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REVIEW 2012 HTM file
Drug policy and the public good: evidence for effective interventions
Review of relevant research by an international team of leading researchers offers policymakers guidance on the interventions most likely on the evidence to achieve national policy aims in respect of illegal drug use.
Unequivocal backing from UN agencies for methadone and other forms of long term maintenance treatments as the prime modality for the treatment of dependence on heroin and allied drugs. In contrast say the experts, detoxification results in poor long term outcomes.
The evidence which led the UK government's drug policy advisers to call for the legalisation of the supply of foil by medical and drug services to drug users to promote transition from injecting to smoking heroin and crack cocaine.
British needle exchanges which piloted distribution of foil packs for smoking heroin found they were widely used and may have increased attendance and reduced the number of injections, lending weight to calls to legalise such provision.
This wide-ranging review uniquely draws together findings from authoritative reviews of rigorous research conducted for the Cochrane collaboration and later studies concerned with the pharmacological and psychosocial treatment of dependence on opiate-type drugs like heroin, concluding that retention is the common key to success.
Among the messages of this simulation model for the UK and other countries is the resilience of hepatitis C in the face of considerable investment in methadone and needle exchange services, that these have nevertheless helped and need to be maintained and if possible expanded, but also that further measures are required to substantially curtail the virus.
Until June 2008 Victoria in Canada had a comprehensive extended hours needle exchange at a fixed site in the city. Neighbourhood pressure led to closure, creating a natural experiment in the withdrawal of services. The result seemed to be more sharing of injecting equipment entailing a greater risk of infection.
STUDY 2012 HTM file
Estimating the cost-effectiveness of needle-syringe programs in Australia
Latest mathematical model from Australia probably broadly applicable also to the UK suggests that needle and syringe programmes have cost-effectively saved/improved lives, and in the long run save the health service money due to averted HIV and hepatitis C infections. But in both countries adequately curbing hepatitis C requires much more.
Together studies recently conducted across the UK suggest that consistent participation in methadone maintenance treatment plus adequate access to fresh injecting equipment has prevented many hepatitis C infections, supporting calls for needle exchange to be expanded and methadone treatment sustained.
REVIEW 2011 HTM file
Substitution treatment of injecting opioid users for prevention of HIV infection
Updated review conducted for the respected Cochrane collaboration finds that methadone maintenance and allied treatments for opioid dependence consistently and significantly reduce the risk of transmission of blood-borne viruses and curb the spread of HIV.
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