A humble service that has delivered public health good

Abstract

On 1 June 1976, the first methadone clinic was officially opened in Hong Kong, following pilot studies in the preceding years, and in response to the recommendations of Dr Robert Newman, then consultant to the Hong Kong Government. One year later, an extensive network of 21 clinics came into being, serving up to 10 000 drug users in the territory on a daily basis. Mr Peter Lee, a British colonial civil servant and then Commissioner for Narcotics, was the innovator behind this new programme. In retrospect, we argue that the low threshold methadone treatment programme is not just essential in promoting health in drug users, but has contributed to public security, and protected Hong Kong from the onslaught of HIV infection. Over the past 3 decades, the mode of operation of Hong Kong’s methadone clinics has remained the same. The clinics are operated as a walk-in methadone treatment service, for which 98% are on maintenance. Although largely a public health concept today, methadone treatment served public security objectives when it was first established. As an expensive habit, many drug users committed crime to obtain quick money to pay for their heroin. Not surprisingly, a significant proportion of the prison population in the 1960s and 1970s were drug users. Shortly after the introduction of the methadone treatment programme, crime rates fell