NHS heroin 'will protect women'

[apothecary]

http://news.bbc.co.uk/2/hi/health/6342091.stm

Earlier this week the first funeral took place of one of the five young women killed in Ipswich while working as prostitutes.

The deaths of Ipswich prostitutes raised concerns over the link between sex workers and drugs

All had been supposedly working on the streets to help finance an addiction to heroin and crack cocaine.

Their deaths led to calls for heroin to be widely prescribed on the NHS as a way of stopping drug addicts becoming prostitutes.

On a cold night in Ipswich's red light district, Janine is working.

She is selling herself in order to buy drugs, specifically heroin and crack cocaine.

It's the same for all of the other prostitutes she knows. She says: "I can't name one girl who doesn't have a drug habit who works the streets."

Before the killings Janine was making almost £200 a night. All of it would be spent on drugs "apart from a phone credit and a packet of fags".

The heroin also helps her to do the work as, "it just numbs your emotions".

Her friend and fellow heroin user, Paula, the mother of a young baby, doesn't work as a prostitute but has watched many of her friends end up on the streets.

"I have seen girls do things for crack (cocaine) they would never dream of doing otherwise", she says.

'Daily dose'

Ten years ago Erin O'Mara, who lives in north west London, was in the same position as Janine.

To finance her habit she began working in the sex industry, initially as an escort. As her addiction developed she couldn't keep to any routine.

"When you have got a habit the drugs come first and if you don't have them by the time you start your shift you can't do it. That's why a lot of girls end up working on the street."

Erin no longer works as a prostitute but she does still take heroin. After 20 years on the drug she has tried every kind of treatment. Now she is part of a select group of drugs users who get their heroin on the NHS.

At a chemist near her flat there are several other addicts there collecting methadone prescriptions.

Methadone is synthetic heroin substitute and is the tried and trusted route for heroin addicts trying to kick the habit.

Erin is getting the real thing. The chemist is expecting her and hands over a bag containing her daily dose of pharmaceutical heroin. She has been doing this every few days, week in, week out, for the last four years.

She says: "You've got a measured dose, you know exactly how much you're taking and you can function perfectly well on it."

Her speech is a little slurred and she seems a little woozy but getting heroin on the NHS has given her stability - she now has a job and a flat.

"I felt like I was trapped on this treatment nightmare. Now that I get my heroin prescribed, all that anxiety has gone."

Control

Erin is a special case. She is HIV positive and has had Hepatitis C so it's vital she doesn't share needles.

Currently just over 1% of heroin users in the UK, around 400 people, get their heroin in this way.

Each one costs the taxpayer around £10,000 a year.

In spite of this, some policy makers and police would like to see a lot more people being prescribed heroin.

Tom Lloyd, the recently retired Chief Constable of Cambridgeshire says heroin on the NHS could dramatically cut the cost of drug relate crime and improve the lives of heroin users.

"If they were allowed to have heroin under controlled circumstances then that chaos would be taken out of their lives, they could get their lives sorted out."

'Huge improvements'

This is exactly what's currently happening in three areas in Britain where trials are being conducted into prescribing heroin on the NHS.

Users don't get it at their local chemist like Erin, but have to go to a centre to take the drug under strict supervision.

The trials have only been running for a year but Professor John Strang, director of the National Addiction Centre, says the early results are promising.

"Our strong clinical impression is we are seeing huge improvements which we would not ordinarily have seen."

The stiffest opposition to wide scale heroin prescribing comes from Professor Strang's own colleagues within the medical establishment.

Will suit 'a minority'

At his private GP practice in Felixstowe in Suffolk, Dr John McMurray has been dispensing methadone to heroin users for many years.

He says giving heroin to patients, even heavily addicted users like Erin O'Mara, could end up killing them.

"What you needed to feel perfectly OK yesterday if you use today could be sufficient to kill you".

Even those campaigning for heroin on the NHS say it will only be suitable for a minority of heroin users.

That could still mean up to 25,000 addicts being given free heroin. The bill for the NHS would be around £375m.

Dr Emily Finch is a consultant psychiatrist in addiction at the Maudsley Hospital, one of the sites conducting trials into heroin prescribing.

