Susan Dalgety: Going green is killing us

WITH the heroin substitute methadone implicated in many drug-related deaths, we urgently need to reassess how we treat addicts and get them clean for good, writes Susan Dalgety

I am never going to have the chance to ask Alex Salmond a question at his weekly First Minister’s Questions joust in the Scottish Parliament, but if I were able to ask him something it would be about turtle juice.

Confused, well you would be if you were to try it. Turtle juice is one of the slang expressions for methadone, the bright-green, sickly-sweet heroin substitute that 22,000 Scots take every day – courtesy of the NHS.

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Over the past five years, the Scottish Government has spent £129 million on the drug, which is then given away free to drug users.

It is estimated that chemists across Scotland make 
£36 million a year dishing out the heroin substitute, with high street giant Boots earning nearly £4m last year from its methadone services. And, chillingly, official figures published this month show that nearly half of all drug-related deaths in Scotland last year were caused by methadone – with 275 people dying from the effects of their NHS prescription.

Consider those figures just for a moment. The NHS, in a clumsy attempt to treat people addicted to heroin, is actually helping to hasten their death by providing them easy access to a powerful narcotic.

And it is not just hardened addicts who are falling victim. A few years ago a teenage friend of my son’s died, only 15-years-old, after buying some turtle juice on the street. Until that fateful night, when the heroin substitute shut down his nervous system, he hadn’t even smoked a cigarette.

And there is anecdotal evidence that occasional heroin users are able to secure a regular methadone script because they know how to present themselves as serious addicts.

For some users, methadone is their drug of choice, not the treatment for an addiction.

I have no doubt that Scotland’s minister for community safety and legal affairs, Roseanna Cunningham, is sincere when she says that the Scottish Government is committed to helping addicts recover.

The government’s national drugs strategy – the Road to Recovery – sets out an impressive array of tactics, from the supply of the life-saving drug naloxone, which can treat drug overdoses, to rehabilitation services.

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Its commitment, and that of previous governments, to supporting the recovery of those affected by drug addiction is not in doubt.

Ms Cunningham – and the thousands of social workers, medical staff and policymakers involved in the treatment and management of addiction – understand only too well that poly-drug abuse affects not just the user.

As a councillor for Wester Hailes in the 1990s – and the place where I raised my children – I saw firsthand the terrible havoc that drugs – be that heroin, cannabis, or illegally obtained prescription drugs – can wreak on families and communities.

An addict cares only about where their next fix is coming from, so the cries of her cold, hungry baby will go unheeded while she tries to score.

I have seen cheeky young boys grow into hollow-eyed junkies, and personally knew several who died in their twenties.

And, sadly, it is still our most vulnerable communities that are worst affected by drugs. There may be as much coke snorted in Morningside as there is smack injected in Muirhouse, but drugs and poverty are a lethal cocktail.

However, dishing out methadone at the local chemists is not going to end the scourge of drug addiction.

The misuse of methadone has been the subject of much debate in recent months, across the UK as well as in Scotland.

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Jackie Baillie, Labour’s health spokesperson in the Scottish Parliament, has acknowledged that “methadone can help to stabilise chaotic lives and has a role to play in treatment”, but she stresses it is not a long-term solution.

The Centre for Policy Studies think-tank has called the methadone programme “nationalised drug dealing”. It suggests that real recovery will only come from residential detox and abstinence-based rehabilitation, as does the National Treatment Agency for Substance Misuse.

And the flamboyant actor Russell Brand, a former heroin addict, argued in a BBC documentary this month that government resources should be directed away from methadone and towards the kind of abstinence-based recovery initiatives that saved his life.

So why do the Scottish and the UK governments continue to pump cash into methadone, when the arguments against it are stacking up and the human and financial costs continue to rise?

The Scottish Government admits that it does not hold any statistics to show how many addicts have stopped using heroin thanks to methadone – its primary purpose after all.

But figures on the cost of untreated drug abuse may give a clue as to why successive governments, in Scotland and the rest of the UK, continue to deal in the heroin substitute.

It is estimated that the health and wider criminal and social costs of one untreateddrug addict is £50,000 a year. Abstinence-based programmes, such as those advocated by Brand and others are costly, and require a long-term relationship with the addict – and his wider networks – to be successful.

But the annual cost of methadone treatment for a long-term addict is only about £6,000 a year according to Community Pharmacy Scotland.

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The unpalatable truth is that dishing out turtle juice, or green gunge, to 22,000 Scots a year is much, much cheaper than investing in a national network of abstinence programmes and the other social and economic changes required to prevent drug misuse taking hold in the first place.

Scotland will never be drug free. As one occasional heroin user once told me: “Smack makes you feel good, that is why we take it.” Human beings have a fatal attraction for mind-altering drugs, whether that is a good Cotes de Rhone or strong skunk.

The challenges facing our most vulnerable communities where poly-drug misuse often takes root will not be solved with the dash of a ministerial pen, or even a First Ministerial pronouncement.

But surely we can’t stand by and watch while the NHS kills more people with a legal drug than the illegal drug the methadone programme was designed to stop people using?

The SNP’s 2011 election manifesto, which forms the basis for the Scottish Government’s programme over the next few years, promised “less reliance on methadone”.

So First Minister – my first question to you next Thursday would be: “When is the NHS going to stop dealing in methadone, a hard drug that kills people and blights our most vulnerable communities, and starts treating them instead?”

Susan Dalgety is a writer and a specialist in public policy campaigns and events. She was a Labour councillor in Edinburgh City and adviser to Jack McConnell during his time as first minister