DO YOU CARE WHERE YOU TAKE YOUR METHADONE?

There has been quite a debate occurring in Monkey magazine regarding the issue of observed consumption of methadone, and some quite wild allegations have been made ABOUT the IDEA and its legitimacy. I would argue that observed consumption of methadone can be delivered in a user-friendly, non-judgmental way. I believe that the low threshold observed consumption of methadone service offered at the Waterloo Project is not a way of punishing or controlling drug users, but an innovative service reaching to people who have found it hard to get methadone from ‘mainstream’ drug services or their G.P.

The service is low threshold, meaning that there are fewer hoops to jump through to get methadone treatment. The clients would refer themselves on a Wednesday afternoon, they would then see myself, the doctor and provide a urine sample. The doctor and myself would undertake an assessment, and the urine sample is tested on site. If the urine sample is positive for opiates and the client is suitable, demonstrating a difficulty in engaging in treatment elsewhere, they will receive their first dose of methadone that day. Initially no-one is prescribed more than 40mgs of methadone for safety reasons. But if they attend every day the client can go up 10mgs a week. At the weekend a 'take home' doses is dispensed rather than a prescription if the client has attended three times a week. Again this is for safety reasons of tolerance. Myself and the client work in partnership to achieve the dose the client and myself believe they need, more often than not the client wants less than I would have thought they needed. The client makes their own choices regarding how much they wish to engage in the other services offered, such as needle exchange, welfare advice, drop-in, hep b vaccines, acupuncture etc. The supervised methadone is delivered at the Waterloo project, which is a user-friendly project run by the STASH team. So the problem, if there is one, is not supervised consumption, but who delivers it and where. Tea, coffee, methadone on the day of assessment, advice, information, a massage, etc. Who can complain about that? Nobody does. I have read in a previous issue of [Monkey Magazine] that diverted methadone is the lowest tier of service delivery. I strongly believe that this is not the case. There have been numerous research papers published on methadone related deaths and the diversion of methadone is put down as a cause of overdoses. I believe it is the responsibility of drug services to reduce the diversion of methadone as the safety of users should be the primary concern.

The clients on the scheme don't believe that they are being punished for being drug users or that Tony Blair's Britain is waging a war upon them. The majority of clients state that they prefer the on site dispensing of methadone, believing that it was easier to access and knowing that there was always someone around that they could talk to and can access other services available to them. Methadone is a medication that can be delivered to the clients within the context of accessibility, safety, user-friendliness and a non-judgmental approach.