Clamour grows for heroin on the NHS
Experts call for national network of 'shooting galleries' after hailing successful trials
Digg
del.icio.us
Facebook
Reddit
Google
Stumble Upon
Fark
Newsvine
YahooBuzz
Bebo
Twitter
Independent Minds
EPA
The programme was modelled on one in Switzerland where introduction of injecting-clinics "medicalised" heroin use
enlarge
A group of government-appointed drug experts will call for a nationwide network of "shooting galleries" to provide injectable heroin for hardened drug addicts across the country.
A pioneering trial programme prescribing heroin to long-term addicts has shown "major benefits" in cutting crime and reducing street sales of drugs. Results of the programme are to be presented at a conference in London tomorrow. An expert group set up by the National Treatment Agency for Substance Misuse to assess the programme has concluded that the approach should be adopted nationwide.
The prescription of heroin to hardened addicts is one of the most controversial in medicine. Giving addicts drugs such as heroin on a maintenance basis, rather than weaning them off them, turns existing policy on its head and presents a challenge to ministers.
Critics say giving addicts the drugs they were previously scoring on the street is not "treatment", and the cost at £15,000 a year per head cannot be justified when NHS patients are being denied the latest cancer drugs. But addiction experts say this is about "harm reduction", not cure.
Long-term heroin users are among the hardest addicts to treat and impose huge costs on the medical and penal systems. Ten per cent of drug addicts commit three-quarters of all acquisitive crime in the UK, official figures show. The existing government drugs strategy includes a commitment to roll out the clinics, subject to the findings of the trial programme.
The trial started three years ago and yielded benefits within months. Early results showed crimes committed by the addicts dropped from about 40 to six a month, after six months of treatment. A third of the addicts stopped using street heroin and the number of occasions when the rest "scored" dropped from every day to four to five times a month.
The programme was modelled on one in Switzerland where introduction of injecting-clinics "medicalised" heroin use, removing its glamour and transforming it from an act of rebellion to an illness requiring treatment. Last year, Swiss voters backed the scheme in a referendum, proving it could be a vote-winner. Similar clinics have also been established in France, Germany and Canada.
The first British injecting clinic, run by the Maudsley Hospital, opened on a south London high street in 2005. Heroin addicts who had failed on all other treatments and served repeated prison sentences for shoplifting and other crimes attended twice a day and received a dose of diamorphine (pharmaceutical grade heroin) which they injected themselves, under supervision.
Two further clinics were opened, in Darlington in 2006 and in Brighton in 2007. For the trial, 150 addicts received drugs at the clinics, one third of them heroin. Their experience was compared with two other groups who received either oral or injectable methadone under the same conditions.
The strict rules allow no "take-away" from the clinics, to avoid the users selling their drugs on the streets. All injections are witnessed at the clinic. The approach introduces routine and drudgery by forcing the users to attend for their twice-daily fix.
There are an estimated 280,000 drug users in the UK, most taking heroin and crack cocaine, and about 2,500 deaths a year. The scheme, targeted at the 3,000 to 6,000 long-term, hardcore addicts, operates seven days a week, 365 days a year.
Professor John Strang, head of the National Addiction Centre at the Maudsley, who led the study, said the findings had sent a ripple of excitement through the addiction treatment community, which is unused to seeing progress with hardcore heroin addicts. He would not comment yesterday on the panel's recommendations, but before, speaking about the early successes of the trials he said: "This is genuinely exciting news. These are people with a juggernaut-sized heroin problem and I didn't know whether we could turn it around. We have succeeded in people who looked as if their problem was unturnable, and we have done it in six months.
"It is 'intensive care' for drug addicts, more expensive than standard treatment but a third of the cost of sending them to prison at £44,000 a year. And they become re-addicted on release. We are dealing with a profound drug hunger and trying to medicalise it to break the link with street heroin use and crime."
War on drugs: The liberal experiments
*BRITAIN
Doctors have been allowed to prescribe heroin since the 1920s but very few do so. Most prefer to prescribe methadone, a heroin substitute, which is taken orally once a day. Its effects are longer-lasting but duller. Many addicts continue to buy heroin. There are currently three "shooting galleries" operating across the country which may now be extended.
*SWITZERLAND
Throughout the mid-1990s the Swiss were at the forefront of trialling prescription heroin schemes and the country has seen a major reduction in crime and better rehabilitation success rates. For years the main "shooting gallery" was in Zurich but last year Swiss voters approved a nationwide rollout of prescription heroin in a referendum.
*PORTUGAL
Portugal has the most liberal drugs policy in Europe. In 2001, it took the radical step of abolishing criminal penalties for drugs. Anyone caught with drugs was referred through the civil, rather than criminal, courts and either fined or put into treatment. Critics predicted that narcotics use would spiral out of control but addiction rates fell.
View all comments that have been posted about this article.
Offensive or abusive comments will be removed and your IP logged and may be used to prevent further submission. In submitting a comment to the site, you agree to be bound by the Independent Minds Terms of Service.
