Sir, - Highlighting the plight of the "underclass" of heroin abusers and the prevalence of drug abuse among young people in our society is both worthy and timely. Your Editorial of June 3rd and Fintan O Toole's article of the same day deal very well with the complexity of the problem and the dilemmas facing those of us involved in treating heroin addicts. There are, however, two issues which I wish to clarify.
Firstly, there are no restrictions on the numbers of GPs allowed to treat heroin addicts. On the contrary, we encourage as many family doctors as possible to get involved in the Methadone Treatment Programme. There is now a quality assurance mechanism in place. All participating practitioners are required to receive specific training and undergo a regular audit as part of the programme. The training and audit provided by the Irish College of General Practitioners is proving very successful.
Secondly, Fintan O'Toole suggests that prescribing injectable heroin, as in Switzerland may be a complete solution to the heroin problem. It is important to note that the Swiss programme is used for only a small number of addicts who fail to stabilise despite treatment with methadone and other strategies. The majority of addicts in Irish methadone programme stabilise and reintegrate into their families. We certainly need to find better alternatives for those who continue to inject heroin. - Yours, etc.,
Dr Ide Delargy, Director, Substance Misuse Programme, Irish College of General Practitioners, Lincoln Place, Dublin 2.