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

Citation

Fingleton NA, Matheson C & Holland R (2015) Specialist clinicians' practice and views regarding methadone/buprenorphine supervision and contingency management: A national survey. Journal of Substance Use, 20 (1), pp. 6-10. https://doi.org/10.3109/14659891.2013.858781

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 6d 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.

Keywords
Contingency management; opiate dependence; supervised consumption;

Journal
Journal of Substance Use: Volume 20, Issue 1