She says it won't be up to doctors to decide whether the scheme should be rolled out: "Society will have to think about whether they want this treatment to be available and whether they are prepared to pay for it."

[Ace]

Perhaps they should prescribe Iboga. God knows that'll get you off the smack

[Jesus On Peyote]

Yea i agree, get the source of the problem instead of just the symptoms. of course this would need a course of treatment and i dont think alot of "normal" people will understand or accept iboga, let alone the governments.

[Anodyne]

That's a pretty fucking big "just" there, JoP.

[Jesus On Peyote]

So was "just" getting into space, and onto the moon (debatable ), but we did it

What do you mean?

i know its a problem but its Just a problem so to speak, there has been alot worse problems in the world then self afflicted addiction that human kind has gotten past.

my post dident mean to belittle the problem,but you can eaither leave the system how it is and let these people go though their lives addicted or you can go that step further and actually *try* cure them, not from the drug per se, but from the addiction itsself, i know it sounds eaiser said then done but it can be.

[nabraxas]

Each one costs the taxpayer around £10,000 a year.

that seems pretty fucked. 30 quid a day...... a score bag (20 quid) used to be half a gram & most junkies would manage fine on that.....so it seems that the bastard drug companies are charging more than the dealers

[Jesus On Peyote]

that seems pretty fucked. 30 quid a day...... a score bag (20 quid) used to be half a gram & most junkies would manage fine on that.....so it seems that the bastard drug companies are charging more than the dealers.

Good point, never thought of t he pricings, altho at least with the companies, youlld be getting a safer,cleaner product

( yould want to think so)

[AndyAmine.]

Diferent stroke for diferent folkes..

Bring it on I say.....

IMO If they brought it in over here when they were going to this bloody ICE epidemic wouldnt be anywhere near as bad.....

[Jesus On Peyote]

Ice should be classed as a biological weapon :/

But yea, If that system was in action here for ice, im sure ittle help the more violent ice problem ALOT.

[MrBumpy]

Would it actually help with violent Ice users?

Please, correct me if I'm wrong, I've never been in a scene where heroin or Ice had a strong presence, but I thought most of the crime attributed with herion addicts, was as means for them to get funds for their next hit, and not so much when they actually are on their drugs.

But with Ice, aren't a lot of the problems from when the have doesd up, and end up running amok... at least from the stories you see make it to the media ( I know its not the best least sensationalised source, but... ye know..)

-bumpy

[Anodyne]

10,000 pounds is a lot - but what if you just throw them in jail - how much does it cost then? There's no way heroin actually costs this much to produce - I imagine these costs are to cover the program itself: the regular expensive drug tests, security, counsellors & all the rest. Also, in Oz at least we subsidise participating pharmacies - basically bribing them to allow these filthy junkies in their shops, which adds more costs to the program. But the costs may go down with a larger-scale program.

Ice should be classed as a biological weapon :/

But yea, If that system was in action here for ice, im sure ittle help the more violent ice problem ALOT.

I agree with Mr Bumpy - I wouldn't want to see that introduced anywhere. Sure, opiates are hugely addictive. However, aside from the addiction, there are actually very few long-term effects of opiates, except for constipation. The addiction itself is a huge hurdle (just thought you were dismissing the problem too lightly JoP, though iboga does sound interesting) - but only actually becomes a problem if they don't have a regular supply. As for ice, it can cause both immediate psychotic symptoms ("running amok"), as well as permanent (? - or at least long-lasting) psychoses in long-term/regular users. And then you have the addictive properties on top of that. Oh, and damage to dopamine neurons. And the withdrawals from an ice addiction aren't going to fuck you up anywhere near as badly as opiate WDs - you just sleep a lot basically. Also remember that many opiate addicts use because they have legitimate pain problems, but can't get the medicines they need because doctors are so suspicious of opiates - at least they may get some help under this scheme, even if they have to register as a drug-abuser to do so.

A step in the right direction, anyway.

[shruman]

I think its a step in the right direction but I think ultimately the goal should b rehabilitation.

"Please, correct me if I'm wrong, I've never been in a scene where heroin or Ice had a strong presence, but I thought most of the crime attributed with herion addicts, was as means for them to get funds for their next hit, and not so much when they actually are on their drugs.

