Medicine polarises views and nowhere is this more evident than in the swampy field of drug addiction.
Drugs are noxious to our users, ruinous for their children and families and a pernicious shadow that threatens to eclipse our society. And yet there remains controversy about what exactly should be done about it.
In Manchester, at the Piper Project in Trafford, they offer a highly accessible drop-in service for stimulant drug users. On the menu for ‘clients' is shiatsu massage, auricular acupuncture and one-to-one advice about the extra benefits they can claim. They are pampered and luxuriated – and what better way to relax after a hard night on the smack?
Elsewhere in the UK, contingency management is gaining momentum and junkies are being offered Boots vouchers in exchange for clean urines. There are also more and more weekend and night-time clinics because, after all, the NHS should fit around the life of the busy user.
The situation in China, though, is a little different.
According to January's BMJ these hardened drug users, are forcibly incarcerated and denied treatment. They are worked hard, go cold-turkey without so much as a whiff of methadone and their antiviral scripts are left snagged and fluttering in the barbed wire.
Interestingly, the prevalence of drug addiction in both countries is comparable. Manicure or medieval torture? I know which I would prefer!
Dr Kevin Hinkley
Aberdeen
