Geographical variations in substrate misuse services waiting times and methadone treatment of opiate dependence in England and Wales

Abstract

Aims and methods: A postal and telephone survey of 140 community drug teams was undertaken to determine geographical variations in waiting times and methadone prescribing policies. Results: The average waiting time was 7.2 weeks for assessment and 10.6 weeks from referral to receiving methadone. 'Methadone maintenance' was not available in 25 units, although it was commonly provided in 41 units. In-patient detoxification for illicit drug dependence was available in 108 units, of which 59 units had access to beds in dedicated drug-dependency units, while the remaining 49 units referred in-patients to general psychiatry wards. Clinical implications: Despite government guidelines, it was clear that methadone was readily available to opiate users in some units whereas prescribing was very limited in others. The great variation in prescribing policies and waiting lists between community drug teams will make it extremely difficult to compare their effectiveness. Waiting lists are an explicit target for the National Treatment Agency involved in commissioning substance misuse services.