Treat addicts, not the addiction

doi:10.1136/bmj.39465.474792.3A

BMJ 2008;336:173 (26 January), doi:10.1136/bmj.39465.474792.3A

Letters

Heroin prescription to misusers

Treat addicts, not the addiction

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

Rehm and Fischer, in calling for what amounts to the legalisingof heroin,¹ have selected evidence to support their view. Theydid, however, not include the Cochrane review that concludedfrom randomised control trials that no definitive conclusionsabout the overall effectiveness of heroin trials is possible.²

The authors also seem to be unaware that heroin addicts continuouslyuse other psychoactive drugs, and therefore simply by prescribingheroin all one is doing is treating that addiction rather thanthe addict, who is also likely to be experiencing severe emotionaland mental problems. In prescribing heroin to heroin addictsone is instrumental in increasing the severity of the addiction.Would the authors recommend smoking for those with emphysema?Or alcohol for those with alcohol related liver disease?

Peter O’Loughlin, principal

¹ Beckenham BR3 3AT

peteroloughlin5@hotmail.com

Competing interests: Drug and alcohol recovery counsellor.

Rehm J, Fischer B. Should heroin be prescribed to heroin misusers? Yes. BMJ 2008;336:70. (12 January.)[Free Full Text]
Ferri M, Davoli M, Perucci CA. Heroin maintenance for chronic heroin dependents. Cochrane Database Syst Rev 2003;(3): CD003410. doi: 10.1002/14651858.CD003410.pub2