Specialist clinicians' practice and views regarding methadone/buprenorphine supervision and contingency management: a national survey

Niamh Fingleton, Catriona I. Matheson, Richard C. Holland

Research output: Contribution to journalArticle

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Abstract

Aims and methods: The aim of the study was to determine the current models of supervised consumption of methadone/buprenorphine practised, and to establish the extent to which contingency management is used, and in what forms. A postal questionnaire was sent to all lead specialist clinicians in the field of substance misuse in England in 2010 (n = 194).

Results: The response rate was 66% (n = 129). Clinicians generally supervised patients for a period of 3 months, although considerable flexibility was used depending on individual circumstances. The majority of patients consumed their methadone/buprenorphine on pharmacy premises 6 d per week. Supervised consumption arrangements were believed by respondents to cause a minority of patients to drop out of treatment and prevent a minority from starting treatment. Contingency management is widely used throughout England, with the most common forms relating to changes in supervision or dispensing arrangements.

Conclusion: There is marked heterogeneity in clinicians’ practice of supervised consumption, suggesting uncertainty regarding the optimal approach. Further research, such as an RCT, is required.
Original languageEnglish
Pages (from-to)6-10
Number of pages5
JournalJournal of Substance Use
Volume20
Issue number1
Early online date16 Dec 2013
DOIs
Publication statusPublished - 2015

Keywords

  • contingency management
  • opiate dependence
  • supervised consumption

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