Letters and comment

We welcome your letters…

Please email them to claire@cjwellings.com or post them to The Editor, DDN Magazine, CJ Wellings Ltd, 57 High Street, Ashford TN24 8SG. Letters may be edited for space or clarity – please limit submissions to 350 words.

 

Lack of vigilance

 I wonder if your editorial team wittingly sanctioned such a flagrant piece of product placement as that exhibited by ‘The road less travelled’? (DDN, November, page 16). 

The authors, McKeganey et al, are discussing the active ingredient buprenorphine and the active ingredient methadone, but one would be forgiven for thinking otherwise. They consistently refer to one by its trade name (Suboxone) the other by its pharmacological name (methadone) and then go on to equate buprenorphine with the buprenorphine-naloxone product as if there is equivalence, or in this case, superiority. 

This ‘sleight of tongue’ renders the European monitoring data quoted meaningless. The penetration of Suboxone as a new product in these European countries is primarily of relevance to the drug company. Comparative prescribing of buprenorphine generally, however, may be a story. The research reported (small numbers, uncontrolled, open-label, not statistically relevant, drug-company funded) is similarly meaningless, seeming to function primarily as product placement. The article is then dressed up more portentously with a quote from Robert Frost and a strap line suggesting we have all got it wrong.

If one means to compare buprenorphine with methadone, do so. If one wants to look at the superiority of a newer product (Suboxone) over buprenorphine then this is not the study, nor would this be the journal to report the findings.

It is acknowledged that the research is supported by the manufacturer of Suboxone, but the authors do not disclose their conflicts of interests. 

In an age when research, and research reporting, is beset with controversy around drug-company involvement, undisclosed interests, ‘ghost writing’ and suppression of negative findings, it is important we all are vigilant as to how data is presented and used.

Dr Ron Alcorn, by email

 

Wrong fan club

 Is Paul Hayes getting his mum to write letters to DDN (November, page 14)? ‘I don’t wish to hail Mr Hayes as a great visionary’ said the letter-writer in the last issue of DDN, before going on to spend over six paragraphs doing exactly that. 

The argument seemed to be that all the people who campaigned for years to challenge stigma and have people addicted to drugs and alcohol viewed with compassion and caring, and their chronic condition treated as a debilitating illness, have inadvertently managed to dramatically reduce the available funding for treatment. Apparently this well-meaning campaign was in vain, and we should have taken a ‘pragmatic approach’, continued to let it be a social and criminal justice issue and quietly taken the money. Taking this argument to its logical conclusion, presumably drug users should have just increased their criminality every time they wanted a rise in funding.

I would like to tell your letter-writer, and Mr Hayes, that to me and all of the people I have met in the treatment system over the last 20 years, changing public attitudes towards drug and alcohol problems from one of hostility to support of people’s condition is the most important battle that we are fighting. If this can be achieved, drug treatment would not be losing out by competing against perceived worthier health needs like old people’s services or child welfare, but would be viewed as an equally deserving health issue.

This is not an attack on Mr Hayes, or the NTA, who have done a great deal of good improving access to treatment over the last ten years, but your letter-writer should put the pompoms and Paul Hayes fan club stickers back in their box, and put their efforts into campaigning to have drug treatment seen as a health issue deserving of proper funding.

N White, by email

 

Treatment treat 

I would just like to congratulate DDN on their recent residential treatment directory (DDN, November, centre section). My colleagues and I find it a very useful resource and wondered if it was available in any other formats, and how often it was updated.

R Glover, by email

 

DDN replies: We are glad you find the directory useful. We work to make it as comprehensive a resource as possible and update the printed version twice a year. The residential directory and our training and service user group directories are available in the resources section of the new look DDN website. All directories can be viewed as virtual magazines and downloaded as PDFs to print. 

We are working on revamping the layouts of our directories in 2013 to include as many features as we can that will be useful to readers. We are already considering adding map views so that organisations can be searched for geographically as well as alphabetically, but if anyone has any suggestions for improvements please email them to directories@cjwellings.com