A survey was undertaken of senior medical specialists in drug dependence in England and Wales, enquiring about their attitudes and practices concerning the prescription of amphetamines to dependent users. Of the 149 who replied, 60% saw a role for amphetamine prescribing, with 46% currently doing so. Of those who did not prescribe, 32% would like to have done so. Respondents often did not know if general practitioners in their area were prescribing amphetamines. Many could not estimate the percentage of injecting amphetamine users in their area. There was a wide range in the dosage of amphetamine prescribed with a mean maximum of 66 mg. There was agreement about entry criteria for prescribing programmes and also on ways of monitoring those receiving amphetamine. Our results indicate that amphetamine prescribing is widespread in England and Wales although there is little scientific evidence for its efficacy. We have developed some guidelines for good practice, drawing on our own and others' experience.

We visited St Petersburg in the autumn of 1999 as the guests of Professor Leonid Shpilenya, Director of the city's addiction services, and Dr Olga Khvognova, Director of Nurse Training, College Number Three. This was part of an exchange programme financed by the Know How Fund – Health Sector Small Partnerships Scheme (Russia). Two of the authors (P.F. & A.G.) have been involved in these exchanges for a number of years. The current project is a joint one, involving medical and nursing staff (Green et al, 2000).

the need of additional finance or team time. Second, the improvements were gained at a cost of no extra paperwork. And finally, the audit was prioritised, designed and carried out in a true multidisciplinary setting. The main goal of risk assessment audit, to demonstrate an effect on the actual incidence of violent incidents, needs to be studied in further research.