Dear Editor,
Further to Dr Cathal Ó Súilliobháin’s recent reply (www.imt.ie/opinion/2010/06/resources_must_target_proven_t.html) to my letter on the topic of detox units, I want to comment on his remarks on methadone prescribing for 10,000 heroin addicts.
With methadone, we are replacing one illegal addiction with another legally prescribed one. Methadone was to be prescribed for only a minority (10 per cent) of heroin addicts who had failed to abstain, but at present it is prescribed for ‘all’ addicts.
Individuals are not detoxed from mood-altering substances and no abstinence rehab programme is instituted. Thus, the continuous prescribing of a severe addictive substance from which it is difficult to abstain is continued for life, if one was to follow Dr Ó Súilliobháin’s recommendations. This is wrong: we should take people off methadone. Ireland needs a proper addiction policy with detox facilities and rehab units.
At a later date, I may well reply on the issue of alcohol addiction withdrawal problems, or maybe other GPs might like to reply to Dr Ó Súilliobháin’s letter themselves and let the debate continue.
The major problem is that many patients cannot detox as outpatients. In fact, there are very few heroin detox beds in Ireland, perhaps a maximum of 20.
By coincidence, I read in the same issue of Irish Medical Times (June 11, 2010, see www.imt.ie/news/2010/06/methadone_scheme_review_due.html) that the HSE has requested Dr Joe Barry to review the Methadone Treatment Protocol.
I hope he will look at the need for detox units and the life-long prescribing of methadone, which is so costly (if resources and finances are the problem). But I still feel abstention from methadone also needs to be reviewed.
Dr Moosajee Bhamjee,
Consultant Psychiatrist, Ennis
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I stumbled upon this article and I felt compelled to leave a comment. I don’t have a medical background, but I have been on the other side of this situation. Brief synopsis of my backround is I was a heroin user for four years, tried everything from detox, cold turkey, you name it. I started on the methadone treatment programme; at first I had a quite a few hurdles, but soon after, about a year on the programme, I learnt to live my life not as a heroin user but as a methadone user. At last I wasn’t roaming the streets looking for my next score, trying to figure out where I was going to get money from. Eventually I gradually reduced my dosage of methadone weekly over a period of three years and I have been drug/methadone free for four years now and in this time I have a great job, settled down, have my own house and am getting married next year. If it wasn’t for this programme I do not know what position I would be in now. It taught me how to deal with the pressures of life and not turn to drugs. And I am sure that I am not the only success story to come out of this programme.