jasbird

Why does injectable Heroin cost 5 times more than oral methadone
treatment?
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<http://news.independent.co.uk/uk/this_britain/story.jsp?story=428554>

Lottery fund awards £500,000 to drug trial that will give addicts free
heroin

By Maxine Frith, Social Affairs Correspondent
29 July 2003

The National Lottery's Community Fund has awarded a £500,000 grant to
fund a scheme that will provide drug addicts with heroin, The
Independent can reveal.

In the first study of its kind, 100 heroin users who previously failed
to respond to detox treatments will be provided with the drug, under
supervised conditions, to see if they can be weaned off it.

If the results are positive, the trial could encourage the Government
to adopt a system of clinics where drug users would be able to obtain
and inject free heroin. Researchers hope that the trial will prove
effective in treating long-term addicts, who cost society an estimated
£35,000 a year each through crime, welfare and health care.

The Community Fund was criticised last year for donating lottery money
to, among others, a group which works to block the deportation of
failed asylum-seekers, a farm project in Peru that breeds guinea pigs,
and a scheme to support male prostitutes in Yorkshire. Under an
overhaul of the National Lottery, announced earlier this month, the
Community Fund is to be merged with the New Opportunities Fund to
create a board that will control how ticket revenue is spent.

The grant for the heroin trial will be announced by the Community Fund
later this week. The £500,000 will fund a year-long trial by Professor
John Strang, director of the National Addiction Centre at the Maudsley
Hospital in south-east London. Professor Strang chaired a working
group of the National Treatment Agency for Substance Misuse, which
recommended that the Government increase the number of people who are
prescribed heroin on the NHS.

At the moment, about 400 addicts receive heroin on the NHS but they
are given the drug to take home to inject.

Of the 100,000 heroin addicts in treatment, about 90 per cent receive
methadone, a heroin substitute which is taken orally. A small minority
are given an injectable form of methadone or another oral substitute,
buprenorphine. About 10 per cent of addicts do not respond to oral
methadone or buprenorphine treatment, and these are the people who
will be recruited for the study.

The trial will compare the benefits of "super-charged" oral methadone
with injectable methadone and injectable heroin. The addicts on
prescribed heroin will have to attend the clinics in London three to
four times a day to receive their hits.

Treating addicts with injectable heroin is expensive; oral methadone
costs about £3,000 a year per patient, while injectable heroin costs
£15,000.

Professor Strang said: "We will be recruiting people who are at the
extreme end of the scale of addiction, who have failed on the first
line of treatments. We would hope to see that by giving them
prescribed heroin under supervised conditions, we see a reduction in
their illicit drug use and criminality, and gains in their health.

"We want to medicalise the way in which they take the drug, so there
won't be joss sticks and Led Zeppelin records. They will go into a
cubicle and inject the heroin themselves, under supervision, and we
will then keep an eye on them for a few hours until it is safe for
them to go out."

He added: "I think it is impressive that the Community Fund is
supporting research like this. These people [heroin addicts] are a
disadvantaged group, and the Community Fund tends to focus on
disadvantaged people. The grant may strike some people as
controversial but whatever the rights and wrongs of their behaviour,
these people need help.

"Their behaviour also has a massive impact on society in terms of
petty theft, criminality and health issues such as HIV infections, so
from a cold-blooded point of view, society will benefit."

The grant also has the backing of the Home Office. A spokeswoman said:
"Heroin addiction can lead to the total disintegration of people's
lives and we need radical thinking about how we engage users in
treatment. These trials will begin that process and look at ways in
which the most entrenched and difficult drug users can move away from
illicit drug use and crime."

Lesley King-Lewis, the chief executive of Action on Addiction, said:
"These addicts can make major recovery from their addiction and it is
important to find the most effective way of treating them."

Greg Knight, the Tory spokesman on Culture, said: "The National
Lottery is there to help the original good causes of heritage, arts
and sporting charities. If this grant goes ahead, it will serve as
another example of the Government's failure to keep the lottery
focused on these original good causes."

steve harris

Injectable anything costs more than the oral form.
Injectable heroin would cost far more than oral heroin. To
be safe, IV drugs have to be more pure and have to be kept
sterile. All that costs money.

Finally, heroin is also inherently a more expensive drug
than methadone because a heroin dose doesn't last as long,
so it simply takes a lot more of it. Addicts prefer heroin
because it crosses the blood brain barrier better and
faster, and provides more of a "rush". But only when used
IV.

SBH

steve harris

oral methadone

addicts on

London three to

methadone

heroin costs

are at the

the first

them

reduction in

health.


drug, so there

COMMENT:

And why the hell not? The whole point of this exercise is
for the government to pay for the habits of people who don't
get enough pleasure for powerful oral narcotics, but must,
for some reason, mainline IV heroin. So, as long as we're to
pay for them to do this, why not have the government pay for
incense and peppermints and maybe a massage and a hooker or
two, as well? And why not just heroin? Won't there be
addicts who prefer speedballs, and need IV cocaine? I'm
confused.

Why oh why does the government always have to *&^% things
up? Are we going to go straight from a society where your
drug habit gets you into prison at taxpayer expense, to one
in which your drug habit gets you nirvana at taxpayer
expense?

With never an intervening libertarian time in which you're
expected to be a responsible adult (gasp) and be personally
responsible for the consequences (both good and bad) of your
*own* addictions, pleasures, hobbies and pursuits?


Fund is

addicts] are a

on


behaviour,


I don't think it's "impressive." It makes me want to lose my
lunch.

Hey, I need help, too. Somebody needs to pay for my extra
scuba vacation to to Cozumel! I promise if the government
pays for it, I won't rob any little old ladies to get the
money. And I'm disadvantaged, really I am. In fact, anybody
who hasn't seen those coral reefs up close and 60 ft down,
is disadvantaged. It's very addictive. Seeing _Finding Nemo_
is like methadone-- it just is no substitute for the real
thing, and many people like me just cannot quit on such thin
stuff.

Hey, if the Brit government promises to pay for my scuba
trips, I'll even let you all "medicalize it." Get me a nurse
or two in a starched white cap (slender, please, age 25-35),
and you can take chart notes and make sure I'm safe. For
£15,000 a year, which is what you'll be spending to mainline
these heroin addicts, I figure I can have a pretty damn good
Carribean vacation, and as always I'm sure that my feeling
of disempowerment and disadvantagment will be amazingly
dissolved by the island breezes, the coconut palms, and a
little rum punch.

Add nurses and it's still no problem, mon.

SBH