METHADONE should continue to be the main treatment for addicts in Scotland, but more support needs to be in place to encourage users to become drug-free. That is one of the recommendations from a series of reports scrutinising the heroin substitute programme, which will be published by the Scottish Executive tomorrow.

A major review was ordered by previous First Minister Jack McConnell, in the wake of the death of toddler Derek Doran. The two-year-old died after drinking methadone in his parents' home in 2005, with the case triggering a UK-wide debate on the use of methadone for treating heroin addiction.

The Sunday Herald can reveal that the findings of the new studies include: l Over 21,000 people in Scotland are currently receiving methadone treatment - a figure which is 10% higher than the previous estimate in 2004.

l Around half consume their methadone under daily supervision.

l Around one third have children under the age of 16 living with them, all or part of the time.

In addition, an expert group set up by the Scottish Advisory Committee on Drug Misuse to review the support available to those on methadone has concluded that the subsitute drug should still be the major element of treatment available for opiate dependency.

However, the group highlighted concerns around attitudes towards the prescribing of methadone and the limited availability of treatment options. It recommended that addicts should be encouraged out of methadone treatment and to recovery wherever possible.

Professor Neil McKeganey, director of the centre for drug misuse research at Glasgow University, last year carried out research which revealed that fewer than 4% of addicts prescribed the heroin substitute were drug-free three years after beginning treatment. He agreed that methadone would have to remain the principle treatment for addicts, because a suitable alternative does not currently exist.

But he added: "The problem over the last 10 years is that it has increasingly become virtually the only treatment - for too long addicts have been remaining on the programme, well beyond there being clear evidence that they are deriving positive benefit from it.

"I think it is absolutely right now that our drug addiction treatment services, methadone services and any other new services to be developed are all very clearly working towards drug users becoming drug free."

However McKeganey also pointed out that while there was an apparent shift in political views regarding the methadone programme, it also had to be backed by health professionals working in treatment services.

"The policy is now clear, I think the challenge is one faced by doctors and other workers in the drugs treatment field to see that they can take on board this expectation that they need to work towards drugs users becoming drug free," he said.

Tom Wood, chairman of the Scottish Association of Alcohol and Drug Action Teams, argued that the focus for drugs strategy should be on improving other aspects of support and treatment for addicts, rather than on continuing to debate the use of methadone.

"Generally speaking I think methadone has been given a bad name, not because of the drug itself but because of what has not been available to go along with methadone," he said.

"Methadone was never - and can never - be the whole answer, but it is a very valuable part of the solution. However it has to be accompanied by the other support services that have to go with it and on too many occasions in Scotland this has not been the case."

David Liddell, director of the Scottish Drugs Forum, agreed that the wider needs of drug addicts had to be addressed, such as housing support and effective counselling. But he cautioned that this had to be in place before moving towards an emphasis on abstinence.

"The drug - whether that is illegal drugs or a substitute drug such as methadone - is a crutch to help people get through and survive," he said. "You have got to be careful if you take that crutch away, that there is something in its place.

"We have got to be cautious about potentially not pushing people too quickly to abstinence, because then what happens is that you get more of the revolving door - people are pushed out at one end, but then in a couple of months time emerge in a chaotic state back in front of services at the other."

Minister for community safety Fergus Ewing said that while methadone has an important part to play in tackling addiction, drug treatment had to involve more than a "prescription service".

"It serves no purpose to be simplistically anti-methadone," he said. "Methadone can stabilise lives and it has a positive impact on the lives of many people who are treated with it."