Doctor comments on drug treatment

Press, Volume CXIII, Issue 33158, 23 February 1973, Page 2

Doctor comments on drug treatment

(New Zealand Press Association) AUCKLAND, February 22. , Drug addicts must realise the dangers of using other drugs besides the prescribed medication when they are under treatment for addiction. Dr R. A. Roche, who runs a methadone treatment programme in Auckland, said today.

He was referring to) evidence at an inquest yesterday into the death of an addict who had been a patient under Dr Roche’s programme. The man had been injecting methadone and also taking alcohol and other drugs. Dr Roche said the use of alcohol with injections of methadone could cause a person to go into a deep sleep on his back, and choke on his tongue. “Vital*’ treatment "It is vitally important that' anyone seen to be unconscious where there is a possibility of drug use should be turned on his side with the head down,’’ he said. “If the person cannot be roused quickly medical help should be summoned. It is also vital that any doctor prescribing mind-altering drugs should check by telephone whether the patient is receiving maintenance drugs on another programme.” The recently published Ford Foundation report in America said methadone maintenance clinics were a

I valued approach, now widely ■ used, to narcotic abuse. The Coroner, Mr A. D. Copeland, drew attention to deaths of patients who had been under treatment by Dr Roche’s clinic. Three clinics Dr Roche said three doctors were now running these clinics, and the load was increasing because of an influx of addicts from outside areas. It was unfortunate that the official hospital board clinic was not receiving acceptance, but this was because it issued methadone only in (liquid form. This was to 'allow greater supervision, but lit meant that those working (ano 80 per cent of Dr Roche’s patients are at work) could not get the time to attend the clinic twice a day. They also resented the rule that they must not leave Auckland, even for a weekend. His own clinic could not i use liquid methadone, be- . cause the extra staff and J facilities needed ruled it out. Dr Roche said his programme called for methadone .■to be swallowed in tablet form. The evidence at yes- ' terday’s inquest was that the ' man had been injecting him--1 qaIF if

self with it. Heroin feared “If legislation is passed.; preventing general prac-l titioners from running methaidone treatment clinics. we j have evidence that most of the addicts will go back underground and use heroin again," he said. Since his programme began little heroin had been in Auckland. “We have gone as far as we can to tighten controls by making patients obtain supplies daily from chemists,”! he said. “The problem is that | on week-ends and holidays] thev have to be issued with extra supplies to tide them over. "It would appear from the i Coroner’s comments that alii the deaths were directly due to methadone prescribed by! myself being injected in large quantities, instead of swallowed as directed. “In all the cases there is > ample evidence that metha- ■ done was not the only drug being used at the time of : death. Others were coming; ■ from illegal sources. Also,! not all were receiving treat-! - ment from me when they • died. Some had left the pro- • gramme some time earlier.” Not all patients were moti-

’ vated. Some ignored instructions and obtained drugs . elsewhere. It was inevitable > that because of fear of reI criminations all the evidence - would not come out at an ini quest. Dr Roche said. I The drug clinic run by the Auckland Hospital Board is treating four patients a day. I The medical superintendent! : of Oakley Hospital (Dr P. P. ' E. Savage), who is in charge { of it, describes them as “the • faithful people who stick to ; their doses and don’t complain.” Some prospective patients! a back out of the scheme when 1 they find they cannot take 3|the methadone away from t the clinic, and others demand Harger doses and leave when r they are refused. )! Dr Savage could not pre-1 > cisely estimate the total . numbers treated at the clinic. ; but described it as “pretty » small.”