Managing Alcohol Use Disorders in OTP [methadone maintenance] Patients"
Policies regarding "managing alcohol use disorders in OTP [methadone maintenance] patients" is the lead story in current Addiction Treatment Forum (vol. 20, no. 2, spring 2010). An example is cited: "A patient arrives [at the methadone clinic] obviously inebriated, but docile. Some OTPs send the patient home in a taxi without dosing. Others keep the patient in the waiting room until breathalyzer scores are low enough for at least a partial dose ... "Question is: is there a basis for either practice? Any evidence that a constant daily dose of methadone to which, by definition, the patient is presumed to be tolerant), would be risky if the patient is intoxicated - and/or the breathalyzer "score" is above a certain threshold? And if there is basis for considering usual - or reduced - dose of methadone to be risky, how does the danger compare to that which might be expected if the patient resorts to illicit opiates to prevent or treat withdrawal symptoms before the methadone is available from the clinic the next day? Comments (and references) welcomed!