Drug treatments

You cite the recent report of visual deficits in the children of opiate users (leader, 28 February). However, you conflate the prescribing of an opiate substitute, methadone, with the use by pregnant women of illicit opiates such as heroin, benzodiazepines and other drugs of misuse.

In the original piece by Claire Smith, the report's author is quoted as stating, "because of the often chaotic lifestyle of drug users, it was hard to single out methadone or any other factor as the principal cause of eye problems". Indeed, the next phase of research will explore this further to try to determine the causal role, if any, of opiates, benzodiazepines, and other psychoactive drugs. Thus, to state that there exists the "chilling prospect" of thousands of children having visual impairments on account of their mothers' drug use is tantamount to scaremongering. Methadone has an extensive history of safe, effective use when prescribed and used appropriately.

It has been acknowledged through the Scottish Government's Road to Recovery drug strategy that methadone cannot be considered effective treatment in isolation. The emphasis therefore, has already begun to change from harm reduction towards recovery, in combination with measures to reduce supply, build safer communities, and support families affected by drug misuse.

Dr Gary Tannner

Clinical director

Dr Steve Conroy

Lead GP,

Alcohol and Drug Services

NHS Lanarkshire

Coathill Hospital

Coatbridge