Saturday 25 March 2017

€11m being 'wasted' on urine tests for addicts

Experts say expensive HSE policy out-dated and serves no purpose

Terence Cosgrave

Nearly €11m is being wasted by the HSE conducting urinalysis tests for drug addicts that doctors and addiction experts say serve no purpose.

HSE figures provided by the HSE show that there are around 9,200 people receiving methadone and all are required to provide urine samples for testing.

The cost of each of these 'in-house' tests is €9.40, but the cost is higher when the HSE has to use private companies on a contract basis

Taking an average cost of €10 per test, it means an annual bill to the taxpayer of €4,690,608.

But doctors within the addiction service have estimated the total bill at more than double that figure.

Dr Cathal Ó Súilliobháin -- a GP working in addiction services -- last week estimated it to be at least €5.5m, with the same amount being spent on staffing and administration costs. He says the total cost is at least €11m.

But many -- including doctors treating these patients -- believe that the tests serve no practical use and come from an out-dated view of harm reduction for addicts, and are simply a waste of money. The Irish Medical Organisation (IMO) --in a submission to the current review of methadone protocols -- have recommended a review of this expenditure.

"Resources currently being wastefully expended in this area could be better used to provide treatment to presently excluded populations," says the IMO.

Minister for Community Pat Carey has also recommended to the Methadone Protocol Review that the frequency of testing should be reduced.

The submission states: "The frequency of screening for clients, particularly those who have been stable for a long period should be reduced given the significant costs involved that could be put to better use. Randomised testing might be involved in such cases to reduce the risk of abuse."

Another submission to the Methadone Protocol Review from a doctor working in addiction services quoted international studies which showed that there was little to be gained by using urinalysis to monitor drug use.

"On the basis of the available evidence, it has been concluded that there is no compelling evidence that the absence of urinalysis leads to an increase in illicit drug use."

At a time when hundreds of drug addicts around the country who want to quit are on waiting lists for access to treatment, this huge expenditure on an out-dated methodology is coming under increasing scrutiny.

With international evidence not supporting weekly testing, and its prohibitive costs, many argue that the frequency of urine testing should be at the discretion of the prescribing doctor.

However, at least one doctor within the service has been reprimanded for failing to administer the tests on all his patients every week and threatened with further action if he fails to do so.

Sunday Independent

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