SHOULD WE PRESCRIBE HEROIN?

There are two theories behind the shocking 70% rise in drug deaths
across Strathclyde so far this year. The first is that there is a
group of long-term addicts, weakened by hepatitis C, whose bodies
simply cannot take any more heroin.

The second is that the heroin dealers, who have been losing regular
customers to cheaper high-quality cocaine, are increasing heroin
purity as a cynical marketing ploy to win them back. There is
probably some truth in both theories.

It is these deaths that help account for the fact that average male
life expectancy is 12 years less in Glasgow than areas of Dorset.
Twelve years is the length of an average life sentence.

Nobody can accuse the Scottish Executive of complacency, but the fact
remains that Scotland has one of the biggest drugs problems in
Europe, and drugs services are struggling and often failing to help.
The war on drugs is being lost on every level: prevention,
rehabilitation, harm reduction. In addition, we are failing to
contain the social problems that result directly from illegal drug
use. It is time for some fresh thinking.

Several voices, including independent MSP Margo MacDonald and the
former drugs minister, Dr Richard Simpson, united yesterday to call
for the country's worst addicts to be provided with heroin on
prescription, quoting encouraging results from such programmes in
Germany, Switzerland and elsewhere.

Turning the state into a licensed drug dealer is no panacea.

A system that obliges occasional users to pay for drugs but provides
them at taxpayers' expense to daily users appears to offer perverse
incentives. There are also doubts about the efficacy of such schemes
in getting users to quit. Their main achievements have been in the
areas of reducing harm and improving social order.

It would be foolish either to ignore lessons learned elsewhere or
assume that their successes automatically can be replicated here,
when other conditions may vary. For example, in Hamburg, nearly half
those on the programme are in employment. And Switzerland has both a
strong drug abuse prevention programme and an excellent
rehabilitation programme. In Scotland, despite recent improvements,
many addicts still wait months to be assessed for a clinic place and
the level of social care support is patchy.

One thing is clear.

The methadone programme appears to be as much a part of the problem
as part of the solution, fuelling addiction, rather than curing it
and at a cost to the taxpayer of UKP 15m a year. Scotland may not yet
be ready to contemplate prescribing heroin, even to hardcore users.

However, the idea of a modest pilot scheme could form part of a
cogent debate that should also include the ultimate possibility of
decriminalising the use of class A and B drugs as a means of creating
a clean supply and cutting gangsters out of the supply chain, as was
proposed at the recent Scottish Police Federation conference.
Eighty-two drugs deaths in Strathclyde alone since January is an
unacceptable score.