From Dr P. Quartey, FRCS
SIR,-The article "ACMD calls for methadone supervision" (PJ, July 1, p6) summarised the recently published "Reducing drug related deaths: a report of the Advisory Council on the Misuse of Drugs". It was stated that "because methadone has a narrow window of clinical safety, the committee recommends that the Department of Health should plan trials on alternative treatments for opioid addiction as a matter of urgency".
At Schering-Plough, we totally agree with this view and have already taken action to implement such a trial.
Subutex (buprenorphine) was introduced in the United Kingdom in January, 1999, supported by robust clinical evidence demonstrating efficacy similar to that of methadone, with an improved safety profile. In France, where Subutex is widely used (nearly 10 times more patients are treated on Subutex than methadone) they have seen a consistent decrease in opiate overdose deaths per annum.
As part of an ongoing commitment to the field of opiate dependence, Schering-Plough has recently started the Sirius project. This is a safety assessment study into which 110 investigating centres have already been recruited. The design is observational and it is expected that Subutex and methadone will be compared in approximately 5,000 patients from 200 treatment centres.
Sirius will be by far the largest study ever carried out in the UK in the area of substance misuse and we are confident it will confirm the existing evidence of enhanced Subutex safety.
At Schering-Plough we applaud the Government focus on the problem of drug dependence and are committed to working in partnership with interested agencies, with a view to adding further impetus to the excellent 10-year strategy.
Paul Quartey
Medical Director, Schering-Plough Ltd, Welwyn Garden City, Hertfordshire