Restoring the Double Disconnect: Towards a Conceptual Reinstatement of Opiate Addiction as a High Risk Behaviour

Implication for health policy/practice/research/medical edu- cation: The fact that the long term health effects of opiates have been se- riously underestimated is a potent stimulus to the quest for new forms of analgesia which are less damaging, contraindicates in- definite opiate agonist maintenance programs such as methadone, argues against heroin trials, and suggests that understanding why addicts get so many disorders of advanced aging would greatly improve our treatment not only of opiate dependency but also of degenerative disorders of the elderly such as atherosclerosis, neuro- psychiatric disease, cancer and ageing. It also powerfully underpins law enforcement and harm prevention efforts.