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[Executive summary] Consideration is given to adopting local prescribing policies, at least until such time as a wider consensus on the objectives of meathadone prescribin is agreed. In determining local policy objectives a balance is struck between prescribing in support of social and public health gain against the possible conflict with individual gain: the correct balance will depend upon the value given to different elements of policy at different times. A hierarchy of methadone programmes aimed at the needs of different individuals is proposed. Methadone programmes and detoxification protocols are defined. Prescribers have a responsibility to balance cost and patient convenience against safety and risk of leakage onto the illicit market when setting the frequency of meathadone dispensing. Prescribing style is an important factor in determining compliance which is, additionally, checked by urinalysis and plasma methadone measurements. Training reflects local policy and service provision. Training for general practioners comes primarily from medical practitioners, focuses on interventions at the primary health care level, and is conducted at times convenient to general practioners. Costs of methadone programs vary markedly depending particularly upon frequency of dispensing, therapeutic input, and monitoring of compliance. There is and enormous potential for shifting costs and benefits of methadone programmes between health care, social care, the criminal justice system, families and individual drug users. Programme evaluation is complex. Evaluation of methadone programmes combines clinical and econometric outcomes. [Author]