:00:01. > :00:11.Assange. I wanted to go to Sweden and so we can find out if he did
:00:11. > :00:15.
:00:15. > :00:18.those things and whether he is Tonight on Newsnight Scotland. Why
:00:18. > :00:21.are we no longer shocked by the ever spiralling numbers of people
:00:21. > :00:25.on illegal drugs? Treatments like methadone or abstinence can help
:00:25. > :00:28.tackle the medical addiction. But they don't tackle the underlying
:00:28. > :00:37.social issues. Do we need to rethink the way we approach this
:00:37. > :00:41.intractable problem? Methadone was one of the great
:00:41. > :00:44.hopes in the so called war on drugs. The theory was that it could be
:00:44. > :00:50.used to stabilise addicts, get them off heroin, and help them towards a
:00:50. > :00:53.drug-free life. But what was intended to be a staging post on
:00:53. > :00:56.the road to recovery has instead for many become a permanent way of
:00:56. > :00:59.life. And at the same time, the number of drugs deaths in Scotland
:00:59. > :01:08.continues to rise, with methadone often implicated as one of the
:01:08. > :01:18.contributory factors. Here's David I have been on methadone, on and
:01:18. > :01:21.
:01:21. > :01:31.off, for 15 years. Perhaps more. I have had jobs. If I was not on
:01:31. > :01:31.
:01:31. > :01:37.methadone, I would make sure I got out that every day for many drug
:01:37. > :01:41.users, methadone has become a way of life. The might are no longer
:01:41. > :01:46.inject heroin, but many end up stabilised in a pharmaceutical
:01:46. > :01:56.prison. Their annual bill for methadone in Scotland is now �36
:01:56. > :02:00.
:02:00. > :02:04.million. There are now 22,000 users. They could put you into a three
:02:04. > :02:14.clinic and Divya after-care. Make sure you have after-care for at
:02:14. > :02:15.
:02:15. > :02:22.least a month. -- and give you after-care. At the moment, I am
:02:22. > :02:27.like a ghost, just walking about. People do not recognise me. Well as
:02:27. > :02:35.a methadone users have their doubts, for some chemists methadone has
:02:35. > :02:39.become big business. Some pharmacies like this one are well
:02:39. > :02:44.paid for dispensing methadone. But is it an expensive way of parking
:02:44. > :02:50.the problem? For the wider community, methadone can make a
:02:50. > :02:55.welcome difference. There used to the needles on the pavement,
:02:55. > :02:59.needles everywhere. People were walking into the middle of the road
:02:59. > :03:05.and not knowing where they were. It was just a mess. But I have to say
:03:05. > :03:12.that in the last eight or nine years, it has been a better and
:03:12. > :03:17.safer place. There is still a lot of drugs. In fact I have heard that
:03:17. > :03:27.a lot of readers have started back again. But it has been more
:03:27. > :03:36.peaceful. -- a needles. Pharmacies are on the front line of
:03:36. > :03:46.distributing methadone. The aware of the need to do more. The lead
:03:46. > :03:50.fairly chaotic lives. We need to stabilise them and work with them.
:03:51. > :03:58.We to help them take their addiction. Is that second-stage
:03:58. > :04:03.happening enough? No, it is not. I think we do quite well in his
:04:03. > :04:10.stabilising patients, maintaining patients, helping them to lead and
:04:10. > :04:18.relatively normal lifestyle. But we do not then make the next step.
:04:18. > :04:25.the meantime, they point out that methadone it does help the wider
:04:25. > :04:33.community. A drug user not on treatment can cost almost �60,000 a
:04:33. > :04:38.year in terms of crime. The cost, for a drug user on methadone, drops
:04:38. > :04:48.to �23,000 in the first year, then a �15,000 after that. But are we
:04:48. > :04:52.failing to see the big picture? There are obvious things. The loss
:04:52. > :05:00.of the industrial economy, the loss of purpose and meaning that comes
:05:00. > :05:03.from employment. But added to that his individualism, materialism, the
:05:03. > :05:07.type of culture we create for ourselves where you always have
:05:07. > :05:11.meaning of life if you are able to spend and make your way as a
:05:11. > :05:21.consumer. Many people are denied that, and in being denied that, and
:05:21. > :05:22.
:05:22. > :05:31.in being denied the more traditional forms of life such as
:05:31. > :05:41.family life, you deny them a future. Methadone helps you so much. Most
:05:41. > :05:41.
:05:41. > :05:48.of the time, if you take it early in the morning when the shop opens,
:05:48. > :05:53.by 9 o'clock at night, it wears off. You do not fear that. What are you
:05:53. > :05:59.going to do? You want to go and have a charge. If you have the
:05:59. > :06:09.money it, that is. We wonder what to do. Drug-related deaths in
:06:09. > :06:28.
:06:28. > :06:30.Scotland are on the rise. 584 drug I'm joined this evening by Dr Neil
:06:30. > :06:33.McKeganey, the director for the Centre for Drug Misuse Research at
:06:33. > :06:36.the University of Glasgow. And by the Chair of an Independent
:06:36. > :06:46.Drugs Enquiry, John Matthews. And finally Dr Peter Cawston, a
:06:46. > :06:53.
