Pubdate: Tue, 24 Feb 2004
Source: Guardian, The (UK)
Copyright: 2004 Guardian Newspapers Limited
Contact:  http://www.guardian.co.uk/guardian/
Details: http://www.mapinc.org/media/175
Author: Steven Morris
Bookmark: http://www.mapinc.org/find?131 (Heroin Maintenance)
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)

DOCTORS ACCUSED ON HEROIN ADVICE

Seven doctors from a world-renowned private centre specialising in the 
treatment of heroin addicts were accused yesterday of prescribing drugs in 
an inappropriate manner.

The nature, quantity and combination of the drugs handed out by doctors at 
the Stapleford Centre was flawed, the General Medical Council was told 
yesterday.

The GMC's professional misconduct committee was told that one addict 
treated by the founder of the centre, Colin Brewer, 62, choked to death on 
his vomit after undergoing a "DIY home detox" in which he was prescribed 16 
drugs.

Another became confused and violent towards his girlfriend and took an 
overdose, it was claimed. Doctors at the centre also allegedly prescribed 
drugs without taking into account one woman's pregnancy and another's anorexia.

Some of the doctors are accused of issuing such large quantities of drugs 
that they could be sold on or of not establishing if a patient had the 
legitimate means to pay for his or her drugs, which can cost up to UKP200 a 
week.

The hearing, the biggest in the GMC's history, will focus attention on a 
fundamental clash over how drug addicts should be treated.

As revealed in the Guardian last week, the Stapleford centre, in Belgravia, 
central London, and Stapleford Tawney in Essex, has won plaudits for its 
liberal approach to treating addicts. Its technique of giving users 
"maintenance prescriptions" of the heroin substitute methadone, which is 
intended to take addicts out of the illegal drugs market and allow them to 
lead normal, crime-free lives, has been applauded.

The technique is legal but tends to be resisted in the public sector, where 
the preference is for drugs such as methadone to be used on a short term 
basis to wean patients off illegal substances.

The way the doctors treated 15 patients, ranging in age from 21 to 54, will 
be examined over the next two months. One of the most striking cases was 
that of a 29-year-old man identified only as GS, who arrived at the centre 
with his mother in August 2001. He was seen by a nurse and then by Dr Brewer.

GS agreed to undergo a "DIY detox" at his parents' home. He was prescribed 
16 drugs and his mother was given written instructions about the process.

Four days later she phoned to say her son was not sleeping and Dr Brewer 
was said to have prescribed another drug. But he allegedly did not tell 
GS's mother that the new drug was to replace the old ones. GS took both and 
on September 1 died in his sleep, choking on his vomit.

The "charge sheet" claimed that the "DIY detox" should only be performed in 
a setting where there is "trained nursing and medical care". It also 
claimed the instructions Dr Brewer provided were "complex, unclear, 
confusing and inadequate".

Also under scrutiny will be the treatment of a 54-year-old woman known as 
ST. She suffered narcoleptic episodes, depression and mood swings. During 
her treatment Dr Brewer is alleged to have learned she had driven while 
under the influence of drugs but failed to alert the authorities.

Dr Brewer was also accused of interfering with potential witnesses in the 
disciplinary proceedings. He allegedly wrote to two doctors who had 
provided reports critical of two of his colleagues at the Stapleford Centre 
asking them to withdraw their comments.

One heroin addict and patient of the centre, Ian Harris, 52, turned up to 
the hearing yesterday to register his support.

Mr Harris, of Dagenham, Essex, warned that people could die if the 
maintenance treatments stopped. He said: "They've given me some sort of 
stability in my life. I'm able to function without withdrawal symptoms."

Mr Harris, who is now on 285mg of methadone a day, added: "If the centre is 
forced to close down the reality for many is they will once again be at the 
mercy of drug dealers."

Dr Brewer is accused of serious professional misconduct in relation to 13 
patients stretching back to May 1990.

The other six doctors are Anthony Haines, who is accused in relation to two 
patients, Hugh Kindness (four patients), Nicolette Mervitz (one), Martin 
O'Rawe (one), Ronald Tovey (six) and Timothy Willocks (two). All deny 
wrongdoing.

The hearing continues.
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