Intended for healthcare professionals


Evidence based policy for illicit drugs

BMJ 2010; 341 doi: (Published 01 July 2010) Cite this as: BMJ 2010;341:c3374

This article has a correction. Please see:

  1. Evan Wood, associate professor
  1. 1University of British Columbia, BC Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, Canada V6Z 1Y6
  1. uhri-ew{at}

    An ethical obligation for those working in the field of drug addiction

    Systematic reviews have shown that methadone maintenance treatment significantly reduces heroin use compared with other treatments,1 and it also reduces HIV risk behaviour among injecting drug users.2 Not surprisingly, it is on the World Health Organization’s list of essential medicines.3 In the linked prospective cohort study (doi:10.1136/bmj.c3172) Kimber and colleagues describe the effect of opiate substitution treatment on mortality and time to long term injection cessation.4

    The study, which is based on observational data from a single primary care facility in Edinburgh, found that longer duration on opiate substitution treatment (primarily methadone) was associated with reduced mortality, but that it was also associated with a lower likelihood of injection cessation. Although the association with improved survival might be expected on the basis of past research,1 2 the negative association between opiate substitution treatment and injection cessation is curious. Despite the limitations of the study, which Kimber and colleagues acknowledge, the study overall supports the already extensive evidence base for using methadone as a first line treatment for opioid …

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