple of hundred yards from my house was found dead of a opiate overdose, he'd been doing a bit of dealing to support his habit & some meth was found in his system + a few bottles that people had swapped with him for gear which he would keep in case he ran out.
Now I've known my prescribing GP for many years, he's also my GP at my local surgery & we have a great relationship. He knows me better than any key or manager & knows that ALL my meds go down MY throat ( I'm to selfish / greedy to share    ) . So I walked into the clinic on my next appointment, saw a big sign on the door saying because of this lads death everybody on a meth script would have to go on daily obs., because of the hours that I work & the opening hours of the only pharmacy in my area to dispense meth this was going to be impossible for me. I started having a panic attack right on the spot & sat waiting for my appointment in total anxiety. When I got to see my GP I think it was the first thing I started going on about. I'm on a reasonably high dose & to work a shift without my medication, well it just wouldn't be possible. My GP is aware of this as he knows the kind of job I do & also that I have access to pharmacuetical opiates at work. He agreed that there was no way that I could carry out my duties at work without my meth & how tempting it would be for me to use the opiate based pain relief that is meant to be dispensed to patients, which would more than likely end up with me losing my job. I said to him that surely the notice on the clinic wall would / could not apply to me, he agreed, but then had to leave the office, go to the manager of the CDT & practically beg for me to not be included in this daily obs. punishment. In the end the managers did exclude me, though I was put on twice weekly obs. which I could manage due to my shift pattern. I think that was the first time that I realised how powerless my GP was when it came to policies, even though he is the only medically trained person in the whole pecking order from CDT management, Senior keys ( whatever the fcuk they do ? ), keys who can play god with your life & him, a fully qualified GP with additional training in the prescribing of substitute scripts for people with addiction problems. Before then I somewhat nievelly thought that the GPs say so was final, but no. Not anymore, it's the faceless paper-pushing policy makers that pull the strings & treat us like cattle. The very people who live in their "recovery micro-cosim " never spending any time with actual addicts apart from maybe a brief " hello " if you happen to meet them outside of their well insulated little offices, wondering "why" these people want to remain on a substance that has saved hundreds of thousands of lives.
God knows what I would have done if I hadn't known my GP for so long & developed the trusting relationship that we have. I probably would of had to either fess up to my employers who could have possibly sacked me for witholding information from the Occupational health Dept., or would have to of gone of on the sick just to get my prescription that I had been picking up weekly for years.
IMO your GPs decision should be final, it is him that is signing your script. In my case every month when I see him face to face & will tell him what drugs I've used & how I'm doing...not if anybody from the CDT is present though. He knows that there is very little point in asking me for a sample because most people can refrain from using on top for 3-4 days before their appointment & he thinks it's a waste of money, in my case anyway. So I think GPs are aware of the positive side of maintenance but quite often have to work within the limits of the organisations policies. Basically at times their hands are tied because of these policies.
Rant over!