Source: Sunday Independent (Ireland)

27 January 2008

By: Joanna Kiernan

The drug substitute methadone is leading to the deaths of more addicts
than heroin, disturbing figures have revealed.

A report by the Dublin City Coroner has shown that of the 87 inquests
heard in his court last year, pure heroin was found to have caused the
deaths of 14 people and contributed to a further 12. However,
methadone, the legal substitute used to treat those with a heroin
addiction, was found to have caused the deaths of 12 people and
contributed to a further 19 deaths.

The highly lucrative nature of the “methadone industry” acting as a
barrier to the exploration of other therapeutic treatments for drug
addiction has now been highlighted by Marie Byrne, Director of Aisling
Group International. “Doctors get a payment for putting people on
methadone programmes. There is huge money in the methadone industry,”
she says, referring to capitation fees, which are paid to doctors who
participate in the Methadone Maintenance Scheme.

These payments by the HSE to participating doctors are thought by some
to constitute a possible financial incentive for doctors to agree with
methadone use as an addiction therapy. Others believe that it , in
effect, “danger money” for caring for volatile patients.

When contacted, the HSE did not wish to comment in detail on the
payments, saying only that “these payments could certainly not be
considered commission or any form of financial incentive.”

According to drug centre Merchant’s Quay Ireland, it is more difficult
to withdraw from methadone as it stays longer in a person’s system.
However, it is considered beneficial because, unlike heroin, its
dosage can be stabilised at a specific level and maintained at this
level for an indefinite period.

In 2002, Dr Greg Kelly, GP and Medical Officer at Castlerea Prison,
was involved in a public spat with both the Western Health Board and
the Department of Justice following his refusal to prescribe methadone
to prisoners under his care. Speaking last week, Dr Kelly, who is
still not convinced that methadone can be considered a “cure” for
heroin addiction, said : “When there are as many dying from the cure
as from the disease there’s something wrong. Methadone is highly
addictive, you are basically substituting one addiction for another,
legal for illegal.”

Methadone maintenance programmes appear to be the only option
available through the Irish health services to heroin addicts wishing
to break free of their addiction. This is largely because of a lack of
resources allocated to Ireland’s drug detox facilities.

Last year, the National Strategy for Rehabilitation committed to
doubling the number of beds available for the detoxification of drug

 addicted people. However, reports on the ground suggest that even if
this does come to fruition, it would simply be a drop in the large
ocean that is drug-addiction in this country.

We now have a “semi-legal” drugs industry, according to leading
anti-drugs campaigner Marie Byrne. The Aisling Group has criticised
the Government for its failure to deal with the “heroin industry”. It
says: “There are approximately 9,200 people on methadone maintenance
programmes in Dublin city alone and only 23 residential detoxification
beds are available in the entire country for those who want to get off
drugs completely.”

Merchant’s Quay has voiced concern that too many people are now
“parked” on methadone, with no resources available to develop their
recovery any further.

While up to =80100 million is pouring into the State-sponsored methadone
programme, only a trickle of State funds are being spent getting
people off drugs altogether.

According to Mel MacGiobuin, coordinator of the North Inner City Local
Drugs Taskforce, the period of time that a person is kept on methadone
maintenance can vary. However, in his experience “there are a large
amount of people on methadone for a considerable time, possibly eight
to nine years in general.”

Marie Byrne predicts that the adherence to methadone maintenance
programmes in this country will leave us ill equipped to treat
addictions to new drugs entering the market.

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