Methadone users to get more help.

Drug detox programmes for heroin addicts are to be overhauled in an attempt to reduce the death toll among former drug users and bring down the numbers who stay on methadone for years.

John Curran, the minister for drugs strategy and community affairs, has asked the Health Service Executive (HSE) and the National Advisory Committee on Drugs (NACD) to review all methadone-maintenance programmes and report on how effectively they wean patients off the heroin substitute.

Of the 400 drug-related deaths each year, up to 60 occur among the 8,600 registered methadone users, prompting fears that they are not being steered off the laboratory drug and that many are combining it with illegal substances.

“I have a grave concern that people seem to be on methadone for an extended period of time,” said Curran. “I would like to see the hard evidence to show progression. I want to see an active methadone-reduction programme.”

Curran said the HSE is developing an “overdose prevention strategy” to address the risk to methadone clients. Since becoming minister, he has met many former addicts who were on methadone maintenance for years.

While methadone helps heroin addicts stabilise their chaotic lifestyles, Curran believes this period of stabilisation must eventually be used to reduce the dosage to help former addicts progress to a drugs-free lifestyle.

Methadone, also known as physeptone, helps block withdrawal symptoms for someone coming off opiates. Properly supervised and managed methadone patients can reduce or stop their use of substances such as heroin.

Jack Wall, the Labour drugs spokesman, has challenged Curran about the death toll among those registered on state-run methadone programmes. Wall said he was concerned that some patients were getting supplies of the drug from a number of sources.

“If that is the case, instead of curing themselves, addicts are creating more problems for themselves and can become addicted to using methadone,” he said.

Curran confirmed that, out of 400 drug-related deaths in 2005, 60 people died while on methadone maintenance and the use of drugs with alcohol and other substances was a factor in many of the deaths.

The national drugs-related death index published by the Health Research Board last year showed 2,442 young people had died as a result of problem drug use between 1998 and 2005. Causes of death included overdoses, illnesses linked to hepatitis C and HIV infection, and trips and falls linked to incapacitation from drug use.

“When a person enters drug treatment they should have a realistic prospective of becoming drug-free,” said Curran. “We need to be much more proactive in exploring ways towards helping people to exit successfully from opiate substitution treatment, and this is something that I intend to pursue.”

He said drug users’ relatives also needed help in accepting and coping with the problem that had arisen within their family, and support to help their relative re-engage with society.

The minister said the national drugs strategy for 2009-2016, now nearing completion, would set demanding but achievable targets to tackle the problem of substance abuse in Ireland.

In Vienna last week, Curran signed a new UN political declaration on drugs that commits Ireland to closer co-operation in the international battle against the illicit drugs trade.

Source: Stephen O’Brien, The Sunday Times Online, 15/03/2009