Psychiatric Bulletin (2008) 32: 387-390. doi: 10.1192/pb.bp.107.017632
© 2008 The Royal College of Psychiatrists
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Injectable opiate prescribing in Cornwall

Rupert White, Consultant

Cornwall Partnership Trust, Cornwall Integrated Alcohol and Drug Service, Tolvean House, West End, Redruth, Cornwall TR15 2SF, email: Rupert.white{at}cpt.cornwall.nhs.uk

Lizzie Shearman, Medical Student

Peninsula Medical School, Royal Cornwall Hospital, Truro, Cornwall

Declaration of interest

None.

AIMS AND METHOD

To compare local practice with national guidelines, examine the areas of divergence, and establish complication rates for methadone and diamorphine. Fifty-one patients from Cornwall treated with injectable methadone or diamorphine were interviewed using a standard questionnaire.

RESULTS

Fewer problems were reported by individuals using injectable diamorphine, though for both drugs intramuscular injection was more problematic than intravenous injection. Injections into the groin were common, as was problem drinking.

CLINICAL IMPLICATIONS

Intramuscular administration of medications may be more likely to cause abcesses or cellulitis. Ongoing groin injecting and alcohol misuse is common, but should probably be tolerated if other harm reduction benefits accrue. It may be prohibitively expensive to set up injecting rooms in rural parts of the UK and future policy should reflect this.




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