] Date: Mon, June 2nd, 1997 Source: The Scotsman, Edinburgh, Scotland (http://www.scotsman.com) Contact: 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."