:06:53. > :07:03.Drumchapel GP who runs a methadone John, from your years as a minister,
:07:03. > :07:08.what did you meet in your parish that was drug addicted and what
:07:08. > :07:18.could have problems have led to that situation? When I first
:07:18. > :07:23.
:07:23. > :07:33.started my ministry in rough hill, -- Ruchill, the hospital there
:07:33. > :07:35.
:07:35. > :07:43.distributed lidos and methadone. That was 20 years ago. -- needles.
:07:43. > :07:52.It was brought him because of fares over HIV and Aids. This was seen to
:07:52. > :08:01.be a stabiliser and a civic protection. Over the 20 years that
:08:01. > :08:11.I was a parish minister there, I conducted over 1300 funerals, a
:08:11. > :08:12.
:08:12. > :08:22.quarter of which were young people who had died as a result of drugs
:08:22. > :08:25.misuse and it just general wear and tear on their bodies. You can see
:08:26. > :08:30.why methadone was seen to be something that saved it lives,
:08:30. > :08:40.stabilised people, but we did not bring along the panoply of other
:08:40. > :08:44.
:08:44. > :08:52.things a were promised. The goal rather used to stabilising people.
:08:52. > :09:02.-- we got rather used to bus stop in a way, the report suggests that
:09:02. > :09:09.
:09:09. > :09:16.I was, I have a small clinic practice and over seven years I
:09:16. > :09:19.have had 45 people come through it. Eight of them are in full-time
:09:20. > :09:29.employment and quite a number have been in significant employment over
:09:29. > :09:33.that time. To my mind, these are eight people who I suspect their
:09:33. > :09:38.taxes have paid for their treatment. There are many people who have
:09:38. > :09:44.moved on to feel that their lives are what they want them to be. Some
:09:44. > :09:48.of those people work around methadone and some are not and I
:09:48. > :09:55.think to focus entirely on the medication rather than on people's
:09:55. > :10:02.lives and letting people move on is a mistake. That is precisely what I
:10:02. > :10:10.do not want to do tonight. But when you look at the extent to which we
:10:10. > :10:16.are drug-addicted in Scotland and the UN very recently said that we
:10:16. > :10:23.had the 6th worst problem in the world, is it a particularly
:10:23. > :10:28.Scottish problem and why should that be? Perhaps I should say that
:10:28. > :10:33.the centre for drug misuse is entirely independent of Glasgow
:10:33. > :10:39.University so it is important that I -- you understand that I am not
:10:39. > :10:43.here as a member of the university. The scale of the problem eclipses
:10:43. > :10:48.any other country. It surprises us because it is a problem that
:10:48. > :10:53.started in the late 80s and nobody expected that the drugs problem in
:10:53. > :10:57.Scotland would reach anything like the scale which we are now seeing.
:10:57. > :11:01.That presents us with a massive challenge. It was always
:11:01. > :11:06.unrealistic to expect the methadone would be the answer to that problem.
:11:06. > :11:11.It is part of an answer but it was never designed to be the main
:11:11. > :11:15.answer to Scotland's heroin problems. Let's get back to
:11:15. > :11:22.methadone in a bit but I am trying to understand how we got here in
:11:22. > :11:28.the first place. The film talked about the de-industrialisation as a
:11:28. > :11:33.major factor. The parish I had was very poor. When I first went there
:11:33. > :11:40.it was in freefall in terms of the lack of employment, the state of
:11:40. > :11:46.the housing where young men ducked and dived and young girls saw it as
:11:46. > :11:50.attractive to start a family, and young people were generally
:11:50. > :11:54.rubbished and if you are rubbished every day and told you are rubbish
:11:54. > :12:00.then you start to believe that and then you do not care how you live,
:12:00. > :12:04.what to swallow, who you go with. To that extent we were trying to
:12:04. > :12:13.give young people the sense at which they were valued but I would
:12:13. > :12:17.have to say that drugs and alcohol do not happen in a vacuum. They
:12:17. > :12:22.happen in a culture and our culture has moved that way and we are
:12:22. > :12:26.parties are baiters, all of us, you and I are participating as in that
:12:26. > :12:33.culture. Is it a culture that has now become embedded or is it
:12:33. > :12:40.changing? I think it is certainly a major part of many people's life
:12:40. > :12:47.experience. We know lots of people who do use drugs or come across it
:12:47. > :12:53.at school so I suppose it is embedded in some respects. Scotland
:12:53. > :13:00.is a very unequal society and in a sense this is simply one facet of
:13:00. > :13:05.that inequality. As a society, are we becoming immune to the 500 plus
:13:05. > :13:13.drug deaths that are reported? Are we shrugging our shoulders and
:13:13. > :13:19.saying, that is how it is? Sadly we are. If in Scotland we had a jumbo
:13:19. > :13:24.jet crashing every year, we would be shocked by that to a degree much
:13:24. > :13:28.greater than we greet these figures. They are shocking for a few number
:13:28. > :13:33.of days that the figures come out and then they recede in interest
:13:33. > :13:39.and we somehow have become attuned to the level of drug mortality in
:13:39. > :13:43.Scotland. That is a shocking situation to find ourselves in.
