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We thought we’d explore the issue of supervised consumption of methadone, as it’s likely to be about the only bit of the Clinical Guidelines (see Arse from Elbow article) that the drug treatment industry bothers to follow. The buzz-phrase now in drug treatments (and other aspects of medicine and social care) is “evidence of effectiveness”. You can’t do anything unless there’s a solid “scientific” evidence basis for it. Prescribing heroin? Well, you can.....(if you’ve got a Home Office license) but it’s not encouraged because there is ‘little evidence’ for its usefulness. Want to give someone a gallon of oral methadone? Get pouring, there’s a stack of evidence for that. “Roll up and drink your slime!” “Science” says it’ll reduce your heroin use, help you keep your sticky fingers to yourself and put hairs on your chest (sorry about that girls, but there’s drawbacks to everything). And the new Clinical Guidelines on the treatment of drug users that the Department of Health have issued to doctors throughout the land is full of this kind of stuff: “You don’t want to do that...there’s no evidence of effectiveness...you want to do this!” This seems to apply to everything. Everything, that is, except things like supervised consumption. Monkey would like to ask the Department of Health, the people who drew up the Clinical Guidelines and any consultants in drug dependence, general practitioners and drugs the following questions: “Where on earth is the body of research that says standing at the counter in Boots swigging your meth in front of 10 people waiting for antibiotics scripts is (a) therapeutic and (b) is going to stop methadone leaking out on to the grey market?” And if you can’t show us the evidence for this practice, then we’ll be forced to conclude that you’re doing it simply because it suits you. These aren’t evidence- based but prejudice-based. We await the flood of letters from doctors’ citing the research papers that contradict our views. Has it not occurred to any of the grey men and women in white coats who drew up this advice that addiction is a stigmatising enough condition as it is, without the added humiliation of drinking your meth in full view of the public? We thought that one of the points of the new drugs strategy was to re-integrate addicts into society, not have them advertise themselves as meth-heads in their local pharmacies. |
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