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Home > Maintaining or enabling? An evaluation of a methadone prescribing service in Dublin City.

Lawless, Marie and Cox, Gemma (2003) Maintaining or enabling? An evaluation of a methadone prescribing service in Dublin City. In: Pieces of the jigsaw: six reports addressing homelessness and drug use in Ireland. Dublin: Merchants Quay Ireland. 79 - 140.

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Methadone treatment is the most commonly used maintenance option for opiate-dependent individuals in Ireland, based on the premise that such treatment can reduce the risk of blood-borne infections, reduce criminality and lead to improvement in general health.

This evaluation of the methadone prescribing service in Merchants Quay Ireland (MQI) attempted to measure its effectiveness in terms of client outcomes. Baseline information was collected by means of the Opiate Treatment Index questionnaire from 31 clients living in the Dublin 8 area who were receiving oral methadone prescribed by the MQI service in mid-1999; the questionnaire was administered again to clients who remained on the programme 18 months later.

At follow-up, 14 (55%) clients were still on the programme, the majority of them male. Findings at follow-up showed: reductions in drug-using risk behaviour, in quantity and frequency of licit and illicit drug use, in criminal activity and in a range of psychiatric complaints; improvements in social functioning; increased sexual risk behaviour. Health status remained largely consistent over the 18-month period. Qualitative data were obtained by means of three focus groups, two comprising clients who where currently on methadone treatment and one comprising staff members of MQI. Analysis of these data highlighted that while methadone was regarded as a favourable treatment option, the way the service was delivered was in need of review.

This study concludes that the MQI programme illustrates the effectiveness of a multi-disciplinary approach to the treatment of opiate use, in which the expertise and skills of both the treatment centre and the general practitioner are employed.

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