:13:43. > :13:50.do now have recovery at the heart of government policy but do we know
:13:50. > :13:54.what we mean by that, John? Differ in people mean different things by
:13:55. > :13:58.yet. There are those who say recovery is about total abstinence
:13:58. > :14:03.and what Peter were saying was that they are right people who can
:14:03. > :14:09.stabilise their lives and enjoy a certain quality of life by obeying
:14:09. > :14:12.the rules in terms off taking methadone. What we see it in these
:14:12. > :14:16.figures that were released are people who are messing about with
:14:16. > :14:20.other things which is a very dangerous thing to do with
:14:20. > :14:27.methadone. You are not supposed to mess about with other substances if
:14:27. > :14:32.you are on the methadone programme? It is not a requirement and we have
:14:32. > :14:36.to understand that for many people who are not as I described working
:14:36. > :14:41.or feeling that their lives have some meaning, life can be very
:14:41. > :14:49.meaningless and boring on methadone and it is a huge problem for me to
:14:49. > :14:54.try and help people deal with other problems. A significant number of
:14:54. > :15:00.my patients take alcohol as well as methadone. There is a lack of help
:15:00. > :15:05.for people on methadone and who have mental health problems. Many
:15:05. > :15:08.are psychologically traumatised by their experience of drugs and also
:15:08. > :15:14.many people are physically carrying these bars in terms of their bodies,
:15:14. > :15:20.so a lot of my time at the clinic is spent treating heart, liver,
:15:20. > :15:27.lung problems. A I was quite struck by the methadone user in the film
:15:27. > :15:33.who talks about the need for going into an intense clinic based
:15:33. > :15:36.programme and then having help and support thereafter. I'll be good at
:15:36. > :15:44.continuing to support people who may be do manage to become drug
:15:44. > :15:48.free? No, we do not do that well at all. The research shows that
:15:48. > :15:53.addicts who have managed to come off drugs were those who were able
:15:53. > :15:58.to move into a reservation -- residential programme. That will
:15:58. > :16:02.not be successful for everybody but those who have secured that period
:16:02. > :16:06.in a presidential we have, they did better but it is a worried that we
:16:06. > :16:10.have a drugs policy in Scotland that is committed to recovery but
:16:10. > :16:15.we still do not know how many people on the methadone problem are
:16:15. > :16:20.actually coming off a drug-free. That was a criticism of the Labour
:16:20. > :16:24.government in the past but it is a situation that persists. We do not
:16:24. > :16:30.have accurate numbers of drug users on the methadone programme or
:16:30. > :16:36.accurate information about those recovering from it. Do you see
:16:36. > :16:43.methadone as continuing to be a part of our drugs strategy or do
:16:43. > :16:47.you think it could be replaced altogether? I think we have a
:16:47. > :16:51.fantasy that they can be a short, sharp solution where people come
:16:51. > :17:01.off drugs and I think there are significant risks associated with
:17:01. > :17:08.coming off. People lose their tolerance to opiates and then go
:17:08. > :17:11.back on to drugs and die. Their run risks associated with both
:17:11. > :17:15.rehabilitation and methadone treatment. Icy methadone as
:17:15. > :17:20.continuing to be part of the picture. I think what people need
:17:20. > :17:24.more than anything his people that work with them who are committed to
:17:24. > :17:28.helping them move on in their lives, whether that is three about the
:17:28. > :17:36.Dome or other means. How hopeful are you that we can make some
:17:36. > :17:41.headway? The smoking situation in terms of improved health to 20
:17:41. > :17:45.years. The independent inquiry used a metaphor of the iceberg. It
:17:45. > :17:50.exists because the temperature of the water is too cold and this
:17:50. > :17:53.iceberg that we have is continuing to grow and will do so unless we
:17:53. > :18:00.have raised the temperature of the water, and the temperature of the
:18:00. > :18:04.water is the culture of Scotland of which we are all participants in.
:18:04. > :18:10.Until we decide to help and do something about it, then I fear
:18:10. > :18:15.that we will continue in the way that we are doing. Thank you. Let's
:18:15. > :18:19.take a look at tomorrow's front pages. Let's start with the
:18:19. > :18:25.Scottish Daily Mail. It goes with say no to students from the middle
:18:25. > :18:31.classes. Scots are being frozen out of universities in favour of
:18:31. > :18:36.children from poorer areas. There is a picture of Prince Harry. The
:18:36. > :18:42.Scotsman goes with my mum's killer was just like a brother to me in.
:18:42. > :18:50.The paper says the sun cannot forgive the friend or family it of
:18:50. > :18:55.the Nadal of Jenny. The Independent has an interesting front page story
:18:55. > :19:00.on the NHS in England. Global that work of NHS hospitals to exploit
:19:00. > :19:04.the brand and there has been confirmation that this is to be