Methadone Treatment of Heroin Addiction in Out-patient Facilities

Overview

In 2000 substitution treatment with methadone was extended to a total of eight departments inthe Czech Republic. One of them is also the AT surgery for the prevention and treatment ofaddictions in Mělník, which is the only department lacking in-patient facilities.The paper deals with the general approach to methadone substitution, availability of treatment,the ratio of methadone substitution in the treatment of drug addiction and problems associatedwith treatment: selection of patients, optimal dose, methadone tolerance, non-compliance withabstinence from opioids and complications associated with the use of other drugs, in particularbenzodiazepines.The author emphasizes the ritual component of addiction and the necessity of toxicological exa-mination of urine.The conclusion contains a brief recommendation of the procedure for methadone substitution indepartments without in-patient facilities.

Key words:
methadone substitution, optimal dose, heroin and Rohypnol, ritual component ofaddiction, toxicological examination.