Controversial trial at NHS clinics to offer cash for drug addicts who stay clean

Experts say financial incentives in the form of a £10 shopping voucher could revolutionise drug treatment in Britain

Health Reporter

NHS drug clinics have begun offering heroin users financial incentives to quit as part of a major trial which could radically transform the UK’s drug prevention strategy.

In the groundbreaking study, 33 NHS and voluntary clinics are giving a £10 shopping voucher to every user of opiate drugs, including heroin, if they can provide a clean urine sample at a weekly meeting with their key worker. 

The revelation came as the team behind the trial presented evidence yesterday from a separate study which found that financial incentives offered to heroin users to encourage them to take up vaccinations for hepatitis B (HBV) had led to “striking” increases in uptake. They said a rise in vaccinations would have major benefits in preventing the spread of infection among drug users and the wider population.

The research is being carried out by public health experts from three leading London universities, and is led by current and former advisers to the standards body, the National Centre for Health and Care Excellence (Nice).

Professor John Strang, from the National Addiction Centre at King’s College London, who led the study, said that he and his team understood that people might be “ill at ease” at the idea of giving handouts to people using illicit drugs, but said that financial incentives that brought clinical benefits represented a powerful “tool” for improving public health.

“We understand that ill-at-ease feeling because it will be what we ourselves are feeling,” he said. “But the nature of medicine and its development is that you need to examine the evidence and improve methods of treatment.”

Few details will be released until the study is completed but full results are expected to be published within the next two years. 

The team’s HBV vaccine uptake trial enlisted 210 people already receiving drug treatment at 12 NHS clinics across the UK. At four of the clinics, drug users were given supermarket vouchers valued at £10, when they received each of three HBV vaccinations. Another trial group was given vouchers of an escalating value of £5, £10 and then £15. Patients who were offered incentives were nearly five times more likely to complete the vaccination programme within 28 days than those at four clinics where no incentives were offered. Forty-five per cent of patients at the clinic which offered a flat-rate incentive, and 49 per cent of patients at the clinic which offered escalating incentives, completed the programme in 28 days. This was compared with just 9 per cent at the clinic which did not offer incentives. The study was published in The Lancet today.

Injecting drug users, of which there are estimated to be around 250,000 in the UK, are at high risk of infection from HBV and other blood-borne viruses, including HIV, contracted after using shared needles. Sexual partners and children of injectors are also at high risk, and controlling the spread of infections within the drug-taking community is seen by public health experts as a key goal to protecting the wider population.

Professor Strang said that financial incentives for HBV vaccination were a strong candidate for rollout across the NHS. “If your brother was going through a healthcare system and somebody had a tool that meant they had a 50 per cent completion rate of vaccination, but out of squeamishness they went for [a tool with] a 9 per cent [completion rate] and your brother was therefore infected, I’d feel aggrieved about that,” he said.

The team’s second trial, which will ascertain whether incentives encourage abstinence from heroin, is likely to prove more controversial. Cash and voucher incentives are viewed as a powerful tool for improving the health of lower-income groups, and helping to break the link between poverty and ill health. 

ebooks
ebookA delicious collection of 50 meaty main courses
Life and Style
ebookNow available in paperback
  • Get to the point
Latest stories from i100
Have you tried new the Independent Digital Edition apps?

ES Rentals

    Independent Dating
    and  

    By clicking 'Search' you
    are agreeing to our
    Terms of Use.

    iJobs Job Widget
    iJobs General

    Ashdown Group: Marketing Manager (B2B) - Romford - £40,000 + car

    £35000 - £40000 per annum + car and benefits: Ashdown Group: Marketing Manager...

    Ashdown Group: Helpdesk Analyst - Devon - £20,000

    £18000 - £20000 per annum: Ashdown Group: Helpdesk Analyst - Devon - £20,000 ...

    Ashdown Group: Data Scientist - London - £50,000 + bonus

    £35000 - £50000 per annum + generous bonus: Ashdown Group: Business Analytics ...

    Ashdown Group: IT Project Coordinator (Software Development) - Kingston

    £45000 - £50000 per annum: Ashdown Group: IT Project Coordinator (Software Dev...

    Day In a Page

    General Election 2015: ‘We will not sit down with Nicola Sturgeon’, says Ed Balls

    'We will not sit down with Nicola Sturgeon'

    In an exclusive interview, Ed Balls says he won't negotiate his first Budget with SNP MPs - even if Labour need their votes to secure its passage
    VE Day 70th anniversary: How ordinary Britons celebrated the end of war in Europe

    How ordinary Britons celebrated VE Day

    Our perception of VE Day usually involves crowds of giddy Britons casting off the shackles of war with gay abandon. The truth was more nuanced
    They came in with William Caxton's printing press, but typefaces still matter in the digital age

    Typefaces still matter in the digital age

    A new typeface once took years to create, now thousands are available at the click of a drop-down menu. So why do most of us still rely on the old classics, asks Meg Carter?
    Discovery of 'missing link' between the two main life-forms on Earth could explain evolution of animals, say scientists

    'Missing link' between Earth's two life-forms found

    New microbial species tells us something about our dark past, say scientists
    Ronald McDonald the muse? Why Banksy, Ron English and Keith Coventry are lovin' Maccy D's

    Ronald McDonald the muse

    A new wave of artists is taking inspiration from the fast food chain
    13 best picnic blankets

    13 best picnic blankets

    Dine al fresco without the grass stains and damp bottoms with something from our pick of picnic rugs
    General Election 2015: Ed Miliband's unlikely journey from hapless geek to heart-throb

    Miliband's unlikely journey from hapless geek to heart-throb

    He was meant to be Labour's biggest handicap - but has become almost an asset
    General Election 2015: A guide to the smaller parties, from the the National Health Action Party to the Church of the Militant Elvis Party

    On the margins

    From Militant Elvis to Women's Equality: a guide to the underdogs standing in the election
    Amr Darrag: Ex-Muslim Brotherhood minister in exile still believes Egypt's military regime can be replaced with 'moderate' Islamic rule

    'This is the battle of young Egypt for the future of our country'

    Ex-Muslim Brotherhood minister Amr Darrag still believes the opposition can rid Egypt of its military regime and replace it with 'moderate' Islamic rule, he tells Robert Fisk
    Why patients must rely less on doctors: Improving our own health is the 'blockbuster drug of the century'

    Why patients must rely less on doctors

    Improving our own health is the 'blockbuster drug of the century'
    Sarah Lucas is the perfect artist to represent Britain at the Venice Biennale

    Flesh in Venice

    Sarah Lucas has filled the British pavilion at the Venice Biennale with slinky cats and casts of her female friends' private parts. It makes you proud to be a woman, says Karen Wright
    11 best anti-ageing day creams

    11 best anti-ageing day creams

    Slow down the ageing process with one of these high-performance, hardworking anti-agers
    Juventus 2 Real Madrid 1: Five things we learnt, including Iker Casillas is past it and Carlos Tevez remains effective

    Juventus vs Real Madrid

    Five things we learnt from the Italian's Champions League first leg win over the Spanish giants
    Ashes 2015: Test series looks a lost cause for England... whoever takes over as ECB director of cricket

    Ashes series looks a lost cause for England...

    Whoever takes over as ECB director of cricket, says Stephen Brenkley
    Fishing for votes with Nigel Farage: The Ukip leader shows how he can work an audience as he casts his line to the disaffected of Grimsby

    Fishing is on Nigel Farage's mind

    Ukip leader casts a line to the disaffected