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Time limit for treatment would not help addicts

Independent experts have warned time limits on access to heroin substitute treatment would not benefit drug users' recovery from addiction.

This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government
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Imposing a time limit on drug users’ access to heroin substitute treatment would increase the possibility of relapse – and could drive up crime, according to independent experts.

A report by the Advisory Council on the Misuse of Drugs (ACMD) says it found strong evidence that forcing people off opioid substitution treatment (OST) treatment is not the best way to help them towards recovery.

It also suggests drug addicts are dropping out of the treatment too soon and more should be done to help them stay within this process.

In 2011/12 there were around 150,000 people dependent on heroin in the UK who were receiving OST – which involves a person receiving counselling to encourage behaviour change alongside a prescribed substitute, such as methadone or buprenorphine.

The Inter-Ministerial Group on Drugs asked the ACMD’s Recovery Committee to consider if there was a case for placing a maximum time limit on access to OST.

The ‘Time Limiting Opioid Substitution Therapy’ report published today (Thursday) says an imposed time limit could lead to the vast majority of addicts suffering a relapse - and a potential increase in fatal overdoses. It could also lead to wider problems, such as a steep rise in drug-driven crime and the spread of blood-borne viruses like hepatitis and HIV.

Annette Dale-Perera, co-chair of the ACMD’s Recovery Committee, said:

All the evidence suggests restricting access to OST leads to an increased risk of people relapsing, turning to crime to fuel their habits - and even dying from an overdose.

However, it is important to remember that medication alone will not lead to a successful recovery. OST should be delivered alongside therapy designed to change behaviour, as well as recovery interventions, to help people tackle their addiction and rebuild their lives.

The ACMD’s research found the majority of people are not ‘parked’ on OST for long periods of time, with only 10-15% receiving OST for five years or more. The ACMD is concerned more people are in OST for too short a time to benefit, as almost 40% stopped OST within six months.

The report also supports the government’s push for a culture change and recovery-orientated drug treatment systems for those dependent on heroin.

Professor Les Iversen, chair of the ACMD, added:

OST should be seen as a stepping stone on a path to overcoming heroin dependency and achieving recovery.

When a person with a heroin addiction is also given help to deal with their personal, social and economic problems there is a greater chance of a positive outcome.

Today’s report is the first of a two-part response to the Inter-Ministerial Group on Drugs. The ACMD will now look to provide advice on how different drug users can have targeted treatment, including OST, to reach recovery more quickly, with less threat of relapse.

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Published 6 November 2014