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Aims and Method  A satellite methadone prescribing service was set up in a hostel in London's West End. The aim was to investigate if it were feasible to engage and retain these hard-to-reach, chaotic, polydrug users in treatment. A basic needs assessment was undertaken with staff and clients at the hostel. Treatment outcomes were assessed at 16 weeks using the Maudsley Addiction Profile.    Results  At 16 weeks 87% of the original cohort (26 out of 30) were still in treatment. There were also significant reductions in mean heroin use (from 29.7 to 14.5 out of the past 30 days,  P &lt;0.001) and in the frequency of injecting (from 25.9 to 15.9 days,  P &lt;0.001).    Clinical Implications  This outreach clinic offers a model for developing services to homeless people with substance misuse problems.

Setting up a methadone maintenance clinic in a hostel in London's West End