Methadone Treatment

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Published: 26 July 2007

Methadone Treatment

Three reports on methadone treatment were published recently, the findings of which will help formulate a key part of a new strategy for tackling drug misuse in Scotland.

Minister for Community Safety Fergus Ewing vowed to ensure that better support services are made available to help more methadone users get off drugs and back into healthy, productive lives.

The first report, Reducing harm and promoting recovery: a report on methadone treatment for substance misuse in Scotland: SACDM Methadone Project Group, is by a group of experts & academics set up by the Scottish Advisory Committee on Drug Misuse to review the support available to those currently accessing methadone treatment.

The second, Review of Methadone in Drug Treatment: Prescribing Information and Practice, summarises what NHS Boards know about the number of people prescribed the drug, how they receive it and the number of children who may be affected.

The third, Scottish Drugs Forum: Review of the role of methadone in the treatment of drug problems, contains findings from a consultation commissioned from the Scottish Drugs Forum. It reflects the views of people receiving methadone, their carers & families and those working with them.

Some of the main findings were:

· Over 21,000 people are receiving methadone in the community to treat their drug addiction - 10% higher than the previous estimate in 2004

· Approximately half consumed their methadone under daily supervision

· Around one third had children under the age of 16 living with them all or part of the time

· The majority of respondents to the SDF consultation believe methadone has had a positive impact on the lives of people being treated with it

· The expert group concluded that it is entirely appropriate for methadone to be the major element of the treatment available for opiate dependency

· Methadone is more cost effective than any other medical treatment and forms an important link between the drug users and treatment which has the potential to lead to change and recovery

· There are, however, genuine concerns around issues such as prescribing philosophy, the limited availability of treatment and support options in some areas, inconsistency in practice and quality of service

· Progress to recovery must be encouraged, making a way out of methadone treatment possible whenever appropriate

Mr Ewing said:

"We welcome, and are grateful for, these reports and will discuss in detail with all those who have an interest how best the findings can be taken forward.

The true scale of the challenge we face is now clear for all to see. As a government we will not take sides in the debate between the 'just say no' and the 'harm reduction' lobbies. There is a place for both approaches.

It is clear that methadone does have an important part to play in tackling heroin addiction. The benefits it can bring in terms of harm reduction are well established.

Methadone can stabilise chaotic lives and has a positive impact on the lives of many people who are treated with it.

Experts have concluded that it is entirely appropriate for methadone to be the major element of the treatment available for opiate dependency.

The report makes clear that there are, however, areas of concern about the use of methadone.

Tackling those areas is a key priority for us. That means improving service delivery; improving consistency of provision; and, above all, improving integration of methadone treatment with the extra support needed to achieve the ultimate goal of recovery from addiction.

Methadone must come with genuine rehabilitation to help addicts find a route out of drugs. We need to be more than a prescription service.

Tomorrow I will chair a key meeting of the Scottish Advisory Committee on Drugs Misuse. It will provide an ideal opportunity to consider in depth the findings of these reports, and to start working together towards a new strategy for tackling drug misuse in Scotland."

Scotland's Chief Medical Officer Dr Harry Burns said:

"I welcome the significant contribution that these reports will make to the debate around the use of methadone in drug treatment.

Practitioners in the field will not be surprised by the expert group's conclusions that methadone is a highly effective treatment option for drug misusers with an opiate addiction and will recognise the positive impact that methadone can have on people's lives.

Although rarely highlighted, the benefits of methadone are considerable and should not be understated. Injecting drug users put themselves at significant risk of contracting blood borne viruses such as Hepatitis C from sharing injecting equipment. Bacterial infections from non-sterile equipment are also common, as is vascular damage arising from long-term drug use.

Put simply, involvement in a methadone treatment programme means a drug addict no longer needs to inject drugs."

The government has recently also published two other drug-related reports:

· The Report of the Stock-take of Alcohol and Drug Action Teams (ADATs) assessed the performance of ADATs and examined their capability to deliver national drug and alcohol priorities against the principles of best value

· The Review of Residential Drug Detoxification and Rehabilitation Services looked at the availability, use and cost of existing residential detoxification and rehabilitation services across Scotland.

Information for the methadone reports was obtained in three main ways:

· They asked NHS Boards about who received methadone as a substitute for heroin in their areas, the supervision those clients received and whether they had dependent children living with them

· Boards also provided information on how current clinical guidelines are used and monitored

· Review of Methadone in Drug Treatment: Prescribing Information and Practice

o They commissioned a consultation to hear the views of people with direct experience of receiving methadone for their drug addiction, their families and carers, key workers and other interested individuals

o This was carried out for us by the Scottish Drugs Forum who conducted focus groups and open meetings.

· Scottish Drugs Forum: Review of the role of methadone in the treatment of drug problems

o They convened an expert group of practitioners and academics in the field of substance misuse in Scotland - SACDM - and asked them to review the support available to those currently accessing methadone treatment and to develop recommendations on how that support could be improved.

Further information

Reducing harm and promoting recovery: a report on methadone treatment for substance misuse in Scotland: SACDM Methadone Project Group

Review of Methadone in Drug Treatment: Prescribing Information and Practice

Scottish Drugs Forum: Review of the role of methadone in the treatment of drug problems

Report of the stocktake of Alcohol and Drug Action Teams

Review of Residential Drug Detoxification and Rehabilitation Services in Scotland

Scottish Drugs Forum

Health Scotland - drugs

Scottish Drug Services Directory - Search the Drug Services Directory

Improving services for substance misuse: a joint review

National Treatment Agency for Substance Misuse (NTA)

Drug action teams (DATs)