Addicts 'offered extra medication' to stay off drugs

Thursday, 18 October 2007 12:00 AM

Cocaine and heroine addicts are being offered medication as a reward for keeping off drugs.

A survey by the National Treatment Agency (NTA) reveals in nearly 200 rehabilitation clinics, good behaviour is rewarded with extra methadone or antidepressants, while the BBC has uncovered those providing clean urine samples are also being rewarded.

The BBC found a third of clinics are offering medication in return for those steering clear of drugs.

However, the NTA has said such contingency management rewards have not been sanctioned.

NTA chief executive Paul Hayes said: "It isn't practice that we would advocate.

"One of the things that is important before we start rewarding people through things like contingency management is to make sure that we are doing it according to the best principles of drug treatment.

"There are a range of practices associated with drug misuse in this country that are not what we would want them to be, particularly if you go back a few years."

Public health minister Dawn Primarolo has now called for a report into the issue of rewarding drug misusers.

She told BBC Radio 4: "It is unacceptable, unethical. It should not happen that prescription drugs and doses are used, or suggested that they should be used as either incentives or withheld sanctions as part of a treatment programme.

"What the National Treatment Agency has told me, looking at the report, is that they recognise there are issues but they don't accept it is on the scale of the independent report that was published."

She added: "Treatment should be based on clinical need, decided by a doctor and not used to penalise or reward. It is unethical."

The use of rewarding drug misusers with treatments has also been described as unethical by a number of experts.

Transform Drug Policy Foundation spokesperson Steve Rolles told BBC Radio 5 Live's Breakfast programme: "The idea of having a reward system where you are rewarded drugs of any kind is unethical.

"Drugs in terms of clinical provision should be provided according to need and that is a decision to be made between that patient and the doctor."

However, he said there was an argument for non-drug based rewards.

Figures from the NTA released today reveal the number of drug misusers in contact with treatment services has increased by 130 per cent over the last eight years.

The figures show 195,464 people were in contact with specialist drug treatment in England during 2006/7, a ten per cent rise on last year.

As much as 75 per cent of new clients remained in structured treatment for 12 weeks or more.

Two-thirds of NTA clients used heroine, six per cent crack and a further six per cent heroine.

For those under 18, the main drug of misuse for three-quarters was cannabis.

Ms Primarolo said: "These figures released today are a remarkable achievement and I would like to thank all NHS staff or service users for their contribution to the step change that has been made.

"Many thought that the targets set in 1998 were aspirational and unrealistic. We have made massive strides in tackling the harm that drugs cause to both individuals and society as a whole. Through the Drug Strategy we will continue to ensure that effective drug treatment is available to those who need it."

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