I'm thinking of writing a novel, a dystopia, in which the population are kept in check by the free availability of mind-numbing drugs like heroin, as well as cannabis which creates in people the feeling of creativity while removing the energy to actually do anything.
There is no police force or army in my future world as the health and social services have grown so much, and become so intrusive, that there's no need for clumsy security men anymore. Hidden cameras are everywhere and they track your every move. Whenever there's a problem, the perpetrators are taken to a clinic where they're tranquilized and then given a lifetimes supply of drugs.
I believe we're heading towards this kind of dystopia and the way that addictive drugs like Methadone are prescribed by doctors is part of this process. Other parts of the puzzle are the ready availability of "legal highs", the way that medics liberally prescribe highly addictive painkillers and antidepressants and the gradual legalization of cannabis despite the fact that it can cause psychosis, lethargy and paranoia.
The misuse of Methadone, a highly addictive opiate, has been disturbing me for a long time but when a colleague recently published this article - 5 Reasons to Stop Methadone - I realised how dangerous it really is. Evelyn McKechnie writes: "there has been an increase in deaths by Methadone poisoning, accounting for 25% of all deaths by drugs poisoning." It also lengthens dependency, can cause osteoporosis and brain damage, makes it difficult to return to a normal life and costs the UK Government over three billion pounds a year.
If Methadone is so bad why does the British, American and most EU Member States dispense it every day to millions of injecting drug users?
To be fair, there are many arguments in favour of Methadone; the best one being that it gives heroin addicts an alternative to dirty needles and has helped stop the spread of the HIV and Hepatitis "C" viruses. It has also cut down crime committed by desperate addicts. If someone is not willing to seek abstinence, and is using heroin, then a short term Methadone course can be the right first step. The problem is that "Methadone Maintenance" tends to become the permanent solution and some people end up on it indefinitely.
Professor Jonathan Chick, the Medical Director at Castle Craig Hospital, puts it into historical context: "Methadone Maintenance has a long and important history of enabling people whose lives and whose families' lives were in tatters because of the pressure of heroin addiction to get that next hit, and because of its cost involved in crime and causing hardships to others...However, it's not an easy life being tied to a Methadone clinic and there is this sense of enslavement - that's the original term - addiction - "addictare" is a latin word meaning enslavement."
My own view is that Methadone is a curse that has helped to solve one problem - the spread of HIV and Hepatitis "C" - but has created another big problem: a large number of people who are indefinitely addicted to Methadone. Do we want to sustain a minority of the UK population in permanent addiction, at an estimated cost of £3.6 billion a year?
If the government were serious about this issue they would put more funding into the therapy programmes that are supposed to accompany the distribution of Methadone, as well as residential rehab where abstinence is the goal.
Professor Carlton Erikson believes there are four characteristics of a good Methadone programme: The dose has to be taken in front of the pharmacist; there has to be a regular urine test to ensure no cheating; the client should have a job so that he/she can pay for their Methadone; and the client must receive regular counselling to come off the Methadone.
These characteristics all make perfect sense but I wonder how many of them are actually respected? From what I have heard -- and please correct me if I am wrong -- only one of these conditions is offered to the majority of Methadone users in the UK: the dose is usually taken in front of a pharmacist.
I contacted a pharmacist assistant called Lucy who worked in the Newhaven area of Edinburgh in order to find out what happens on the ground. Her job was to organise the Methadone prescriptions at a chemist shop. This is what she told me:
"The first step of coming off heroin is Methadone. It provides focus, a goal. However, so often this solution turns into a long time problem. I found that specialised clinics in the centre of town [Edinburgh] that focused on drug addiction were better suited: they provided the support and they reduced their patients down until they were on it no more.
"In sharp contrast was the doctors at the surgeries. They would prescribe Methadone and increase when they were asked. They would often do as the patient wished. Some would be allowed to take home a full week's dose. And you would rarely see the patients from the surgeries being reduced, mostly they would be increased on their dose of medication. Some patients only see their doctor every two months, solely for their Methadone prescription. This can't give them anywhere near the support they would need to successfully come off drugs altogether."
In case you were thinking the UK Government is doing something about this problem you should see this report from 2011: "The Coalition has inherited a failing and costly drug policy which prescribed methadone to drug addicts in the hope that that this would replace their use of street drugs and cut criminal justice costs. This has been counter-productive. It impeded and delayed addicts' recovery from addiction."
The report quotes Dr Phil Peversley, who said: 'Prescribing for opiate addicts is like throwing petrol on a fire; pointless, counter productive, stupid, self-defeating. And yet we keep doing it.'
Evelyn McKechnie and Kate Hillier contributed to this article.