Friday 13 November 2009

Britain's Million Pound Lost War

Britain has been fighting a war on drugs for almost 50 years. A war that is being lost and one which is costing the taxpayer £3 million a day.
Heroin is public enemy Number One. If your car has been stolen, your handbag snatched or your house broken into, it’s pretty safe to say that heroin was the motivation behind the crime. Three out of four heroin addicts commit crime to fund their habit.
There are an estimated 800,000 problematic drug users in the UK. This means the UK is the country with the highest proportion of heroin users in Europe.
Of these, 300,000 are parents who may be subjecting their children to neglect and abuse, exposing them to crime from an early age and increasing their likelihood to become addicted to drugs when they are older. The age at which children are starting hard drugs is getting lower. In the past seven years the number of children under the age of 15 in Scotland checking into rehab clinics has quadrupled to 418.
Blood born diseases are also on the rise: the number of HIV cases in the EU has almost doubled since 1999 and hepatitis C cases are rising by roughly 10% every two years.
These viruses aren’t the only health risk that habitual heroin users face in the UK: their veins can become infected and blocked, withdrawal symptoms between hits cause them cramps, nausea and intense pain, not to mention the risks to personal safety involved in obtaining heroin.
With this many problems caused by heroin it’s no wonder that people scowl at addicts when they walk past, call them the scum of society, or spit on homeless people whilst they beg. £573 million of public money is spent each year on putting addicts into rehab- so people tend to feel their hard earned money is going towards helping the very people who are destroying society.
But what if all these problems are not caused by heroin but government policy? And what if there was a solution out there which would reduce crime rates, protect children from neglect, reduce the number of HIV and Hepatitis C cases and cut the numbers of drug related deaths. A solution ministers have resolved never to put into place. That solution is legalizing heroin and making it, once more a prescription drug like it was before the 1960s.
It’s a strategy Switzerland has adopted. Ten years ago a visit to their capital city, Bern, would have included some unexpected tourist sites, such as heroin users taking over whole streets and parks to deal and inject. That was until the government took the controversial decision to introduce needle exchanges and clean injection rooms where addicts could take heroin under the watchful eye of a nurse. Then, in 1998, the government made its most controversial decision to date: to introduce a ten-year trial heroin prescription programme. Available only for addicts for whom everything else has failed, those on the programme have an average heroin usage behind them of 13 years. Addicts on the programme are viewed as having a chronic, relapsing disease for whom nothing else has worked. And they must have tried at least two abstinence programmes before being accepted for the scheme.
Fast forward ten years and the differences the trial has made to Swiss society have been huge. Drug related crime has dropped by 60% and parents can relax: their neighbourhoods are drug litter free. These are just some of the reasons why, when asked whether the trial should become an established remedy, 68% of Swiss voters voted in favour.
Opponents say that it encourages young people onto drugs and never gets addicts completely clean.
However, Dr Chrisoph Buerki disagrees. Working in Switzerland’s main clinic each day, he cannot see how clinics like his would ever glamorise heroin.
“Heroin was a very ‘in’ and fashionable thing to do in the 1980s, 90s, but now people who take heroin have the image of losers, junkies,” Buerki says. “Just looking at my clinic, nobody thinks this is a good thing - it’s not cool to go to a clinic like ours to get heroin twice daily. We’ve medicalised heroin in Switzerland - it has the image of an ugly illness and that is why, I think, the number of new addicts are falling. Very few young people are turning to heroin in Switzerland these days”
Currently, the argument that the programme never gets addicts fully clean is compelling. Of the 16,000 patients on the programme, very few have managed to quit the drug completely. However, that may not be a bad thing. Users with the level of addiction of those on the programme may never get completely clean from heroin, studies have shown. At least the programme keeps their use steady - and allows them to lead a normal life.
Jan, 33, has been an addict since he was 20 and for the last eight years he has been on the programme.
“At first I didn’t want to come here,” Jan says. “I thought it was the lowest of the low, but I am an addict. And I’ve got a job now, and two sons, so I live a pretty normal life. My kids just know that Dad is sick and has to take his medicine each day.”
So far the benefits the programme brings in Switzerland far out way the cons. But would anyone in Britain vote for such a scheme?
Doctors were allowed until 1962 to prescribe heroin to patients who had subsequently become addicted. That was until three doctors were caught selling heroin to their patients for profit. Others were suspected of over-prescription, with the extra heroin sold by addicts on the black market. Prohibition was introduced and doctors were allowed to prescribe it only if they had special permission from the Home Office.
Methadone was introduced as a substitute drug. But critics claim its use was based on inconclusive research combined with pressure on doctors from the drug companies that manufactured methadone.
