SOME local agencies dealing with drug users do not know how many are on methadone programmes, according to a panel of experts set up by the Scottish government.
The performance of the country's 31 alcohol and drug partnerships (ADPs) is described as "highly inconsistent", and the report states that five years after being ordered to introduce "recovery-orientated systems of care" intended to getting users off drugs, work on this has barely started in some areas.
In its long-awaited report published yesterday, the Scottish Drugs Strategy Delivery Commission concluded that opioid replacement therapy (ORT), particularly methadone, is supported by strong evidence and is being dispensed in accordance with national guidance.
The commission's report calls for urgent improvements in drug research amid rising deaths and stigma attached to ORT fuelled by ignorance, cautious politics and media scaremongering.
Drug misuse costs Scotland's economy £3.5 billion but the public sector spends a hundredth of that (£36 million) on drug services, the report found.
But while backing the use of methadone as part of the strategy to tackle heroin use, the report, Delivering Recovery, states: "There is a credibility issue for ADPs raised by this review."
It adds: "This review has found that, with regard to the specific issue of local governance and accountability of opioid replacement therapy (ORT) delivery, ADPs remain highly inconsistent. We have found similar inconsistencies with regard to planning, delivery and governance of recovery-orientated systems of care."
The Drug Strategy Delivery Commission, chaired by Dr Brian Kidd, states: "Despite clear guidance it appears from our observations some ADPs do not have the most basic systems in place with which to govern delivery of ORT.
"Information is unavailable in some areas even in terms of basic numbers of people on ORT - a failing identified in the last methadone review in 2007. Recovery-orientated systems of care are poorly developed in some areas."
But the report adds: "There are good examples of some ADPs dealing with local challenges and demonstrating they are improving performance. There is a need to improve the consistency of ADP performance. The Scottish Government should reconsider how it receives and actions expert advice."
The report makes 12 recommendations, including: addressing the link between drug use and inequalities; better national and local statistics; improve governance and accountability of ADPs; adopting best practice for linking GPs and community pharmacists; and greater concentration on progress to becoming drug free.
Sir Harry Burns, Chief Medical Officer, said of replacement therapies: "They often simply switch one form of drug use for another, albeit a safer one. That's why we need to find more ways of helping people access treatments and support tailored to their needs."
Roseanna Cunningham, Minister for Community Safety, said that after meeting with cross-party politicians and experts in the field, the Government would issue a formal response later in November.
Labour's Elaine Murray said: "This report identifies serious problems which the Scottish Government needs to address."
Scottish Liberal Democrat Leader Willie Rennie said: "This is an evidence-based report that should reassure people methadone is part of the solution to Scotland's drug problem."
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