Dr. Azarakhsh Mokri, a leading Iranian clinician/academician, discusses opiate dependence and the impact of Islamic beliefs on treating addiction. The interview provides insight into Iran’s history of treating addiction and the cultural and political forces at work in Iran and around the globe.

A July 2006 paper in Annals Academy of Medicine Singapore (vol 35, pp492-5) reports on abuse of prescribed buprenorphine. New guidelines introduced Nov. 2005 seem to follow closely US guidelines - e.g., doctors require eight hours of training, and directly or through referral should be able to "adequately counsel and manage" their patients. Whether in practice such "counseling and management" will be provided remains to be seen; no evidence appears to have been gathered re: compliance with this standard in the US.

The Minister of Health has announced there’ll be a major tightening of regs governing substitution treatment, including mandatory training(at least 40 hours) for physicians wishing to become prescribers. Slow-release morphine (currently prescribed to more than half of Austrian patients) would become a third- line medication after methadone and buprenorphine. The rationale: the black market – in a country in which over 80% of all opiate dependent individuals currently receive no care of any kind! Inevitably, many patients will have their treatment interrupted, and the prospect will be more gloomy than ever for significant expansion of services to those not currently reached. In addition, ironically the new restrictions almost inevitably will fuel the black market. Initially the regs were to be implemented Jan. 1, 2007 – but the date was pushed back to March 1 after strong protest from medical groups (an expert medical committee was appointed by the Government to review and discuss the changes – at the same time a press conference was held down the hall to announce implementation!)
Full article available in German (DiePresse.com, 9 Nov 2006)

In Britain, a group of six opiate dependent prisoners and former prisoners were awarded an out-of-court settlement from the British government for "cold turkey" in jail. The group argued in a lawsuit that the short, sharp detoxification in prison was a breach of their human rights. The plaintiffs, from prisons across Britain, said they had not given consent and that the "negligent" failure to provide appropriate treatment amounted to assault.

According to the lead paragraph in the Frankfurter Rundschau (1 Nov 06), "The provision of heroin to hardcore addicts has been demonstrated to be a very successful treatment approach. And yet it is now threatened with termination [in Germany] because the CDU and CSU parties can't reach agreement." The opposition CSU party drugs chief, Maria Eichhorn, told the newspaper that the party refuses to be pressured. "And yet," states the article, "the pressure is enormous: at the end of the year the project will end."

CORRECTION :  we incorrectly identified the CSU as "the opposition party" in German government.  In fact, the CSU is the bavarian branch of the CDU and is part of the government and the cabinet as well. The CSU (and the CDU, A.Merkels party) opposes the coalition-partner's SPD (drug czar S.Baetzing) plan to implement heroin prescription.  Our apologies for getting the German political parties mixed up. 

The head of what is billed as the largest multi-center addiction treatment outcome study in the world ("COBRA") reported at the annual conference of the German Association of Addiction Medicine (DGSM) on 4 Nov. that "treatment with methadone and buprenorphine is effective and without parallel." In calling for significant expansion of availability of this treatment, the report notes that currently "in many communities opiate dependent individuals are markedly neglected ..." Full statement (in German) of Prof. Dr. Wittchen, the Director of COBRA, click here

Report is Available at http://www.euro.who.int

"Off the Drug Scene", the documentary film by well- known Swiss director Rolf Lyssy, provides an inside look at opiate addiction and heroin-assisted treatment that was pioneered in Switzerland. The DVD is provided free of charge by The Baron Edmond de Rothschild Chemical Dependency Institute, while quantities last (one DVD per request). more