One-year follow-up of opiate injectors treated with oral methadone in a GP-centred programme

Aims. To Examine changes in drug-related behaviour in opiate-dependent inje ctors treated with oral methadone, in a shared care scheme where consumptio n of the daily dose is usually supervised by a community pharmacist. Design . One-year cohort study. Setting. Recruitment from the main routes into met hadone prescribing in Glasgow during 1996: General Practitioner Drug Misuse Clinic Scheme and the Drug Problem Service. Participants. Current opiate i njectors entering methadone treatment. Findings. Among the 204 injectors re cruited, 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-repo rted daily opiate injecting reduced from 78% to 2%; overdose in the previou s 6 months from 24% to 2%; mean daily drug spend from pound 50 to pound 4; and mean monthly number of acquisitive crimes reduced from 13 to three. Ass uming participants lost to follow-up were unchanged, significant improvemen ts in the total cohort were seen in daily opiate injecting (from 80% at rec ruitment to 43% at 12 months), overdose (from 27% to 15%), mean daily drug spend (from pound 63 to pound 38) and,mean monthly number of acquisitive cr imes (from 18 to 11). Discontinuation of treatment was mainly due to impris onment (39%) or sanctions by the prescriber (33%). Conclusion. Treatment of opiate-dependent drug injectors with methadone in a community-wide general practitioner-centred scheme, with supervised daily consumption, was associ ated with major beneficial change for a substantial proportion of patients.