Pubdate: 28 Dec, 1999 Source: Herald, The (UK) Contact: http://www.theherald.co.uk/ Author: James Freeman 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. - --- MAP posted-by: Derek Rea