Madness of allowing a jobless drug addict to languish on methadone for 31 years

By Graham Grant

WHEN grandchildren come along, it’s natural to contemplate slowing down a little, and to plan your retirement – or at the very least daydream about it.

In Dundee, one grandmother, aged only 48, is among those looking forward to a change of pace: giving up not a career, but three decades of sustained methadone use.

‘Parked’ on the heroin substitute for 31 years, she claims the last time she had a conversation with her family doctor about her prescription was seven years ago.

She has never worked and two previous partners have died from overdoses, while her daughter is addicted to heroin and crack cocaine – meaning drug-dealers chasing debts are regular visitors to their home.

‘I know it’s going to be hard but I’m a granny now,’ she told the Daily Record, ‘and I can’t be running off to chemists every day to take my prescription, so that’s my big goal.’

It is an admirable objective, and yet for someone who has languished on methadone for so long, the chances of kicking the habit without intensive support must be vanishingly small.

Her determination to quit is laudable, but medics warn that scaling down dosage gradually, as she proposes to do, could lead to relapse, or recourse back to heroin – a very real prospect, with dealers at the door.

It is estimated that about 8,000 people in Scotland have been on methadone for more than five years, and of those we can only guess at how many have regular GP reviews of their case files to reassess whether their consumption could be scaled down.

The national methadone programme in Scotland costs around £60million a year, and yet the drug is in itself highly addictive; it was implicated in or potentially contributed to 439 deaths in 2017, about 47 per cent of all drug-related fatalities.

Deaths linked to methadone are at a record level, as are all deaths connected to drug abuse – 934 drug-related deaths were registered in 2017, eight per cent more than in 2016, according to the latest National Records of Scotland data – the highest rate of drug deaths in the EU.

Then there is the legion of the drug-addicted, including those wretched souls such as the Dundee grandmother who has been taking methadone for her entire adult life.

In horrifying microcosm, her tragic story represents the social catastrophe of drug addiction, which since the 1980s has claimed more than 11,000 lives in Scotland, but it also graphically lays bare its enormous economic cost.

The cost of servicing an individual’s methadone usage over a period of 30 years is estimated at roughly £40,000.

While they remain on methadone, most users are incapable of work, meaning they rely on state handouts to live.

Benefits under UK Government reforms are now limited to £13,400 a year – equivalent to more than £400,000 over a period of 30 years.

In Dundee, where the methadone-dependent grandmother lives, 25.8 per cent of all households have no working adults, the highest proportion in Scotland, while rates of ‘worklessness’ north of the Border are higher than the UK as a whole.

Drug addiction feeds into the ‘economic inactivity’ that leaches millions from the public purse each year, a system that hinges on the mass prescription of methadone, aimed in theory at restoring some degree of stability to deeply chaotic lives.

Widespread methadone prescription began in the 1980s, when health experts were faced with the problem of injecting drug-users sharing needles, leading to a risk of spreading HIV.

Methadone was meant to encourage drug-users into the health system to give them care, advice and clean needles; in public health terms it was deemed to have worked, helping to reduce HIV infection rates in cities including Dundee and Edinburgh, which had the biggest problems.

Three decades later, more than a third of Scotland’s 61,000 opioid drug users are on methadone – leading to a zombie-like existence which long-term users compare to a form of sedation.

Historically, the use of methadone has been credited with reducing crime rates, particularly the number of housebreakings – a belief that may have discouraged any meaningful attempt to shift the emphasis of drug rehabilitation away from methadone use.

The SNP came to power in 2007 promising radical solutions, and a move towards a reduction in methadone spending which never materialised – while experts advocating alternatives such as ‘cold turkey’ treatments have been marginalised or ignored.

The net result is the emergence of a subsection of the population whose drug dependence is financed by the taxpayer: emaciated figures glimpsed on furtive trips to the pharmacist for the cup of green liquid that will allow them to continue functioning.

In 2009, a court case in Perth revealed the astonishing story of a serial criminal who began getting a daily dose of methadone when he turned 16 and was still taking it aged 34, when he was charged with shoplifting.

Some methadone users who have been moved onto more expensive Suboxone – designed to reduce drug reliance over time – claim it is far more effective at allowing a relatively normal life to be lived, though it has its own range of dangerous side-effects.

Supporters of methadone say that if it is administered and overseen properly, it is safe, but the real problems are caused when people mix the heroin substitute with street drugs such as fake Valium and prescription pills, creating a deadly cocktail.

Other treatments which could be deployed in future include monthly injections which mean addicts would be able to make fewer trips to the chemist – so they could avoid running the gauntlet of local pushers trying to get them back on heroin.

But as long as the debate about how to manage entrenched drug addiction centres solely on substitute substances, there can be no guarantee that those receiving the injections won’t be ‘parked’ on them, just as they were parked for years on methadone.

Now health and council chiefs in Glasgow are setting up a specialist clinic where addicts for whom methadone hasn’t worked can get medical-grade heroin under strict supervision, helping to keep them off the street and – hopefully – away from the clutches of dealers and their ‘impure’ product.

This project is the culmination of decades of failure, leading to wasted potential on an incalculable scale: if attempting to allow addicts to live on state handouts, with regular top-ups of methadone, doesn’t work, they will be corralled into a bleak city centre shelter to feed their habit, at yet more expense to the taxpayer.

The noble intentions of those who sought to keep addicts safe from infection, and from dealers pushing even more lethal heroin, can’t be doubted – even if in reality all they have done is swap one addiction for another.

But in the process they laid the foundations for a human tragedy that consigned thousands to the fringes of society – with no credible plan to rescue them from their nightmarish subsistence.

*This column appeared in the Scottish Daily Mail on April 9, 2019.