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Promoting abstinence for drug users is about saving money not science

BMJ 2013; 346 doi: (Published 22 March 2013) Cite this as: BMJ 2013;346:f1481
  1. Jason Luty, locum consultant in substance misuse, Ipswich Substance Misuse Service, Ipswich IP1 2NZ
  1. jason.luty{at}

Despite overwhelming evidence that substitution therapy reduces harm, the UK government now advocates abstinence. Jason Luty wonders if this is because it seems cheaper

In Autumn 2009, Professor David Nutt publicly stated (more or less) that alcohol and tobacco were just as damaging as cannabis. Although he told the truth, he was immediately dismissed as head of the UK Advisory Council on Misuse of Drugs.1 Since then we have had two ministers of health, a new government, and one reshuffle. Nevertheless, the message was clear: any bolshie academic who speaks out of turn is likely to get the chop.

In 2010 the new UK government announced that substance misuse services should follow a recovery model.2 Basically, this means that patients receiving opioid substitution therapy are encouraged to reduce and stop all addictive drugs, including prescribed drug substitutes. (Opioid substitution therapy refers to use of drugs such as methadone and buprenorphine for treatment of heroin addiction; detoxification is the process of reducing and stopping addictive drugs such as methadone; and maintenance is the prescription of substitute drugs over years with no …

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