Catherine Salmond: Shooting galleries offer a fix for the city's heroin problem

SOME ideas are guaranteed to provoke a storm of protest. Suggesting that drug addicts be given their substance of choice is right at the top of such a list.

When addiction specialists claimed to have produced remarkable results by prescribing heroin to some of the most hopeless addicts, the reaction was predictable – cue gnashing of teeth about soft-touch Britain.

The results of the experimental "shooting galleries" are certainly worth a closer look though, particularly at a time when heroin abuse in Edinburgh has returned to the levels last seen in the 1980s.

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With only three per cent of those put on to methadone ever getting off that drug, there are major doubts about the effectiveness of the current regime. Could prescribing heroin to addicts be the answer?

The argument for setting up injecting clinics – or shooting galleries, as they have been dubbed – is relatively straight forward. By giving a heroin addict a clean, daily supply of the pharmaceutical grade heroin diamorphine in a controlled environment, the user's need to source their next hit will be reduced.

The result? A drop in the sorts of crime that addicts often turn to in order to fund their habit, plus an immediate improvement in their health and, ultimately, an increased ability to come off drugs for good.

That is what findings from three pilot projects in England, as well as studies from Switzerland, suggest.

In the UK trial, clinics opened in London in 2005, Darlington in 2006 and Brighton in 2007 to treat small numbers of hard-to-reach users.

Their results of the trials saw one third of addicts stopping using street heroin while their crimes fell almost immediately, from about 40 per month to six.

The results of the schemes have prompted Scottish drug experts to call for similar methods to be rolled out north of the border.

David Liddell, director of the Scottish Drugs Forum, says: "If we can reduce crime, if we can improve an individual's health and improve their relationships and in the long-term move them very much towards recovery, that's something we should certainly look at."

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Dave Crosbie, substance misuse manager with Edinburgh-based Turning Point Scotland, believes the approach would help some addicts in the Capital.

"It will be a small number of people who would use this method – probably those with very chaotic lives," he says.

"It could give them structure and support and needs to be something given consideration in these very early days of the discussion."

The plan which was due to be discussed today at a conference in London, led by the National Treatment Agency for Substance Misuse. The treatment does not come cheap though. Each clinic user costs the NHS around 15,000 a year.

That will undoubtedly be used as a stick with which to beat it,

but when you consider that the cost of caring for a drug addict, including everything from state benefits to hospital treatment, has been estimated at around 1.5 million – 15,000 for a clinic placement starts to look like a better investment.

At a time when all Government budgets are strained, and many NHS users face a postcode lottery for various treatments, the notion of spending more money on drug addicts will certainly raise tensions.

Away from the bottom line, doubts remain within the health professions about the wisdom of rolling out the approach across the country.

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Professor Neil McKeganey, from the Centre of Drug Misuse Research at Glasgow University, says: "Start providing people with heroin and their recovery could be a long way down the road – they may be on that in many, many years to come.

"It's enormously expensive and it runs the risk of being a road from which it's very difficult to withdraw. Once you start somebody on it, it's very difficult to know at what point you can actually bring them back off it."

With no fully residential rehabilitation places in Edinburgh – a highly expensive method which many experts believe is the most productive treatment – medics are faced with a dilemma. Is it worth trying the shooting gallery method or continue with the largely ineffective status quo?

Tom Wood, the former chairman of Action on Alcohol and Drugs in Edinburgh, believes change is needed, but that it will only happen if the country is prepared to have a more rounded, mature debate of all the issues.

He says: "Often stories in the papers end up frightening politicians who run for cover.

"We are dealing with a problem that is complex and we need all the available evidence to allow us to look at this pragmatically, not through a distorted moral view."