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Agreement for Methadone Prescriptions

Name:
 
Date:
 

The goals of treatment are:

 

 
 
 
 
 
 
 

Whilst aiming to achieve these goals, please note:

 
  • We ask all the patients in this practice to be on time for their appointments and to let us know if they are unable to attend.
  • That out of hours calls or home visits should not be used to discuss your prescription.
 

Please remember that:

 
  • Methadone:
    • can cause serious harm, or death in overdose.
    • may cause drowsiness, and you must not drive or operate machinery if you are drowsy.
    • may be dangerous if taken with alcohol or other street drugs e.g. benzodiazepines.
     
  • If you lose any scripts or medication they will not be replaced unless there are highly exceptional circumstances.
  • You will be asked to give a urine sample at some appointments.
 

Any other points:

 

 
 
 
 
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