BANNED HEROIN SUBSTITUTE CLEARED FOR PRESCRIPTION

New Tamper-Proof Formulation Prevents Addicts Using Drug Intravenously

A HEROIN substitute virtually banned in Scotland amid concerns over
abuse has been made available on the National Health Service.

The Scottish Medicines Consortium (SMC), which advises health boards
on what drugs can be prescribed, has approved a tablet form of the
opiate substitute buprenorphine for those who cannot take methadone.

Campaigners have welcomed the move, arguing it will expand treatment
choices. But some experts opposed wider access to substitute
prescribing, saying the focus should be on abstinence. advertisement

Buprenorphine has been widely used in England, continental Europe and
Australia. It is four times more expensive than methadone, but
addicts are less likely to overdose on it. In Scotland, its use has
been limited because in the 1980s it was abused by addicts who heated
and injected it to get high. The new form of the drug, Suboxone, is
"tamper-proof", containing an ingredient its manufacturer says will
cause withdrawal symptoms if injected.

The SMC guidance says Suboxone should be restricted to patients for
whom methadone is not suitable, and only "within a framework of
medical, social and psychological treatment".

Edinburgh psychiatrist Malcolm Bruce said doctors in Scotland had
been wary of other forms of buprenorphine because of the abuse problem.

"If you look in England now, it's used in about 40% of substitute
prescriptions for opiate dependents." he said. "In Scotland, it is
probably less than 5% or so."

In some users, methadone wears off too soon, while others have
reactions to additives in the mixture, he explained.

The decision was welcomed as a "useful addition" by David Liddell,
director of the Scottish Drugs Forum. Andrew Horne, of drug treatment
charity Addaction Scotland, said: "We think it is a useful
alternative and will complement the rehabilitation work we do."

But Neil McKeganey, professor of drug misuse research at Glasgow
University, argued that substitute prescribing was "part of the problem".

He added: "We have a large number of people on substitute medications
and here is another substitute drug; it will still leave us with too
few abstinence-focused drug treatments."