But with Ice, aren't a lot of the problems from when the have doesd up, and end up running amok... at least from the stories you see make it to the media ( I know its not the best least sensationalised source, but... ye know..)"

That may b true to an extent but certainly the vice versa happens Ice addicts steal to support there habit & heroin users run amok.

I dont see any reason to discriminate between addicts for there drug choice the central issue addiction is the problem not there drug choice.

[MrBumpy]

This is why I wanted to make sure people knew I had limitied knowledge on the subject.

At the moment, from what I've read, probably the biggest problem you encounter with someone who is doped up on opiates is them falling asleep while you are trying to carry on a conversation (something I remember reading here). Yet with the actual addiction, the withdrawls are extremely difficult, and most of the crime is from people who are have sobered up, but due to their addiction, are driven to extremes to obtain funds to get another hit. I agree with treating the addiction by supplying the drug in this.

Where as, with Ice, people actually go ballistic as a result of taking the drug, and then get a double whammy when addiction comes in.

I'll admit that I don't know anything about the withdrawl symptoms from ice, but I don't really see how letting people dose up to enable them to become potentially, a danger to themselves and to others is gonna help solve any of the problems associated with ice, since a lot of the problems come from when the people are actually affected by the drug.

Unless maybe letting them get a fix, and then keeping them in a padded cell, but that doesn't really accomplish anything. Esp. if what Anodyne is correct and that ice WD's aren't too severe (again, I have don't have any knowledge on this subject, just repeating what has been said).

I dont see any reason to discriminate between addicts for there drug choice the central issue addiction is the problem not there drug choice.

I disagree here. There are different ways to beat addiction to different substances, and some substances are gonna be harder to kick then others.

Look at the legal drugs nicotine and alcohol. You can get patches, gum, inhalers and pills to steadily reduce the amount of nicotine you take, rather then going cold tukery.

I haven't heard of an alcoholic switching from full strength, to mid strength, to light to help them deal with their drinking problem.

I've kinda gotten lost on the point I was trying to make... but pretty much I don't think that the same program that is proposed for heroin would help counter the problems from violent meth users.

-bumpy

Edited May 2, 2007 by MrBumpy

[Conan Troutman]

do they not use methadone in UK?

[shruman]

I do think its a step in the right direction mayb for different reasons to other people here, my main reason being addicts & any user for that matter should have access to good clean pure drugs at reasonable prices but I dont see how simply supplying someone with a simple alternative for there addiction is going to rehabilitate them. But if thats the root they want to take I dont see why H using pros get free methadone & Ice using pros have to work for their fix.

"Erin is getting the real thing. The chemist is expecting her and hands over a bag containing her daily dose of pharmaceutical heroin. She has been doing this every few days, week in, week out, for the last four years."

Doesnt sound like its done anything for Erins addiction in 4 years.

"probably the biggest problem you encounter with someone who is doped up on opiates is them falling asleep while you are trying to carry on a conversation "

I have seen a H addict hit a guy in the head with the blunt side of an axe over a simple argument hell have no furry like a H addict scorned this was not an isolated incident either I have seen this guy get into to numerous altercations to count. From wot I've seen of H addicts they have peaks & troughs one minute theyll b asleep on the table the next there bouncing round being the life of the party 10 foot tall & bulletproof.

"There are different ways to beat addiction to different substances, and some substances are gonna be harder to kick then others. "

Totaly agree here no one treatment is going to b effective for everyone.

"I haven't heard of an alcoholic switching from full strength, to mid strength, to light to help them deal with their drinking problem."

Me neither but in my younger more hedonistic days I used 2 binge drink like a madman up to bout 5 days a week, I knowrealise I was an alcholic (like a lot of other people in aus) and I didnt switch to mid strength or nothing I just cut back in incremental steps Id say to myself Im not buying that extra six pack this week. I usualy drink on average 5 drinks a week now but Ive been on a health kick of late so havent touched a drop in bout a month, but like I said wot works for some aint gonna work for overs.

"there are actually very few long-term effects of opiates, except for constipation."

Ur talking bout physical effects (of which depression is one that springs to mind) I dont think ur thinking about the big picture here wot about the social & economical effects opiate addiction has on people, addicts often bcome isolated bcause theyv burnt all their friends & family & often if addicts have anything to show for themselves its a long list of debts.

