RESIDENTIAL REHAB PLACES TAKEN BY DUTCH ADDICTS

Residential drug rehabilitation places at one of Scotland's leading
addiction hospitals are being taken by Dutch heroin users because
authorities in Scotland will not pay to use them, preferring to put
addicts on methadone instead. Peter McCann, chairman of Castle Craig
Hospital in Peeblesshire, told The Observer that Scottish addicts were
missing out on the best care available because of an obsession with
meeting Holyrood methadone treatment targets, despite 'overwhelming'
evidence showing that the drug is 'ineffective'.

McCann said that at the private Castle Craig hospital up to 30 beds
for intensive detox and long-term care which should be available at
any one time for home-based addicts - at a cost of UKP800 a week paid
for by their health authorities - now go to patients from the
Netherlands. With only 300 residential rehabilitation places available
across Scotland, this represents 10 per cent of the total.

'The take-up for these places from authorities in Scotland is
extremely poor and has been for a number of years now,' McCann said.
'We have an excellent reputation around Europe, and as a result we
fill the beds with people from the Netherlands, where health
authorities are happy to pay for the rehab here.'

A study by the Centre for Drugs Misuse at Glasgow University concluded
that one in three heroin users who had residential treatment was
drug-free after three years. But only 3 per cent of those who were
just on methadone were clean after the same treatment period.

The head of the centre, Professor Neil McKeganey, said: 'Residential
rehab is expensive, but where is the economic sense of providing a
treatment that is ineffective. Methadone is cheaper - but it is not
working.'

McCann traced the decline in uptake of places to the year 2000 and the
establishment of the Alcohol and Drug Action Teams. These partnership
organisations, which are paid for by local government, the NHS and the
police, were set up to tackle the joint issues of alcohol and drug
problems prevalent in Scottish society.

He said: 'Methadone has proven to be next to useless in terms of
getting people off drugs, but it seems to satisfy their need to meet
targets for care, and this would appear to be more important than
whether they are useful or not.'

But Tom Wood, chairman of the Scottish Association of Alcohol and Drug
Action Teams, argued: 'There is a lot of evidence in support of
methadone - it reduces the amount of chaos in an addict's life and
does help. However, it is a tourniquet which if left on too long can
leave you with gangrene. We have to develop our other support services
as well.Residential rehab is the Rolls-Royce treatment, and while it
is good for some people it is not good for others. It is also very
expensive - which is why we are investing in community-based care.
Castle Craig is a fine institution, but it is also a private business
and our budgets are finite.'

The anomaly at Castle Craig emerged close to the second anniversary of
the death of two-year-old Derek Doran, who drank 50ml of his mother's
methadone at their home in Elphinstone, East Lothian. This tragedy in
December 2005 and other high-profile cases involving children spurred
the then First Minister, Jack McConnell, to order a major review of
the way Scotland deals with heroin users and led to a report critical
of the lack of support given to those prescribed methadone.

But the study came down in favour of the methadone programme as the
cheapest and most effective treatment available.

McKeganey said that 'nothing has changed' since Derek Doran's death,
and there were thousands of children who remained at risk.

There are 51,582 known heroin users in Scotland. A third of these are
believed to be caring for children under the age of 16.