A review and summary by J.M. Guffens (in French, English abstract); Dr.Guffens describes advantages and disadvantages associated with buprenorphine and methadone maintenance. He concludes that use of the two medications complements - rather than opposes - one another. Re. buprenorphine, major problem cited is IV misuse, which he estimates is prevalent among 25-35% of patients in France. Guffens discusses the possible role of Suboxone in lessening this misuse and the associated risks.

An article in the German Pharmacists' Newspaper (Deutsche Apotheker Zeitung, 23 Mar 06) makes a fundamental assumption that nicotine dependence for most people is a complex neurobiochemical disorder rather than "just" a bad habit. It goes on to discuss - and advocate compellingly for - "harm reduction" for nicotine dependent people unable to quit abruptly. It notes - and firmly rejects - the common assumption that smoking cessation must be accomplished "immediately, beginning at once". It notes that with nicotine "substitution" medications (gum, patches, sprays) many are enabled to reduce markedly their smoking, and that some who initially reject the goal of complete abstinence are able to achieve it after a period of controlled, reduced use.

"...we know what works: it is offering substitution -- methadone -- so they don’t shoot drugs..., and that they have access to clean needles, and, of course, that they are helped to kick their habit.As long as that’s not done, I fear that we will see a continuing explosion of HIV driven by a major epidemic of injecting drug users that is there already." Radio Free Europe 28 May 06)

Switzerland was one of the first nations in the world to implement a liberal drug policy, with "substitution" treatment (methadone, buprenorphine, legal heroin), safer injection sites, etc. That policy has been and continues to be denounced by many nations (none more vigorously and uncompromisingly than the USA) because of the fear that "harm reduction" measures will "give a wrong message" and encourage people to use illicit drugs. Switzerland now offers hard data showing such fears are unfounded - and addresses a key rationalization for refusing potentially life-saving services to those who want and need them. Lancet, vol. 367, June 3 2006

HIV prevalence among heroin users in three Spanish cities - Madrid, Seville and Barcelona - was compared for 1995 and 2001-2003. Initially all three had a very high prevalence, but both Seville and Barcelona experienced a drop of roughly 50% over the period of observation, while in Madrid the prevalence remained essentially the same. The key difference between the cities: Madrid, unlike the other two, delayed large- scale implementation of methadone maintenance treatment programs (MMP). The authors conclude: "All the evidence suggests that Madrid lost an opportunity to prevent the dissemination of HIV among injectors during the first half of the 1990s by not rapidly implementing MMPs while other cities were doing so." They go on to state: "A similar situation may currently be taking place in other areas which already have high prevalences of infection, but which in some cases even prohibit MMPs."

Promising headline, but. . . A Russian Orthodox archbishop this week was quoted as saying that a church-run HIV treatment center in Moscow had proved that prayer could cure HIV-positive people "they restore harmony between soul and body." Also, this week, the Moscow City Council moved to ask Putin to "ban foreign health charities from AIDS projects in the capital, and stop free distribution of condoms and clean needles for injecting drugs, which undermines Russians' morality." Reuters, April 21 2006

For the past 7 years there has been an annual of day of mourning, marked in cities large and small throughout Germany, in honor of "the victims of drug politics." The publicity given the 2006 event stresses that in addition to memorializing the dead, this day is devoted to protest and action, and one of the key demands this year is "heroin prescribing as a routine part of comprehensive medical care." Perhaps most surprising is that the 2006 National Memorial Day is under the patronage of the "Drug Czar" of the German Federal Government, Ms. Sabine Baetzing.

The Mayor of Port Lincoln (Australia) urges methadone be dispensed exclusively from police stations or prisons! The Port Lincoln police refused to comment, saying it is not going to be drawn into the issue.ABC Australia News, 22 June 2006

To lessen risk of diversion of dispensed methadone, a trial in Tamworth (Australia) utilizes a device that permits access to only one dose a day (maximum four days). ABC Regional News (Australia), 22 June 2006

This is a conclusion of a just-published report of Public Health Watch HIV/AIDS Monitoring Project of the Open Society Institute. One key illustration that the US is failing at home is that half of Americans who need HIV treatment are not getting it.

AN ANALYTIC ASSESSMENT OF US DRUG POLICY was published in 2005 by the American Enterprise Institute, editors David Boyum and Peter Reuter. Bottom line: "American drug policy, rather than focusing on reducing demand among chronic abusers, has emphasized efforts to limit the supply of drugs through vigorous law enforcement. Yet . . . drugs have become substantially cheaper, casting doubt on the effectiveness of this strategy.... [T]here is now less reason than ever to believe that current policies are an efficient and effective response to the problem of illicit drugs."

The event attracted local, national and international speakers who presented on a variety of topics. The conference was well attended by hundreds of attendees that included patients, families, healthcare providers and early supporters of Methadone.