METHADONE - DEATH BY PRESCRIPTION

THE tragedy of Kerry-Ann Kirk is not the first involving methadone and
will not be the last.

The police inquiry will look at how methadone appears to have been
freely available and accessible to a 15-year-old non-drug abuser. If
early indications are correct and the drug was someone else's
prescription taken by accident or as an experiment, then the inquiry
should identify the weakness in the system which allowed it to happen.

There has already been one case where a 28-year-old man was jailed for
seven years in Edinburgh for killing a 17- year-old youth by
supplying him with methadone and diazepam in Bathgate in 1998, the
first case in which the Crown convicted a drug supplier of culpable
homicide.

The problem in this case may be a simple one, directly related to the
festive season. This time of year always brings a spate of drug deaths.

As some people party, others become depressed and all against a
background of social benefit agencies paying out double tranches of
Giro cash. It is also possible that some addicts receiving methadone
may have been given supplies for several days.

Prescription of the synthetic opiate has been proved to bring
considerable benefits to communities where heroin abuse has run out of
control, but the benefits have brought with them serious risks and,
inevitably, adverse political fallout. It may stabilise chaotic
heroin-addicted lives but methadone is a lethal drug.

The service run by Greater Glasgow Health Board through the Glasgow
Drug Problem Service has become a success story - saving lives,
cutting costs to the community, and reducing offending.

It is professionally run with the addicted recipients receiving daily
methadone doses and consuming the drugs under supervision. In that
way, leakage of the drug on to the black market has been kept to a
minimum.

Unfortunately, other methadone services in the UK have not maintained
such rigorous standards and methadone has become another black market
drug.

Such was the concern over the increasing number of deaths in which
methadone was an element that three years ago a clinical inquiry was
set up involving doctors from the GDPS and Glasgow University
department of forensic medicine and science, initially to examine and
report on the deaths and then to monitor them.

When the inquiry began, 32 of the 98 drug-related deaths that year
displayed the presence of methadone. It allowed clinicians to give
potentially embarrassing or damaging information within a reporting
system which presented no professional threat.

The inquiry found an average age for methadone victims of 29 - 72% of
the dead were male and failings in clinical care were identified by
assessors in 18 of the 34 cases. Possible inadequate organisation of
medical services were identified in another 22 cases with shortcomings
in both fields thought possible in 16 cases.

In 19 of the cases, patients were receiving methadone on
prescription.

All the deaths surveyed were those of people known to misuse
drugs.

The findings, however, served only to drive home the lethal nature of
methadone if it is treated with less than absolute caution.