Should heroin be prescribed to heroin misusers? No

doi:10.1136/bmj.39422.503241.AD

BMJ 2008;336:71 (12 January), doi:10.1136/bmj.39422.503241.AD

Head to head

Should heroin be prescribed to heroin misusers? No

Neil McKeganey, professor of drug misuse research

¹ University of Glasgow, Glasgow G11 6PW

n.mckeganey@lbss.gla.ac.uk

doi: 10.1136/bmj.39421.593692.94doi: 10.1136/bmj.39434.460694.AD

Some heroin addicts are very difficult to treat. JürgenRehm and Benedikt Fischer believe that maintenance with heroinis the way forward for this group, but Neil McKeganey arguesthat it is treating the effects of misuse not the addiction

The first 150 words of the full text of this article appear below.

Prescribing heroin to heroin addicts is a strategy beloved bytop police officers¹ and successive home secretaries.² It isa strategy, though, borne of utter frustration at our seeminginability to tackle an escalating drug problem. If you cannotstop addicts committing crimes to fund their drug habit then,so the argument goes, the next best thing is to provide themwith the drugs that are the reason they are committing the crimesin the first place. The logic may seem faultless, but at theback of your mind is the nagging question, "Is it treatmentor is it social problem prescribing?"

The evidence in relation to heroin prescribing is far from conclusive.On the positive side Nordt and Stohler have suggested that heroinprescribing led to a large reduction in incidence of heroinaddiction in Switzerland, although the authors also point outthat such prescribing may have reduced individual’s . . . [Full text of this article]

Add to CiteULike CiteULike Add to Complore Complore Add to Connotea Connotea Add to Del.icio.us Del.icio.us Add to Digg Digg Add to Reddit Reddit Add to StumbleUpon StumbleUpon Add to Technorati Technorati What's this?

Relevant Articles

Treat patients, not communities: Andrew J Ashworth
BMJ 2008 336: 173. [Extract] [Full Text] [PDF]

Prejudice based medicine?: Roger Weeks
BMJ 2008 336: 173. [Extract] [Full Text] [PDF]

More than a quick fix: Tony Sheldon
BMJ 2008 336: 68-69. [Extract] [Full Text] [PDF]

Should heroin be prescribed to heroin misusers? Yes: Jürgen Rehm and Benedikt Fischer
BMJ 2008 336: 70. [Extract] [Full Text] [PDF]

Seven doctors accused of over-prescribing heroin: Owen Dyer
BMJ 2004 328: 483. [Extract] [Full Text] [PDF]

Medical prescription of heroin to treatment resistant heroin addicts: two randomised controlled trials: Wim van den Brink, Vincent M Hendriks, Peter Blanken, Maarten W J Koeter, Barbara J van Zwieten, and Jan M van Ree
BMJ 2003 327: 310. [Abstract] [Full Text] [PDF]

This article has been cited by other articles:

Ashworth, A. J (2008). Treat patients, not communities. BMJ 336: 173-173 [Full text]
Weeks, R. (2008). Prejudice based medicine?. BMJ 336: 173-173 [Full text]

Rapid Responses:

Read all Rapid Responses

No to prescribing heroin to addicts: Julian C Law
bmj.com, 11 Jan 2008 [Full text]
Prescribing heroin for drug addicts -the fantasy must end.: Jason Luty, et al.
bmj.com, 13 Jan 2008 [Full text]
We need to treat patients not communities: Andrew J Ashworth
bmj.com, 13 Jan 2008 [Full text]
Solutions to living without addiction to illicit drugs: Dreena Kelly
bmj.com, 14 Jan 2008 [Full text]
Re: The 'fantasy must end'.: Peter O'Loughlin
bmj.com, 15 Jan 2008 [Full text]
Sun headlines are not always reliable facts: stephen black
bmj.com, 15 Jan 2008 [Full text]
Re: Sun headlines are not always reliable facts: Peter O'Loughlin
bmj.com, 16 Jan 2008 [Full text]