Heroin is 'easier to get in jail'

RECOVERING heroin addicts who are sorting their lives out with help from a Burton drug centre say “scoring is easier in prison than on the streets”.

Mike Trace, who leads a charity which runs drug rehabilitation programmes in prisons, has claimed that the Ministry of Justice and the Department of Health are “fighting each other about who runs treatment in prisons”.

He said last year a record 20,000 English prisoners were prescribed the addictive heroin alternative of methadone instead of being encouraged to become drug free.

The Mail interviewed a group of recovering heroin addicts who were all telling a similar story — that there is ‘no help at all' in jails and that methadone is the only answer.

Philip Brown, 37, who served 12 years in prison, said giving inmates methadone was throwing a blanket over the problem.

He said: “All the years I have spent inside I have never been offered treatment. Prisoners are given methadone which is more addictive and it is a way of controlling people.

It's a controlling tactic. More people become hooked inside than out.” Methadone can be effective with helping heroin addicts beat addiction but critics dispute that drug services use it as a troublefree alternative and are not determined enough in getting users drug-free.

Andrew Whalley, 46, who was recently released after spending 10 years behind bars for a drug-related robbery with a firearm, said: “The only help I've ever been offered is a safer injecting course.

“For nine out of my 10 years in prison I was using drugs every day. Prison sometimes saved my life — it's free methadone, clothes, a bed, food.

“If you give an inmate free methadone and keep their addiction active, then discharge them from prison, then surely when they come out they've got to commit crime.

Prisons contradict themselves.” Meanwhile, Darren Holt, 36, who has served 19 years for drug-related offences, said: “I originally became a heroin addict in prison. My last five-year sentence I told prison medical staff I wanted to get clean but they refused to listen. I was so desperate to get off the methadone they were giving me I detoxed myself in the end.”

Noreen Oliver, the founder of Burton Addiction Centre, who has been through treatment for alcohol dependency in the past, said: “The interest in drug treatment affects families, individuals and the community. We need a balanced system rather than methadone being the preferred treatment in prisons.

“The majority of the 60,000 population that use drugs in prison are repeat offenders. “In total 850 prisoners out of 60,000, are only given the chance to become clean — it's shocking.” 10.12.09

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Hooked on happy pills: Internal bleeding. Strokes. Birth defects. The long term effects of antidepressants are terrifying

Just a few years ago, Yasmin Miller would have been horrified by the suggestion she might take antidepressants for the rest of her life. But today, the 37-year-old can barely imagine a future without this daily chemical boost. Yasmin's 'perfect' life as a corporate tax adviser was shattered when, in 2003, she developed severe depression. Although incapacitated by the illness, she needed convincing that a pill could make a difference.

'I was gobsmacked when my GP suggested antidepressants, because I thought they were addictive,' she recalls. 'But now I've changed my mind: depression is just like epilepsy or diabetes or any other illness where you need to take a daily pill for life in order to stay healthy.' Just 20 years after the launch of the 'sunshine drug' Prozac, Yasmin is one of hundreds of thousands of young women who can't imagine life without antidepressants.

But some experts are warning of disturbing parallels with the 'mother's little helper' scandal of the Seventies and Eighties, when thousands of women became addicted to widely prescribed tranquillisers, including Valium. Antidepressants are meant to be taken for nine months for a first episode and for a maximum of two years for those experiencing further depression, under guidelines set out by the National Institute for Clinical Excellence (NICE).

However, new research from the University of Southampton has found that at least 15 per cent of women under 45 - around one million women - are prescribed antidepressants every year, and a substantial number continue to take them far beyond this recommended time limit.

'We estimate more than two million people are taking antidepressants for more than five years and the largest group are women aged 18 to 45,' says lead researcher Tony Kendrick, professor of general practice at Southampton University. 'Many young women today are picking up repeat prescriptions for months and years apparently without any checks - in many cases these are women who want to stop but can't.

Even those who make a deliberate choice to stay on the medication long-term may not be aware of the dangers, not least the risk of missing out on the normal ups and downs of ordinary life.' Doctors still routinely reassure patients that the side-effects of antidepressants are largely mild and short term - these include drowsiness, dizziness and weight gain that become obvious in the first few weeks and can normally be reversed by trying another type of pill.

