Abstract
After a brief historical review of British drug legislation and public and governmental attitudes, this paper describes the wide range of policies and practices that have appeared since the explosion of illicit drug abuse in the 1960s. The spectrum goes from a reluctance to prescribe at all to maintenance on injectable opiates. Comparisons are made with differing attitudes to the availability of abortion in public health services. Compared with 5 years ago, about three times more methadone is being prescribed. There is a steady increase in prescriptions for injectable methadone but heroin maintenance is still rare. The "British System" permits great flexibility in the choice of opiates for maintenance. Some amphetamine-prescribing programmes also exist. Hair analysis for drugs to monitor levels of both prescribed and unprescribed drugs is a welcome and promising alternative to undignified and often misleading urine tests.
Full text
PDF
Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Brewer C. Hair analysis as a tool for monitoring and managing patients on methadone maintenance. A discussion. Forensic Sci Int. 1993 Dec;63(1-3):277–283. doi: 10.1016/0379-0738(93)90281-e. [DOI] [PubMed] [Google Scholar]
- Caplehorn J. Methadone maintenance treatment. Britain has been overcommitted to psychological theories of drug dependence. BMJ. 1995 Feb 18;310(6977):463–463. doi: 10.1136/bmj.310.6977.463. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Crawley J. A. A case-note study of 134 out-patient drug addicts over a 17-month period. Br J Addict Alcohol Other Drugs. 1971 Nov;66(3):209–218. doi: 10.1111/j.1360-0443.1971.tb02388.x. [DOI] [PubMed] [Google Scholar]
- Fleming P. M., Roberts D. Is the prescription of amphetamine justified as a harm reduction measure? J R Soc Health. 1994 Jun;114(3):127–131. doi: 10.1177/146642409411400303. [DOI] [PubMed] [Google Scholar]
- Magura S., Freeman R. C., Siddiqi Q., Lipton D. S. The validity of hair analysis for detecting cocaine and heroin use among addicts. Int J Addict. 1992 Jan;27(1):51–69. doi: 10.3109/10826089109063462. [DOI] [PubMed] [Google Scholar]
- McCarthy J. Quantitative urine drug monitoring in methadone programs: potential clinical uses. J Psychoactive Drugs. 1994 Apr-Jun;26(2):199–206. doi: 10.1080/02791072.1994.10472267. [DOI] [PubMed] [Google Scholar]
- Mieczkowski T., Barzelay D., Gropper B., Wish E. Concordance of three measures of cocaine use in an arrestee population: hair, urine, and self-report. J Psychoactive Drugs. 1991 Jul-Sep;23(3):241–249. doi: 10.1080/02791072.1991.10471585. [DOI] [PubMed] [Google Scholar]
- Newman R. G., Whitehill W. B. Double-blind comparison of methadone and placebo maintenance treatments of narcotic addicts in Hong Kong. Lancet. 1979 Sep 8;2(8141):485–488. doi: 10.1016/s0140-6736(79)91550-2. [DOI] [PubMed] [Google Scholar]