Methadone Maintenance - Dispensing

Dispensing

Methadone maintenance generally requires patients to visit the dispensing or dosing clinic daily, depending on state controlled substance laws. Most states allow Methadone clinics to close on Sundays and provide medication (take homes or exception doses)prior to the closed day/s. States may require or mandate drug testing, in clinic drug abuse groups and/or outside Alcoholics and Narcotics Anonymous meetings. Generally, after 90 days take home medication and group meetings privileges are extended to more take homes and less mandated meetings, but the amount that clinics will let individuals take home has been reduced in recent years, this is as a result of Methadone diversion (selling the Methadone to other addicts) and to protect children who may be present in the household of the prescribed individual. Methadone, at constant daily milligram doses will stabilize patients and relieve all withdrawal symptoms. Patients will not feel the usual "high" or "euphoria" associated with methadone, other opiates, or heroin abuse. In the UK, the prescribing model has changed over the years, from being the norm to prescribe 14 days of Methadone to take home from day 1 of the treatment outset, to today's model that leans more to on-site supervised consumption. The reasons for such a shift in practice is to reduce the "diversion" of prescribed Methadone onto the black market and to ensure that individuals are in fact taking the dose as required. The current mantra for the prescription of MMT is to "start low and go slow" - this is to ensure that a newly prescribed individual is not accidentily overdosed by the Methadone and that the right amount for that person can be titrated without over prescribing, some users over exaggerate the amount of illicit substance that they previously used in order to be prescribed a large amount of Methadone, but careful administration and a knowledgeable practitioner should be able to asscertain when the correct dose has been reached for that particular individual. It is now normal to prescribe daily on-site consumption for the first 3 months and then to move to daily pick up and consumption of site. Such a move should be considered as a reinforcement of the trust between prescriber and patient, but it is at the sole descretion of the prescriber when and if take home supplies will be allowed.