Whatever is going on up in Scotland? Despite a general trend of decreasing drug use throughout the UK, the Scottish government handed out 22,980 more prescriptions of methadone in 2014 than they did in 2013. A staggering 470,000 doses costing the tax payer more than £17.9 million disappeared into what Dr Neil McKeganey from the Centre for Drug Misuse Research called “literally a black hole into which people are disappearing.”
Community Safety Minister Paul Wheelhouse told the BBC: “Fewer Scots are taking drugs – numbers are continuing to fall among the general adult population, and drug taking among young people is the lowest in a decade.” So how to explain the methadone increases?
Data obtained from National Services Scotland under a freedom of information request may hold an answer. The number of methadone prescriptions increased in more than a third of all Scottish local authorities in the period covering the last two years. The largest increases were found in Renfrewshire, Inverclyde and East Ayrshire.
Methadone has been central to drug treatment strategies since the 1980’s. Despite widespread criticism by recovering addicts and drugs workers it is by far the most widely used opioid replacement therapy. Most recipients take it for years without being weaned off it altogether.
Some doctors like Dr Neil McKeganey fear that the long-term approach to prescribing methadone must be re-looked at. He believes that methadone has a role to play in helping the addict to wean themselves off heroin, but it should not be so widely prescribed, or for so long as it is now. He says that a two year assessment period would be ideal. If the “highly addictive” methadone isn’t getting the addict to quit after two years they could either try the more expensive suboxone or be admitted to a drug-free residential heroin rehab facility to kick the habit.
Figures released by the NHS in 2012 show that methadone-implicated deaths increased dramatically in cases where the addict had been prescribed methadone therapy for more than a year. This lends weight to the call for a timed review and reassessment evaluation to determine whether the methadone use is leading to decreased use or merely parking the addict on an endless cycle of addictive prescriptions.
Gladstones Clinic has a policy of complete abstinence from drugs during the primary treatment phase of residential heroin rehab. Our clients need to be sober and fully functionally aware in order to benefit from the intense group and one-to-one therapy sessions. Intensive psychoanalysis, cognitive behavioral therapy and complementary therapies work best when the individual receiving treatment is 100% involved in their recovery. For these reasons we do not prescribe methadone therapy to any of our clients. Our goal is to eliminate addiction, not redirect it to another unhealthy addiction.