CALLS have been made for a rethink on the use of methadone in Scotland after official figures revealed the number of deaths in which it was implicated reached a ten-year high last year.
Amid a general fall in people being killed by drugs, fatalities in which the heroin substitute was cited as a contributory factor rose to 173 in 2009, up from 169 in 2008 and a surge of 51 per cent since 2007 when it was associated with 114 deaths.
The controversial drug treatment was found to be at least partly responsible for more than a third (32 per cent) of all of the 545 drug-related fatalities in Scotland last year, and was associated with the second-highest number of drug-addict deaths after heroin or morphine, which contributed to 322 losses of life - 59 per cent of the total.
The 2009 methadone figure also equates to roughly one death every 48 hours.
The rising number of deaths linked to methadone led to calls for the policy of wide prescription of the treatment to addicts to be reviewed, with one drug-misuse expert describing the current situation as being of "enormous concern".
Professor Neil McKeganey, the director of the Centre for Drug Misuse Research at Glasgow University, said: "The situation in relation to methadone - where it appears we have around a third of addict deaths associated with the drug we are prescribing most widely to treat drug addiction - is of enormous concern.
"We really ought to be looking again at this policy of widespread methadone prescribing. The statistics are inescapable - we ought to be looking at why we are doing it and whether all of those to whom it is being prescribed are deriving benefit from it."
Peter McCann, the chairman of the Castle Craig Hospital for alcoholism and drug addiction, lent his weight to the calls, adding: "Today's drug-death figures would have been described as totally catastrophic just a few years ago. There must now be a total rethink in Scotland along the lines of the National Treatment Agency in England which totally reversed its policy earlier this month.
"They will be limiting the use of methadone with strict multi-disciplinary assessments at regular intervals. The policies prescribing methadone in Scotland have obviously failed and must be revised."
Murdo Fraser, Scottish Conservative health spokesman, said the focus of the Scottish drugs strategy should be on recovery and abstinence.
He said: "The attempts of the last decade to merely manage the problem, based on harm reduction and an over-reliance on methadone, just have not worked.
"The challenge now is to expand the range of rehabilitation services on offer and move to abstinence and recovery."
But the treatment was defended by Biba Brand of the Scottish Drugs Forum: "We know from research that staying on methadone tends to prolong their life by about 13 per cent.
"We also know that of those deaths that are occurring (overall], two-thirds are outwith treatment, so being in treatment - and generally that involves methadone - is helping people stay alive.
"Methadone can help save lives, but we need to help people progress through treatment."
A Scottish Government spokesman added: "We do not favour one form of treatment over any other. Decisions on the most appropriate treatment to prescribe an individual are for clinicians, in discussion with their patients and in line with national guidelines."
Overall, the number of people killed by drugs in Scotland fell by 5 per cent since 2008, but the 545 drug-related deaths during 2009 equated to the second-highest total ever recorded; an increase of 20 per cent since 2007 and a rise of 87 per cent since 1999.
A wider analysis, using figures recorded by the Office for National Statistics, showed the number of deaths related to drugs in Scotland last year was 716, down from 737 in 2008, but a rise from the 2007 total of 630.
This figure included people killed by solvent abuse, legal highs and through overdoses of prescription medication. It also included people dying with mental-health problems linked to drug abuse, as well as those killed by the health complications allied to contaminated drugs.
More than a third of all deaths in Scotland, some 200, were in the Greater Glasgow and Clyde NHS board area, and this represented the highest total on record. Deaths in Lothian dropped, by 13 to 81, as did fatalities in Fife (37 to 32) and Forth Valley (23 to 14).
There was also a rise in the number of older people dying from drugs, with deaths among those aged 35 and over rising from 271 in 2008 to 296 in 2009, while at the same time deaths among users under 35 dropped from 303 to 249.
By Christopher Mackie
18 August 2010
Methadone is linked to one in three drug deaths