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<b><i>Background and Context:</i></b> Realization of the life-saving potential of "take-home naloxone" has been a personal journey, but it has also been a collective journey. It has been a story of individual exploration and growth, and also a story of changes at a societal level. "Take-home naloxone" has matured since its first conceptualization a quarter of a century ago. It required recognition of the enormous burden of deaths from drug overdose (particularly heroin and other opioids), and also realization of critical clusterings (such as post-release from prison). It also required realization that, since many overdose deaths are witnessed, we can potentially prevent many deaths by mobilizing drug users themselves, their families, and the wider caring community to act as intervention workforce to give life-saving interim emergency care. <b><i>Summary of Scope:</i></b> This article explores 5 areas (many illustrations UK-based where the author works): firstly, the need for strong science; secondly, our improved understanding of opioid overdose and deaths; thirdly, the search for greater impact from our policies and interventions; fourthly, developing better forms of naloxone; and fifthly, examining the challenges still to be addressed. <b><i>Key Messages:</i></b> "Take-home naloxone" is an exemplar of harm reduction with potential global impact – drug policy and practice for the public good. However, "having the potential" is not good enough – there needs to be actual implementation. This will be easier once the component parts of "take-home naloxone" are improved (better naloxone products, better training aids, revised legislation, and explicit funding support). Many improvements are already possible, but we hesitate about implementation. It is our responsibility to drive progress faster. With "take-home naloxone," we can be proud of what we have achieved, but we must also be humble about how much more we still need to do.

Presenting a comprehensive account of the development of policies and treatments, Heroin Addiction a brings together the perspectives of policy makers, practitioners and social commentators. The book contributes to a proper understanding of how.

The British system of dealing with drug addiction is notable for its flexibility and its capacity to adapt to changing circumstances. Because of this it has attracted considerable international interest, although it is rarely fully understood or accurately represented.Presenting a comprehensive account of the development of policies and treatments, Heroin Addiction brings together the perspectives of policy makers, practitioners and social commentators. The book contributes to a proper understanding of how policy and practice has evolved so that lessons for future policy and practice may be identified.Volume II of Heroin Addiction charts the development and use of treatment and policy responses in the UK, highlighting the limitations of these approaches as well as their achievements. It is a unique source of reference for students, researchers, healthcare professionals and drug agencies both in the UK and overseas

<b><i>Aim:</i></b> To assess the impact of femoral ultrasonography accompanied by explanation of the findings (UFV) on groin-injecting behaviour. <b><i>Methods:</i></b> 348 heroin-addicted groin injectors (GIs) on opioid substitution treatment (OST) were included in the study: 174 received UFV (cases), 174 did not (controls). Injecting behaviour among cases and matched controls were compared for both 'persistent GIs' (patients who had injected via the femoral vein in the 28-day period preceding the baseline) and 'former GIs' (patients with a history of previous groin injecting). <b><i>Findings:</i></b> There were no significant between-group differences in gender, mean age, time in treatment, substitute medication and mean dose at baseline or injecting behaviour prior to baseline. After baseline, reduction by a third in the proportion still groin injecting was immediately evident among UFV cases versus controls (number needed to treat: 3, 95% CI: 2, 8; p < 0.001). Marked reduction in groin-injecting behaviour among UFV cases was maintained over 12 months, including fewer relapses among 'former GIs' (number needed to treat: 5, 95% CI: 4, 9; p < 0.001). <b><i>Conclusion:</i></b> Single-session UFV may promote cessation of groin-injecting behaviour among patients receiving OST. This benefit appears to be evident 12 months later. Further evaluation of this novel approach to the management of groin injecting, a particularly harmful behaviour, is now warranted.

The initial assessment and subsequent monitoring of compliance in methadone treatment programmes are excessively reliant on the accuracy of self-report from opiate addicts themselves. Given the central position of methadone treatment in the therapeutic options currently available and with the increasing number of opiate addicts requiring treatment, improved methods of judging optimal methadone treatment are required. This paper explores the possible future options for assessing the adequacy of methadone prescribing from the analysis of methadone levels in urine, blood, hair and saliva. The particular promise of plasma therapeutic drug monitoring for methadone is explored, accompanied by an account of the state of the art at the time of writing.