Methadone eye scare risks lives

IN YOUR leader (Insight, 28 February) you cite the recent report of visual deficits in the children of opiate users. 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.

It is of note that, in the original piece, 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.

However, it has been acknowledged through the Scottish Government's Road to Recovery drug strategy that methadone cannot be considered effective treatment in isolation, and that recovery from drug misuse requires a range of treatment and care options. The emphasis, therefore, has already begun to change from harm reduction towards recovery. This has seen the use of alternatives to methadone, as well as the development of psychosocial support, and other efforts aimed at improving the quality of life of drug users and their families. This approach to recovery, in combination with measures to reduce supply, build safer communities, and support families affected by drug misuse, will have a positive impact on drug users.

Substance misuse services across Scotland put a great deal of effort into caring for a demanding, but vulnerable patient group. It is unfortunate commentaries from the media may deter pregnant drug users from treatment, thus increasing the likelihood of danger to both mothers and their babies.

Dr Gary Tanner, Clinical Director, Dr Steve Conroy, lead GP, Alcohol and Drug Services, NHS Lanarkshire, Coathill Hospital, Coatbridge