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DOCUMENT 2014 HTM file
Time limiting opioid substitution therapy
Rather than being ‘parked’ on methadone, generally Britain’s heroin-addicted patients leave too soon to fully benefit, argue official government advisers on drug policy. Their report unambiguously countered concerns within the current UK government over methadone maintenance.
From Norway, strong evidence that being in a methadone or buprenorphine maintenance programme protects heroin-dependent patients from drug-related ill-health including life-threatening overdoses and infections, even if the treatment has not completely subdued illegal drug use.
Consolidates WHO guidance on HIV prevention, diagnosis, treatment and care for key populations including prisoners and people who inject drugs. Strongly advocates universal access of injectors to needle exchange and of dependent opioid users to indefinite, high dose methadone and buprenorphine maintenance.
A combination of needle exchange, methadone maintenance and a shift away from injecting meant that between 2008 and 2012, 1000 fewer Scottish injectors had to face chronic infection with the potentially deadly hepatitis C virus.
This British study concluded that it takes extended opiate substitute prescribing to realise the treatment's life-saving potential. The implication is that the current push to get people off methadone sooner could cost lives.
This thorough review formed the evidential basis for recent guidance from England's National Institute for Health and Clinical Excellence on how best to distribute sterile syringes. Maximising the proportion of injections done with sterile equipment is the key objective.
DOCUMENT 2014 HTM file
Needle and syringe programmes
The UK’s health advisory body recommends high coverage and if need be, 24-hour needle exchange to combat HIV and the hepatitis C epidemic. The aim they say is for every injector to have even more sterile injecting equipment than they need for every single injection.
A major concern about needle exchanges is that after use the injecting equipment they supply will be left unsafely disfiguring public areas, but this US study based on a comparison between San Francisco (has legal exchanges) and Miami (exchanges illegal) strongly suggests the opposite.
REVIEW 2009 HTM file
Alcohol and drug screening of occupational drivers for preventing injury
Exhaustive search finds just two rigorous studies of workplace testing for alcohol and/or drug use of people employed as drivers. For drugs there was some evidence of a long-term effect in averting injuries and deaths but in respect of both drugs and alcohol the evidence was too thin to support any particular policy.
The evaluation which led to the Welsh national programme to distribute naloxone to opiate users and their associates to curb rising overdose deaths, one of several UK studies to give momentum to this peer-based strategy.
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