Petitions

Dr McKee and I have experience of prescribing methadone in the community. It is important to consider certain facts, which I am sure the Public Petitions Committee considered. The amount of methadone being prescribed rose enormously between 1997 and 2007 because of Government policy to bring people into treatment as rapidly as possible. We will not get into a discussion on the alternatives.For the purposes of the petition, it is important to recognise that during that period of substantial increase in the prescription of methadone, the number of deaths from methadone dropped, which means that, on the whole, clinicians have acted responsibly and followed the approach to prescribing methadone that was recommended by the Minister for Community Safety in his letter and by the Scottish Advisory Committee on Drug Misuse in its report of last year.The only issue is whether further research is needed, because it is clear that there is variation in whether methadone is prescribed on a supervised or an unsupervised basis. The minister's letter refers to the guidelines of the National Treatment Agency for Substance Misuse in England, which are relatively clear and state that during the initial phase of treatment, when someone is introduced to methadone, the treatment should be supervised seven days a week, if possible, although in Scotland supervision tends to be provided six days a week because only supermarket pharmacies open on a Sunday. That is an issue. In many cases, a reduction in supervision will be something that is earned. If someone's general state improves, if they respond to treatment or if they cease the use of alternative opiate drugs, they will be moved on to the unsupervised use of methadone, but there are some groups for whom that is problematic. In the most recent audit that I did in my own clinical work, 9 per cent of my clientele were in work at the time of referral. It is clear that it is more difficult for someone who is in work to obtain methadone, although the situation has improved over the past 10 years, as pharmacies have moved into supermarkets. The fact that supermarkets' pharmacy sections are often open until 9 o'clock at night means that access to methadone for people who are in work is less restricted.I make a plea to the committee: rather than close our consideration of the petition, we should write to the minister to ask him whether, in the light of the SACDM report on methadone prescribing, "Reducing harm and promoting recovery", which was published in July 2007, further research will be carried out—perhaps by SACDM's new research sub-committee, the minister's setting up of which I very much welcome—into the variations in methadone prescribing across Scotland and the presence or absence of links between those variations and deaths that occur as a direct result of methadone consumption, particularly when the victim is not in treatment. That is what the petitioner is concerned about—the leakage of methadone from people who are prescribed it to others who are not prescribed it.