ABSTRACT
INTRODUCTION Methadone has become established as the standard medical treatment for opiate dependence in many countries. In most of these countries, it can only be prescribed by a doctor if it is taken by the patient under the direct supervision of a professional, typically in a specialist clinic (Farrell et al., 1994; Harkin et al., 1997; Ward et al., 1999). The United Kingdom is unusual in that doctors can prescribe methadone in any dosage form and not necessarily for dispensing in daily instalments. This means that patients can present a prescription for methadone at a community pharmacy and leave the shop with a large quantity of methadone in the form of oral mixture, tablets or ampoules for use as they see fit. Recently, there has been growing recognition in the United Kingdom that this has led to widespread misuse and diversion of methadone onto the illicit market, diminishing the effectiveness of treatment and contributing to a growing number of methadone-related deaths (Cairns et al., 1996).
