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I am a forensic physician working in the east end of Glasgow, and I write with reference to the debate by Burns and Shaw.1 2 A high percentage of detainees are on opiate substitution programmes. From my own personal observations, nearly all are using “top-up” heroin.
Additionally, alcohol consumption while receiving methadone treatment is high. It is obvious that a £2 shopping voucher could easily be diverted into paying for two litres of cider to fund a dual addiction.
I also find it ridiculous in a cash strapped NHS service, where we are unable to fund life saving or life extending medications, we are able to pay addicts to “comply” with a treatment that offers no treatment benefit other than to “reduce harm.”
Competing interests: None declared.