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Following is a question by the Hon Chan Kwok-keung and a written reply by the Secretary for Security, Mrs Regina Ip, in the Legislative Council today (January 22):

Question:

Regarding drug rehabilitation services, will the Government inform this Council:

(a) of the public expenditure on and manpower deployed for providing out-patient methadone treatment by the Department of Health, the respective numbers of persons who have received the treatment and those who have successfully been rehabilitated, in each of the past three years; and

(b) whether it has compared the effectiveness of the Methadone Treatment Programme to other drug rehabilitation options and treatments with other medicines?

Reply:

Madam President,

(a) At present, methadone treatment services are provided at 20 clinics operated by the Department of Health. The expenditure, staffing and patient attendance of these methadone clinics in the past three years are shown in the Annex.

The Methadone Treatment Programme (MTP) in Hong Kong comprises two programmes. Patients can enroll in the "maintenance" programme and replace illicit heroin use by adequate methadone dosage prescribed by doctors. They can also enroll in the "detoxification" programme where they will be assisted to achieve a drug-free state by taking decreased dosages of methadone over a period of time. The vast majority of MTP patients are enrolled in the "maintenance" programme. But there are also some drug dependent persons with a strong motivation to be detoxified who have been successfully rehabilitated under the "detoxification" programme. The number of successfully detoxified cases over the past three years is as follows:

                  Year 2000       Year 2001       Year 2002

                  ---------       ---------       ---------

                 75 persons      53 persons      97 persons

(b) Hong Kong adopts a multi-modality approach in providing drug treatment and rehabilitation services to cater for the needs of drug dependent persons coming from various backgrounds. Apart from the MTP, other treatment modalities include a compulsory placement scheme operated by the Correctional Services Department, voluntary residential treatment programmes run by non-governmental organisations and out-patient services provided by the Substance Abuse Clinics of the Hospital Authority. These drug treatment modalities have different targets and aims. Amongst them, the MTP is the only "substitution" therapy which caters for those who are not suitable for or receptive to residential or other forms of treatment. Therefore, it is difficult to directly compare the effectiveness of the MTP with that of other treatment modalities.

As far as the MTP is concerned, the Government has been closely monitoring its usefulness and effectiveness since its implementation in 1972, with several reviews conducted. In mid-1999, the Narcotics Division and the Sub-committee on Treatment and Rehabilitation of the Action Committee Against Narcotics set up a Working Group to conduct a comprehensive review of the MTP. In its report released in early 2001, the Working Group concluded that the MTP had fulfilled its declared objectives and was effective in helping to sustain the employment and social life of drug dependent persons, as well as reducing instances of drug overdose, drug-related deaths and even spread of blood-borne diseases. It was also considered that the MTP had been effective in reducing drug-related crimes.

The Working Group also examined the possibility of substituting or supplementing methadone by other drugs such as buprenorphine and naltrexone. Buprenorphine can be used for "maintenance" or "detoxification" while naltrexone is a supplementary drug to prevent relapse into heroin or opium after detoxification. According to the Working Group, there is at present no evidence to prove that buprenorphine is a better drug than methadone in "maintenance" treatment. In the light of local and overseas experience on the use of naltrexone, the Working Group recommended that a research study on the use of the drug be conducted to fully assess its effectiveness in relapse prevention for detoxified methadone patients. In April 2002, the Beat Drugs Fund approved a grant of $3 900 000 to conduct a research on the effectiveness of naltrexone in relapse prevention for opiate drug abusers. The research commenced in mid-2002 and is expected to be completed in 2005.

End/Wednesday, January 22, 2003

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