Advocates of methadone said heroin prescription ‘fed a habit’ whereas methadone was a medical treatment.
But what the medical profession may have failed to realise was that methadone is a potentially more addictive substance than heroin. And although temporarily reducing a user’s need for heroin, it does not remove all cravings. A majority of users on methadone programmes either top up with heroin or quit the programme altogether: a third of patients drop out in their first year of methadone.
There were roughly 1000 heroin users in London when prohibition was introduced. But when their supplies were cut off and the substitute failed to suppress their cravings they found new ways of getting heroin. They broke into pharmacies and sought new users to sell their wares to. As the market for the drug grew so did the supply from abroad. The demand and supply for heroin grew until the UK reached the position we are in now: a multi million pound illegal drug business.
Now, heroin dealers don’t need to seek out new users. Their 800,000 regular customers keep demand so high they don’t have enough product to meet it.
Like any other business, dealers and suppliers stay on top of current trends. Such as the trend for injecting heroin and cocaine together (known as speedballing) or the fashion for many heroin users to use crack cocaine. In Ipswich, for example, if you purchase heroin and cocaine together you’ll receive a £10 discount. In Liverpool, you get a free rock of crack for every two bags of heroin bought. Iceland eat your heart out.
If ministers were doing enough to keep heroin addiction under control, would dealers be able to offer their customers such good deals? Would the heroin and cocaine market be worth more than £4 billion?
Critics like the RSA committee say the answer is a simple no. And as long as the Government keeps trying to fight the drugs trade instead of focussing on individual addiction they are wasting money. The market has grown too large: as long as there is a demand for illegal drugs, the drugs trade will be able to meet it. It is a billion pound industry comprising of many individuals and organisations. And as soon as you arrest one dealer or shut down a network, another can crop up in its place. The resources available to the drugs trade, plus its incentive to continue trading, means it is unlikely to be shut down anytime soon.
Instead, the Government could reduce the demand for the dealers’ product by “nationalising” the heroin supply and distributing it only on prescription, says police chief Constable Richard Brunstrom.
Fulton Gillespie, whose son died of a heroin overdose, was one of three parents who gave evidence to the House of Commons home affairs committee, urges legalisation.
“We have to take control away from criminals and place it back where it belongs- with the people. At the moment it’s the criminals who are calling the shots,” Gillespie said.
“I cannot for the life of me see how we can expect to deal (with the drug situation) if we are not in charge of the supply ourselves.”
Michael Burrows, a 21 year old heroin addict, agrees. “Dealers aren’t stupid. They aren’t going to continue selling something which there isn’t a demand for. A small proportion of their money comes from new users, it’s addicts like me who provide all the profit.
“I’m desperate to get my drug use under control, if I got it on prescription I could get on with my life, pass my degree, get a job, possibly a family. I would never need to see my dealer again, and the rest of his customers would go the same way. If he’s got no one to sell to, he’ll move on, stop selling heroin, stop buying it from the traffickers and the amount there is in the country would decrease. It is as simple as that.”
Once in the grips of their addiction most drug users do not go to their dealers for heroin for the high it gives them. Users who resort to crime to afford their drugs do not do so because they enjoy it. Female addicts who sell their bodies for cash do not find it empowering. They are doing so to fund their habit. To end the terrible withdrawal symptoms they are feeling, to put an end to the fear they feel when they wake up to discover that they have no heroin left. By this point users aren’t using for their high, they need heroin to feel normal again, to function. And they’d give anything to live a normal life like you and I.
A normal life is certainly something Rachel Craick, 29, is aiming for. Using since she was 18, for the past four years Rachel has been facing her demons and trying to put her addiction behind her. Currently working her way up the music business Rachel is desperate not to throw away all her hard work. “I’ve wasted seven years on that shit,” Rachel says. “And I am almost 100% sure I am over it. Although I know full well that my stupidity, that ‘one last fix’ feeling could place me right back where I was.”
That place was full of danger, self destruction and shame:
“I did anything for heroin. I began by fucking my dealer for it, before moving onto working in seedy, low budget pornos then onto the streets. I’d steal thousands off of my punters, putting my life on the line just for my next hit.
“Although I feel so dirty for selling my body like that it’s not the guilt from the prostitution that keeps me awake at night. I hocked my engagement ring, my eternity ring. Gifts which meant the world to me. I stole from my family, my friends. Even those who stuck by me when everyone else had left. I broke their trust and I can’t blame them for not wanting anything to do with me now.
“The severity of what I was doing to myself and everyone around me didn’t set in when I was doing it though. I only realise now, four years later, whilst looking into why I became addicted that I understand how terrible I was. But back then… the need for heroin was far greater than everything else. It consumed me.”
