Prescribers of opiate-substitutes urged to link dosing to client needs
Methadone consumption should be supervised for more clients during
the early stages of programmes |
Prescribers continue to offer drug misuse clients insufficient doses of methadone to prevent the use of illicit drugs, according to early results from a review of UK substance misuse services.
The preliminary findings, revealed by the Healthcare Commission and the
National Treatment Agency for Substance Misuse (NTA) last week, suggest
that although 95 per cent of drug treatment services have good policies
on methadone prescribing, there is a need for prescribing to be more
closely linked to the needs of individual clients rather than to standard
policies.
Martin Bennett, co-ordinator for Sheffield’s pharmacy services
for drug misusers, and whose work was recently highlighted in the new
national framework for pharmacists with special interests unveiled at
the British Pharmaceutical Conference last week, commented: “A
big problem with methadone prescribing in a lot of areas is underdosing.”
The usual dosing range of methadone for drug misusers is 60 to 120mg.
However, Mr Bennett said that some areas have a policy of using 30 to
50mg doses, which is often not enough to keep drug misusers in treatment
programmes.
The review says that drug treatment services should aim to keep clients
in treatment for longer and that more clients need to be supervised during
the early stages of methadone consumption programmes.
“Supervised consumption of methadone or Subutex gives prescribers
more confidence to give the correct dose,” said Mr Bennett. Prescribers’ concerns
that drug misuse clients who request a higher dose are intending to sell
the product on the street can be reduced by pharmacy involvement, he
explained.
“Prescribing improves if the prescriber feels secure that their
prescription is being used properly under supervision,” he said.
Patients are usually aware of the right dose to keep them in treatment,
he said, and
if their consumption is being supervised they know that too much will
only make them drowsy.
A detailed report is expected from the NTA and the Healthcare Commission
later in the year. |
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Pharmaceutical Journal
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