- Print Article
- Email Article
-
Click here for copyright permissions
Copyright 2009 Independent News and Media Limited
Comments
This gives some control and common sense to the process and also offers a glimmer of hope to those stuck in the trap of addiction. People will shout about the morals of giving drugs to addicts but they need to be reminded of the many respectable people being supported in their valium or painkiller addictions. Just because they're taking them doesn't make me want to join them.
These sound like great proposals.
I do not understand why it costs 15,000 pounds to give heroin to an addict.
Heroin is very cheap. Twice a day means 730 injections per year. Even with the cost of a nurse to watch to prevent overdose, the estimate seems large.
Finally, the world is recovering from the insanity of the USA's insane drug war
+
That simply does not sound right. So the other 90 per cent of drug addicts?
Drugs have always been around and they will certainly ever remain. To pretend that both users and non-users will be better protected because some drugs are impure and very expensive and sold by criminals, who by the way are indistinguishable from undercover policeman and plain businessmen, is simply ridiculous. And yet more so when the street supply grows year after year. The obvious result is a growing output of crimes committed by illiterate youngsters, who use the illicit substances, partly as an adult initiation rite and partly as an alibi: declaring oneself irresponsible, unfree, a victim — a very comfortable position by the way — at such a critical moment of life when they should learn responsibility and the abnegation practiced by their elders.
So the true option is not vice as opposed to law and order, the real choice is between irrational consumption of adulterated products or an informed use of pure drugs. Demonizing them has only made us more helpless, more cruel towards our fellows, and more "idiotic" in the original sense of the word, for "idiotes" in classical Greek means a person who blindly delegates the things of his own to the public care of others. Not only our well-being, but the well-being of our sons and grandsons depends on disseminating patterns of "sobriae ebrietas" (sober inebriation), which reconsider the use of psychedelic drugs as a moral and aesthetic challenge, essentially related to the adventures of knowledge, and as palliatives for difficult parts of our lives, and for very bitter lives. In other words, we should dignify what is now being debased in order to cope with the generalized delusion and abuse created by the prohibitionist experiment.
The revolving door of crime, prison and re-offending upon release needs to be broken.
Perhaps this will work where past efforts have failed.
Some addicts undoubtedly benefit from this treatment, but we need to be aware that it won't be cheap. If we have galleries it may be possible to bulk buy the diamorphine more cheaply, but there will be staff and security costs as well.
America's "wars on" things are a bloody menace. Drugs won’t be able to sign an armistice, nor will terror. And if Europe is brighter, perhaps they can learn from us.
But the Daily Mail will be poisonous, as usual.
If they do get free heroin they should sign a disclaimer that the NHS are not responsible and do not admit them to any hospital for treatment
I absolutely despair of these people,and this country.
You know what? as an ex qualified psychiatric nurse I do honestly believe this country is psychotic-well at least the policymakers,and their advisors-but then again the public put up with it-so I don't know who's worse.
Heroin on the NHS eh........the cheapest crappy cancer drugs if you have paid for this service all your life and then develop cancer (one in three of us eventually)
No no no!
No free heroin,unless you promise to do MOST of us a favour and overdose,and die.
I will just wait now for some of the usual crackpots,freaks,dreamers etc who post on this most bloody awful papers forum, to start with their drivel about how inhumane I am etc.
Yes-and allowing someone who has paid for this now third rate st elsewhere system to die of cancer because it won't fund some of the very effective drugs from America, is not inhuman eh?
But the evidence shows that it reduces the number of drug peddlars on the street, and cuts crime- in particular petty theft and burglary. This, in my view, can only be a good thing. The savings in terms of reduction of police effort expended on crimes such as the above would probably cover the cost of the treatment by itself.
Addicts commit an appalling amount of property crime, their habit supports the more violence based organised crime. Put together the whole thing's a running sore and current approaches Just Don't Work. We used to hang people for stealing goods above the value of ten shillings. That didn't work either. We should do what we might colloquially refer to as "the bleeding obvious" and Try Something Else. Not bleeding heart (would it be churlish to point out that a heart that doesn't bleed is a common symptom of death?) but pure, hard headed practicality. And a chance to see Mail readers frothing at the mouth, which is always good for a laugh.
Right-ho!
It is abhorrent to me that our genuinely ill people are waiting for treatments when the 'self inflicted' bunch get it all their own way...
Drug addicts are the epitomy of selfishness, they have no purpose, they don't contribute to society
The laws of nature dictate that the weak should not survive, ergo drugs could be natures way of natural selection of weak minded people....its a just a theory...and im entitled to it if a portion of the 28% of my salary that is taken from my daily grind is being used to fund a drug habit, together with all the other stealth taxes levied against the hard working and healthy.
Theory query ; In your street, you, your wallet, your mobile phone, 22.30, two heroin addicts desperately needing a fix (begging didn't pay enough today). Theoretically which of the three submits a crime report ?
