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. - --- MAP posted-by: Jay Bergstrom