Praise is heaped on heroin substitute by experts

In a letter to The Scotsman, the group, comprising dozens of international specialists, have condemned the "continuing misrepresentation" surrounding the effectiveness of the heroin substitute and rejected claims that is too expensive.

The defence of methadone by the coalition of GPs, psychiatrists, counsellors and epidemiologists comes in the wake of growing criticism of the treatment and accusations that the Scottish Government has become overly reliant on the drug.

Last week, Professor Neil McKeganey, the director of the Centre for Drug Misuse Research at the University of Glasgow, argued that more effort was required to get Scotland's addicts off drugs through abstinence.

However, the 43-strong expert group claim that methadone "has helped more people in the world overcome their problems with heroin than any other (method]".

Amid established evidence asserting its effectiveness in reducing deaths, infection and drug use, the experts express "dismay" at the "contrary" view.

The group includes Dr Richard Watson, clinical chief for drug misuse at the Royal College of General Practitioners Scotland, and Professor John Strang, director of the National Addiction Centre. They said: "If policy-makers were to heed the critics' advice to close down methadone treatment, or impose an arbitrary time limit on its administration, the community can anticipate more overdose deaths, more HIV and more crime.

"Surely this is not what the public want and deserve."

The group's leader, Dr Roy Robertson, a GP and honorary clinical reader at the University of Edinburgh, told The Scotsman he and his peers were increasingly concerned about the criticism of methadone.

"There has been growing anxiety surrounding a view we don't agree with – one that is unhelpful, destructive and, at worst, likely to cost lives," he said.

"Methadone works as just well as anti-cancer drugs and better than treatments used for depression, hypertension and diabetes. Yet it is sheer prejudice and politics that make people scrutinise methadone in a way other drugs are not."

Last week, Prof McKeganey criticised Scottish Government policy over drug misuse and said the nation was "paying a massive price" for its drugs problem, warning a single addict set the country back more than 60,000 a year.

He wrote: "At the moment, we have about 22,000 addicts on methadone in Scotland. When Scottish ministers are asked whether they have any plans for reducing that number, the typical answer is to say that prescribing methadone is the responsibility of individual doctors.

"Our political leaders, surrounded by those who counsel them on the benefits of methadone, find themselves passing responsibility for our national methadone programme on to the shoulders of those prescribing the drug in the first place. This situation is going to get worse."

He added: "If we are going to change the culture of acceptance around drugs, we need to do something that is almost beyond comprehension – we need to normalise abstinence."

Dr Robertson, a former member of the Advisory Council on the Misuse of Drugs, acknowledged the arguments in favour of an abstinence-based solution, but said the seriousness of heroin addiction demanded different approaches, including methadone.

"If it was my son or daughter, of course you'd want them to be abstinent. There isn't a GP in the country who doesn't want people to move towards abstinence," Dr Robertson said.

"But we're talking about a very serious addiction problem that is causing people to die in large numbers. We see young people in our surgery dying from primitive diseases. It's breathtaking."

The Scottish Drugs Forum has defended the use of methadone which, it says, has an important part to play in helping people stabilise chronic drug use. Sacro, the offenders' charity, believes total abstinence is a goal that should be worked towards, but warns that if methadone treatment is stopped overnight, it would bring about a "huge rise" in criminal activity.

A Scottish Government spokesman said: "It is for individual clinicians, who follow UK-wide agreed prescribing guidelines, to decide on the most appropriate medical treatment for any person.

"Our national drugs strategy sets out our commitment to reducing the damage drugs do to communities and individuals in Scotland. A key part of delivering this is making sure people can recover from their addictions and are able to access treatment and support when they need it.

"That's why we are working closely with our partners to reduce waiting times for services and why we have, for the first time, a target to make sure the NHS reduce waiting times for drugs services – helped by record funding in frontline drug treatment services."

What the letter said…

"AS A group of experts in the treatment of opiate dependent people, we write to express our dismay about the continuing misrepresentation in the media of the evidence on the effective-ness of methadone treatment."

"Compared to other essential medical therapies, methadone is not expensive."

"Methadone treatment has helped more people in the world overcome their problems with heroin than any other."

"If policy-makers were to heed the critics' advice to close down methadone treatment, or impose an arbitrary time limit on its administration, the community can anticipate more overdose deaths, more HIV and more crime."

• The letter in full