And you goatjuggler.
what exactly was your special area of practice.
I for my pains,spent twenty two years working as an RMN in a special hospital-with many years dealing with those deemed to have the euphemistically termed 'personality disorder' (always made me laugh that one)
Any experience of that sort of thing? or was it just the depot injections,and the bottom wiping for you.
The medicalization of crimminals....and a very nice little earner for all those involved it was too I might add.
Why! it was almost an industry.Twenty seven grand a year (thirty five on nights) for us lowly nurses..and as for the social workers,and armies of doctors,and hangers on....why its lottery win figures.And then there was those lovely lovely lovely index linked pensions.
Funny thing that.....Unless its changed Scotland never bought into this travesty-and just threw them in jail rightly so.
Let me repeat that phrase again....the medicalization of crimminals.
That is the unpalletable truth of the matter, the whole idea of medicalizing heroin addiction, or for that matter alcoholism,paying them incapacity benefits etc, and now this latest atrocity to be leveled at the British taxpayer, is an utter disgrace-no its worse...its an abomination.
An addiction.......selfishness with a sick note
great-just great.
My observations over the months about this newspapers various comment facilities, are that it is infested with individuals that are full of bright idea's-as long as its someone elses money thats paying for them to be implimented.
Its dishonest
Its morally objectionable.
Its completely selfish.
And it won't wash anymore,in the new austere Britain thats coming.
And finally,
My hobby is travelling the world.I pride myself on not being parochial or insular.
I am a self confessed heliocentric globe trotter.. WHY it must be an addiction no less !!!!
And you know what i have objectively concluded goatjuggler, about other countries I have frequented(but shusssssh-keep it to yourself in case it catches on, and upsets some of those 'types' on this site)
The more severe the penalties surrounding drug pushing,trafficking,and usage-the less of a problem there seems to be.
Bloody well strange thing that Eh!
Now enough on this preposterous topic for me-I'm off to make some more money.
Reported today, The Adam Smith institute has determined the solution to be :
http://www.guardian.co.uk/commentis
May we talk figures?
The estimated 6000 long term heroin addicts costing some Ł15000 per year to service comes to a grand total of Ł90 MILLION POUNDS and usually government estimates ar far off the mark so this figure could be exceeded
Regarding the sources where heroin is from does this mean a further boost for Afghanistan economy or will we set aside acres of the English farmland to produce our own growing and distribution factories
This money could be put to a better use by the NHS in other fields or even more spent on seeking out the serious drug dealer/importers
Once again we discover the lunatics are running the asylum
Well done for trying to sort your Shit out as it can`t be easy and furthermore the fact thatyou`ve actually been brave enough and reflective to actually contribute to a public forum such as this(stay clean and continue to live you`re life ;-)).
Unfortunatly most of the ranting and raving about this topic are by those who should really know better ( the ex health professionals who think they can patronise us because they were "in the trenches" as it were as we civvies haven`t got a clue I am particularly disappointed with and in a way its kind of good that they are ex health service as the people i have come into contact with in that chosen field have a degree of honour and human empathy which i honestly think would prevent them from being so cynical so its probly good you got out when you did save you start to play "shipman" or develop a dependency yourself e.g booze abuse).
Im in two minds as to the wiseness of making smack legal (as someone who has a brother who is struggling with a dependency problem which has virtually torn an already fragile familly apart .with the stealing and denial and health scares and spells in every prison in the south of England) as it could have the Dam affect (cures an initial problem ..but causes further aggro upstream) but on the other hand it can or may improve quality of life of the sufferer and thier families which from personal experience could potentially saved a lot of heartache (e.g my 8 year old nephew would still have his play station and I might have that leather jacket and pair of Nikes i was particularly found of!.)
Joking aside ,As for those who think its a good idea to let them have enough to "finish themselves off" could you give the rest of us some tips on how to be as morally and humanly unimpeachable as yourselves as it must be hard to be so perfect
By sharing that knowledge with the rest of us mortals you woiuld`nt have to feel you were obliged to take time out from putting the world to rights to inform us of whats what and you could get on with the important stuff (Like plannning your next trip to some impoverished third world country or whos getting in the next round or wether you can afford that nice semi in Hamstead or the other NIMBY business which youre pre occupied with ... see its easy to be judgemental isn`t it? have I covered all the stereotypes yet?).
Rant aside karma is a strange thing and wishing someone dead anonomously on a website ain`t big and speaks volumes about the person who espouses that filth and a lot less about who its directed at and for the record don`t doubt what I have written here i would`nt say face to face if given the opportunity.
Prescribing addicts heroin is just the first part of the treatment it should be complemented by psychological attention to be sure the treatment is working. With this approach we can be sure they could be rehabilitated and reintroduced to society. Although with the state of mental health care in Britiain this second step is the more challenging. As for the cost, there is always money for drugs of whatever kind. What we lack is knowledge and proper attention to the psychological needs of the patient, this does not require money, it requires humanism, compassion, empathy and diligence.