PrescriPtions
MORE CHOICE...
It hasn’t always been
the case, but opioid
substitution therapy
is now accepted as a
key instrument in
enabling recovery.
Having got this far –
and despite the ever-
present threat of
cuts – is improving
choice the next key
step, asks DDN
lthough divisions inevitably still exist, and
probably always will, we’ve come a long way
since the sector was polarised by those
bitter harm reduction versus abstinence
arguments, with concerns over budget reductions and
the austerity agenda perhaps helping to focus minds
on the bigger picture.
A significant step on this journey was the NTA’s 2012
Medications in recovery report (DDN, August 2012, page
A
5), which has come to be seen as a landmark document.
A fundamental re-examining of the treatment methods
and objectives that can lead to recovery, it concluded
that while ‘entering and staying in treatment’ and
‘coming off opioid substitution treatment’ (OST) were
undoubtedly important indicators, they did not
constitute recovery ‘in themselves’.
Delivered properly, OST had ‘an important and
legitimate place within recovery’, providing as it did a
platform of ‘stability and safety that protects people
and creates the time and space for them to move
forward,’ it stated.
What was also vital, it stressed, was to focus on
broader support and make sure that OST is always
delivered in line with clinical guidance.
Shortly after the report’s publication, Professor
Oscar D’Agnone – at the time clinical director of CRI,
and now medical director of London’s OAD Clinic –
wrote a DDN article expressing hope that the report
might help put an end to the false dichotomy
between abstinence and prescribing and bring about
a situation where services would simply choose what
worked best from a range of interventi