"if what Anodyne is correct and that ice WD's aren't too severe "

This makes me wonder why we have an Ice epedemic if its that easy why dont they just give up? Its not that easy addiction is addiction no matter what the substance or vice & addiction is the core problem.

I would probly agree with anyone who said meth (or amphetamine for that matter ) is a worse drug than heroin, but then again I dont think any substance is inherently bad there just drugs if u abuse them then u can have negative effects.

[nabraxas]

apparently the new treatment centers for Ice addicts are going to be using modafinil as a substitute drug. i'm interested to see if that works.

[Jesus On Peyote]

Would it actually help with violent Ice users?

Please, correct me if I'm wrong, I've never been in a scene where heroin or Ice had a strong presence, but I thought most of the crime attributed with herion addicts, was as means for them to get funds for their next hit, and not so much when they actually are on their drugs.

But with Ice, aren't a lot of the problems from when the have doesd up, and end up running amok... at least from the stories you see make it to the media ( I know its not the best least sensationalised source, but... ye know..)

-bumpy

Yea, ild agree with shrumans answer,Ice addicts can be more violent when on the drug, but when their at a point of addiction, the violence spreads to help fund the habbit, weather its break ins or just plain robery with a knife or anything that they can get their hands on at the moment.

I recon ittle help crime a little, but like my original point, rehabilitation is better then keeping people on it, though that system would have its merits in fighting both H and ice addicts,ild like to see more on the side of rehabilitation.

modafinil sounds interesting, would be good to see how it goes.

[reptyle]

People should be allowed to aquire either by money or donation of effort an substances they want.

Raising the average intelegence of drug users in regards to safe techniques and first aid would provide a step towards helping people learn as a society to be more responsibile for the impact they have as idividuals. This is where the problem lays, people dont give a shit about a society that doesnt give a shit about their rights as human beings, it has very little to do with drugs having said x or y effect. its the people using them who want something different.

WOOFing on a happy happy heroin farm. Assist in cultivation of poppy's and food for free fix a place to hang out, get high and meet like minded tweakers.

24/7 meth mania mindfields. Learn to cook your favourite substances, safely and purely. Make music, mull up and utilise some of that indispensable energy for the benefit of conciousness evolution. Learn the techniques of stabalising paranoia for the sake of disincarnate communication. Harness and hone your amphetamine inspired psychedlic skills whilst having as long a list of anti-psych meds on hand for safe realisation of the point when you need to relax.

It appears that safe places for would be experimenters to visit and learn the ropes in regards to each differnt substance such that the information is spoon fed to those who most need it is the only way towards utilising the variety of conciousness tools. The information and creative invention that would develop as a result of these research centres would exceed the current scientific ratio of work to idea's a million fold., and it would be fun fun fun for all those who currently wish they could utilise the knowledge they have accumulated over the years.

may seem a litle liberal for some to completely invision but the prospects of funding for health care, community food organisation and speciatly products adds to the amount saved on "fighting" drug crime and propaganda.

Its an entire new industry of and unto itself.

The future has to happen some time i spose.

[Anodyne]

do they not use methadone in UK?

Yes, and buprenorphine too. But people with needle fixations won't go for either bupe or 'done as both of these are taken orally, and some people just don't find methadone an adequate substitute, and end up using H as well. And bupe is only good for fairly mild habits - people with a serious tolerance can't use it due to the "ceiling effect". Also, for people who have an opiate addiction because they have chronic pain problems, then heroin is a far better painkiller than methadone.

but I dont see how simply supplying someone with a simple alternative for there addiction is going to rehabilitate them.

It's not. From what I know of this program it is limited to people who have tried all the other treatment options & had no success. The point isn't to get them off drugs - there are other programs for that - The point is to let them live their life in the least disruptive way possible. Which is why I mentioned the lack of side-effects from opiates in my last post.

Ur talking bout physical effects (of which depression is one that springs to mind) I dont think ur thinking about the big picture here wot about the social & economical effects opiate addiction has on people, addicts often bcome isolated bcause theyv burnt all their friends & family & often if addicts have anything to show for themselves its a long list of debts.

