Death toll drops in drug war
Exclusive: Glasgow tactics reducing supply of heroin
JENNY BOOTH Home Affairs correspondent

A FALL of two thirds in drug deaths in Glasgow this year has been
hailed by police and drugs workers as a major breakthrough in the
drugs war.

The death toll has dropped from 36 in the equivalent period of 1995,
to just 11 in 1997 in the year to the end of May, the first significant
fall since records began eight years ago.

Delighted drug workers say that Glasgow's unique, controlled
programme of prescribing methadone to heroin addicts is probably
the major factor in producing the fall.

But drugs seizures by police and customs, a fall in the numbers of
injecting addicts in Glasgow, the quality and range of services now
available for addicts and the effects of outlawing the gel form of
temazapam, have also contributed.

Dr Laurence Gruer, the addictions consultant at Greater Glasgow
Health Board, said the fall was both "dramatic" and "a surprise", in a
city where drugs deaths have soared relentlessly. Last year there
were 66 drugs deaths in Glasgow, and 75 the year before.

"It is the first time we have seen a reduction since we started
collecting the figures in 1989, so whatever's happening is going in
the right direction," said Dr Gruer.

"We think the use of methadone is helping. Studies elsewhere have
suggested that people on methadone are three or four times less
likely to die than people on heroin.

"The decline in the availability of temazepam ("jellies") has helped a
lot as many deaths have been due to a mix of heroin and temazapam.

"And there has been a shortage of heroin in Glasgow for the last few
weeks, which might also be helping."

Unfortunately, supplies of heroin have resumed in Glasgow in the
last week. But Alex Meikle, whose work at Possil Drugs Project in
Glasgow keeps him at the sharp end of the war against drugs, says he
too has noticed the decline in deaths.

"I genuinely don't know if this is the turning point," said Mr
Meikle.

"It could be down to the increase in methadone prescribing, that's a
major factor, or it could be the relative decline in injecting. More
people are smoking heroin now instead of injecting, partly because of
the methadone (which produces a very bad physical reaction to
injected heroin)."

Unlike other health boards, Greater Glasgow pays its pharmacists to
supervise addicts as they take their methadone dose on the spot, in
the shop.

The system has only been in place since 1994, as Glasgow doctors
were for many years reluctant to prescribe methadone unlike
Edinburgh, where the drug has been in use since the 1980s. Now
Glasgow has 2,300 addicts on methadone, and 130 pharmacists
involved in dispensing it.

Dr Bob Scott, the clinical director of Glasgow Drug Problem
Service, who supervised setting up the methadone service, welcomed
the "great news" but said that it was too early to celebrate, as the
death rate had been way too high.

"Provided it is done properly, methadone can have a very significant
impact on many things, including drugs deaths," said Dr Scott.

"But it isn't a life preserver in itself, it is a powerful drug. This
success is as much to do with how methadone is delivered as in its
intrinsic qualities."

Glasgow's method of delivery prevents addicts from taking their
methadone away and selling it on the black market. In Lothian,
methadone "leaking" onto the streets was responsible for 44 of the
region's 70 drug deaths last year, as an average dose for an addict is
fatal to an inexperienced drugtaker.

David Macaulay, of the Scotland Against Drugs campaign, warned:
"Methadone is not a universal panacea. It is a mechanism that, used
responsibly, can reduce your deaths from 36 to 11, but used
irresponsibly, can get out onto the streets and kill people."

He praised the new multiagency approach to tackling drugs abuse
in Scotland, which he said was responding better to the real
problems.

Today's news will increase pressure on other Scottish health boards
to introduce stricter controls on their own methadone programmes,
to prevent "leakage".

As The Scotsman reported yesterday, there is 1million of Scottish
Office money on offer to the rest of Scotland's health boards to help
fund supervised methadone systems on the Glasgow model.

A Lothian pharmacist said that the onus now fell on Lothian to find
out more about the Glasgow system.

Dr Jonathan Morton, the director of research at the Health
Education Board for Scotland, said: "This is tremendous news. I'm
very pleased for Glasgow, but when something like this starts to
happen it takes time to tease out the particular causes that have
contributed to it."

Det Supt Kevin Orr, of Strathclyde Police, said: "We are really
delighted. This is not to say that there won't be more heroin deaths
in Glasgow. For the first time there is a wee chink of light at the end
of the tunnel."