Yet there is growing evidence that long-term use is linked to more serious health problems including bleeding in the gut, low sodium levels in the elderly (which can lead to falls) and increased risk of stroke.

Recently it's been claimed that some antidepressants may increase the risk of rare birth defects - with a U.S. mother awarded £ 1.6million damages last year after a court decided that antidepressant medication was responsible for her three-year-old son's heart defects. At the same time, there is a continuing controversy over their effectiveness. The latest major investigation, published last week in the Journal Of The American Medical Association, reported that medication has 'negligible' impact except in cases of very severe depression. Yet with depression now a leading cause of disability in the under-45s in the UK, there's little sign the medical profession is exercising caution.

Prescriptions for antidepressants have increased dramatically, from nine million to 34 million, over the past 15 years. This increase is largely explained by an unprecedented growth in the number of people staying on them for several years, according to new research in the British Medical Journal. Depression is far more common in women - one in four suffers from it at some point in her life, compared with one in ten men.

'Women of child-bearing age are the most disadvantaged in society due to a combination of being responsible for children and elderly relatives alongside the pressure of work, while also suffering hormone fluctuation,' explains Professor Kendrick. 'It's inevitable, therefore, that they will suffer higher than average rates of depression. But that makes it all the more important that they are not embarking on treatment that may be highly risky. 'It is imperative to look at whether so many young women should be on these drugs for so long - and whether they are coming to harm.'

Yasmin certainly had reservations-before she started taking antidepressants, but her depression was so severe that she felt she had no choice. 'I was struggling with rock-bottom self-esteem and motivation, and I'd become tearful at the slightest problem,' she recalls. When she went to her GP, he immediately suggested antidepressants.

There is a dizzying range of these drugs, from the early tricyclic drugs to the more commonly prescribed Prozac- style SSRIs (selective serotonin re-uptake inhibitors). All work in different ways to increase the activity of feelgood chemicals in the brain to raise mood.

At first, it looked as though Yasmin was going to be one of the 20 per cent of patients who don't respond to medication. And it wasn't until the summer of 2007 - after more than three years of trying different drugs - that she finally found an effective one, an MAOI (monoamine oxidase inhibitor), one of the oldest, that has largely fallen out of use because it can cause side-effects. 'After just four or five weeks, I realised it was days since I'd broken down in tears for no reason at all. And I had no adverse effects, either.'

As the months passed, she started a new job at the Learning And Skills Council and was socialising. 'After so many years of severe depression, it was such a relief,' she says. Yet after two years, personal problems led to renewed depressive symptoms. 'I pretended all was well, fearing to admit to the doctor that I was ill again - so silly because when I finally went, the psychiatrist helped me back to health by adding two more drugs, a tricyclic antidepressant as well as folic acid, which in certain doses is known to have an antidepressant effect '

Yasmin says that while it would be good to feel she could cope without medication, she is content to keep taking antidepressants for the rest of her life. But for those who don't want to, or who find the side-effects unacceptable, coming off them can prove a terrible trial.

'Although these drugs are not addictive in the sense that someone would steal to pay for another dose, there do seem to be a large number of patients who are taking them against their will because of severe and unpleasant withdrawal symptoms when they try to stop,' says Professor Kendrick.

Around 500 people are suing GlaxoSmithKline on the grounds that the company concealed evidencethat their drug Seroxat (a selective serotonin re-uptake inhibitor) may cause withdrawal ‘syndrome' with symptoms including anxiety, pain, palpitations and memory lapses.

‘Doctors are simply unaware of this withdrawal syndrome and unable to advise on what to do,' says Janice Simmons, co-ordinator of the Seroxat User Group.  Her husband John is one of the worst affected — she says each time he's tried to stop taking it, the symptoms have been so severe he's had to give up; he's been taking Seroxat for 19 years.

There are ways of tapering withdrawal - for instance, using a liquid dose of medication which can be gradually reduced far more easily than a tablet and which can normally be prescribed by GPs.

'The problem is most people haven't a clue how to access advice on withdrawal,' says David Healy, professor of psychological medicine at Cardiff University, whose protocol on the withdrawal of SSRIs is widely regarded as the best method of stopping the medication. 'GPs are rarely informed - and the pharmaceutical companies are unwilling to even admit that there is a problem.'

