This news from Scotland is depressing:
Scotland you will remember was at the vanguard of introducing supervised methadone consumption in response to its appalling rate of drug related (and methadone related) deaths in the late 80's - the fall in deaths that followed was further evidence of the value of high quality methadone prescribing. And it was Scotland's heroin users who discovered the value of buprenorphine as well in the great Scottish Temgesic "scandal" which led to the CD Classification of buprenorphine and later, in a poetic twist of irony, to buprenorphine receiving a licence for the treatment of opiate dependency. And it is Scotland where high doses of methadone are championed, and where just last year, some Chief Police Officers were calling for a return to abstinence treatments because of the "failure" of methadone programmes! what a confused state of affairs. It is remarkable that since Dole and Nyswander first wrote about methadone treatment in JAMA in 1965, every single study published has reinforced the message of the life saving effects of high quality substitute prescribing - I hope that Scotland does not loose sight of that message - whatever is going on in Caledonia to increase the rate of drug related deaths now is evidence (if we ever needed it) of the need for more treatment, not less.
