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Heroin treatment has itself become a problem

Methadone is responsible for a growing number of deaths, writes Joanna Kiernan

IRELAND has the highest number of heroin users per capita in the EU, according to the annual report by the European Monitoring Centre for Drugs and Drug Addiction. Deaths for those on methadone programmes also appear to be on the rise.

There were 9,264 people on the HSE methadone programmes nationwide at the end of October 2011. It is estimated that there are another 10,000 heroin users who are not currently on methadone.

Methadone, once viewed as a way to wean a patient off opiates, has now become a fact of everyday life for many former heroin addicts. Each person accessing a methadone programme costs the State an average of €2,714.52 a year.

Dr Chris Luke, an emergency medicine consultant at Cork's University and Mercy Hospitals, has frontline experience of the dangers of methadone and believes the area needs further examination. "I retain a healthy scepticism about methadone as a treatment," he said.

"We continue to see a significant number of deaths from methadone consumption. While methadone may be a very valuable maintenance treatment, and it allows people to live a more or less 'ordi-

nary life', it is traded on the black market by patients and users, and it does cause a lot of deaths. Methadone is potentially lethal. It's frequently lethal. It's a very dangerous drug in itself."

He adds, "The medical profession and others did resist its introduction into Ireland. But lately there's been a much more relaxed approach towards it, a significant increase in doctors who are enthusiastic about using it and who are trained and licensed in using it.

"There are many people who stay on methadone for years, sometimes decades, and it is not really a 'curative drug' and it's very important that that is recognised. It's one of the ingredients that are frequently part of a cocktail that bring patients to my door."

Gardai say that methadone is generally traded when heroin is in short supply, and the seller can dictate the price.

There are 71 clinics offering methadone services, 23 of which are methadone dispensing clinics. But a majority -- just under 66 per cent -- of methadone users receive their medication in pharmacies.

In 2008, the Dublin City Coroner reported that in the drug-related inquests heard in his court the previous year, methadone had contributed to more deaths than heroin. Although there are no up-to-date statistics available, coroner Dr Brian Farrell confirmed last week that methadone remained a significant factor in the drug deaths he came into contact with daily.

Sunday Independent