Sir, - Highlighting the plight of the "underclass" of heroin abusers
and the prevalence of drug abuse among young people in our society is
both worthy and timely.

Your Editorial of June 3rd and Fintan O Toole's article of the same
day deal very well with the complexity of the problem and the dilemmas
facing those of us involved in treating heroin addicts.

There are, however, two issues which I wish to clarify.

Firstly, there are no restrictions on the numbers of GPs allowed to
treat heroin addicts.

On the contrary, we encourage as many family doctors as possible to
get involved in the Methadone Treatment Programme. There is now a
quality assurance mechanism in place.

All participating practitioners are required to receive specific
training and undergo a regular audit as part of the programme.

The training and audit provided by the Irish College of General
Practitioners is proving very successful. Secondly, Fintan O'Toole
suggests that prescribing injectable heroin, as in Switzerland may be
a complete solution to the heroin problem.

It is important to note that the Swiss programme is used for only a
small number of addicts who fail to stabilise despite treatment with
methadone and other strategies. The majority of addicts in Irish
methadone programme stabilise and reintegrate into their families.

We certainly need to find better alternatives for those who continue
to inject heroin. - Yours, etc.,

Dr Ide Delargy, Director, Substance Misuse Programme, Irish College of
General Practitioners, Lincoln Place, Dublin 2.

Referenced: http://www.mapinc.org/drugnews/v00/n741/a05.html and
http://www.mapinc.org/drugnews/v00/n741/a03.html