Australian and New Zealand Journal of Psychiatry (1979) 13:69
B R lEF C O M MUNICATIONS
SUMMARY OF RECENT NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL DOCUMENTS
The Feingold Diet
The Food Science and Technology Subcommittee of the N.H. & M.R.C. recently considered the claims made by Dr. Benjamin Feingold regarding the use of an elimination diet bearing his name in the treatment of hyperactivity in children. Dr. Feingold has suggested that some individuals are genetically predisposed to toxic effects of some naturally occurring and synthetic chemicals in food and that the consumption of these chemicals by susceptible individuals results in a variety of behavioural and neurological abnormalities. Dr. Feingold has claimed a success rate of about 50% with the use of the elimination diet. The subcommittee concluded that at this stage there is not adequate evidence to support these claims and that the diet should not be used without medical supervision as it is an elimination diet and may have possible nutritional disadvantages if used over long periods.
Methadone Use in the Treatment of Narcotic Addiction
The N.H. & M.R.C. recently approved a document on the use of methadone in the treatment of narcotic addiction. The document points out that there have been relatively few controlled studies to date but outlines some guidelines for its use. It concludes that ‘methadone treatment should be made available, as one part of a total approach for those chronic addicted persons who have failed to respond to other forms of treatment and whose addiction impairs their health or their social functioning or threatens their life.’ The document suggests two uses for methadone in the treatment of narcotic addicts:
(i) Methadone withdrawal. In cases of narcotic withdrawal where addiction has been present for at least twelve months. The dose required is usually less than 50 mg/day and should never be continued for more than 90 days. (ii) Methadone maintenance. May be used where there is chronic, intractable addiction. The goals of the treatment are the reduction of morbidity and mortality as well as the reduction of associated crime; the reduction of the contagion of illegal drug use; increased productivity; and assisting the individual addict to cope. High dosage schedules (80-120 mglday) are recommended as they are more effective than low dose (less than 60 mglday) which are often associated with continuing illegal drug use. A number of criticisms have been levelled against methadone including its potential dangers, the perpetuation of addiction, the substitution of one narcotic for another and the encouragement of the community’s dependence on drugs. While acknowledging some of these hazards the document concludes that the benefits far outweigh the dangers when methadone is used in carefully selected patients in a well controlled programme. Finally, the committee suggests that a number of restrictions in availability are required: (i) Methadone should only be made available to chronic addicts or those with severe intractable pain. (ii) The power to prescribe methadone should be restricted, by law, to specially authorized practitioners. (iii) Access to methadone should be restricted to daily consumption, by all clients, of the appropriate dose, in the form of syrup, in the presence of a professional person nominated by the prescriber.
Downloaded from anp.sagepub.com at NANYANG TECH UNIV LIBRARY on June 18, 2015
B R lEF C O M MUNICATIONS
SUMMARY OF RECENT NATIONAL HEALTH AND MEDICAL RESEARCH COUNCIL DOCUMENTS
The Feingold Diet
The Food Science and Technology Subcommittee of the N.H. & M.R.C. recently considered the claims made by Dr. Benjamin Feingold regarding the use of an elimination diet bearing his name in the treatment of hyperactivity in children. Dr. Feingold has suggested that some individuals are genetically predisposed to toxic effects of some naturally occurring and synthetic chemicals in food and that the consumption of these chemicals by susceptible individuals results in a variety of behavioural and neurological abnormalities. Dr. Feingold has claimed a success rate of about 50% with the use of the elimination diet. The subcommittee concluded that at this stage there is not adequate evidence to support these claims and that the diet should not be used without medical supervision as it is an elimination diet and may have possible nutritional disadvantages if used over long periods.
Methadone Use in the Treatment of Narcotic Addiction
The N.H. & M.R.C. recently approved a document on the use of methadone in the treatment of narcotic addiction. The document points out that there have been relatively few controlled studies to date but outlines some guidelines for its use. It concludes that ‘methadone treatment should be made available, as one part of a total approach for those chronic addicted persons who have failed to respond to other forms of treatment and whose addiction impairs their health or their social functioning or threatens their life.’ The document suggests two uses for methadone in the treatment of narcotic addicts:
(i) Methadone withdrawal. In cases of narcotic withdrawal where addiction has been present for at least twelve months. The dose required is usually less than 50 mg/day and should never be continued for more than 90 days. (ii) Methadone maintenance. May be used where there is chronic, intractable addiction. The goals of the treatment are the reduction of morbidity and mortality as well as the reduction of associated crime; the reduction of the contagion of illegal drug use; increased productivity; and assisting the individual addict to cope. High dosage schedules (80-120 mglday) are recommended as they are more effective than low dose (less than 60 mglday) which are often associated with continuing illegal drug use. A number of criticisms have been levelled against methadone including its potential dangers, the perpetuation of addiction, the substitution of one narcotic for another and the encouragement of the community’s dependence on drugs. While acknowledging some of these hazards the document concludes that the benefits far outweigh the dangers when methadone is used in carefully selected patients in a well controlled programme. Finally, the committee suggests that a number of restrictions in availability are required: (i) Methadone should only be made available to chronic addicts or those with severe intractable pain. (ii) The power to prescribe methadone should be restricted, by law, to specially authorized practitioners. (iii) Access to methadone should be restricted to daily consumption, by all clients, of the appropriate dose, in the form of syrup, in the presence of a professional person nominated by the prescriber.
Downloaded from anp.sagepub.com at NANYANG TECH UNIV LIBRARY on June 18, 2015
