The number of drug users living on methadone or other heroin substitutes in Dundee has fallen by more than 10% in the last five years – but the total still represents 1% of the adult population.
Figures obtained by the Tele through freedom of information requests show an 11.7% reduction in patients receiving opiate substitution therapy (OST) between 2014-15 and 2018-19.
A total of 1,356 people received treatment last year, down from 1,537 in 2014-15. Those figures include patients who no longer receive the treatment.
However, a snapshot of patients receiving ongoing treatment in Dundee in the last month suggests the figure could fall further.
Just under 1,100 people – about one in 100 city residents – are presently prescribed methadone or another substitute such as buprenorphine – down a fifth from the same time period in 2014.
The World Health Organisation recognises OST as an effective way of reducing both heroin use and other harmful side-effects such as the risk of transmitting HIV.
However, those who work with problem drug users say OST is not being administered effectively, leaving people floundering.
Solicitor Ian Houston, of Bruce Short Solicitors, said: “I know of people who have been on methadone for 20-plus years.
“And I know of several who have asked for their prescription to be reduced, only to be fobbed off and told no, which I think is just a farce as it’s supposed to be a reduction programme.
“Once they’re on it and they find the right level of medication for the patient, it never seems to reduce.
“Addicts seem to get to a stage where they just accept that they will be on methadone virtually all of their lives and become resigned to that fact.”
A retired GP – who declined to be named – said: “When I worked in a big practice I had a zero tolerance attitude to drug addicts. I believed it was their own fault, I was a bit of a dinosaur.
“Then I did some work with the Salvation Army after I retired and my attitude changed.
“By using methadone instead of heroin, the patient is no longer at risk of dirty needles, HIV, hepatitis, overdose or other dangers relating to injecting.
“I am now in support of it as a harm reduction programme but I am not in support of it as a drug for life.”
A spokesperson for Dundee Health and Social Care Partnership said: “Problematic substance use continues to be a concern in Dundee and improving the support for people who have problem drug use is a priority for us.
“The use of opiate substitution treatments methadone and buprenorphine in assisting people dealing with the problems associated with opiate use is part of a broader package of care to help break the cycle of harmful drug use.
“When opiate substitution treatments forms part of a comprehensive treatment programme, as applied in Tayside, research points to a lower risk of overdose, less involvement in crime and generally fewer physical and mental health problems for individuals.
“The decision to detox from methadone/buprenorphine is always made on a patient centred, individual basis.
“If a patient opts to stop using opiate substitution therapy, they can take part in community detoxification and will work alongside a key worker to agree a scheduled reduction regime over an agreed time period.
“Patients detoxing in Dundee can also attend the Integrated Substance Misuse Service community programme which includes prescribing interventions to support abstinence, psychosocial interventions, peer support from other group members, and introductions to third sector agencies and SMART recovery to support individual’s recovery journeys.
“When clinically appropriate, patients can also be admitted to the Kinclaven Ward at Murray Royal Hospital where they can undertake a detoxification programme.
“Drug and alcohol treatment in Dundee is provided by the Integrated Substance Misuse Service (ISMS).
“The service is available via a multidisciplinary direct-access drop-in assessment clinic which ensures that we can respond quickly and effectively to the needs of service users and start treatment as soon as possible.
“Integrated Substance Misuse Service for Dundee continues to work closely with partner agencies, including the Dundee Alcohol and Drug Partnership and Dundee Drugs Commission, to improve services and support for people with problem drug use.
“Early intervention is important to tackle the circumstances that lead to substance use, alongside the provision of co-ordinated, holistic health and social care to address the multiple needs of those at highest risk of drug-related injury or death.
“If anyone has concerns about their own drug use or that of a friend or family member, we would encourage them to seek support from: Integrated Substance Misuse Service – 01382 632542.”