New Petitions

First, I want to say that giving such a large quantity of methadone to addicts is like giving a bottle of whisky to an alcoholic and expecting him to take two nips of it a day. Because of the nature of addiction, it is highly unlikely that a drug addict would take the prescribed amount.I have spoken to numerous doctors and health officials, who freely admit that methadone gets sold on. Last year, figures from the General Register Office for Scotland showed that there were 87 deaths from methadone. That is absolutely shocking. In a previous inquiry into methadone-related deaths in Scotland, 30 of the 56 deaths referred to it had methadone cited on the death certificate and 45 per cent of those 56 people were not even on a methadone prescription. The way in which methadone is prescribed is shocking. Doctors freely admit that it is getting sold on and yet they prescribe quantities like 700ml a week. Some doctors will even prescribe a month's supply in one go.I lost my son through methadone that had gone into the illicit market. Two individuals were arrested for supplying the drug to my son, but the fiscal's office seems to be dragging its heels on taking them to court. The figures speak for themselves: 87 lives have been lost. The East Lothian drug and alcohol action team's objective is to cut drug-related deaths by 25 per cent by 2004-05.

This year, up to June, there have been six deaths in East Lothian. That figure should be compared with the total of only two deaths last year. If we want to cut the number of deaths, methadone should be prescribed only on a daily basis and consumed at a pharmacy. We have to find a way in which to do that. It would help the addict to stabilise, as they would not be able to take more than their daily dose. I imagine that that would make it easier to reduce their intake and, hopefully, to get them to become drug free. The figures speak for themselves. I have taken them from the Scottish Executive website and from the information and statistics division of the NHS. I cannot say much more than that, although I should perhaps mention some of the reports on the subject and the meetings that I have had with Jim Sherval of the national health service and the community drug-problem service—everybody admits that there is a problem with the present set-up. Lives would be saved if methadone were prescribed on a daily-dose basis and consumed on pharmacy premises. It would have helped to prevent the 87 deaths that occurred last year because of methadone.

As far as I know, no doctor dispenses methadone in their surgery, yet doctors are paid £350 just to take a drug addict on to their books. The payment is meant to be an incentive to doctors to take on drug addicts, but as far as I can see it is a bribe. If a doctor is getting £350, why does he not dispense methadone in his surgery? After all, it is the doctor who prescribes the methadone.

Generally, that is where the problem lies, as that is where large quantities are prescribed and dispensed in one go. When a larger quantity of methadone leaves a pharmacy, it is hard to get an accurate figure as to what happens to it. It was only recently that I was able to get the 2003 figures from the Registrar General of Scotland. Numerous advisory council reports have recommended that those on methadone should undergo a period of six months' supervision—indeed, that was a recommendation in the 2000-01 report I mentioned. Those recommendations were made by advisory councils but as yet they have not been implemented. Confidential inquiry reports, some of which date from 2000, have asked for action to be taken. As far as I can see, none of the recommended measures have been implemented and the deaths are still happening. I can understand it if someone dies when they inject heroin, but although doctors freely admit that methadone is being sold on, they still prescribe large amounts of it. The nature of addiction is that those people have trouble controlling what they are taking and the amounts they are taking. It is common knowledge that people sell methadone on to enable them to buy heroin. The report produced by Professor Neil McKeganey states that six out of 10 addicts are asking for detoxification rather than methadone prescriptions.

I mean anyone who is qualified to dispense medicines. I do not have sufficient knowledge to know who is qualified to do that. I believe that nurses can dispense medicines.The figures that I have come across for Glasgow suggest that methadone deaths are dropping as a result of supervised consumption. I would like such a measure to be introduced not only Scotland-wide, but nationwide. I feel strongly that if a drug addict is put on a daily dose, it helps them. A drug addict who gets a prescription of 700ml can take as much of it as they want. Some people get a month's supply and they can take as much of it as they like. They use various tricks to get a reissue of a prescription. They might break a bottle of methadone in a brown paper bag and drain it through that. I am aware that people spit the methadone out into a receptacle. I have family who work in the Royal Edinburgh hospital. They use a stalling tactic when they dispense a daily dose of methadone. They say to the addict, "Hold on: we have a form for you to fill in." Or they check the person's mouth to make sure it is empty.

