Where do you get the idea methadone consumption is unsupervised from?

Certainly most DDU’s have been doing supervised consumption for several years now (at least back to 2003)

http://www.edrugrehabs.com/SubstanceAbuse/Brown-sugar,-Heroine-Addiction-Treatments/Rehabs/index.html

Have you updated your essay prior to posting it above?
What other amendments have you made from the original?

Tell us, or I’ll issue and FoI request on you!

(Pedant? Moi?)

Also… “On the streets of the UK, a gram of heroin costs between £50 and £120 (UNDCP 1997 p194). The cost of acquisitive crime committed to pay for this heroin has been estimated at £1.5 billion per year. ” Yikes.

By the way, I suppose that where not stated, these are all 1998 prices? Just for the record. IIRC this last week I heard Terry Pratchett explain to Mark Lawson that his daughter, a journalist like him, was aged 21 for three full years because other journalists writing about him would look up on the Internet and see that his daughter is 21.

**reflects drunkenly and dejectedly at own hollow life**

1. “After the war on drugs options for control” report from Transform Drug policy Foundation (2004) (*declares interest – i wrote this one*)

Transform’s major report that examines the key themes in the drug policy reform debate, detailing how legal regulation of drug markets will operate, and providing a roadmap for reform.

http://www.tdpf.org.uk/Policy_General_AftertheWaronDrugsReport.htm

2. A Public Health Approach to Drug Control (2005)

By: British Colombia Health Officers Council

This report was produced by an independent group of public health officials in British Colombia and is a detailed consideration of regulatory options for currently illegal drugs. Thoughtful, detailed and logical analysis.

http://www.keepingthedooropen.com/files/hoc_public_health_approach_to_drug_control.pdf

3. Effective Drug Control:Toward A New Legal Framework’ (2005)

By: The King County Bar Association

This report comes from the drug policy project of the Kings County (Seattle) Bar Association. They have produced an excellent report discussing the same issues from a slightly different perspective. Again this is a detailed and comprehensive review of regulatory options and wider policy considerations (Transform’s work is referenced). They have produced a number of other useful drug law policy reports.

http://www.kcba.org/ScriptContent/KCBA/druglaw/pdf/EffectiveDrugControl.pdf

Tie this up with an advertising campaign designed to change the way drugs are regarded. Remember that drink driving was considered acceptable not too many years ago. Opinions can be changed.

Obviously I have no scientific data to support the above position but as the war on drugs has clearly been lost why not try a different approach.

Alternatively we can carry on pretending that prohibition will suddenly start to work. In the face of plenty of evidence to the contrary.

Coupla points:

“Crucially, in comparison with heroin, methadone has a greatly reduced euphoric effect.”

Eh? I wouldn’t have said so. The main difference in the experience derives from the methods of administration – oral v. intravenous – and the consequence speed of onset. The overall longer term effect is indistinguishable to me at any rate. And I know an addict who has a licensed supply of injectable methadone ampoules, and rates it the best of all possible worlds.

“Firstly, it is important to recognise that methadone is not a pleasant drug to take, causing nausea and vomiting, weight gain, profuse sweating, dysphoria, and tooth decay.”

More puzzlement. I assume that weight gain and tooth decay result from the concentrated sugar solution carrier (there’s a sugar-free diabetic version), but the other symptoms you mention sound like mild overdose, and certainly not the effects of ‘normal’ use.

“However, there is good evidence that untreated addicts must indulge in low level and aggressive marketing of heroin to provide themselves with a supply; that is, they push the drug in order to obtain it, thus promoting increased general consumption (Gilman and Pearson, 1991)”

I wonder if this was specific to the period of the research, because it’s not something I recognise in more recent times. I’ve asked, and no-one has even heard of real ‘pushing’ taking place. In fact, it’s generally considered a risible, Reefer Madness-style myth that anyone would actually need to tout for custom in what is – now at any rate – such a seller’s market.

Otherwise, worth every penny of 250 quid!

CD

it’s an issue. shooting galleries are a possibility, or no supervision i suppose, just like methadone. that would save money, and make it more practical, but it would mean we accepted leakage as a side effect of prescription, in the same way that we accept acquisitive crime, violent crime, exploitation in developing world producer countries, recruitment by dealer-users, HIV and Hep C, increased prevalence of IV use, etc, as side effects of “prohibition”.

whatever we choose, people don’t stop taking drugs simply because we tell them to stop, so unfortunately “prohibition” is essentially a byword for “organised criminal distribution”. it is possible that having drugs distributed on a huge industrial scale by organised criminals is the best solution for our society; but in the name of clear thinking, the one thing we really shouldn’t do is pretend to ourselves that “prohibition” means “people not taking drugs”.

i’m not sure that either is necessarily the right route, i just think we’re choosing between different sets of problems, rather than fantastical ideal world solutions.

Diamorphine can still be prescribed for the treatment of opioid addiction, but only if the doctor has a licence from the Home Office, this also applies to cocaine and dipipanone (Diconal).

Not sure how you could supervise administration of diamorphine though.

was it an SSM or something?

I havent read the essay – but Im sure its great.