Alan McEwen: Still searching for the cure to a lethal problem

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THE use of methadone in the Capital has been put back in the spotlight. Recent headlines have brought back memories of tragic Derek Doran, the two-year-old who died after drinking methadone prescribed to his parents in East Lothian nearly five years ago – re-igniting the debate on its use in the community.

Studies show that only 3 per cent of methadone users ever emerge drug-free, making the danger of stocking homes with seemingly endless supplies of methadone even more stark.

Indeed, the poor figures may be partly due to the policy of allowing those on the programme to manage their addiction by taking the opiate home rather than consume it within pharmacies.

Calls have been made to ensure all methadone prescriptions are taken in front of a pharmacist, a potentially huge task for these healthcare professional given the 3,000 or so people prescribed the drug in the Lothians.

Figures from 2007 showed that more than 1,000 Lothian drug addicts being treated with the methadone had children living with them at home.

Some have suggested that methadone users with young children could take the drug under supervision, but even then it would probably need to be decided on a case-by-case basis.

Understandably, the strongest calls for a revamp of the system come from the grieving parents of methadone victims themselves.

Troubled teenager Danielle Scott died aged 17 after being given a cocktail of alcohol and methadone by an addict in 2005. Her mother, Lorraine, today called for supervision for every methadone user. She said: "People who are on methadone can't be very responsible to have been hooked on drugs in the first place. Therefore I don't think they are responsible enough to be given methadone to take away."

But if more than 3 per cent of methadone users are ever to be weaned off drugs, responsibility is part of the prescription they need.

Lothians MSP Dr Ian McKee, a GP in Wester Hailes and Sighthill for 34 years, admits the practicalities of increasing supervision are "a mixed picture". He said: "One of the problems is that those who are stable and trying to rebuild their lives would find it almost impossible to continue working or get a job. If they had to go to a pharmacy on a daily basis to take their dose it could stop some getting through the recovery process.

"Having full supervision would require a lot of expense and re-engineering of the current system, but it would be possible. It's the impact on those trying to recover which has to be considered.

"That would be the same for parents of children, whom you would want to see back and working. But for those parents of children with no intention of working, then I could see there being supervision for them. It would be practical for that group."

Although some patients have to report daily to pharmacies, others are given weekly amounts to take home.

Even some of the most unstable addicts are able to take methadone home to cover Sunday doses, when most pharmacies are shut.

The Scottish Drugs Forum believes the "merits of prescribing methadone on a take-home basis have to be judged on an individual basis".

A forum spokeswoman said: "However, the relaxation of supervision of methadone can be seen as an important component of rehabilitation and take-home doses may be essential for someone in recovery if they are unable to attend a pharmacy because of work or educational commitments.

"If there are concerns about the safety of medicines stored in the home and possible risk to children, the UK guidelines state that take-home doses might be permitted but the dose taken home limited by frequent dispensing."

Lothians Tory MSP Gavin Brown called for mandatory supervision for methadone users to be considered after Edinburgh teenager Vikki McGovern died of an overdose in 2008.

He said: "I still firmly believe that the best solution is to work towards getting people off drugs such as methadone, not merely managing them into a situation it is impossible to escape from."

Until more addicts have their cycle of addiction broken the debate over appropriate levels of supervision will remain.

Only greater funding for intensive rehabilitation programmes seems to have any chance of bringing that about and preventing more tragedies taking place.

The facts

3,000 heroin addicts are registered in Edinburgh.

60 and 120ml of methadone are the guideline daily doses for doctors to give addicts, but they can prescribe as much of the heroin substitute as they feel is necessary for a patient.

3.6m a year is the cost of prescribing methadone to addicts in the Lothians, with a dose of the drug given out in the area every three seconds.

200m is the estimated amount heroin-addicted criminals cost Edinburgh each year.