Europe: Edinburgh "Drug Czar" Says Time to Consider Prescribing Heroin 3/10/06

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The debate over heroin has turned lively in Scotland this week, thanks to Edinburgh "drug czar" Tom Wood, who has urged the Scottish Executive to consider prescribing heroin to addicts through the National Health Service (NHS). Wood, a former deputy chief constable for Lothian and Borders Police and current chairman of the Edinburgh Drugs and Alcohol Action Team, said prescription heroin should be explored as an alternative to methadone.

In remarks reported by the Scotsman, Wood said favorable findings from a Swiss prescription heroin trial suggested it could benefit addicts who continued using even after being prescribed methadone. "We should look at each case on its merits," Wood said. "In Switzerland they have used heroin itself in a controlled environment. I'm not saying I support that, but it is an option we should look at. I'm not a medic and I can't give a medical opinion, but prescribing heroin may be the best thing for some people. It seems to have worked in other parts of the world."

While emphasizing that he was not recommending prescription heroin -- only that it be considered as an option -- Wood said methadone was not enough. "Methadone has been hugely successful, but unfortunately we've become over-dependent on it," he said. "It is only meant to be the first rung on the ladder. The problem is in many cases there are no other rungs."

There is rising concern in Scotland that methadone is being overused. In the Lothians, more than 3,000 people were being prescribed methadone at the end of 2004, a 42% increase over 2002. The increase was 17% across Scotland as a whole. Scotland paid about $20 million for methadone treatment in 2004, according to official figures.

The initial response to Woods' remarks shows there is rising interest in the idea of prescription heroin -- at least among service providers. "We would welcome any discussion about the various types of treatment," said Turning Point Scotland. "We would be in favor of any treatment that would assist addicts to move on with their lives."

"Tom's idea is certainly interesting and one that I think we have to examine," said John Arthur, of Crew 2000 drugs support service. "However, if you're starting from the point that all drug prescribing to addicts and dependent users is a means to get them off drugs then you're on a hiding to nothing. Not everyone can or will come off drugs no matter what we do," he pointed out. "If, however you want to prescribe drugs to reduce the harm from using street drugs, to help people stabilize their lives, and cause less acquisitive crime, then prescribing heroin should be one tool in the armory of the state."

But not everybody was gung-ho. "If we are now talking about prescribing heroin because we've lost control of methadone, that's absolutely stupid," said Mothers Against Drugs. "If heroin is prescribed on the NHS when are people going to want to come off it? We are going to legalize drug-dealing in this country."

The Scottish Executive was noncommittal, with a spokesman saying only: "We've got no plans to introduce heroin prescriptions. However, pilot schemes are running south of the Border and we will keep an eye on them and those abroad."

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Issue #426 -- 3/10/06

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