All face being called in to have their case reviewed and their needs re-assessed. Under a more wide-ranging review of all drug services still on going, those on methadone will be offered much more than the drug substitute and will be expected to participate in individual programmes designed to help addicts come off methadone.

But addictions specialist Dr Brian Kidd, who is leading the redesign of services, stressed that those on methadone would not have their drug substitute withdrawn immediately, but would be given an opportunity to benefit from the new services.

When pressed, he agreed addicts would not be prescribed methadone indefinitely.

“People ultimately have to make a choice about whether they want to be in treatment or not,” said Dr Kidd.

Justice Minister Cathy Jamieson said earlier today it was not acceptable for addicts to be on methadone “forever”.

Local health chiefs know they have a massive problem with lots of patients on what one recently retired Tayside doctors’ leader described as “NHS-prescribed drug addiction”.

Methadone is supposed to divert junkies away from the threat of street deals and the drug culture towards a gradual reduction in dependency that will get them off drugs for good.

But, until now, that hasn’t happened in Tayside, with a frank admission from a top local nursing boss that many addicts had been on methadone for a number of years with no attempt to “wean” them off drugs completely.

Dr Kidd said methadone-only programmes developed as a response to the emergence of HIV in the mid-1980s when the focus was on preventing people dying.

The primary concern was harm reduction rather than treatment. People like himself who had worked with methadone programmes over a number of years, accepted that methadone with other treatment such as counselling and support was of greater benefit to patients than methadone maintenance alone.

To deliver the boosted service would take more staff than currently worked in drug addiction services in Tayside. However, he said the good news was that NHS Tayside had agreed extra funding and a further 20 staff would be recruited to deliver a new look drugs service for the region, the fine detail of which is still being worked out with general practitioners and others who will be involved.

While stressing the review was about more than simply re-designing the methadone programme, Dr Kidd accepted methadone had been an issue of public interest and in particular the apparent lack of effort to reduce dependency in the past.

“We are tailoring the methadone programme so people can progress to a drug free life style.”

Meanwhile, Ministers today announced plans to improve and expand drug treatment and rehabilitation services across Scotland.

Cathy Jamieson unveiled the results of the Executive’s review of support services, including a multi-million pound funding boost, in a drugs policy debate at Holyrood.

A new five-point action plan includes strengthening links between criminal justice and health services, introducing new care standards, local improvement plans and waiting time targets, as well as new first aid training to help reduce drug-related deaths.

Tory justice spokeswoman Annabel Goldie claims the Executive’s policy has left Scots “wallowing in a sea of methadone” – the heroin substitute given to many drug users in a bid to wean them off their addiction.

But Ms Jamieson again rejected claims that Ministers have favoured such harm-reduction programmes over alternative “cold turkey” abstinence initiatives involving total withdrawal.

The Minister insists there is no “one-size-fits-all” approach to helping addicts and that the Executive will support those services shown to achieve results.

The new funding, therefore, will support both harm reduction and abstinence-based projects.

The Executive says it is building on the success of its current policy, both to both improve individual health and tackle drug-related crime.

There has been a 41% rise in the number of non-residential services (to 211) since 2000, as well as a 33% increase in residential services (to 28) and a doubling of the number of beds available for substance misuse cases to 285. In the current financial year the allocations to NHS boards and local authorities has totalled over £26.5m.

An Executive spokesman said an additional £34m spent on drug treatment and rehab in the last three years had already showed signs of success, including a 10% rise in the number of Scots accessing treatment services this year, and a smaller proportion of first time service users injecting and reporting heroin and valium use. There was also a fall in the number of drug-related deaths last year, from 382 in 2002 to 317 in 2003.

But he added, “Our review of treatment and rehabilitation has shown we can and must sharpen up our overall strategy and Ministers are determined to do just that.”

However, Annabel Goldie claimed, “The only way forward is a road towards abstinence and a clear strategy on how to get there.”

Drug crimes had risen by 38% and one was committed every 12 minutes, while the Executive was spending nearly £4.5m a year on prescribing methadone, Miss Goldie said.

“While addicts are yelling out, pleading for help, the Scottish Executive is content to let them wallow in a sea of methadone.”

The Conservatives seized on a recent study which suggested drugs strategies put too much emphasis on harm reduction rather than abstinence. In a study of 1007 addicts carried out by Glasgow University’s Centre for Drug Misuse 60% said abstinence was the sole reason for contacting treatment services, while 7% were looking to stabilise consumption and just 1% were seeking advice on safer use.