DRUG AGENCY CALLS FOR HIGHER METHADONE DOSE

Government drug chiefs are to order an increase in the dosage of methadone
prescriptions for tens of thousands of heroin addicts amid fears that
treatment is not working.

The National Treatment Agency confirmed last night that a report by a panel
of experts set up to investigate the effectiveness of methadone
prescriptions in Britain will recommend that the dosage be increased by more
than 13 per cent, from 53mg to a minimum of 60mg per day.

In some cases, addicts should be allowed up to 120mg a day, it states.

The report, which will be published in the summer, warns that addicts who
are given inadequate doses face dropping out of treatment programmes and
returning to heroin use or turning to black market suppliers to obtain extra
methadone.

Annette Dale-Perera, the agency's director of quality, said that doctors
were often under-prescribing methadone because they feared their patients
might overdose.

She said: "Some doctors are very wary of prescribing high doses of what they
see as a dangerous drug."

But Ms Dale-Perera, who chaired the working group, said that although these
concerns were "very valid", evidence showed that methadone doses of between
60 and 120mg a day were most effective in safely managing a patient's
addiction.

She said: "The evidence shows that that this dosage band is the best for
reducing mortality, crime and [the need for] injecting, and improving
people's well-being and social functioning."

The agency's prescribing expert group included representatives of the Royal
College of Physicians, the Royal College of General Practitioners and the
Royal College of Psychiatrists. Other members were representatives of
drug-user groups like the Methadone Alliance.

Ms Dale-Perera said that risks of overdosing could be minimised by
supervising consumption of methadone in the early days of prescription and
only dispensing it on a daily basis. She said it was vital to minimise the
diversion of methadone on to the illicit market.

Last week the House of Commons' Home Affairs Select Committee published a
report on Government drugs strategy recommending greater availability on
prescription of diamorphine (clinical heroin).

But the National Treatment Agency will later this year publish new
guidelines on diamorphine prescription, which have been drawn up in
conjunction with the Department of Health. The agency believes that
diamorphine should only be made available in extreme cases, for "those not
responding to or accessing any other form of treatment".

Unlike methadone, which is taken orally, diamorphine is almost always
injected and carries risks of infection from shared needles.

The agency has accused the select committee of putting "undue emphasis" on
diamorphine, and that the key issue is methadone -- prescribed to the
majority of opiate addicts.

The increased dosages would be made available to people who were undergoing
a complete treatment package which included other support like structured
counselling, the agency said.