And I don't think you're thinking about the implications of a scheme like this. The problems you're talking about are almost all caused by the legal status & expense of opiates - if addicts have a gov't subsidised prescription they don't need to sell their mum's DVD player to buy their drugs, right? If they know exactly how strong each dose is, they're much less likely to OD & traumatise the housemates. If they have a legitimate prescription for their drugs, they're less likely to shoot it all in one go to get rid of the evidence, and hence less likely to OD. And what kind of depression are you talking about? Respiratory or mental? If it's mental, then again, that's mainly a problem caused by them feeling guilty about the problems their illegal addiction has caused, like them stealing from their friends or drooling on the family Xmas cake or whatever.

This makes me wonder why we have an Ice epedemic if its that easy why dont they just give up? Its not that easy addiction is addiction no matter what the substance or vice & addiction is the core problem.

I didn't say it was easy - just that it was a lot easier than opiate withdrawals as there is almost no physical component to amphetamine WDs. So if they can get around the mental side & make the decision to quit, ice addicts might feel a bit shirty & tired for a few days. Whereas opiate addicts have the joys of simultaneous anxiety & depression, muscle aches/tremors/weakness, joint pain, severe diarrhea, goosebumps, cold sweats, loss of appetite, loss of attention span, and so on. Oh, did I mention the insomnia? - imagine having all those things going on - basically combine your worst stimulant OD/come-down with your worst muscle pains/weakness from the flu, then multiply it by 10 or 20, and then imagine suffering through all that for a week or two, during which you can't sleep AT ALL for at least the first 3 days. If you could buy a cure for the flu for $50, wouldn't you do it & get back to work rather than suffer for a week? This is what opiate maintenance programs are about - just letting addicts get on with their lives. As I mentioned in the last post, I don't think this is a good idea for amphetamines because they aren't safe to take regularly (in recreational doses, at any rate).

WOOFing on a happy happy heroin farm. Assist in cultivation of poppy's and food for free fix a place to hang out, get high and meet like minded tweakers.

[Jesus On Peyote]

Now it kinda sounds like your belittling the Ice problem, Iv seen people go crazy on a one way ticket on that stuff, it might not be as physical in its withdrawals but it can totally fuck ur mind. Personally i would rather 3 weeks of physical hell then a lifetime of mental "collapse".

[Conan Troutman]

Bupe or done will never be a substitute for heroin, nothing will! (users will shoot bupe anyway)

Dont get me wrong im all for NHS heroin, no one should have to go cold turkey...NO ONE

BUT I thought the idea of maintenance programs is to provide the addict with a regular standardized dose, no needles ect.?? so they dont have to prostitute themselves, steal handbags or whatever to get there fix.

Id also like to say that it is very disappointing that done is the only option for most and has proved to be much harder to kick than H (hydrocodone, kratom should be viable options but arent!) But by removing needles from opiate addiction would also remove the major heatlh risk factor.

Also dont think purity is a big deal over there, so only reason that comes to mind might be to under cut the dealers...who knows...

Anyway I think it very unlikely to help mitigate addictions, although I guess this isnt the purpose??

time to get high...

[Conan Troutman]

didnt see your post JOP

I think the alcohol and tobacco epidemic should be the first focus, as they kill more ppl than all the illegal drugs combined.

The government should finish what they start, before worrying about th Ice 'epidemic' as the media touts it, its easy enough diverting funding from heroin programs and saying look what were doing to help the ice problem, what a crock! This is a 'zero tolerance' government lets not forget, or so they say...

we are zero tolerance but here is your fits, doesnt make sense does it?? they atlk the talk (to the right crowd) but cert dont

walk the walk..

end rant pt.2

[Jesus On Peyote]

I think the alcohol and tobacco epidemic should be the first focus, as they kill more ppl than all the illegal drugs combined.

100 percent agree, but ittle be very hard. most people who smoke or drinks, would go crazy over prohibition of their "perfectly" legal stuff. Would they (majority) listen to the stats?, i dont think so coz even on the cig packs these days it tells ya in front of ur eyes the death ratio with just smoking and all illigal drugs. That plus the business side of them both will make it near impossible.

