BMJ  2007;335:317 (18 August), doi:10.1136/bmj.39303.688611.3A

Letters

Payment for treatment adherence

Drug misusers are likely to abuse the system

The first 100% of the full text of this article appears below.

I am a forensic physician working in the east end of Glasgow, and I write with reference to the debate by Burns and Shaw.^{1 2} A high percentage of detainees are on opiate substitution programmes. From my own personal observations, nearly all are using "top-up" heroin.

Additionally, alcohol consumption while receiving methadone treatment is high. It is obvious that a £2 shopping voucher could easily be diverted into paying for two litres of cider to fund a dual addiction.

I also find it ridiculous in a cash strapped NHS service, where we are unable to fund life saving or life extending medications, we are able to pay addicts to "comply" with a treatment that offers no treatment benefit other than to "reduce harm."

Strathclyde Police, Glasgow G40 3RX

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Competing interests: None declared.

1. Burns T. Is it acceptable for people to be paid to adhere to medication? Yes. BMJ 2007;335:232. (4 August.)[Free Full Text]
2. Shaw J. Is it acceptable for people to be paid to adhere to medication? No. BMJ 2007;335:233. (4 August.)[Free Full Text]

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