Chamber and committees

Alcohol Focus Scotland and the Health Education Board for Scotland have submitted a proposal to the Executive for a gender issues network on alcohol and this is currently being considered.

In July, the Executive issued a framework for alcohol problems three-year local action plans. This outlines the information that Alcohol Action Teams (AATs) are to include in these plans and will provide the basis for future reporting on progress and accountability. The Executive and AATs will discuss how reporting and accountability will work once local plans are received in March 2003.

Mrs Barbara O'Donnell was appointed as National Alcohol Liaison Officer on 1 February 2002. Her remit is to facilitate the sharing of information and good practice between local Alcohol Action Teams and provide a link between national and local alcohol problems activity.

The provisional findings of an exercise undertaken by ISD Scotland indicate that approximately 17,000 individuals were in receipt of a prescription for methadone in the months of November and December 2001. Quality checks are still being undertaken, however, and I will write to you when the final results are available.

The guidelines on the clinical management of drug misuse and dependence include advice on the prescribing of buprenorphine. A recent Effective Interventions Unit review of the effectiveness of treatment for opiate dependent drug users recommended that supervised buprenorphine administration should be piloted and evaluated to test the feasibility of wider prescribing and dispensing in Scotland. We are considering this recommendation.

The personal and clinical circumstances of each patient are different. Treatment programmes must be based on the needs of the individual and clinical judgement. The guidelines on the clinical management of drug misuse and dependence emphasise these points, and they also provide advice on dose reduction regimes and detoxification. The guidelines also recommend a multi-disciplinary approach to treatment, including liaison with other professionals who can help with the factors contributing to an individual's drug misuse.

There is no single, centrally-managed methadone programme. The duration of methadone treatment and aftercare arrangements are matters for individual patients, their clinicians and local organisations which provide support. There is no routine central monitoring of progression rates. However, the Drug Outcome Research in Scotland Study is examining the effectiveness of drug misuse treatment services in Scotland. This study will include methadone treatment and, over a four-year period, the researchers will endeavour to map pathways through services and to measure patients' progress across a range of life areas.

The Executive estimates that the concessionaire will have recovered all agreed costs some 14 to 18 years after the bridge opened in 1995, that is between 2009 and 2013. The actual date depends on future traffic levels. It is our intention that tolling at the bridge will end once these costs have been recovered.

The Community Care and Health (Scotland) Act 2002 provides carers with an independent right to have their needs as carers assessed. This new right took effect from 1 September 2002. We are working with local authorities, COSLA and carers' organisations to develop ways to monitor the outcomes achieved for carers under the 2002 act and our Carers Strategy. This will include improved monitoring of the numbers of carers' assessments being carried out. This information is not currently being collected by authorities in a consistent way.

The range of treatments available for opiate misusers includes different forms of prescribing, for example substitute drugs, counselling and other psychosocial interventions, detoxification and alternative therapies. The various treatment options are described in Drug Misuse and Dependence - Guidelines on Clinical Management, and are also examined in the Effective Intervention Unit's research publication, A survey of NHS services for opiate dependents in Scotland, which can be found at http://www.drugmisuse.isdscotland.org/eiu/pdfs/eiu_nhs_opi.pdf.As indicated in the clinical guidelines, a key aim of treatment for opiate users is to "assist the patient to remain healthy, until, with appropriate care and support, he or she can achieve a drug-free life." The nature and duration of the treatment are determined by health professionals in accordance with the needs of the individual patients concerned.