More putting out fires with petrol:

There have been many press reports this week of the recent "discovery" that Dihydrocodeine, in the form of DF118's, is at least as effective as Methadone in "treating" opiate dependency. This is no discovery at all - all the addicts that I have mentioned this story to have yawned politely and made comments like "now tell me something that I don't know".

Of course any opiate or opioid drug will serve to assuage the symptoms of opiate withdrawal - whether or not giving an opiate user such a drug constitutes "treatment" is another matter. It seems that if a doctor in a drug service hands out Methadone for example then that is "treatment" - providing of course that reams of paperwork have been filled in and certain procedures have been followed.

If an addict was to buy the same amount of the same drug on the street - then this constitutes dealing and the supplier is liable to lengthy prison sentence - up to life imprisonment in fact!

In other words if a doctor does it then it's treatment, harm reduction etc and a good thing but if I do it then it's a very bad thing. Of course the addict's body would not differentiate between the "good" methadone and "bad" methadone - it would react exactly the same and the effects would be the same.

Coming back to DF118's - Doctors in the UK seem more than happy to hand this medication out like sweeties, I can remember doing a straw poll in a prison where I worked that showed that the incidence of back pain requiring Dihydrocodeine was around 20 times the expected average figure in the community.

On one hand these were young men in their 20's and 30's on the other hand many of them had a long history of drug dependency, however they all knew that Dihydrocodeine was an opiate type drug and they were not taking it to treat their addictions either, more to feed them.

The fact is that these drugs have changed hands on the streets for many years - with most of the supply being diverted from legally prescribed sources. Addicts have known about this, so have many drugs workers, counsellors etc.

I find it rather alarming that a "scientist" discovers what has been obvious to everyone else for years and suddenly it's a newsworthy piece of "new research".

So much for learning from our clients.

Whitehall's "Spinball" Drug of Choice!

There were two very interesting, yet contradictory, stories in the press this weekend regarding Methadone:

The Scottish press, in the form of Scotland on Sunday and The Scotsman, ran a story on Professor Neil McKeganey's research (from Glasgow University) which shows that only 3.4 percent of drug users who were prescribed Methadone were “drug-free” after 3 years as opposed to 29 percent of those who went into residential treatment.

Other differences were just as startling:

Of those who received Methadone:

• 29 percent were in employment or education.
• 47 percent said that they “felt better”.
• 91 percent admitted to committing crimes.

Of those who took the abstinence route:

• 59 percent were in employment or education.
• 79 percent said that they “felt better”.
• 13 percent admitted to committing crimes.

Professor McKeganey's research seemingly shows that Methadone “treatment” is only marginally better than no treatment at all.

There are apparently around 20,000 addicts receiving Methadone in Scotland.

Meanwhile in England the Sunday Mirror reported that 84,583 people were in treatment for Heroin addiction (in England). Caroline Flint MP (now the Health Minister, previously the Drugs Minister) reported that the figure had almost doubled over the past 2 years and that this was a sign that the government's drug strategy was a success.

It also reported “experts” as claiming that the true number of Heroin addicts could be 120,000 because many users “weren't receiving medical help” . We reckon that the real figure is likely to be at least double this – say 250,000?

Um........ We also note that the report talks about “medical help” - effectively prescribed Methadone. The article then went on to report that drug related crime had fallen by 16 percent from April 2004 to March 2006. It then trots out the old statement that “for every £1 spent on treatment £9.50 is saved in crime and health costs”.

Am I the only one to sense a contradiction here?

Either Scottish Addicts are very different from English ones (They are not – I have worked with both) or Scottish professionals are less competent than their English counterparts ( again we know that they are not) or something is wrong with the figures! Especially so when Caroline Flint's figures don't even seem to relly match up with those from the National Treatment Agency which last month reported 181,000 people in treatment for drug use! ( If 84,000 are Heroin addicts what are the other 97,000 doing?)

Could it actually be that someone, somewhere – perhaps not a million miles away from Central London – is massaging the figures?

If I have to chose between the 2 stories I would have to say that in my experience Professor McKeganey is the one that we should be believing! But Scotland and Glasgow are a very, very long way from Whitehall (unlike Baghdad and Kabul) so we very much doubt that anyone will take any notice whatsoever of this research.

"Evidence based Research" only counts when it says what they want to hear!

Alcohol and other drugs......

I had a telephone call from a well known National newspaper today asking if I could give any details of anyone that I knew of who had died of a heroin overdose recently - the idea was to establish some kind of a link to the price of heroin coming down.

What is it in this country? More people die of overdoses involving Methadone- prescribed or otherwise - and admitedly usually used in conjunction with other drugs than heroin. However all the total drug deaths pall into insignificance when compared to alcohol and tobacco related deaths.

If one teenager takes an ecstasy tablet and dies then its all over the media for a few days, but I have yet to see the same sensational headlines about the 100 or so alcohol related deaths each day. That might well change however as thanks to the "National Alcohol Harm Reduction Strategy" and longer opening hours the numbers are rising rapidly.

It is very interesting to contrast the differences between the Alcohol and Drug Strategies however...

For Drugs: We must reduce the supply and we will lock up the suppliers for life for preying on the inocent victims.

For Alcohol: It is the consumers fault for not drinking sensibly and we will involve the suppliers in writing the strategy and do all that we can to make it easier to obtain supplies in the name of consumer choice!

Of course the Government taxes alcohol and tobacco but not drugs. Could there be a connection we wonder?

Why do the media fail to see all the inconsistencies and lack of logic in all this? Uhmm? Answers on a postcard please!