I have never come across anybody who does that. Most people who take methadone and the drug addicts to whom I have spoken are put on a prescription and stick there. If their records were checked for a couple of years, they might have had a reduction for so many months.Doctors have clinical guidelines in what is referred to as the orange book. I spoke to my doctor just on Friday. His practice would happily support supervised consumption. I asked him why he did not prescribe methadone daily. The previous Deputy Minister for Health and Community Care, Tom McCabe, wrote to me because John Home Robertson asked a question in Parliament. The letter said that how to prescribe methadone was up to a doctor and that a doctor can prescribe it to be consumed daily on pharmacy premises if he likes.However, my doctor says that if doctors did that, there would be no way that pharmacists or doctors could cope. He said that Department of Health policy prevents doctors from following guidelines in the clinical management guide for doctors—the orange book. The guidelines say that doctors should take adequate precautions to ensure that the methadone that they prescribe does not filter on to the illicit market. In the present situation, it is impossible for a doctor to ensure that.

Yes.

It is for each drug addict. Jim Sherval of the Department of Health's policy department gave me the figures in a meeting.

It is an incentive for a doctor to take on a drug addict. The money is not spent on building a wee room in a practice to dispense methadone; it is like a bonus. The money could be better spent. The doctors and pharmacists to whom I have spoken would like a clinic to be established to deal with the problem. The problem used to be prevalent in areas that were considered to be bad, such as Niddrie and Bingham, but now it is everywhere, including small villages.Gone are the days when somebody obtained a methadone prescription because they were hooked on heroin. They are prescribed methadone because they are hooked on pills or street methadone. That is a vicious circle.I repeat that if methadone was dispensed and consumed daily in pharmacies, drug addicts would benefit because they would not be able to take any extra, the drug would not get on to the street and methadone deaths would be virtually wiped out.

When I first approached my doctor, Dr Clubb, he could not understand why we do not take the approach that is taken in Amsterdam, where what people call the methadone bus travels round schemes. Addicts have to meet the bus at a certain time in the morning and if they miss the bus they do not get their prescription for the day. They are given their daily dose on board the bus.If we are throwing £100 million at the problem in one year and putting aside £160 million, we should be spending the money wisely to reduce deaths. It is no good stabilising someone on methadone if no attempt is made to reduce their dependence and make them drug free.Doctors and pharmacists want clinics to be established. The pharmacists I have spoken to want clinics because when they dispense methadone there is increased shoplifting on their premises. We hear that the figures for drug crime are going down. Given that stealing is the most common offence that drug addicts commit, if a pharmacist keeps handing over bottles of methadone, the crime rate for thieving will go down because addicts sell on the methadone and do not have to steal as much. I have spoken to a police inspector in Musselburgh and to numerous other policemen, who say that it is well known that methadone is used as a currency. That says it all.

Any type of clinic would do. For example, if there is a community centre in an area that has a problem, the centre could be used. I support the use of any place, if it means that we can deal with and reduce methadone use. Edenhall hospital in Musselburgh would have been ideal for serving Tranent, Prestonpans and other areas close by, but it has been shut down. We have been promised a new clinic, but the Edenhall hospital building is already there. Some organisations argue that we must protect drug addicts' dignity and treat them as though they were normal patients with a normal illness, but drug addiction is a self-inflicted illness, if it is an illness at all.

That is exactly what happens. According to the letter from Tom McCabe, the former Deputy Minister for Health and Community Care—I did not bring it with me—it is for the doctor to direct that the methadone be taken under supervision. The doctors I have spoken to say that they cannot possibly do that. It seems to me that the Health Department's policy simply stops doctors following that way, even if they wanted to. The funding is not there. People would not be paid.

Definitely.

It is negotiated differently with different health boards. The payment is £350 in Musselburgh, but it could be £250 elsewhere. Pharmacists get an allowance as well, but I have not been able to get that figure.

The clinical management guide that I referred to—the orange book—gives figures that show that withdrawals from methadone are more severe and take a longer time than withdrawals from heroin do. That makes me question why people are being prescribed methadone. Edinburgh is starting to introduce a drug called Subutex, which is in the form of a tablet that dissolves under the tongue and can be taken three times a week instead of daily. Issues like that have to be considered as well. The main thing, however, is to save lives that are lost to methadone.Dihydrocodeine is prescribed along with methadone and it is not even licensed for the treatment of drug dependency. That is stated in the clinical management guide as well. I find it strange that a drug is being used to treat drug dependency when it is not licensed for that purpose.