Yet he also warns that even tapered withdrawal can be unsuccessful. 'The pharmaceutical industry should be spending money to develop tests that identify people likely to face these problems,' he says. 'Young women in particular should not have to face a lifetime on drugs without understanding the risks.'

One of those who's struggled with giving up the drugs is Kate, a student who was first prescribed the tricyclic antidepressant imipramine when she was 14, after developing depression following a tonsillectomy. 'The pills gave me a new lease of energy as well as ending my feelings of hopelessness and anxiety,' she recalls. A year later, she decided she was better and simply stopped the medication - 'a huge mistake, because I descended into a kind of hell and tried to kill myself, I was so low'.

Now 27, she's tried to stop the drug three times, most recently in April last year. 'By then I'd trained as a mental health worker and also got married - and I desperately wanted to find out whether I could manage without the medication. 'My doctor knew I was withdrawing, but I handled it myself. I felt confident that I understood how to deal with any problems and I also had the support of my family, especially my husband.'

Six months later, Kate admits that she's still not out of the woods. 'In the weeks after stopping the medication, I experienced painful limbs, headache, sweats and crying - very difficult to bear when you know that just taking one pill will end the suffering. 'If I don't feel better soon, I'm ready to go back on the medication to stop the symptoms.'

Of course, there is a role for medication. Under NICE guidelines, the optimum treatment for depression is a combination of medication and talking therapies including counselling and cognitive behavioural therapy (CBT).

However, an estimated nine out of ten people who go to their GP with depression are prescribed antidepressants - a far higher rate than are offered talking therapies.

Indeed, studies by five mental health charities have recently shown that depressed patients wait for six to 18 months to get an appointment with an NHS counsellor, with many forced to go private. 'It worries me that with a shortage of talking therapies, GPs may feel they have little to offer in the way of alternatives to antidepressants,' says Professor Kendrick.

This should change with the Department of Health investing £300million in training thousands of new practitioners, aimed at offering talking therapies to 900,000 more people by 2011. The move has been welcomed by support groups such as the charity Rethink. 'All young women with depression should be offered psychological therapies,' says Rethink's deputy director Jane Harris.

Yet users themselves too often fail to fit neat solutions to depression. Kate tried meditation - which has been shown to help those with severe depression - without success. Yasmin's experience of talking therapies has been decidedly negative. 'I can't make myself choose to believe the glass half-full option,' she says. 'On the other hand, I find I can believe in a drug that adjusts the chemical balance in my brain.'

Despite the problems, antidepressant medication continues to be viewed as a powerful tool in fighting the insidious pain and disability of depression.

Dr Paul Blenkiron, consultant psychiatrist at Bootham Park Hospital, York, says: 'As long as people are not suffering unpleasant side-effects, I am not convinced that the long-term risks of the medication outweigh the benefits. And while I am strongly in favour of talking therapies, the fact remains that they are often not right or not enough, particularly for people with severe depression.'

Paul Farmer, chief executive of the mental health charity Mind, dismisses any attempt to compare 'tranquillisers which sedate the individual and antidepressants which are very much a treatment to make someone better, where the right drug in the right dose can help people to manage their symptoms and get on with their lives'. But even Yasmin admits that a part of her would love to ditch the daily pill.

'Of course, there's the risk that drugs blunt the good feelings as well as the sharpness of the lows. I had a car crash recently and I didn't feel anything - and I wondered if I should have. In the long run, though, I'd rather miss out on a few highs than experience the hell of deep depression.' 12.1.10

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Antidepressants Under Scrutiny Over Efficacy

The effectiveness of a dozen popular antidepressants has been exaggerated by selective publication of favorable results, according to a review of unpublished data submitted to the Food and Drug Administration.

As a result, doctors and patients are getting a distorted view of how well blockbuster antidepressants like Wyeth 's Effexor and Pfizer Inc.'s Zoloft and most others really work, researchers asserted in this week's New England Journal of Medicine.

Since the overwhelming amount of 'published data' on the drugs show they are effective, doctors unaware of the unpublished data are making inappropriate prescribing decisions that aren't in the best interest of their patients, according to researchers led by Erick Turner, a psychiatrist at Oregon Health & Science University. Sales of antidepressants total about $21 billion a year, according to IMS Health.

