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Summary

Introduction
Limitations
Target group and Outline Paper

State of the Art of Methadone in Europe
Opiate addiction in Europe
History of Methadone Substitution Treatment
Methadone Substitution Treatment in Europe

The Evidence for the effectiveness of methadone
Pharmacology
Research
Cost-effectivenes

Outline of Best Clinical Practice
Criteria for treatment
Assessment
Treatment plan and treatment goal
Induction
Detoxification regime suggestions
Maintenance programme suggestions
Detoxification from Methadone Maintenance Treatment
Special groups and settings
Pregnant women
Neonates of opioid dependent women
Parents of young children
Young People
People with HIV/AIDS
People with hepatitis
People with mental health problems
Multiple-drug users
Minority ethnic groups
People in prison
People in hospital
People who travel
Figure 2: Steps in methadone treatment
Other substitution drugs
Route of administration: oral, injectable
Psychosocial interventions

Practical issues of programme organisation
Staff requirements
Training
Teamwork
Role of the medical doctor
Role of the nurse
Role of the drug worker
Role of the clinical psychologist
Role of pharmacist
Record keeping
Dispensing
Other services
Physical setting
Funding
Consumer involvement

Monitoring and Evaluation

Bibliography
Reports
List of experts involved
Recommended literature and useful website