Medical treatment is an important component of comprehensive services for problem drug takers. The possibility of prescribing drugs such as methadone attracts problem opiate takers into contact with services, thus providing opportunities for the social and psychological interventions described in other chapters. Having a clear understanding of current medical practices and of recent developments in this area enables non-prescribing drug workers to co-operate most effectively with medical practitioners whether they be general practitioners or psychiatrists. This chapter focuses solely on medical treatments in order to present current standards of good practice particularly related to detoxification. It recognises the wider issues of prescribing policies (discussed by Wilks in Chapter 9) but confines itself to practical clinical issues.
Drug-dependence clinics need to develop full assessment procedures and be very familiar with the changing local drug scenes so that needs can be identified early and met. Knowledge of other local services provided by both statutory and voluntary bodies is essential to avoid duplication of services and to link the facilities available. If possible the size and nature of the local drug problem should be ascertained. Surveys in East Dorset have been used to involve probation and social services and to emphasise the important needs of comprehensive school children (Pritchard et al. 1985, 1986).
Immediately on referral it is important to check with the Home Office Drugs Branch to see if the patient has been notified to them and if any treatment, particularly the prescribing of controlled drugs, is currently available to them. This simple step will go some way