Europe: Heroin Substitute Buprenorphine Now Available in Scotland

A Scottish government agency has approved the use of the heroin substitute buprenorphine as a replacement for heroin users unable to take the more common substitute methadone. A tablet form of the drug, Suboxone, is now available through the National Health Service.

Although buprenorphine is widely used in England, Europe, and Australia, and is available with restrictions in the United States, it had been banned in Scotland since the mid-1980s because it had been abused by users who heated and injected it to get high. But Suboxone will, according to its manufacturer, cause withdrawal symptoms if injected, easing fears of abuse.

The Scottish Medical Consortium, the agency that decides which drugs can be prescribed, has approved Suboxone only for patients for whom methadone is not suitable. It also requires that Suboxone maintenance stand place only "within a framework of medical, social, and psychological treatment."

Drug experts interviewed by the newspaper the Scotsman generally thought it was a good thing, although at least one advocated abstinence instead. The decision was welcomed as a "useful addition" by David Liddell, director of the Scottish Drugs Forum. Andrew Horne, of the drug treatment charity Addiction Scotland, said: "We think it is a useful alternative and will complement the rehabilitation work we do."

But opiate maintenance is "part of the problem," said Neil McKeganey, professor of drug misuse research at Glasgow University. "We have a large number of people on substitute medications and here is another substitute drug; it will still leave us with too few abstinence-focused drug treatments."