Page 2753 - Week 11 - Tuesday, 20 October 1992
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Rather, they are intended to ensure the safety and effective clinical management of clients being treated with methadone. The ACT methadone program strictly follows the national methadone guidelines in its policies and procedures. As I said before, Mr Humphries sat on the MCDS when it agreed to these guidelines and procedures - - -
Mr Moore: The guidelines are out of touch.
MR BERRY: Mr Moore says that they are out of touch.
Mr Moore: I said, "If they are out of touch". If they are out of touch, then we proceed beyond them; but I will get back to that.
MR BERRY: So, Mr Moore will proceed unilaterally. Urinalysis is used only as a means by which extraneous drug use can be assessed and treatment progress monitored. (Extension of time granted)
Mr Kaine: This is a 40-minute speech.
MR BERRY: If it were not for all of the interjections from the Liberals opposite, it would be quite a lot easier. Frequent testing is important in the initial stages, as it is critical to ensure that the dose of methadone is safe and not creating hazardous toxic substance levels. Madam Speaker, later on I will be tabling the Government's response to the committee report. I refer particularly to page 4 of the Government's response, which refers to the following:
- the development of large practices with low quality care and hence little harm reduction;
- increased cases of death through overdose due to inappropriate prescribing by general practitioners who lacked appropriate training;
- major diversion of methadone to black market sales because of double dosing or poor administration techniques (in NSW this reached a peak of 20% of doses).
In Victoria a special investigation of 14 deaths of methadone users over a short period of time found treatment by inadequately prepared general practitioners contributed to the deaths. Starting doses had been too high and the doctors had failed to take into account the effect of other prescription drug use and the presence of liver disease caused by alcohol use and or hepatitis. Victoria now operates a vigorous training program for general practitioners.
There was no mention of that by the committee - no consideration of that by the committee. It was all done in a big hurry. Madam Speaker, the national guidelines state that precautions must be taken to ensure that there is no substitution of urine specimens and that pathology results are accurate, provided speedily and cover a range of drugs. Mr Moore suggests a different course - do not bother with the national guidelines in that respect. Are they out of touch, Mr Moore?
Mr Moore: Indeed.
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