Who would win in an election, Someone who is driving towards making tabaco and alcohol Illegal Or someone thats going to try legalize weed an shrooms? (anything illegal in general)

(hope thats understandable)

[shruman]

"It's not. From what I know of this program it is limited to people who have tried all the other treatment options & had no success. The point isn't to get them off drugs - there are other programs for that - The point is to let them live their life in the least disruptive way possible. Which is why I mentioned the lack of side-effects from opiates in my last post."

I think I missed that point the article is a little confusing.

"Methadone is synthetic heroin substitute and is the tried and trusted route for heroin addicts trying to kick the habit."

I think for them to live there lives in the least disruptive way or for that matter have any real life at all addiction has to b dealt with

" if addicts have a gov't subsidised prescription they don't need to sell their mum's DVD player to buy their drugs, right?"

If they stick to the program yeah, there are always going to b some that will abuse the progam & continue crime.

"If they know exactly how strong each dose is, they're much less likely to OD & traumatise the housemates."

Yes their probly less likely but a dose thats tolerated 2day has the potential to kill 2morrow with opiates. Not sure wot u mean by traumitise their housemates, do u mean the trauma of losing a housemate to addiction?

"And what kind of depression are you talking about? Respiratory or mental? If it's mental, then again, that's mainly a problem caused by them feeling guilty about the problems their illegal addiction has caused, like them stealing from their friends or drooling on the family Xmas cake or whatever."

I was talking bout mental but respiratory is a good point too & they will still drool in the Xmas cake wether they can get opiates legaly & maintaining a relationship with an addict is difficult regardless wether their stealing from u or not . Other long term side effects of opiate abuse include:

-Abscesses

-Collapsed veins

-Bacterial infections

-Infection of heart lining and valves

-Arthritis and other rheumatologic problems

-Infectious diseases, for example, HIV/AIDS and hepatitis B and C

-Suicide

-O.D

"I didn't say it was easy - just that it was a lot easier than opiate withdrawals as there is almost no physical component to amphetamine WDs. So if they can get around the mental side & make the decision to quit, ice addicts might feel a bit shirty & tired for a few days. Whereas opiate addicts have the joys of simultaneous anxiety & depression, muscle aches/tremors/weakness, joint pain, severe diarrhea, goosebumps, cold sweats, loss of appetite, loss of attention span, and so on. Oh, did I mention the insomnia? - imagine having all those things going on - basically combine your worst stimulant OD/come-down with your worst muscle pains/weakness from the flu, then multiply it by 10 or 20, and then imagine suffering through all that for a week or two, during which you can't sleep AT ALL for at least the first 3 days. "

I agree Heroin addiction withdrawals are terrible I just dont think they are the biggest part of combating heroin addiction or any addiction the mental side of addiction seems like the hardest thing to combat which I believe is for the most part the same for all drugs. Oh & I dont have to imagine anxiety, depression, & insomnia unforunately I know them quite well.

"If you could buy a cure for the flu for $50, wouldn't you do it & get back to work rather than suffer for a week?"

Im not sure I understand ur analogy here if ur comparing this program to a flu cure u would have the flu for the rest of ur life, I dont see how a heroin addict can maintain a job espescialy if their drooling on their desk.

" This is what opiate maintenance programs are about - just letting addicts get on with their lives. As I mentioned in the last post, I don't think this is a good idea for amphetamines because they aren't safe to take regularly (in recreational doses, at any rate ). "

I realy dont think addicts have much of a life their life revolves around their addiction. I dont think its safe to take any drug regularly (in recreational doses, at any rate).

"Id also like to say that it is very disappointing that done is the only option for most and has proved to be much harder to kick than H (hydrocodone, kratom should be viable options but arent!) But by removing needles from opiate addiction would also remove the major heatlh risk factor. "

I agree Blue lotus or apomorphine should also b an option.

Naltrexone is a wonder drug that should also get more attention but with any of these methods I think pschological counseling is the real key.

Edited May 4, 2007 by shruman

[Hagakure]

"-Abscesses

-Collapsed veins

-Bacterial infections

-Infection of heart lining and valves

-Arthritis and other rheumatologic problems

-Infectious diseases, for example, HIV/AIDS and hepatitis B and C

-Suicide

-O.D"

most of these go away when a person has clean heroin and syringes.

all infectioins are due to dirty stuff, suicide depends on environment, OD depends on not knowing what you are shooting up.