Pubdate: Mon, 15 Mar 2004
Source: Scotsman (UK)
Copyright: The Scotsman Publications Ltd 2004
Contact:  http://www.scotsman.com/
Details: http://www.mapinc.org/media/406
Author: Tanya Thompson

CRIME THREAT IF GPS QUIT ADDICTS SCHEME

THOUSANDS of heroin addicts across Scotland could be left without methadone 
when new GP contracts are introduced next month, creating an upsurge in 
crime as drug users steal to fund their habit.

Senior health sources have warned that addicts denied their prescription of 
the heroin substitute will turn to crime to feed their dependency - at 
great cost to the taxpayer.

The contracts, which come into force in April, will allow GPs to opt out of 
providing methadone programmes, raising fears that users will be forced to 
buy heroin on the black market.

NHS insiders have told The Scotsman that a confidential survey of GPs has 
revealed many no longer want to treat heroin addicts.

There are currently 2,000 methadone patients in the Lothians and, if 
doctors opt out as predicted, as many as 600 patients will be left without 
methadone, with the figure rising to thousands throughout the rest of the 
country. An NHS source said: "From April, GPs can choose to opt out of 
providing methadone. That would leave the addict with no methadone. 
Inevitably, addicts will steal to get heroin, and that will be a major 
problem."

The survey of GPs by the Lothian Primary Care NHS Trust has indicated that 
many will stop prescribing methadone once the new rules are in place next 
month.

"There is a possibility of 600 patients in the Lothians not having GPs 
prescribing methadone to them," said a source.

"There are about 4,000 in Glasgow on methadone prescriptions. If the same 
happens there, it could affect 1,200 people."

The impact of drug addicts on crime in Scotland is colossal. An estimated 
55,000 addicts use hard drugs such as heroin, and some them steal up to 
?40,000 a year to finance their habit.

Patients now find themselves at the centre of a funding row between GPs and 
the Scottish Executive over the cost of providing the methadone programmes. 
It is understood that GPs are preparing to ditch drug users because of the 
costs associated with such high-maintenance patients.

GPs are reluctant to provide methadone, and the new contracts are likely to 
act as a deterrent as concerns grow over the level of funding.

The Scotsman has learned that it was agreed that GPs would receive ?350 per 
methadone patient per year, but the Scottish Executive is trying to reduce 
that figure as negotiations continue with local trusts.

"Part of it is financial and the other is that GPs don't want to deal with 
drug users," said a source. "Some GPs don't see it as their role to 
prescribe methadone. These are quite time-consuming patients and they see 
the GP 12 times more often than other patients."

Last night, Graeme Pearson, the director of the Scottish Drugs Enforcement 
Agency, stressed there were important issues about access to treatment 
which had to be resolved.

He said: "We would be concerned if there was an immediate withdrawal of 
services from people who have drug problems. It's now March and one of my 
concerns is that a policy change will affect us in less than three weeks' time.

"It's important that they receive their treatment."

Without the methadone, which helps to wean patients off heroin, users would 
be left to find other sources of the opiate.

David Liddell, the Director of the Scottish Drugs Forum, called for urgent 
action to ensure drug users did not drop out of the system and return to 
injecting street heroin. "We have raised our concerns with the Scottish 
Executive about the impact of these changes, particularly in the short term.

"Our understanding is that drug users may lose a service because some GPs 
will now be able to opt out of treating drug users. This could seriously 
affect the health of drug users."

A spokeswoman for Lothian Primary Care NHS Trust refused to reveal how many 
GPs were intending to opt out, but said those with drug problems would 
continue to receive the best care.
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MAP posted-by: Keith Brilhart