Treatment for heroin addiction should have more focus on supporting patients to recover from their dependency, says the head of the National Addiction Centre.
In an interim report for the National Treatment Agency, Professor John Strang signalled the direction of new clinical guidance for treating the estimated 260,000 heroin addicts in England.
Prof Strang recommended that treatment for opioid drug addiction should:
· ‘incorporate wider social interventions as well as medication to support recovery outcomes
· include considered provision of medications including opiate substitution treatment (OST) to gain maximum benefit
· guard against incorrect provision or unnecessary drift into long-term maintenance on substitute prescriptions'
In his report on Professor Strang said: ‘The drive in recent years to reduce waiting lists and retain people in treatment has generally been successful... However, the desire of clinicians to secure these benefits has led, in some instances, to over-reliance on medication and patients being allowed to drift into long-term maintenance.'
Dr Chris Ford, a practising GP and clinical director of the IDHDP, welcomed the emphasis on recovery-oriented drug treatment: ‘It's what we've been doing in general practise for a long time. It's not all about prescription – it's the patient's general health, the risk of thrombosis, hepatitis C, HIV and care of the family as well.'
‘Sometimes recovery is two steps forward and one back, but in general practice we're able to support people in that environment. It's what happens with asthma obesity and blood pressure – it happens in all conditions, when actually people are progressing.'
Dr Stefan Janikiewicz, a GP in Moreton, Cheshire and a representative of NHS Wirral's drugs and alcohol services, said: ‘The recovery agenda will always be pushed but at the same time, there are some patients who are stable on methadone and lead a normal life.'
‘There are no QOF indicators on substance abuse at the moment, just a few local enhances services. If the government were to add in, say, 20-30 QOF points for drugs or alcohol abuse it would be astonishing what might happen.'
A full report will be published later this year before the NTA hands over its critical functions to the new body, Public Health England.
