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April 16, 1973

The "British System" of Heroin Maintenance

Author Affiliations

Washington, DC

JAMA. 1973;224(3):397. doi:10.1001/jama.1973.03220160047017

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To the Editor.—  In the article discussing the 'British system' of heroin maintenance (223:539, 1973) Dr. Edward Lewis, Jr., presented an appealing statistical basis for the adoption on a limited basis for such a system in the United States. He described a country that apparently has stabilized its addict population, that has no significant crime problem associated with addicts, and that has fewer medical complications secondary to illicit drug use.What is disconcerting is that he contradicted this evidence in four of his five conclusions, returning to the 'wait and see' attitude that has paralyzed rehabilitative attempts. He supported his conclusions by noting differences between Britain and the United States, ignoring completely the more compelling and relevant similarities, such as parallel increase in rates of addiction in the 60s, common use of mainlining as a method of administration, preponderance of addicts in urban areas, and failure of other rehabilitative methods.