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Though set up to determine whether the public purse would gain by sending more opiate-dependent clients to residential rehabilitation, this UK government report declared itself unable to conclude one way or the other, but did judge it “highly unlikely” that these treatments’ extra expense would be offset by extra savings.
STUDY 2009 HTM file
The Drug Treatment Outcomes Research Study (DTORS): final outcomes report
Over 10 years since the last attempt, in 2006 a national study assessed the progress of patients starting drug treatment in England. A year later drug use and crime were down and social costs saved, but wider life improvements were minor compared to treatment costs.
STUDY 2014 HTM file
Drugs: international comparators
After seeing how drug policy worked overseas, UK government ministers and officials returned saying, “there is no apparent correlation between the ‘toughness’ of a country’s approach and the prevalence of adult drug use”, and that “better health outcomes for drug users cannot be shown to be a direct result of the enforcement approach”.
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.
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.
Opiate dependent patients in Scotland who opted for or were allocated to methadone sustained their abstinence from heroin as well as those on buprenorphine, but buprenorphine was far better at helping continuing heroin users cut back – suggestive, but the study’s constraints make the practice implications unclear.
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.
An expert committee responds to the Scottish government’s concerns over the role of methadone prescribing in helping patients along the Road to Recovery signposted in the national strategy. On the ground, that road was often barely constructed but methadone was not the problem, rather the failure to optimise programmes for recovery.
DOCUMENT 2012 HTM file
Medications in recovery: re-orientating drug dependence treatment
On behalf of the UK government an expert group has developed and documented a clinical consensus on how prescribing-based treatment for heroin addiction can be made more recovery-oriented in line with national strategy. Their report will be the main reference point in tussles over what recovery means for methadone services and patients.
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