Drug misuse clinical guidelines

In the course of clinical treatment with methadone, certain situations relating to adverse effects are characteristic. Nausea is a general opiate effect, but complaints most frequently relate to the methadone mixture. This preparation does have a syrupy consistency, but the problem for clinicians is that the alternatives - sugar-free mixture or methadone tablets - are both more injectable, and therefore requests or implied requirements for these are often manipulative. So are requests for the antiemetic cyclizine tablets, which are crushed and injected by drug misusers along with injected methadone. As indicated in Chapter 4, thankfully these particular claims have become less common now that guidelines are much more discouraging of any use of methadone tablets. 

Department of Health (1991). Drug Misuse and Dependence Guidelines on Clinical Management. London HMSO... 

DHSS (1984) Guidelines of good clinical practice in the treatment of drug misusers, London HMSO. 

For a general account, see Drug Misuse and Dependence — Guidelines on Clinical Management. HMSO, London, 1999. 

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