You are currently viewing our boards as a guest, which gives you limited access to view most discussions and access our other features. By joining our free community, you will have access to post topics, communicate privately with other members (PM), respond to polls, upload content, and access many other special features. Registration is fast, simple, and absolutely free, so please, join our community today!
Joined: 02 May 2007 Posts: 23 Location: Eastern Ontario
Posted: Thu May 31, 2007 11:55 pm Post subject: Heroin Maintenance Study in England
At present there are around 300 people in England who are prescribed heroin maintenance through their private doctors.
That might seem like a lot (and it certainly is when compared to Canada there are no people receiving heroin maintenance by their physician) however studies have shown that 15% of all people on methadone maintenance are failing to respond well to that treatment. In England, that 15% translates to some 15,000 people.
So, doctors prescribing heroin to 300 people to take up the slack of 15,000 people not doing well on methadone is really just a drop in the ocean.
Therefore, there are experimental studies going on to see if a clinic-style provision of heroin maintenance will work reasonably successfully.
Quote:
So far a third of the 150 needed have entered the trial. Recruits have to have used street heroin regularly despite being on oral methadone treatment for at least six months at the clinics. They must be over 18 and have used heroin for several years and have no serious physical or mental illnesses.
Most of the people on the trial are in their late 30s and early 40s, have been using heroin for an average of 15 years and have been through an average of 10 years treatment. Many are unemployed and without a stable home, while one or two have full time jobs and a small number are rough sleepers.
THE CLINIC
The average dose given out to injectable heroin recruits is 400mg a day, twice the average prescribed by doctors at present. The diamorphine is bought from Switzerland – a far cheaper supplier than the UK – dispensed into individual’s doses and then drawn up in a syringe. Clients can inject using intravenous, intramuscular or under the skin methods. In the clinic’s room, there is a curtain on one booth to provide privacy where necessary. People are allowed a maximum of three attempts to find a vein, if they can’t find they have to go intramuscular, under the skin or are given oral methadone to take home.
Although patients have formed a good rapport and strong therapeutic relationships with staff, the accent is on the clinical. Signs on booths read Have you washed your hands?’ and ‘Have you cleaned your injecting site?’. So where do they go after injecting? “The atmosphere of the clinic is sterile, clinical, brightly lit so they usually want to leave,” says Dr Nicola Metrebian, a senior researcher at the National Addiction Centre and manager of the trial. Metrebian is aware that the tactic of heroin prescribing has been misrepresented as handing out ‘free heroin to druggies’ by some politicians and newspapers. “This is not decriminalising heroin, this is medical treatment.”
Staff check for signs of intoxication or sedation before and after heroin is taken in order to prevent overdoses. The trial has seen one non fatal overdose which occurred after a patient missed a day’s heroin and replaced it with a large amount of benzos. He was immediately stabilised with naloxone. Staff are convinced had he not been inside the clinic the overdose would have been a fatal one.
As part of what could soon be the ‘old system’ 400 people, a tiny proportion of the estimated 80,000 on substitute opiate scripts in the UK, receive ‘take away’ prescription heroin from a small pool of 46 Home Office-licensed doctors, who actually prescribe heroin. A further 3,000 receive injectable methadone. But the heroin prescription system has had no eligibility criteria, there is little evidence of its effectiveness and no control over whether the heroin is illegally sold on. By the end of the trial in 2008, researchers hope to have come to a conclusion over whether supervised heroin prescribing is a safe, effective and cost-effective option in treating problem heroin users who have failed to respond to methadone or other heroin substitute scripts.
You can access tje full article entitled Re-Writing the Script on Heroin from DrugScope's newsletter here _________________
"You have enemies? Good. That means that somewhere, some time in your life, you stood up for something." - Sir Winston Churchill
You cannot post new topics in this forum You cannot reply to topics in this forum You cannot edit your posts in this forum You cannot delete your posts in this forum You cannot vote in polls in this forum