This uncontrollable, all consuming need means that addicts put themselves in extremely dangerous situations daily. Women especially are at risk.
In the midst of her addiction Rachel found herself in some nasty places: “I was working as a prostitute which obviously saw me out on the street each night, places where there was no CCTV, no police presence, and dark, dark places. But it wasn’t just when I was trying to get money I was in danger. Looking back I can’t believe the places I would go to score. Meeting dealers alone, shooting up in alley ways, under bridges, in strangers’ flats. Who knows what could have happened to me? I was too out of it to care.”
You only have to look at the 2006 Ipswich prostitute killings to see how much danger addicts will place themselves in for their next hit.
All five victims were drug addicted prostitutes who continued to work, despite the knowledge that there was a serial killer targeting their area. A killer suspected to be a regular punter who they’d happily climb into a car with.
Victim Paula Clennell told police two days before her disappearance that she would continue to work as she needed the money. The withdrawal symptoms she would face if she couldn’t afford to upkeep her heroin and cocaine addiction were far worse than the risk she was putting her life in.
The danger the girls put themselves into gained a lot of publicity at the time. The public could not believe that when it came to a choice between their lives and heroin they would pick heroin every time. However, for the prostitutes themselves the situation they were in was nothing new.
They felt police telling them to leave the streets was patronising, as they had been told many times that what they were doing was dangerous. They were well aware of the risks, but by this point their addictions were too out of control for them to matter. The only thing the Government could have done to stop these girls being in danger was to give them what they were selling their bodies for: heroin.
It isn’t just women who put themselves in danger. Many drug addicted men are also turning to selling their bodies for drugs. Jake, 31, is one of them.
“Lately I’ve been going to sex parties of rich men,” Jake says. “I let them urinate and spit on me, then I let other junkies have anal sex with me whilst the men watch on. We take turns and are forced to give each other oral during and after. Then many of the men ejaculate on me. I am forced to clean this up with my mouth, eating pee and cum. I receive a brick (of heroin) for each party. I hate living this way.”
An extreme example but many men are doing similar: pimping themselves out in public toilets, acting in porn. All which increase the number of HIV and Hepatitis C cases across the country.
It’s a common myth that those who do not inject drugs or have sex with addicts are not at risk from blood born diseases, but with one third of the population having admitted to having unprotected sex no one knows who their current partner might have slept with.
It is also not just shared needles that increase the infection, addicts who share the same cooking up spoons, water and filters can also spread infection.
As a prescribed heroin programme would provide clean equipment it would result in a serious decrease in blood born viruses across the UK says the RSA.
The programme would also dramatically reduce the billions the NHS spends each year treating the health problems that come with drug addiction.
This is because the only health problem legalised prescription heroin causes is mild constipation. The others are all a result of the black market.
The majority of vein problems caused from injecting are not down to the substance itself but how pure the heroin is, what it is mixed with and unsafe injecting techniques.
When an addict loses his or her limb this is down to unsafe injecting and dirty needles. Bacteria (from using a dirty needle) form under the skin causing a lump about the size of a goose’s egg at the injection site. Forming over a couple of days if left untreated it infects the bone and doctors have to amputate before the bacteria spreads and causes death.
Similarly, a study by BioMed Central showed that the majority of drug related deaths are either down to the user not knowing the heroin’s purity or the conditions in which they use.
An experiment involving two groups of rats showed that unknown surroundings can increase the likelihood of overdose.
The rats were originally given a controlled amount of morphine as a group and then split into two with one group of rats moving to a new cage. Despite the fact that both sets of rats were given the same amount of morphine as before, the rats in the new cage overdosed. None of the rats who remained in the original cage experienced any problems.
Following this, the doctors in charge of the study interviewed ten overdose survivors and seven of these stated that their overdose had occurred in a place where they were not used to injecting.
The doctors concluded that the body can adjust to a drug’s effects if it recognises the surroundings but if your body cannot recognise its surroundings then it cannot prepare itself for the effects of the drug and may react badly.
This study showed that if the Government were to set up environments where addicts could inject safely, such as shooting galleries, the number of drug related deaths would decrease.
Currently some doctors in Britain have obtained licenses from the Home Office to prescribe heroin. However, most doctors tend to prefer prescribing methadone. Some have listed the lack of procedure in place when it comes to prescribing heroin as their reason not to- not because they don’t think it would work.
Here, unlike in Switzerland, addicts aren’t given their prescription under supervised conditions. The very few addicts who are granted a prescription are given pure heroin as a freeze dried powder along with clean injecting equipment to take away with them. As there are no current protocols for doctors to stick to there is no guaranteeing that what they are handing out won’t be resold on the black market.
