By Marjory Inglis, health reporter

NO ADDICT wanting help to come off drugs has to wait for treatment in Tayside, following major reorganisation of services.

That’s a very recent change from a time when NHS Tayside’s drugs problems service was so overwhelmed it had to close its waiting list to new patients.

For most addicts help meant a daily dose of the heroin substitute methadone and not much else. In Tayside some people have been taking methadone for up to 15 years, a situation one GP called “NHS prescribed drug addiction.”

But with better access to services comes an expectation that addicts will literally sign up to become drug free and make changes in their life that will lead to a reintegration into society.

“Every patient on methadone is now expected to sign a treatment agreement,” said Dr Brian Kidd, a psychiatrist specialising in addiction who has led the changes across Tayside.

“That makes clear what our expectations of them are but also what their expectations of us should be.”

Dr Kidd said that it was no longer acceptable for anyone to be taking methadone if they were not committed to becoming drug free and showing signs they were making progress. Methadone prescriptions would be withdrawn as a last resort if addicts did not make an effort to become drug free.

From now on addicts will have no excuse for not moving away from drug dependency and they will have choices.

Dr Kidd said that a whole new range of services to support addicts to come off drugs had been developed and put in place in conjunction with voluntary services and other partners working with the NHS.

The first aim is to stabilise an addict who may have been abusing drugs for years and who has a chaotic lifestyle.

Then they have to face and “do the work” on the problems that have been blotted out by drugs, going through a rehabilitation phase in their treatment. More psychological and psychiatric help is on offer to deal with underlying traumas and extreme anxiety.

Drug addiction also masks real physical pain. Dr Kidd said that all of the 1500 addicts in treatment in Tayside had undergone an assessment that revealed 40% of the addict population had chronic pain that was being masked by drug abuse. Medical and social problems all had to be addressed if addicts were to have any real hope of moving away from drugs and staying clean.

Most of the drug using population is unemployed and one of the goals of those trying to rehabilitate addicts and move them through and out of the system is that they will not only become drug free but join the workforce.

The former Baptist Church in Rattray Street, Dundee, has undergone a £1.5 million conversion and over the last few months has been accepting people who have passed through stabilisation and rehabilitation services and are preparing to fully rejoin society.

A local drugs charity is working with Dundee University in the former church, now called the Cairn Centre, to deliver training packages for people with drug problems with a view to moving them towards employment. A handful have already successfully found work.

“It’s a brilliant place,” said Dr Kidd. “They will take 160 people per year and get them into training or employment.”

Addiction services have changed a lot. Dr Kidd’s prediction is that they will have to keep changing to adapt to the needs of the population he and his colleagues are trying to move away from drug dependency.