Lynn Ruane (Independent)
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This has been a great conversation so far. We need to extend prescription power to nurses. If we do not, it is a clear indication of a further stigmatisation. There is a kind of paternalistic idea that a nurse cannot determine a safe amount to prescribe. It means that where the healthcare service is working with an individual who needs methadone, there is suspicion off the bat. We are suspicious of someone who is looking for methadone. It is as if we think that someone is trying to one-up the system and source free methadone. There is automatic suspicion. People need to prove that they need methadone, attend a methadone clinic or are on drugs. Who decides to arrive somewhere and take methadone if the reasons to do so do not already exist?

I am curious about the difference between methadone and morphine. People have ideas about the types of groups of people who are on methadone and automatic suspicion comes in. We are going to see more and more people on methadone because of morphine addiction. A decision to put someone on morphine for an extended period will probably result in their needing methadone. People who are addicted to tramadol are now being offered methadone by their doctors. That cohort is stretching out beyond heroin users. I am wondering about the financial incentive. If a nurse has done all the work and a consultant is then brought in, is the consultant reimbursed for signing off on the methadone?