Scots consider methadone evidence

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The Scottish Government has commissioned an independent expert group to ‘objectively consider the evidence’ supporting the role of opiate replacement therapy in treating problematic drug use.

The panel will make recommendations to the government to ensure that ‘such medical interventions are being used appropriately and in line with the international evidence base’.

The move follows the announcement of a record number of drug-related deaths in Scotland in 2011 (DDN, September, page 4), of which methadone was ‘implicated in, or potentially contributed to’, 47 per cent. Although it was not known how many of the deaths were among people who had been prescribed the substitute medication, the Daily Record newspaper ran a number of articles highly critical of methadone prescribing and demanding a public inquiry.

The expert group will be led by chief medical officer Harry Burns, in collaboration with the independent Scottish Drugs Strategy Delivery Commission, and is expected to deliver its recommendations next spring.

‘I highly value and respect the important work being done across Scotland by clinicians and professional practitioners in treating people seeking to tackle their own drug addictions,’ said minister for community safety and legal affairs Roseanna Cunningham. While prescribed drug treatment had saved ‘many thousands of lives in Scotland’, however, it was the responsibility of professionals to ‘determine the most appropriate treatment for each person seeking medical help with addiction problems’, she added.

‘The Scottish Government is clear that prescribed drug treatment is not, and cannot be, the only treatment option available on the pathway to recovery. People have a right to a full range of treatment and support options and to decide, in consultation with professionals, what is best for them.’

The chief medical officer’s intervention could hopefully ‘help to establish a consensus’, said Scottish Drugs Forum (SDF) director David Liddell. However, it was unfortunate that methadone had become a ‘political football’, he added, with the numbers on substitute prescriptions used as evidence that Scotland’s drug strategy was not working – a ‘simplistic’ analysis. ‘We need to have our best politicians thinking more deeply about why people use substances and what responses can be made,’ he said. ‘Methadone is merely a response to a large-scale problem and it does not seek to address the cause. Politicians realise this fact in private but sadly their public utterances would sometimes suggest otherwise.’

SDF 2011/12 annual report available at www.sdf.org