Heroin users need regular review to cut addiction, GPs told

GPs caring for heroin addicts should regularly review their use of substitute drugs if patients are to 'leave addiction behind', experts have warned.

Heroin abuse. Hypodermic needle and syringe with a pile of heroin on a spoon. (SPL)
Heroin abuse. Hypodermic needle and syringe with a pile of heroin on a spoon. (SPL)

A report commissioned by the National Treatment Agency for Substance Abuse (NTA) said allowing heroin addicts to be ‘parked indefinitely’ on drugs such methadone makes it harder for patients to ‘break free’ from their dependence.

Experts advised GPs treating heroin addiction to review their existing patients and ensure that any treatment programmes support recovery. Care should be integrated with other support such as employment services and housing agencies.

The report is a result of a two-year inquiry by GPs, psychiatrists, other health professionals and patients. It was launched following the coalition government’s 2010 Drug Strategy, which said too many addicts risked becoming hooked on a substitute prescription.

An estimated 265,000 people are addicted to heroin in England and 165,000 of them are receiving treatment. Out of those being treated, 150,000 are prescribed a substitute medication, typically methadone or buprenorphine.

The report says that despite evidence showing opioid substitution therapy (OST) is effective, there are cases when it does not give enough priority to patients’ desire to quit.

To enable patients to completely quit street drugs, OST must always be delivered in line with clinical guidance. ‘We can help more to realise this ambition if we can ally safe, evidence-based recovery-oriented practice to the public health and wider social benefits we already accrue from treatment,’ said the report.

It adds that ‘there is no justification for poor quality treatment anywhere in the system’.
‘It is not acceptable to leave people on OST without actively supporting their recovery and regularly reviewing the benefits of their treatment, as well as checking, responding to, and stimulating their readiness for change,’ it said.

The report rejected imposing time limits on treatment, saying these could stop addicts from sustaining their recovery and lead to increases in ‘the spread of blood-borne viruses, drug-related deaths and crime’.

Leading specialist Professor John Strang from the National Addiction Centre, who chaired the inquiry, said ‘Overcoming heroin addiction is often very difficult, but with the right support, more people can and will recover from dependence.’

Paul Hayes, NTA chief executive, said its ambition is ‘for the English treatment system to become a world leader in delivering recovery outcomes, ensuring every individual in treatment is given the opportunity to leave addiction behind’.

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