Heroin

Heroin is an opiate made from morphine (opiates dull pain). Morphine is extracted from the opium poppy. Like many drugs made from opium, including synthetic opioids (e.g. methadone) heroin is a very strong painkillerA-Z Of Drugs, Heroin, FRANK, Accessed 13-January-2009. Ninety percent of Heroin found in the UK is supplied from AfghanistanMark Townsend, Anushka Asthana and Denis Campbell, Heroin UK, The Guardian, 24-December-2006, Accessed 13-January-2009.
==Heroin Related Deaths==
Seventy percent of Heroin related deaths are due to fatal poisoningOliver Morgan, Clare Griffiths and Matthew Hickman, Association between availabitlity of heroin and methadone and fatal poisoning in England and Wales_1994-2004, International Epidemiological Association, Journal of Epidemiology 2006;35:1579–1585 Oxford University Press:Oxford, 2006
Figures from the Office for National Statistics show that deaths from heroin overdoses rose sharply in 2008-09. Figures from St George's hospital in London, a national centre for monitoring substance abuse, also showed a rise with the average age of victims now in the late 30s.
The ONS figures, drawn only from England and Wales, show an 11% overall increase in drug poisonings in 2008 - compared with the previous year – and a total of 2,928 fatalities. Of those, 897 involved heroin or morphine – up 8% on the previous year – and 235 deaths related to cocaine – up 20% on 2007. John Corkery, of St George's hospital, said the average age for drug victims had risen from 32 in 1998 to 37.8 in 2008Owen Bowcott and Adam Gabbatt, Sharp rise in fatal cocaine and heroin overdoses, discloses ONS, The Guardian, 26-August-2009, Accessed 13-January-2010.
==Methodone Addiction Treatment==
According to a 2006 study by the International Epidemiological Association:
*Age-standardized mortality rate for heroin/morphine increased from 5 to 30 per million between 1993 and 2000,subsequently declining to 24 deaths per million in 2004.
*Age-standardized mortality rates involving methadone were similar to heroin until 1997, after which they decreased to just over 1993 levels in 2004.
*During this period the number of methadone prescriptions more than doubled and the death rate per 1000 patient years fell by three quarters.
*The age-standardized rate for heroin/morphine deaths and methadone were strongly associated with law enforcement seizures of these drugsOliver Morgan, Clare Griffiths and Matthew Hickman, Association between availabitlity of heroin and methadone and fatal poisoning in England and Wales_1994-2004, International Epidemiological Association, Journal of Epidemiology 2006;35:1579–1585 Oxford University Press:Oxford, 2006
==Government Policy on Heroin==
===Drug Treatment and Testing Orders===
Drug Treatment and Testing Orders (DTTOs) were introduced as a new community sentence
under the Crime and Disorder Act 1998. They were designed as a response to the growing
evidence of links between problem drug use and persistent acquisitive offending. The order
was originally piloted at three sites – in Croydon, Gloucestershire and Liverpool – over an
18-month period, beginning in late 1998Mike Hough, Anna Clancy, Tim McSweeney and Paul J Turnbull, [The impact of Drug Treatment and Testing Orders on offending: two-year reconviction results http://www.kcl.ac.uk/depsta/law/research/icpr/publications/The%20impact%20of%20drug%20treatment%20and%20testing%20orders,%20r184.pdf], The Home Office, Accessed 18-January-2009.
Nick Davies descrbed the scheme as being built on a foundation of falsehood, he says:
:It was the Home Office minister Paul Boateng who last September announced that courts all over England and Wales would now be allowed to impose DTTOs to compel offenders to undergo treatment for their drug problems. Mr Boateng explained that his decision followed three pilot schemes, in Croydon, Liverpool and Gloucester which had proved to be successful. Among those who took part in the pilots, he said, there had been a 'dramatic' fall in the number of offences they committed and in the amount of money which they spent on drugs. The reality, however, was rather different.
:One of the key questions for these pilots was whether drug users would co-operate with treatment which was being forced upon them. The researchers who were hired to study the three pilots found that, even though the 210 offenders had been handpicked, nearly half of them (46%) vanished or were thrown out of the scheme long before it finished its trial run; numerous others were warned for breaching its conditions; and the researchers found that "failure to meet conditions of the order was common in all three sites". Mr Boateng simply did not mention any of this.
