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Health Committee, 23 Jan 2007

23 Jan 2007 · S2 · Health Committee

Item of business

Treatment of Drug Users

Professor McKeganey: Watch on SPTV

I will begin with a brief comment on funding. It is not easy to get information on funding for drug treatment services in Scotland, but the indications are that about £100 million is spent each year. That is a substantial amount, so it is entirely appropriate to consider whether it is being used effectively. Despite the spending, there is clear evidence that drug users in some areas of Scotland do not have ready access to drug treatment services of different kinds.My colleagues and I have considered the range of drug treatment services. Recently, we have focused on methadone. It is evident that methadone can reduce individuals' drug use and offending. However, when we have attempted to measure the degree to which those services enable drug users to become drug free—which is the stated aspiration of the vast majority of drug users whom we have interviewed—we have found that Scottish drug services are doing less well than comparable services in England. Only 3 per cent of drug users who are treated with methadone in Scotland become totally drug free, whereas the figure in England is well in excess of that—approaching 30 per cent.We have examined residential rehabilitation services, which we find are the most closely associated with drug users becoming drug free. Three years after the treatment, about 28 per cent of those who use such services are abstinent, which means that they are not using any drugs at all. Those services are the least available in Scotland but, if our research is right, they are the ones that are most closely associated with recovery. In fact, even the existing provision of residential rehabilitation services is underused and some areas in Scotland make no use whatever of such services. Unquestionably, we will continue to use methadone to treat drug users, which is entirely appropriate, but we must bring about greater co-operation between methadone services and residential rehabilitation services so that, once individuals become stabilised, they are referred to services that are oriented more toward enabling them to become drug free.We have examined the quality of drug addiction services in Scotland. I must say that, using the same measures, Scotland's drug treatment services do not compare well with services in other countries. That is true for a range of measures, including the degree to which drug users feel involved in their care. When drug users are asked whether they feel involved in the major decisions that relate to their care, compared with other European countries, fewer drug users in Scotland say that they have been involved in their care.We have a major issue with the extent of drug abuse in prison. I have argued elsewhere that our very best drug treatment services should be available in prison. In a situation in which 60, 70 or 80 per cent of prisoners—or sometimes more—are drug users, we must deal with their needs if we are to avoid the situation in which people go into prison and become drug users there. We are also falling short in monitoring services and evaluating their impact.

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Health Committee, 23 Jan 2007

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