One-year follow-up of opiate injectors treated with oral methadone in a GP-centred programme.
OBJECTIVE
To examine changes in drug-related behaviour in opiate-dependent injectors treated with oral methadone, in a shared care scheme where consumption of the daily dose is usually supervised by a community pharmacist.


METHODS
One-year cohort study.


METHODS
Recruitment from the main routes into methadone prescribing in Glasgow during 1996: General Practitioner Drug Misuse Clinic Scheme and the Drug Problem Service.


METHODS
Current opiate injectors entering methadone treatment.


RESULTS
Among the 204 injectors recruited, 148 (73%) were re-interviewed at 6 months and 118 (58%) at both 6 and 12 months. Twenty-nine per cent of the cohort remained continuously on methadone for 12 months. In that group, over the 12-month period, self-reported daily opiate injecting reduced from 78% to 2%; overdose in the previous 6 months from 24% to 2%; mean daily drug spend from 50 Pounds to 4 Pounds; and mean monthly number of acquisitive crimes reduced from 13 to three. Assuming participants lost to follow-up were unchanged, significant improvements in the total cohort were seen in daily opiate injecting (from 80% at recruitment to 43% at 12 months), overdose (from 27% to 15%), mean daily drug spend (from 63 Pounds to 38 Pounds) and mean monthly number of acquisitive crimes (from 18 to 11). Discontinuation of treatment was mainly due to imprisonment (39%) or sanctions by the prescriber (33%).


CONCLUSIONS
Treatment of opiate-dependent drug injectors with methadone in a community-wide general practitioner-centred scheme, with supervised daily consumption, was associated with major beneficial change for a substantial proportion of patients.
Hutchinson
S J
SJ
Scottish Centre for Infection and Environmental Health, Glasgow, Scotland, UK. sharon.hutchinson@scieh.csa.scot.nhs.uk
Taylor
A
A
Gruer
L
L
Barr
C
C
Mills
C
C
Elliott
L
L
Goldberg
D J
DJ
Scott
R
R
Gilchrist
G
G
D000328:Adult; D000553:Ambulatory Care / Q000379:methods*; D015331:Cohort Studies; D005194:Family Practice; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D012606:Scotland; D016896:Treatment Outcome
D009294:Narcotics; D008691:Methadone