Select Committee on Home Affairs Memoranda


Submitted by Tony Ralls



  I started to inject soon after hitting the Soho drug scene in the early 1960s. I was a young teenager and quickly became addicted first to methadrine (a powerful stimulant which came in ampoules) and later physeptone an opiate-based drug which also came in ampoules which I used to as an aid to the "comedown" off stimulants. I was offered treatment for my addiction from Doctors Chappel and Grey who had brought methadone to the UK in 1969, and so registered at the Worlds End Treatment Centre in Kings Road, Chelsea. I had never previously overdosed but once I begun treatment with methadone, overdosing became a regular occurrence. Bottles of methadone were given out containing supplies for a week or more, the methadone itself, as today, looked like cough linctus. I saw many of my fellow addicts die of overdoses from prescribed methadone, mainly through combining it with other drugs or alcohol, we were not fully aware of the lethality of the drug due to a lack of information. I also exchanged my addiction from my previous drugs to methadone. I came off drugs in 1970 through the love and support of committed Christians.


  Methadone, although chemically unlike morphine or heroin, produces many of the same effects and has been used for the treatment of narcotic addiction in the UK over the last three to four decades. The effects of methadone are longer lasting than those of morphine-based drugs, up to 24 hours, so permitting administration only once a day in heroin detoxification and maintenance programs, tolerance and dependence always develops. Some say withdrawals develop more slowly and are less severe than heroin but are more prolonged. Others involved in drug treatment say that one of the problems with methadone has been that it is as addictive as heroin and the withdrawals as bad or even worse than heroin, as an ex-methadone addict I would agree with this opinion. Methadone has also been widely prescribed to people with Hepatitis, which is a common condition amongst drug addicts despite the fact that it is known that in it's usual linctus form it is toxic to the liver. Matthew Dolan the author of "The Hepatitis C Handbook" gives the opinion that, "The continued prescription of methadone linctus to HCV+ addicts would seem to have been unnecessarily punitive and ethically questionable."


  In Britain, any medical practitioner can, at present, prescribe methadone for opioid dependence; Drug projects have, however, been the main source for prescriptions. Patients often consume their methadone at home rather than under direct clinical supervision, compared to other countries there is minimal central regulation of methadone maintenance programs, and prescribing practices are not uniform. Guidelines do exist but are not being effectively enforced or adhered to. According to the Home Office "Drug Misuse and the Environment" document: "There has been an extraordinary growth in drug projects and much of what they are doing remains hidden. More information is needed about the processes and experiences with a view to establishing what is good practice."

  Methadone has been actively promoted as the only real answer to heroin addiction. The Methadone Alliance is a powerful body that has pursued this course. I believe however that it is unacceptable that a drug that has killed so many non-drug users continued to be prescribed freely over such a long period of time. There are many examples of the fact that there has always been an overspill of prescribed methadone into society with tragic consequences.


  "According to the DEA, "methadone is frequently encountered on the illicit market and is annually associated with a large number of overdose deaths in the US This narcotic is associated with a number of toxic side effects and is reported by medical examiners to be among the top 10 drugs associated with drug-related deaths in the US"

  It is important to note however that there is no illegal production of this drug in the USA or UK. All methadone at street level has come from a drug unit or a GP.

  This is one example showing that decriminalisation of drugs does not reduce the danger to the community in any way. I became an addict through buying drugs that had been prescribed to someone else. The stark fact is that prescribed drugs are killing as many, in most case, even more, people than illicit drugs. I quote from an article in the "Big Issue": In an expose feature in The Big Issue by Lucy Johnston, (April 15-21, 1996), a strong warning was given concerning methadone.

  "Home Office figures show that the number of methadone addicts has increased from 5,000 in 1990 to nearly 16,000 in 1994. This means that the widespread availability of methadone, has produced, rather than prevented a whole new generation of addicts".

  The article also set out the many dangers of methadone as a potential killer rather than a cure, I quote: "Despite the fact that adulterated street heroin had many more users, Methadone is killing more people. Between 1982 and 1992, deaths by methadone poisoning increased by 710 per cent from 16 deaths to 131. According to Government figures this meant in 1992 the drug accounted for approximately four times more deaths than heroin per 10,000 users." Information from the National Statistics Office, (autumn 1998, Population Trends between 1982-6) states there has been:

  "A significant increase in drug-related deaths amongst men aged 15-44 years in all regions, half the drug related deaths are attributed to opiates. Over the five-year period there were nearly twice as many deaths mentioning methadone as heroin.


  A letter to the British Medical Journal (Volume 315, 6 September 1997) from A M Daniels, a Consultant Psychiatrist associated with the National Poisons Information Centre states: "Many that take Methadone lie about their consumption and sell a proportion of their prescription on the black market. As little as 30mg may be fatal in those who have no tolerance for opiates according to Toxbase, Edinburgh Poisons Information Service 1994. No one dies of heroin withdrawal, whereas 90 people died of methadone poisoning in Manchester between 1985-1994".

  Many users store their methadone in baby bottles because of the measurements on the side; this has led to some appalling deaths of children. In a 1996 Spring edition of the "Big Issue" an article on methadone stated that: "In 1993 a study in Liverpool found that 42 children were hospitalised as a result of accidental overdosing. Two of these died. In one case in 1995 a coroner in Stockport found a baby had died because his stepfather had measured out his methadone in the baby's cup and hadn't rinsed it out afterwards.

  I have personally known responsible addicts use methadone to withdraw from heroin and on a minimal dose build a new life free of the drug culture but I must say these in my experience have been the exception rather than the rule.


  Although attracting considerable media and political interest, deaths from drugs such as ecstasy and cocaine account for less deaths than methadone among both young men and women, yet there is much literature available seeking to warn young people about these drugs.

  On contacting the National Drug Help Line and other national drug information bodies and examining their booklets and leaflets, I found no information warning young people, or parents, about the dangers of methadone. The two most recent guides put out by the Health Education Authority are "The Score—Facts about Drugs" and "A Parents Guide to Drugs and Alcohol". Whilst both are expensive full colour productions there is no mention of methadone either in classification as defined by law or in the general presentation of all the other drugs, although there is always a mention of caffeine. In my research, I could only find one drug group call "HIT" who have any material relating to this drug, this is a postcard size card warning about methadone.

  My question is that if Drug Action Teams bring together all those working in this sector why is it that the deaths of so many appear to have gone unnoticed and why have children not been warned through the years? The LEA Drug advisor has a responsibility to advise schools concerning their drug policy, they meet regularly with their opposite numbers in the treatment field. This is where the lines have become blurred and why harm reduction has been applied not only to addicts in treatment but to education in schools with disastrous results making many drug education lessons drug promotion lessons but that is another subject.


  I was a drug addict for seven years and have been involved in all areas of the drug culture for the past 32 years. I have lectured in rehabs and schools, worked in prisons, written widely on the subject of addiction, but most of all fought a running battle through most of those years with "drug experts" in the areas of treatment and education. At present I am working with addicts at street level in Cornwall. All have seen many friends die through methadone many also have Hepatitis and recognise that methadone with its toxic side effects are bad for the liver. All know where to buy it on the black market. Even though Sebutex is being introduced as a new drug for treatment of heroin addicts many are resistant to this new drug most are so addicted to Methadone they cannot imagine life without it, it is also interesting to note Sebutex is also an opiate, yet again addiction is being treated with an addictive drug.

  I contend methadone has certainly not been proven to be the answer to opiate addiction. What I know has happened is that one addiction has been exchanged for another and along with this countless innocents have died, I therefore can only question this policy, how it came to be in place and was pursued for such a long period of time.

August 2001

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