:One of the 'dramatic' results to which Mr Boateng referred was that within a month of being put on the order, offenders had cut their weekly spending on drugs from £400 to only £25. This was, indeed, a dramatic fall, which sat oddly with the conclusion of the researchers that "quite clearly, many offenders in all three pilot sites were continuing to use illegal drugs". It turns out that this supposedly dramatic result was based entirely on untested claims made by those offenders who had not already been thrown off the scheme and who knew that if they were caught taking drugs, they were liable to be sent back to court for a harsher punishment. Furthermore, these offenders who were claiming to have cut their spending on drugs by 94% had been failing urine tests throughout the scheme: they had failed 42% of their heroin tests, 45% of cocaine tests and 58% of methadone tests. In some cases, they were failing more urine tests at the end of the 18-month pilot than they had been at the half-way point. Indeed, their consumption of drugs remained so high that, by the end of the trial, all three schemes had stopped even requiring them to be drug free, asking only that they "make progress in addressing" their drug problems. Mr Boateng did not mention any of this either.
:The other 'dramatic' result on which Mr Boateng relied for his success story was that, within a month, offenders were committing far less crime - only 34 offences a month compared to 137. But this, too, was based on nothing more than asking the offenders who stayed in the scheme whether they had been out thieving. Mr Boateng failed to mention that some of these law-abiding guinea pigs were actually arrested for committing new offences during the pilots. At the end of the 18-month scheme, the researchers could find only 27 of the 210 offenders who "seemed to emerge drug free" - and they were able to come to that conclusion only by a) overlooking the fact that only 13 offenders passed the final urine tests and b)ignoring their use of cannabis. The best that the researchers could say was that the scheme was "promising but not proven."
:However, none of this troubled Mr Boateng. Even though these pilots had been set up explicitly "to enable the Home Office to decide whether or not to extend the order across the country" and even though the results were so equivocal, Mr Boateng went ahead and declared them 'successful' and invested £60 million of tax payers money in rolling them out nationally. He managed to square this with the results of the pilot studies with one brilliantly effective tactic: in a move which left his researchers 'flabbergasted', he simply did not wait to be told the bad news and made his decision months before the results of the research were known. And this really did not matter at all because even if the scheme does fail, its no-nonsense toughness on druggies has been a great success from the political point of viewNick Davies, The politics of the drug war , The Guardian, February 2001.
===Methadone===
===Freedom of Information Secrecy===
In 2008 The Economist reported that:
:Steve Rolles of Transform says the Home Office is still sitting on two reports from last year that it deems too sensitive for releaseJonathan Rosenthal, Hard to Swallow, The Economist, 9-February-2008, Accessed 13-January-2009.
===Law Enforcement===
A 2001 internal Treasury report was reported in the Economist to show failings in the area of law enforcement:
:law enforcement, the most expensive plank of the anti-drugs strategy, things fall apart. Police-intelligence work scores two out of five, as does that of customs officers. At street level it gets worse: cracking down on drug-dealing and drug-related crime rates only one star, whereas action on soft drugs such as cannabis scores none at allJonathan Rosenthal, Hard to Swallow, The Economist, 9-February-2008, Accessed 13-January-2009.
==Black Market Heroin==
Nick Davies gives the following account of Black Market Heroin:
:Heroin, so benign in the hands of doctors, becomes highly dangerous when it is cut by blackmarket dealers - with paracetomol, drain cleaner, sand, sugar, starch, powdered milk, talcum powder, coffee, brick dust, cement dust, gravy powder, face powder or curry powder. None of these adulterants was ever intended to be injected into human veins. Some of them, like drain cleaner, are simply toxic and poison their users. Others - like sand or brick dust - are carried into tiny capillaries and digital blood vessels where they form clots, cutting off the supply of blood to fingers or toes. Very rapidly, venous gangrene sets in, the tissue starts to die, the fingers or toes go black and then have only one destiny - amputation. Needless suffering - inflicted not by heroin, but by its blackmarket adulterantsNick Davies, What's wrong with the war on drugs , The Guardian, February 2001.
