Documents reveal use of buprenorphine in therapy of heroin addicts. PHOTO: FILE
Despite strong reservations from Pakistani authorities, the United Nations Office on Drug Control (UNODC) has been promoting the use of Buprenorphine — a new but deadly narcotic substance — in oral substitution therapy (OST) for heroin addicts in the country, reliable sources told the Express Investigation Cell (EIC).
Background interviews with concerned authorities and official correspondence between different government departments over the last year-and-a-half suggest that the UNODC initiated the pilot project for the use of Buprenorphine in Pakistan in the face of strong opposition by the Anti-Narcotics Force (ANF) and the Ministry of Narcotics Control.
The ANF fears the substance can be misused if it is made available to heroin addicts, sources said.
According to official documents, the ministry and ANF told the UNODC in clear terms that Pakistan could not afford the use of buprenorphine or any other drug as a substitute for heroin.
Sources said the Project Monitoring Unit (PMU) of the narcotics control ministry also assisted the UNODC in its push for using buprenorphine. PMU chief Shahid Ahmed played a key role by holding seminars and workshops to promote the use of buprenorphine.
The UNODC claims the office is working in collaboration with the Pakistani government on the project. A reply sent to the EIC on behalf of UNODC chief Cesar Gadas states, “The pilot study on OST was carried out in collaboration with the Narcotics Control Division [of the interior ministry] and the National Aids Control Programme of the government… we have the relevant documentation with us.”
“The OST involves replacing the client’s drug of choice with a medically safe drug [in this case buprenorphine] under medical supervision,” the reply clarifies.
UNODC’s statement contradicts correspondence between the ANF and the narcotics control ministry. One of the letters clearly displayed the level of ANF’s concern over the matter. “ANF’s stance on burprenorphine was deliberated upon and conveyed to the secretary Ministry of Narcotics Control… [who] promised to discontinue this project immediately... this did not happen.” When contacted, Ministry of Narcotics Control Secretary Akbar Khan Hoti said the government will take a final decision.
Published in The Express Tribune, April 24th, 2014.
COMMENTS (5)
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This drug must not be used in any treatment as yet: Buprenorphine is as habit forming as any other opioid. In a country like ours Pakistan where all dangerous but legal drugs are available off the shelf without Dr prescription allowing manufacture of higher doses of this lethal substance means spreading addiction wroth higher dividends to richer countries. Presently available as 0.2 mg will enhance to 8 mg for use as OST. And that sure is going to add to addicts not subtract from it. Have a look at the latest research on ill effects of bupernorphin. http://www.cmeinstitute.com/psychs-talk/?url=king13.asp
Dear express editor I read the above comments from the reader. They are absolutely right. the news paper should never publish information which is not confirm and fact based. OST, Oral substitution therapy, is legal in many countries where there is high addiction rates. This serves two purpose,1. to make the drug dependent functional not become a burden on the society. 2 to prevent HIV/AIDS spread among them. What ever you published in your news paper in not true. this is disinformation and a newspaper like yours should not do this
If there ever was an irresponsible, ill informed and misleading work of journalism this is a prime example. The journalist apparently printed what was fed by some elements perhaps the ANF - but clearly shows a total ignorance about heroin dependence and treatment. Firstly Buprenorphine is a legally available drug/medicine in Pakistan as in most counties. It is widely used for post operative care and pain management.
Buprenorphine and Methadone and clonidine are the only substances recommended by WHO for treatment of opioid dependence. Buprenorphine and Methadone are the substances recommended for gradual withdrawal, detoxification and substitution or maintenance therapy. These have been used successfully all over Europe, North America, and inparts of Asia including Iran, India and China to name a few. These substances are the most evidence based regimens for treatment for opioid/heroin dependence.
Pakistan has nearly 1 million heroin and opium dependent persons and another 1.6 million who misuse pharmaceutical opiods. Currently the capacity for treatment for any drug dependence in Pakistan is not more than 2000 people. Pakistan also has one of the highest rate of HIV among injecting drug users (37%) - just imagine the extent of burden of disease all of this causes. Rather than questioning how best to address the burgeoning drug problem in Pakistan. The journalist chose another way to sensationalise the issue
I don't like UN promoting this drug at all, even if it is to wean out the heroin addicts. Eventually, these drugs will find a way in the market and create a new type of addiction.