A former Scottish drugs minister has called for a pilot programme to give the country's worst heroin addicts the drug on the NHS.
By Bob Wylie
Investigations correspondent, BBC Scotland
Dr Richard Simpson says evidence from German heroin clinics proves that they cut drug deaths and drug-related crime.
But opponents said the move would send out the wrong message.
The results of the German trial suggested that on almost all counts the group taking heroin did better than those on methadone.
The findings of the three-year heroin on prescription project were published recently.
Heroin clinics - where addicts get heroin injections paid by the state - were set up in seven cities. The trial compared 500 addicts on heroin with 500 on methadone.
Research director Dr Christian Haasen is based at the University of Hamburg, the city where the largest trial was held.
He said: "The differences between the heroin group and the methadone group are statistically significant.
"Those on heroin stayed in treatment longer and the drop out is less than the methadone group.
"They had much less illicit drug use, using street heroin and cocaine, and so have better health records."
Should heroin be given to addicts in Scotland on the NHS?
Results are indicative and may not reflect public opinion
These positives also seem to affect employment prospects.
Forty of the 90 clients who attend the Hamburg clinic to get heroin are in work.
Ludovic Leblanc works as a waiter in one of Hamburg's best restaurants.
His employer knows that he goes to the clinic twice a day - once in the morning before work and once during his afternoon break.
He claims he will be drug-free by 2007 and is now on a quarter of the daily dose of heroin he was getting when he started at the clinic two years ago.
"I couldn't have dreamed of that on methadone. After a year and a half on methadone the dose stayed the same and I would go to get street heroin almost every night," he said.
The number of drug deaths in Germany have dropped by 40% during the time of the trial, from more than 2,000 to 1,300 last year.
Dr Simpson, a consultant psychiatrist, was the Scottish drugs minister between 2001 and 2002.
He said the German study, along with other successful pilots, meant there was no reason for withholding this treatment from a small group of the most chronic addicts in Scotland.
He believes there is a direct correlation between the availability of heroin on prescription and drug deaths.
"Are those who oppose this idea prepared to allow people to go on dying?" he asked.
"The time is right for this now... it isn't a question of why but why not."
Dr Simpson said a pilot programme could be set up in Glasgow for about 200 addicts to test whether the effectiveness of the results in Germany could be repeated here.
But such a move is opposed by some experts in the drugs field.
Alistair Ramsay, the former head of Scotland Against Drugs, is now a drugs consultant.
He believes that heroin clinics would send out a dangerous and confusing message.
"Would we give an alcoholic a bottle of the best malt every day for life?" he asked.
"In the same way, are we prepared now to say we will pay for people to be on heroin for life?"
Mr Ramsay said setting up heroin clinics would be giving tacit approval to drug taking.
But supporters of heroin clinics said that the successes of trials in Switzerland, Holland, Spain and now Germany proved the treatment was effective for a group of addicts for whom everything else had failed.
The last official figure for drug-related deaths in Scotland was 356 for 2004 - almost 50% higher than a decade ago.
Bob Wylie's report from Hamburg was broadcast on Radio Scotland's Investigation programme at 0900 BST on Monday (see interviews link above). There will also be a special report on Newsnight Scotland at 2300 BST.