Pubdate: Sat, 25 Mar 2006
Source: Guardian, The (UK)
Copyright: 2006 Guardian Newspapers Limited
Contact:  http://www.guardian.co.uk/guardian/
Details: http://www.mapinc.org/media/175
Author: Sarah Boseley, health editor
Bookmark: http://www.mapinc.org/find?131 (Heroin Maintenance)

PIONEERING HEROIN TREATMENT DOCTOR MAY BE STRUCK OFF

A world expert on the treatment of heroin addiction may be struck off 
the medical register after the General Medical Council decided 
yesterday that he had been irresponsible in the way he prescribed 
opiates and other drugs to some of his patients.

The GMC's findings will dismay those who think Colin Brewer, founder 
of the private Stapleford Centre, and his colleagues were saving 
heroin addicts from crime and destitution by maintaining them on 
opiates over long periods. Some of their patients say they have been 
able to lead normal lives for years as a result of the treatment. But 
the GMC's fitness to practise panel yesterday found that Dr Brewer 
had acted irresponsibly and inappropriately towards 13 of his 
patients. It will meet again to decide whether to strike him off the 
medical register.

One of the Stapleford Centre patients died during a "home detox" 
undertaken at Dr Brewer's suggestion. The patient, referred to as Mr 
GS, 29, and his mother were given an instruction sheet and 10 
prescription drugs to sedate him and ease withdrawal. The mother 
failed to realise from the instructions that the patient had to be 
watched 24 hours. The man vomited in his sleep and choked to death.

The GMC was highly critical of the programme, which put the patient 
in charge of the drug dose and offered medical support only at the 
end of a telephone. The panel "did not consider this was a safe or 
suitable method of managing a patient who was being treated with 
large doses of potentially dangerous drugs and supervised by 
untrained carers. The instruction sheet was complex, unclear, 
confusing and inadequate."

Many of the findings relate to the practice of giving patients 
long-term prescriptions with the result that they had large 
quantities of drugs which they may have been tempted to sell. One 
patient, referred to as Mr RB, was given a five-week supply of the 
opiate Phenazocine, which amounted to 1,050 tablets. Later he was 
given 28 days' supply of Palfium, which came to 1,120 tablets. The 
panel ruled that Dr Brewer should have told the Driver and Vehicle 
Licensing Agency that another patient, Ms ST, was driving while under 
the influence of drugs. She had four car accidents. Another addict 
had anorexia nervosa and at one point her weight dropped to six and a 
half stone, yet Dr Brewer failed to treat her for it.

Six other doctors from the centre were also before the GMC. One of 
the doctors, Ronald Tovey, prescribed heroin for two patients at the 
centre. The GMC panel accepted that Dr Tovey gave them heroin for 
pain relief but the panel found he failed to act when tests suggested 
the patient was not using the drug. The panel will meet again to 
decide whether to discipline Dr Tovey and another doctor, Hugh 
Kindness. It dismissed the cases against Nicolette Mervitz, Anthony 
Haines, Timothy Willocks and Martin O'Rawe.
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