Table of Contents

1. Forewords 1. The emerging central position of methadone in outpatient opiate treatment in the UK, comparative international attitudes and controls on methadone and European diversity 2. Preface 2. The history of methadone: analgesic, anti-tussive and addiction treatment 3. The Snake Pit: Anguish and Fury, A Laboratory Smelling of Sulphur, The Psychiatrist's Fair 3. Methadone prescribing in England and Wales: what can we learn from community pharmacy surveys? 4. Preludes: An Unusual Menagerie, Fabricating Human Mental Illness: ''Mind Poisons'', The Beginnings of Psycho-chemistry 4. The dynamics of staff / client relationships Linking psychology and pharmacology 5. Discovery of the Neuroleptics: Manoeuvres, Discovery of the Neuroleptic Action of Chlorpromazine at Sainte-A nne, Neuroleptics and Psychopharmacology 5. Supervised consumption of methadone in the community pharmacy 6. Discovery of the Antidepressants and Mood Regulators: Depression - A Way of Life, Discovery of the Antidepressants, If you are Depressed 6. A methadone programme for substance misusing pregnant women 7. Discovery of the Tranquillizers: What is a Tranquillizer?, The Benefits of Tranquillizers 7. Injectable methadone: a peculiar British practice 8. The Future of Psychiatric Medicine: Realities and Utopias, Where is the World's Anguish Hiding, And so, Tomorrow, Index 8. Prescribing injectable methadone: To whom and for what purpose? 9. Supervised Injecting 10. Withdrawal from methadone and methadone for withdrawal 11. Plasma methadone monitoring 12. Client screening, diagnosis and outcome monitoring in methadone programmes 13. A central assessment service with widely disseminated delivery in primary care 14. A primary care based specialist service 15. A centrally co-ordinated city strategic approach 16. Guidelines and protocols: the pros and cons of greater uniformity 17. Special challenges to methadone prescribing with young people 18. Methadone maintenance and reduction treatment: the need for clarity of goals and procedures 19. Rapid benefit, but what thereafter? The rush and trickle of benefit from methadone treatment 20. Inter-agency variability in benefit from methadone treatment - perhaps the messenger matters 21. Methadone and heroin related deaths: Changing prevalence over time 22. Additional drug use by methadone treatment patients: 'using on top' and the problems it brings 23. The illicit market in different forms of methadone: The play, the plot and the players 24. Dependence on methadone: The danger lurking behind the prescription 25. The way forward - maximising the benefits, minimising the risks