NHS Tayside’s £1 million annual bill to dispense methadone in Dundee is an unavoidable cost in the treatment of the city’s addicts, it has been claimed.
Payments to pharmacies to dispense and supervise the consumption of methadone in the city have totalled more than £1 million every year for at least the last four years.
This is the third highest cost of any area in Scotland, with Glasgow first and Edinburgh second.
Despite the cost, NHS Tayside, Community Pharmacy Scotland, Addaction Dundee and the Scottish Government have all voiced support for the methadone programme.
Opiate replacement therapy is still the best method for enabling addicts to move on from addiction, according to Addaction Dundee.
A spokesperson for the organisation, which supports local people affected by drugs and alcohol, said: “Alarmingly, there has been another dramatic increase in drug related deaths in Dundee and, if anything, greater and easier access to treatment is called for.
“Addaction is committed to delivering evidence-based treatment for heroin dependency and there’s no doubt that opiate replacement therapy (ORT) saves lives.
“For many people this means taking methadone or buprenorphine for sustained periods to provide a stable platform of improved health.
“Studies across Scotland, the UK and beyond have proved that ORT is effective in improving health, social functioning and reducing crime.
“We now need further investment in treatment to enable people to move on from this stage in their recovery journey.”
A spokesperson for industry representative Community Pharmacy Scotland said the methadone programme’s costs are far outweighed by the benefit it provides to society.
He said: “The improvement to the health and social aspects of patients’ lives from treatment are, as for any other illness, the ultimate aim of therapy and this alone justifies any costs incurred – for example, we know that 75% of drug-related deaths occur when patients are not receiving treatment for their addiction.
“An independent review of opioid replacement therapies in Scotland in 2013 highlighted the crucial roles that community pharmacy teams play in supporting patients and many recommendations as to how this should be expanded, which we are fully in support of.”
The amount the NHS pays rose by £300,000 across Scotland between 2015 and 2016.
The fees paid to pharmacies cover dispensing methadone, oral hygiene services, and a supervisor to ensure the dose is taken on-site and not sold on the street.
NHS Tayside pays pharmacies £2.20 per dose of dispensed, and an additional £1.10 to supervise addicts while they take it.
A spokesperson for NHS Tayside said the treatment was “invaluable”.
She said: “There is strong evidence which supports the dispensing and supervision of substance misuse medicines as an appropriate treatment for the illness of addiction.
“There is a number of invaluable benefits of this treatment, both to the individual and the wider community, such as stabilising daily routines, improved relationships and being able to return to the workforce.”
A Scottish Government spokesperson said: “There has been a decrease in both the dispensing of Opioid Replacement Therapy (ORT) drugs, including methadone, and the total prescribing costs over the last six years.
“While we are clear that prescribed drug treatment is not, and cannot be, the only treatment option available on the path to recovery, the use of methadone remains a central component of the treatment for opiate dependency and is backed by the independent expert group on ORT.”
