Amphetamine misuse has been increasing worldwide for a number of years. The United Kingdom is now the largest consumer of illicit amphetamine in Europe. It was in this context that in 1995 the U.K. government appointed a task force to review services for drug users. Among the research commissioned was a study on amphetamine use. This was a large piece of work that investigated delivery of services to problem amphetamine users in the north west of England. This paper describes one aspect of the research, that of substitute prescribing. Primary amphetamine using clients newly presenting to 16 participating agencies in north west of England were recruited to the study. A matched case-control design was used in which an amphetamine user not in treatment (control) was recruited to match each drug agency client. Drug agency clients were prescribed dexamphetamine (PDAs) to determine if this changed their use of street amphetamine. Interviews provided qualitative data that was then subjected to statistical tests. The analysis showed that comparing prescribed clients to their controls resulted in a significant reduction in amount and frequency of street amphetamine consumption over the first 3 months of treatment. Comparisons between PDAs and clients in treatment but not receiving a prescription revealed that the reduction in amount was greater for the prescribed clients. Retention in treatment was significantly greater for PDAs. This study shows a need for services that offer more time for counseling, a greater use of ancillary services, and open discussion between therapist and client about relapse prevention. A model that is increasing in popularity is a package of components that can be assembled to suit the individual client. References