There is also a lack of demand from addicts for prescribed heroin, although many addicts, including the editor of Black Poppy magazine, believe this is because the possibility of getting the script is so rare that they do not bother asking for it.
Some doctors also cited lack of resources as their reason for not prescribing heroin. In Britain there is an unavailability of facilities and inadequate funding for supervised injection.
Supervised injection would require attendance at injecting rooms two or three times daily which would increase treatment costs. Methadone needs to be taken only once a day and can be taken in a chemist. This may prove cost effective for the short term but with the majority of users still using on top it does little to combat long term costs such as those the NHS and Police Services incur each year. The Home Office has estimated that for every pound spent on a heroin maintenance programme will save three pounds in crime costs.
The original intention behind the current methadone programme in place is for it to be used as a short term method for addicts to wean themselves off heroin before being placed in an inpatient rehabilitation centre to get them fully clean.
However, only half of the addicts who make it successfully through a methadone detox are able to obtain a place in inpatient rehab units and of those that do manage to get a place only one third emerge completely drug free.
This is because the success of this programme is down to the quality of the counselling addicts receive whilst on the programme. And with many addicts feeling they cannot be honest with their drug counsellor this treatment is not simply not adequate.
“If an addict admits to using heroin their methadone supply will be cut, so they lie for fear of losing their prescription,” says Joanna Young, a female drugs counsellor at the Homeless Outreach Project. “The women I see have come voluntarily to the charity for help and know they can be honest with me about their use. From this I can get to the bottom of why they relapsed or why they continue to use despite wanting to be clean, yet for many addicts the only counsellor they see is the one offered to them through their methadone programme. If they have to lie to them then there is no way the counsellor can get to the root of why they are using.”
Before even thinking of managing to get clean addicts have to face up to why they began using in the first place, says Young.
The experience of heroin, although hyped up, isn’t as enjoyable as other drugs. It’s the physical and emotional dependence of heroin that keeps addicts going back for more.
This is certainly the case for Esme, a 19 year old addict.
“My counsellor asked me the other week why I chose heroin when I know it makes me ill and I have admitted other drugs do much more for me. The answer I gave him was that I want to hide and a heroin high is the best place to remain hiding from everything.”
For people who have been excluded for the most of their lives, often through neglect from their families the fact that drug taking creates communities is a big appeal for them, explains Young. Through drugs they will meet people from similar backgrounds and in similar situations – people who understand them.
“Heroin certainly attracts fuck ups,” says Mike, “My drug taking friends would never judge me- for they’ve done the same or often worse.”
Self destruction is a common trait in the majority of addicts. John, a 32 year old addict from Bristol has been self destructive since birth.
“I’ve always had a great deal of hatred inside of me, ever since I was a lad.” says John, “Anytime I would get upset when I was younger I’d lash out at myself and it made me feel better. I’m doing the same now with my heroin use- I see it as self medication as it never fails to make me feel better.”
This self medication is often as a way of hiding from problems that have occurred earlier in life. The Home Office have made discoveries that show that the environment addicts have been brought up in was a major influence in why their drug use spiralled out of control.
The most obvious example of this is when a child is subjected to drug use in the womb.
The discoveries showed that less direct environmental influences can also increase the likelihood of drug use in later life. Childhood sexual or physical abuse for example. Abuse obviously causes a great deal of emotional pain which a person may choose to escape from by using drugs but neuroscientists have also discovered traumatic events can also alter chemicals in the brain making an abuse victim more likely to gain support from drugs. ‘Just Say No’ doesn’t seem so simple now, does it?
Ultimately a full blown addiction is a disease. Withdrawal sufferings are the symptoms. Heroin is the cure. Self inflicted it may have been at first, but when an addict first turned to heroin they were not doing so knowing what lay ahead. Campaigners for heroin prescription have shown that by withholding prescription heroin from addicts Britain is forcing them to risk prison, isolation and death- all for a mistake they once made- believing that heroin would improve their lives.
These words were found inscribed on an addict’s walls whilst their writer lay dead on the floor- another victim of Britain’s war on drugs:
“The hot chills and cold sweats, the withdrawal pains,
Can only be stopped by my little white grains.
There's no other way and no need to look,
For deep down inside you know you are hooked.
You'll give up your morals, your conscience, your heart,
And you will be mine until death us do part.”
And these words will live long in the hearts of addicts, as the pact the have made with death slowly begins to run out. That is until the Government open their eyes to the damage the black market, for which they are responsible for, is doing to our country.

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