A RADICAL new proposal to offer Scots addicted to heroin an alternative to methadone has won the backing of a leading drug recovery organisation.
Buvidal – an injectable form of buprenorphine given to people addicted to opiates in weekly or monthly doses – is currently being considered by the Scottish Medicines Consortium (SMC).
READ MORE: 'With Buvidal, I wouldn't have wasted 10 years living in a methadone fog'
The Scottish Recovery Consortium (SRC) has now thrown its support behind the introduction of the drug in Scotland, claiming that a better alternative to methadone is long overdue.
Currently about 85% of people taking opiate replacement therapy (ORT) when coming off heroin are prescribed methadone, usually on a no-choice basis. A further 15% are given buprenorphine tablets.
SRC argues the drug, which removes cravings and stops people “topping-up” with other opiates, would save lives. According to 2017 figures, methadone was implicated in 439 drug deaths, 47% of the total.
Research on the relatively new drug, which is currently being prescribed to less than 1000 people across Europe, suggests it leaves people feeling more clear-headed, allowing them to engage with therapy. It is given by healthcare professionals on a weekly or monthly basis, reducing the stigma associated with daily trips to the chemist.
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SRC’s submission to the Scottish Medicines Consortium, made with the help of volunteers now in drug recovery, claimed though methadone can be important in managing addiction, it has a detrimental impact on people’s quality of life. Some participants had been on methadone for 20 years.
The group reported that though some pharmacists providing their methadone were compassionate, others treated them as “criminals”. They said appointments focused on discussion of methadone prescriptions – known as scripts – with no time left to discuss therapeutic treatments.
All backed the consideration of Buvidal, which they said help give people a better quality of life and helped put a focus on recovery.
Jardine Simpson, chief executive of SRC, said: “Most people prescribed methadone currently are on supervised prescribing schemes which demand that they attend a pharmacy to receive their methadone on a daily basis.
“This means holding down a job, dropping kids at school or picking them up, going on holiday or day trips, or even making treatment appointments are made very difficult.
“Buvidal’s active ingredients work in a different way from methadone. It reduces feelings of needing intoxication, it acts on the recipient in a way that leaves them very clear-headed in comparison to methadone and once on the correct dose the effects are consistent, long-lasting and discreet.”
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He claimed that though it was important not to view Buvidal as a “silver bullet”, it could help people to move from harm reduction measures – which aim at reducing the risk associated with ongoing drug addiction – towards addressing the root causes of their addiction.
HE added: “I’ve heard clinical staff say harm reduction and methadone work for people who do not want recovery. I can’t argue with that but most people who come for treatment hate the lives they are leading and would choose recovery as an option if they were supported by staff to understand that was an achievable option.
“The fact is that most people being prescribed methadone in Scotland receive no psych-social support and therefore can’t see a future that doesn’t involve them being dependent on prescribed medication and or illicit drugs.
"It is my belief that current treatment delivery perpetuates that sense of helplessness.”
David Liddell, chief executive of Scottish Drugs Forum (SDF), agreed that there was a lack of alternatives offered to those at drug addiction services. He added: “Elsewhere there are choices of methadone, buprenorphine and diamorphine – heroin – as well as products which are not even licensed in the UK.”
In the coming months NHS Scotland is to open the UK’s first Heroin-Assisted Treatment centre, offering medical-grade heroin to addicts in a clinical, supervised setting up to three times a day.
Liddell continued: “For some people methadone is not the best medication for them. This should not be about methadone bad and anything else good, or better. It is a matter of having a range of alternatives and a person-centred approach.”
Andrew Horne, director in Scotland of drug and alcohol charity Addaction, claimed everyone in treatment should have a personalised recovery plan drawn up, which should include discussions about the best type of medication for their circumstances. Currently most have not been given any choice.
READ MORE: How devolving drug policy could cut Scotland's disproportionate death rate
He added: “Drugs like heroin pull people into deep water really quickly. Our first step is to try and make sure the person doesn’t sink. That’s why substitute medications like methadone or buprenorphine are so important. They help break the cycle of seeking, finding and using heroin.”
However, he said better therapeutic options – that addressed under lying issues – should be offered. “The vast majority of spending in Scotland goes to medical treatment services,” he said. “While this is extremely important, it should be seen as a way to give people the stability to access different kinds of treatment which address why they use drugs. It shouldn’t be seen as an end in itself.”
Public Health Minister Joe FitzPatrick said: “While we are clear that prescribed drug treatment cannot be the only treatment option available, the use of methadone remains a central component of the treatment for opiate dependency, when provided as part of a package of care, treatment and recovery.”
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