:The Oxford Handbook of Clinical Medicine records that a large proportion of the illness experienced by blackmarket heroin addicts is caused by wound infection, septicaemia, and infective endocarditis, all due to unhygienic injection technique. Street users invariably suffer abscesses, some of them of quite terrifying size, from injecting with infected needles or drugs. Those who inject repeatedly into the same veins or arteries will suffer aneurysms - the walls of the artery will weaken and bulge; sometimes they will start to leak blood under the skin; sometimes, these weakened arteries will become infected by a dirty needle and rupture the skin, leaving the user to bleed to deathNick Davies, What's wrong with the war on drugs , The Guardian, February 2001.
:Street buyers buy blind and so they will overdose accidentally: they have no way of telling how much heroin there is in their deal. Dr Russell Newcombe, senior lecturer in addiction studies at John Moores University in Liverpool, has found the purity of street heroin varying from 20% to 90%. "Users can accidentally take three or four times as much as they are planning to," he says. It is peculiarly ironic that governments set out to protect their people from a drug which they claim is dangerous by denying them any of the safeguards and information which they insist must apply to the consumption of drugs which they know to be harmless. (Compare, for example, the mandatory information on the side of a bottle of Vitamin C tablets with the information available to a blackmarket heroin user.)Nick Davies, What's wrong with the war on drugs , The Guardian, February 2001.
===AIDS===
:In the mid 1990s, the World Health Organisation estimated that 40% of recent AIDS cases internationally had been caused by drug users sharing injecting equipment. The British record on AIDS is better because in the late 1980s, the government quietly broke with its prohibition philosophy and started to provide clean needles. Nevertheless, by June last year, one thousand blackmarket drug users in this country had died of AIDS which was believed to have been contracted from dirty needles. More needless misery and deathNick Davies, What's wrong with the war on drugs , The Guardian, February 2001.
===Hepititis C===
:Hepatitis C, which can kill by causing cirrhosis and sometimes cancer in the liver. The official estimate is that 300,000 people in this country are now infected. Dr Tom Waller, who chairs Action on Hepatitis C says the truth is likely to be much worse. And almost all of these victims are blackmarket drug users who contracted the disease by sharing dirty injecting equipment. Dr Waller says there is now a 'major epidemic', threatening the lives of 'a great many people'Nick Davies, What's wrong with the war on drugs , The Guardian, February 2001.
===Organised Crime===
:Research suggests that in England and Wales, a hard core of blackmarket users is responsible for some £1.5 billion worth of burglary, theft and shoplifting each year - they are stealing £3.5 million worth of property a day. As a single example, Brighton police told us they estimate that 75% of their property crime is committed by blackmarket drug users trying to fund their habit. And yet goverments refuse to be tough on the cause of this crime - their own prohibition policy.
:The global version of this damage was put succinctly by Senator Gomez Hurtado, former Colombian ambassador to France and a high court judge, who told a 1993 conference: "Forget about drug deaths and acquisitive crime, about addiction and AIDS. All this pales into insignificance before the prospect facing the liberal societies of the West, like a rabbit in the headlights of an oncoming car. The income of the drug barons is an annual five hundred thousand million dollars, greater than the American defence budget. With this financial muscle they can suborn all the institutions of the state and, if the state resists, with this fortune they can purchase the firepower to outgun it. We are threatened with a return to the Dark Ages of rule by the gang. If the west relishes the yoke of the tyrant and the bully, current drug policies promote that end."Nick Davies, What's wrong with the war on drugs , The Guardian, February 2001.
==The Media==
==Stakeholders==
Transform | Centre for Policy StudiesCentre For Policy Studies argues enforcement must come before harm reduction, Think-tank denounces "phoney war on drugs", The New Statesman, 17-May-2009, Accessed 13-January-2009 | UK Drug Policy Commission
==Resources==
* Nick Davies, What's wrong with the war on drugs , The Guardian, February 2001
* Nick Davies, The politics of the drug war , The Guardian, February 2001
* NHS National Statistics, Statistics on Drug Misuse, England 2009, NHS Website, Accessed 13-January-2009
*Oliver Morgan, Clare Griffiths and Matthew Hickman,Association between availabitlity of heroin and methadone and fatal poisoning in England and Wales_1994-2004, International Epidemiological Association, Journal of Epidemiology 2006;35:1579–1585 Oxford University Press:Oxford, 2006
*Jonathan Rosenthal, Hard to Swallow, The Economist, 9-February-2008, Accessed 13-January-2009
==Notes==
Category:Addictions