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1. AFGHANISTAN: Number of Drug Abusers Rises to Almost One Million Afghanistan is the leading producer of opioid drugs (87% world production) and is in the process of seeing its own number of "drug abusers" rise to almost a million. Beyond more law enforcement efforts, it's not clear what - if anything - the US and other nations are doing to respond to the massive use problem, and the associated horrors that are predictable, if not already being experienced. For full story click here
2. GERMANY: A Call for Further Mainstreaming of Substitution Treatment (communication 17 Oct 2005 from Albrecht Ulmer, MD, director - ulmerfrietsch@hotmail.com) The Stuttgart regional branch of the German Addiction Medicine Society (established 17 years ago) has called for broadening access to “substitution” treatment, which in Germany is overwhelmingly reliant on methadone. Some specifics: maintenance treatment should not be a treatment of last resort, but prescribed whenever it appears to be indicated. Give up preoccupation with abstinence as a goal and focus instead on the medical condition of the patient. No restrictions/requirements as to choice of medication to prescribe, dosages, take-home arrangements. They also state it is wrong, both regarding patients and their physicians, to proceed under the premise that “trust is good, but control is better.” They also advocate consideration of a general legalization of drugs, but feel the initial focus should be on a more rational treatment approach.
3. AUSTRALIA: Pivotal Role of GPs...An Opportunity Being Lost
From Australia a just-published paper concluded that in general, GPs who treat
opiate addicted patients with agonist medication are few and far between; the
majority of those who have pursued and obtained the requisite training don't
utilize their authority to prescribe and the few who are active tend to have
large caseloads. Similar situations are known to exist in many European
countries and in US with respect to buprenorphine (the only medication permitted
by law to be prescribed by community-based practitioners). A sad reflection on
the commitment of physicians to provide life-and-death care to those who need
it. Source: (Hotham et al. Drug Alc Rev. Sept. 2005; 24(5):393-400)
4. VIETNAM: Discussions on the Reliance on Methadone Maintenance Treatment - A conference in Hanoi in mid-November considered the major role methadone maintenance should play in response to the related problems of opiate addiction and HIV/AIDS.
Source:Global News Wire - Asia Africa Intelligence Wire, Thai Press Reports,November 18, 2005
5. AUSTRALIA: Waiting Lists for Methadone "Unacceptable" Unacceptable is the conclusion of the opposition party in the State of Tasmania,
Australia, where 600 patients receive methadone maintenance in facilities that
are now "closed" to further enrollment because "capacity" has been reached. For full story click here
6. CANADA: Dramatic Impact on Newborns of Homelessness and Untreated Substance Use in Pregnancy
A compelling study documenting the need for TREATMENT of substance use for all
pregnant women, and the implicit message that a punitive, prosecutorial approach
to this problem is counter-productive. For full story click here
7. TREATMENT INFORMATION: Treating HCV in Substance Users - (Sylvestre et al. J. Subst. Ab. Treat. 29 (2005) Many providers – and many nations! - refuse HCV treatment to "substance users" as a matter of routine, and frequently define "use" to include appropriately prescribed methadone. A just-published study evidences the fact that such exclusion is unwarranted by outcomes. In sum: even with" high rates of psychiatric comorbidity, intervening drug use and limited pretreatment abstinence... response rates are similar to those of non-drug-using populations." The implications are huge, since in the US 60% of the estimated 2.7 million chronically infected patients have a history of drug use. Also of note is a new special issue on the medical management of Hepatitis C in Injecting Drug Users in "Clinical Infectious Diseases"
8. GROWING BLACK MARKET FOR BUPRENORPHINE in Countries Lacking Substitution Treatment Several articles have appeared recently citing the growing black market. click for more information
9. JOURNAL ISSUE FOCUSES ON NEUROBIOLOGY OF ADDICTION - Published Nov. 2005; Nature Neuroscience, vol. 8, no.11 This issue contains many important articles. One deals with genetic influences, and concludes, "Clearly, multiple genetic variants . . . may work in concert to affect vulnerability and severity of addiction." Another discusses the treatment and public policy ramifications of the "stigma and misconceptions [that] create formidable obstacles to a more enlightened public policy toward addictive diseases," and concludes,"... treatment parity [with management of other chronic illnesses] will not be achieved until addiction is widely viewed as a disease." For Full Article Click Here
Special thanks to colleague, Hans-Guenter Meyer-Thompson, in Germany, for calling attention to this publication
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