MANAGEMENT STRATEGY?

David Liddell has described the widespread use of methadone in
Scotland today as a "management strategy" (Letters, November 15). If
he is right, we should shake our heads in shame.

Can it be right that we now have tens of thousands of young people in
Scotland drinking their methadone on a daily basis as part of a
"management strategy"? Problem drug-users and their families and
friends aren't looking for a management strategy; what they are
looking for is help to become drug-free. I recently spoke to one of
the leading drug-addiction experts in the Netherlands who told me that
they now had old people's homes for methadone addicts.

That is a shocking prospect and one that we should seek to avoid at
all costs in Scotland. Yes, we have a heroin problem, but we also now
face a methadone-addiction problem as well. Those who are prescribing
methadone will tell you that it is helpful in stabilising the addict.

We could have more confidence in that claim if they could at least
tell us how many people are on the drug and how many are able to get
off it. Without that knowledge it is difficult to avoid the conclusion
that methadone is less part of the journey to eventual recovery than
an end point in itself. David Liddell may feel that there is no
"one-size-fits-all drug-abuse treatment" in Scotland but he has been
remarkably silent on the growth of the methadone industry in Scotland,
which to a large extent has delivered precisely that: a
one-size-fits-all treatment.

Whatever the benefits of methadone (and it does have benefits) sooner
or later we are going to have to face the problem of getting our
addicts off the methadone to which many thousands have become addicted.

Either that, or face the Dutch prospect of old people's homes for
methadone addicts.

NEIL MCKEGANEY

Professor of drug misuse research

University of Glasgow