ATTACK HEROIN NOT METHADONE
I am posting below a brilliant letter by Alex Wodak, MD submitted for editorial to The Times.
Wed, 25 Jul 2007
Subject: Attack heroin not methadone
The recent report (The Times, 23 July 2007, Services failing the children of 7,000 drug addict parents, Charlene Sweeney) into treatment services for drug dependent parents in Scotland attacks the most effective response rather than focusing on the real problem. If Ms Annabel Goldie really wants to listen to experts, she should read the 2005 joint
endorsement of methadone by the United Nations Drug Control Programme, the World Health Organisation and UNAIDS. In 2005, WHO added methadone to its list of Essential Medicines. Methadone and buprenorphine treatment are remarkable for their ability to attract, retain and benefit large numbers of heroin users.
Abundant research confirms that methadone substantially reduces deaths, heroin use, crime and HIV infections. In a 2006 study published in The Lancet, methadone treatment in Zurich reduced the number of new heroin injectors from 850 in 1990 to 150 in 2002 with a large decrease in deaths, crime, HIV infections and heroin seizures.
Supervision of methadone treatment reduces diversion to the black market while inadequate methadone treatment increases the black market. All over the world, methadone treatment is grossly under funded. Consequently, programs have insufficient capacity and quality. Residential treatment programs for heroin users attract few, retain even fewer and are expensive. Finding evidence of benefit is very difficult. Yet they have their place as some drug users will always reject or not receive benefit from methadone treatment.
Dr. Alex Wodak,
Director, Alcohol and Drug Service,
St. Vincent's Hospital,
Darlinghurst, NSW, 2010,