Letters

Fatal methadone overdose

BMJ 1997; 315 doi: http://dx.doi.org/10.1136/bmj.315.7099.55a (Published 05 July 1997) Cite this as: BMJ 1997;315:55

Drug services in Manchester were unfairly accused

  1. Tom Carnwath, Consultant psychiatrista
  1. a Trafford General Hospital, Manchester M31 3SL
  2. b University of Manchester, Rusholme Health Centre, Manchester M14 5NP
  3. c University of Manchester, Manchester M13 9PT
  4. d Leeds General Infirmary, Leeds LS1 3EX

    Editor—Emyr W Benbow and colleagues' letter might lead readers to conclusions that would be most injurious to doctors working in drug services in Manchester.1 It could be read to imply that these doctors cause needless deaths through sloppy practices and that for commercial reasons they have collaborated in preventing open inquiry. There are few allegations more harmful to a doctor's reputation. It is disappointing that the BMJ published this letter without first consulting those implicated and allowing them the chance to reply in the same issue.

    I work as a consultant with drug services in a neighbouring district. Through long familiarity with the drug services in Manchester, I am convinced that such allegations lack foundation. Its prescribing procedures adhere to a high standard, and its consultants, like all specialists in addiction, have the same interest in research that might reduce the death rate among people who use opiates.

    There is no mystery about the increase in deaths related to methadone overdose. Opiate users are at a high risk of sudden death, with an excess mortality of about 15 times the expected rate. The number of opiate users receiving methadone treatment has increased rapidly nationally and particularly in Manchester. This has caused those in addiction services to be justifiably proud because methadone treatment improves health, reduces social disruption, and decreases long term mortality.2 Stimson has argued that with other measures it has averted an epidemic of HIV-l infection in the United …

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