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Q & A: David Liddell


January 21, 2009

The director of the Scottish Drugs Forum joins the debate on whether the use of methadone to tackle drug addiction should be reduced, following a critical report into the treatment by Professor Neil McKeganey.

Q: Why has methadone been used to treat heroin addiction?

A: Methadone is a heroin substitute which reduces powerful cravings among users. It gives many people valuable space to stabilise and take stock of their lives so they can look at moving away from harmful drug use.

Q: The treatment has had its critics, but has it had measurable successes among addicts?

A: Methadone is recognised internationally as an effective approach to heroin dependency. But pharmaceutical treatment has its limits – treatment must also include help to address the complex psycho-social problems arising from the poverty and inequality that lie at the root of the overwhelming majority of problematic heroin use in Scotland.

Q: What are the alternatives?

A: Getting the right type of treatment. at the right time, for the right length of time -supported by a wide range of help, including counseling, family support, housing and routes to employment – is the best approach. This may or may not include methadone or any other substitute prescribing; it depends on what works for each person seeking help.

Q: Why has methadone been attacked in certain quarters?

A: Drug treatment using methadone in Scotland has largely been undermined because the psychological and social support for the prescribing element has often been inadequate, although the latest drugs strategy has pledged to change that.

Q: Is Professor McKeganey right that there should be national targets in reducing methadone use? Why?

A: Creating targets that focus on tackling the reasons for – not the symptoms of – damaging drug use in Scotland would be far more worthwhile.

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