NEW METHADONE POLICY BRINGS DRUGS REALITY INTO COMMUNITIES

THE treatment of heroin addiction is no longer confined to a handful
of communities across greater Dublin. Over the past 18 months the
operation of the methadone treatment programme in areas served by 142
GPs and 190 pharmacists has meant that local communities across
Dublin, Wicklow and Kildare now witness the legacy of heroin addiction
almost daily.

The Central Treatment List operated by the Eastern Health Board now
carries over 4,000 addicts on its register. Just over two thirds of
those registered for methadone maintenance attend one of 51 treatment
centres across the region. These are a mixture of Addiction Centres
operated by the Eastern Health Board and clinics run by GPs. There are
also three mobile clinics.

Under the new methadone protocol, which came into effect with the
introduction of the Misuse of Drugs (Supervision of Prescription and
Supply of Methadone) in July 1998, some 1,138 addicts are now treated
by GPs and pharmacists. The terms of the new protocol allow GPs to
treat between 15 and 35 addicts in their surgeries, provided they have
undergone training supervised by the Irish College of General
Practitioners. Unlike the operation of Addiction Centres, GPs are not
obliged to consult with local communities about the operation of the
methadone treatment programme in the locality. This lack of
consultation has brought uncertainty and unease to some communities
who up until now have had no direct contact with heroin addiction.

According to the Eastern Health Board, the new protocols were
introduced last year to provide more structured treatment for addicts
in their locality, together with stricter prescribing controls to
prevent the flow of methadone onto the illicit market.

However, the scheme has made little impact on the supply of methadone
on the streets, according to a senior investigator at the National
Drugs Bureau. ``It is a bureaucratic answer to the problem and it is
not addressing the issue of demand reduction as well as tackling the
problem of our drug culture,'' he said.

The use of methadone to treat heroin addiction is controversial. It is
increasingly argued that in the absence of a clear, drug-free policy,
methadone maintenance merely feeds the addict's habit. Statistics may
serve to highlight this fact.

The EHB has 17 detoxification beds at Cherry Orchard hospital, and
uses a further 10 beds at Beaumont hospital. It also provides funding
for a limited number of detoxification places at the Merchants Quay
Project in Dublin and Cluin Mhuire in Athy. There is a waiting list of
61 addicts from the current 4,001 population on the methadone
treatment programme.

According to some recovery groups, the methadone treatment programme
is a medical model which is over-used and abused in dealing with
heroin abuse.

``There are not enough after-care and recovery groups run by and for
addicts,'' said Grainne Kenny of the National Drug Prevention
Alliance. ``We oppose harm reduction and the long-term use of
methadone. We believe that methadone treatment should be used for a
six-month period. The public are beginning to object to clinics
because they do create a nuisance. It is not just the addicts who are
being maintained; the dealers are also being maintained,'' she said.

The Eastern Health Board, however, disputes this, maintaining that the
protocols on the new methadone treatment programme mean that local
fears of loitering drug addicts are ill-founded and that there has
been a reduction in local crime and nuisance.

``Our experience is that properly organised drug treatment and secured
drug treatment clinics pose no threat to anybody,'' said a statement
from the EHB. ``Persons on drug treatment programmes are well
motivated and the Gardai have found that there is a reduction in local
crime following the opening of drug treatment centres.''

A garda spokesperson could not comment on the source of the EHB claim.