A Low Threshold Methadone Stabilisation Programme–Description and First Stage Evaluation

Abstract

A low threshold methadone stabilisation programme was set up to cater for the most chaotic clients seen in a central London Drug Dependence Clinic. It set out to reduce HIV risk behaviours, to stabilise drug use and to move clients on to other forms of treatment. The programme was evaluated over the first two months and compared with a consecutive group of outpatients. The methadone programme group had failed more treatments and were more likely to be injecting and have a psychiatric history. They were engaging in higher risk injecting behaviour before entry to the programme and their level of injecting risk dropped significantly more than the comparison group in the first two months in the programme. There was no change in sexual risk. Using the HADS, the numbers of cases of depression dropped only in the methadone programme group (Zigmund and Snaith 1983). The drop out rate was similar in both groups. No demographic or history variables were found to be associated with drop out. It was concluded that the methadone programme was useful for a difficult group of clients but a failure to retain more clients than conventional outpatients may be related to methadone dose.

Key Words:

• Methadone stabilisation
• HIV risk behaviour
• harm reduction
• depression
• anxiety