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NCJ Number: 48381 Find in a Library
Title: CONFLICTS IN DECIDING TREATMENT WITHIN DRUG DEPENDENCY CLINICS (FROM PROBLEMS OF DRUG ABUSE IN BRITAIN, 1978, BY D J WEST - SEE NCJ-48378)
Author(s): M MITCHESON; R HARTNOLL
Corporate Author: University of Cambridge
United Kingdom
Date Published: 1978
Page Count: 6
Sponsoring Agency: University of Cambridge
Cambridge, CB3 9DT, England
Type: Report (Study/Research)
Format: Document
Language: English
Country: United States of America
Annotation: THE ISSUE OF WHETHER OR NOT TO DISPENSE INJECTIONABLE HEROIN OR ORAL METHADONE IN THE TREATMENT OF CLINIC CLIENTS IS EXPLORED USING FINDINGS FROM AN EMPIRICAL RESEARCH PROJECT.
Abstract: QUESTIONING THE WISDOM OF PROVIDING INJECTIONABLE HEROIN TO CLIENTS TO EFFECT CURES, THE MAJORITY OF LONDON CLINICS HAVE ADOPTED THE POLICY OF OFFERING ONLY ORAL METHADONE MAINTENANCE TO NEW CLIENTS, IN THE BELIEF THAT THIS IS MORE LIKELY TO ACCOMPLISH WITHDRAWAL AND ABSTINENCE. THIS THEORY WAS TESTED AT UNIVERSITY COLLEGE HOSPITAL WHEN ONE GROUP OF PATIENTS WAS GIVEN INJECTIONABLE HEROIN AND ANOTHER GROUP WAS ISSUED A METHADONE MIXTURE BY MOUTH. THE BASIC CRITERIA FOR INCLUSION IN THE EXPERIMENT REQUIRED THAT THE PATIENT REQUEST INJECTIONABLE HEROIN, AND THAT A CLINIC CONFIRM THAT THE PATIENT WAS AN ADDICT. APPROXIMATELY ONE-THIRD OF THE PATIENTS COMING TO THE CLINIC BETWEEN FEBRUARY 1972 AND FEBRUARY 1975 WERE CONSIDERED SUITABLE FOR THE EXPERIMENT. RANDOM ALLOCATION OF THESE PATIENTS TO HEROIN MAINTENANCE (HM) OR ORAL METHADONE (OM) WAS CONSIDERED SATISFACTORY IN TERMS OF MOST INTAKE VARIABLES (DEMOGRAPHIC CHARACTERISTICS, PERSONAL CHARACTERISTICS, AND DURATION AND EXTENT OF DRUG USE), EXCEPT THAT THERE WERE MORE PERSONS IN THE HM GROUP WITH FULL-TIME EMPLOYMENT. ALL PATIENTS WERE FOLLOWED FOR A PERIOD OF 12 MONTHS. THE HM GROUP CONTINUED THE REGULAR USE OF HEROIN AT THE END OF 12 MONTHS SIGNIFICANTLY MORE THAN THE OM GROUP THAT WAS REFUSED HEROIN FROM THE CLINIC; HOWEVER, DURING THE YEAR, 70 PERCENT OF THE OM GROUP WERE CONVICTED OF A CRIME, WHILE ONLY 50 PERCENT OF THE HM GROUP WERE CONVICTED. THE MAJORITY OF HM CONTINUED WITH SOME ILLEGAL DRUG USE, BUT THE OM GROUP TENDED TO POLARIZE; A SLIM MAJORITY MADE MORE INTENSIVE PURCHASES IN THE ILLEGAL MARKET WHILE A SIZEABLE PROPORTION CEASED ILLEGAL DRUG USE ENTIRELY. AT THE END OF 12 MONTHS, 76 PERCENT OF HM AND 29 PERCENT OF OM WERE ATTENDING THE CLINIC REGULARLY. THERE WAS NO DIFFERENCE BETWEEN THE GROUPS IN TERMS OF EMPLOYMENT, HEALTH, OR DEATH RATE. IT IS NOTED THAT PRESCRIBING HEROIN IS NOT ASSOCIATED WITH AN IMPROVEMENT IN SOCIAL FUNCTIONING OR A REDUCTION IN CONSUMPTION OF ILLEGAL DRUGS; HOWEVER, IT MAY REDUCE THE DEGREE OF INVOLVEMENT IN CRIMINAL ACTIVITY. ORAL METHADONE RESULTS IN HIGHER ABSTINENCE RATES, BUT DRIVES SIZEABLE NUMBERS AWAY FROM THE CLINIC TO AN INTENSE INVOLVEMENT IN THE ILLEGAL DRUG SUBCULTURE. IT IS CONCLUDED THAT NO CLEAR POLICY APPROACH RECOMMENDS ITSELF FROM THIS STUDY, BECAUSE OF THE AMBIGUOUS CONSEQUENCES DERIVED FROM EACH TREATMENT APPROACH. (RCB)
Index Term(s): Drug treatment; Great Britain/United Kingdom; Methadone maintenance; Research
To cite this abstract, use the following link:
http://www.ncjrs.gov/App/publications/abstract.aspx?ID=48381

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