GERMANY’S HEROIN TRIAL: hold the applause

In a posting just a few days ago it was noted that science- good or bad- often does not get translated into policy. Germany’s pilot heroin program results seem to be a case in point. The Koelner Stadtanzeiger (18 March) reports : the “Unionfranktion” coalition in the German Parliament “torpedoes a pilot [heroin maintenance] project” for long-term, treatment resistant opiate dependent individuals despite “unequivocally positive” conclusions reached by Federal authorities and those of all seven participating cities. As for the prospect of having heroin declared an appropriate, prescribable medication for the treatment of addiction, this was urged just a week earlier by the “Drug Czar” of Germany, Caspers-Merk, based on the favorable outcome of the heroin trial. The response from the Unionfraktion leader: “Any conclusions would be premature.”

2. AUSTRALIA: Generalist Physicians Advocate Applying Principles of Harm Reduction Drs. Bradleigh Hayhow and Michael Lowe, two generalists in Northern Territory, Australia, argue "that the paradigm of harm reduction may offer an appropriate way of thinking about people who are unwilling or unable to adopt particular changes in lifestyle. . . . . People need to make these [lifestyle] choices for themselves . . . " (emphasis in original). There's been much advocacy over the years to have addiction medicine accept principles governing management of all other chronic illnesses; it's nice to see the corollary also applied. Med J Austral 2006; 184:235-237  

3. GERMANY: Heroin Pilot Project Judged a Success Continuation of heroin treatment in Frankfurt was approved by a large majority of the City Council (“Stadtparlament”). Approval of heroin as prescribed medication is expected by mid-2006. In the multi-year study carried out in seven cities, illegal drug use was reduced, health status improved, there was better social integration and less criminality. News release (in German) of Redaktion Rhein-Main -click here – dated March 11, 2006

4. TAIWAN: Harm Reduction Efforts Expanded The Taipei News (English language) reported 9 March that the Taiwan Dept of Health "was planning to expand its needle-exchange pilot program for drug addicts to all counties and cities." Taiwan's Centre for Disease Control estimates that 80% of all HIV/AIDS cases have been caused by needle sharing among drug dependent individuals. Methadone maintenance has also recently been introduced - details to follow. For the Needle Exchange Article click here

5. CANADA: Opiate Agonist Treatment - Try it, You May Like it! In a field where medical and lay communities generally share a similar (highly pejorative) view of patients, illness and treatment, there's a refreshing counterpoint to be found in an announcement of a "locum opportunity" in Kenora, Ontario - "Doctor wanted . . . for holiday coverage in forward-thinking methadone/addiction clinic. See 12-14 patients a day, talk a lot, laugh a lot, witness miracles happen!" For the generalist physician who instinctively views with horror the very thought of providing methadone or buprenorphine maintenance the message is clear: try it, you'll like it! (BTW - the contact for the locum position is Dr. Hanna Hulsbosch at 807-468-5905)

6. CANADA: "Addict Fights for Lifesaver; Troubled by Decision to Cut Methadone" OTTAWA SUN Jessica Weihrich wants people to know that methadone saves lives. The 18-year-old would know. "I would probably have been dead by the time I was 25," she said. "It takes away all thoughts of taking drugs and how I'm going to get them. I can basically start rebuilding my life without having to worry about drugs or think about them," she said. That's why she's troubled by a decision last week that will cut the supply of methadone to a chain of provincial clinics. For more on Jessica's story click here

7. A manifesto: NOTHING ABOUT US WITHOUT US The Canadian HIV/AIDS Legal Network recently announced publication of new resources - in French and in English. Of particular note: "a manifesto by people who use illegal drugs demanding greater involvement" with the brilliant title: "Nothing about us without us" (in French, "Rien a notre sujet sans nous")