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From: Sally Satel
To: Mike GrayPosted Tuesday, Sept. 15, 1998, at 3:30 AM ET

Dear Mr. Gray:

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I'll be signing off now. Good luck to you.
For readers interested in an accurate account of the social phenomena you mentioned in your last reply, I refer them to:
1. Strang, John and Janie Sheridan. Heroin prescribing in the "British System" of the mid 1990s: Data from the 1995 national survey of community pharmacies in England and Wales. Drug and Alcohol Review, 16: 7-16, 1997.
This paper documents the fact that few British physicians actually make use of their heroin-prescribing privileges, based on a survey of more than 4,000 pharmacies and a response rate of 75 percent. In all, about 340 addicts received prescribed heroin at any one time. In other words, the system of physician prescribing is not a great success. (Re Liverpool clinic. See my entry dated Aug. 18 for a brief critique of the Swiss heroin clinic and heroin maintenance in general.)
2. Musto, David F. The American Disease. Second edition. Oxford University Press, 1987. See Chapter 7 for a historical account of morphine maintenance clinics from the 1920s. One of the problems with these clinics was that, contrary to your rosy portrait, virtually nobody got off the drugs. There are no citations in Musto's book of studies documenting reduction in crime. However, many of the clinics, especially the Worth Street Clinic in New York City, were corrupted by diversion of the drugs that were distributed to and meant for the patients.

Sally Satel