Wyeth and Pfizer declined to comment on the study results. Both companies said they had committed to disclose all study results, although not necessarily in medical journals. GlaxoSmithKline PLC, maker of Wellbutrin and Paxil, said it has posted the results of more than 3,000 trials involving 82 medications on its Web site, and also has filed information on 1,060 continuing trials at a federal government Web site.

Schering-Plough Corp, whose Organon Corp. unit markets Remeron, and Eli Lilly & Co, which makes Prozac, said their study results were indeed published -- not individually, but as part of larger medical articles that combined data from more than one study at a time. The New England Journal study counted a clinical trial as published only if it was the sole subject of an article. "Lilly has a policy that we disclose and publish all the results from our clinical trials, regardless of the outcomes from them," a Lilly spokeswoman said.

Pharmaceutical companies are under no obligation to publish the studies they sponsor and submit to the FDA, nor are the researchers they hire to do the work. The researchers publishing in the New England Journal were able to identify unpublished studies by obtaining and comparing documents filed by the companies with the FDA against databases of medical publications.

"There is no effort on the part of the FDA to withhold or to not post drug review documents," an FDA representative said. For newer drugs, information is posted online "as soon as possible." Older documents aren't always available online and efforts to add those files to the Web are slowed by "a lack of resources," the agency said, acknowledging that there is a backlog in complying with records requests.

Dirty Tricks
A total of 74 studies involving a dozen antidepressants and 12,564 patients were registered with the FDA from 1987 through 2004. The FDA considered 38 of the studies to be positive. All but one of those studies was published, the researchers said. The other 36 were found to have negative or questionable results by the FDA. Most of those studies -- 22 out of 36 -- weren't published, the researchers found. Of the 14 that were published, the researchers said at least 11 of those studies mischaracterized the results and presented a negative study as positive.

Five Trials
For example, Pfizer submitted five trials on its drug Zoloft to the FDA, the study says. The drug seemed to work better than the placebo in two of them. In three other trials, the placebo did just as well at reducing indications of depression. Only the two favorable trials were published, researchers found, and Pfizer discusses only the positive results in Zoloft's literature for doctors.

One way of turning the study results upside down is to ignore a negative finding for the "primary outcome" -- the main question the study was designed to answer -- and highlight a positive secondary outcome. In nine of the negative studies that were published, the authors simply omitted any mention of the primary outcome, the researchers said.

The resulting publication bias threatens to skew the medical professional's understanding of how effective a drug is for a particular condition, the researchers say. This is particularly significant as the growing movement toward "evidence-based medicine" depends on analysis of published studies to make treatment decisions.

Colleagues' Questions
Dr. Turner, who once worked at the FDA reviewing data on psychotropic drugs, said the idea for the study was triggered in part by colleagues who questioned the need for further clinical drug trials looking at the effectiveness of antidepressants. "There is a view that these drugs are effective all the time," he said. "I would say they only work 40% to 50% of the time," based on his reviews of the research at the FDA, "and they would say, 'What are you talking about? I have never seen a negative study.'" Dr. Turner, said he knew from his time with the agency that there were negative studies that hadn't been published.

The suppression of negative studies isn't a new concern. The tobacco industry was accused of sitting on research that showed nicotine was addictive, for instance. The issue has come up before notably with antidepressants: In 2004, the New York state attorney general sued GlaxoSmithKline for alleged fraud, saying it suppressed studies showing that the antidepressant Paxil was no better than a placebo in treating depression in children. Glaxo denied the charge and eventually settled with the attorney general. The company later posted on its Web site the full reports of all of the studies of Paxil in children.

But publication of negative studies is an issue that cuts across all medical specialties. And it has engendered some strong reactions in the medical-research world: To make it harder to conceal negative study findings, an association of medical journal editors began requiring in 2005 that clinical trials be publicly disclosed at the outset to be considered for publication later. The system isn't foolproof, since manufacturers often run exploratory studies without registering them and can selectively disclose favorable results. The rule only applies to studies intended for publication in a medical journal.

Some studies that don't eventually get published are registered with online trial registries, including the government's www.clinicaltrials.gov. Nonetheless, many studies still aren't being registered or reported, says Kay Dickersin, the director of the Center for Clinical Trials at the Johns Hopkins Bloomberg School of Public Health. "We need something more meaningful," she said. "The average person has no idea that www.clinicaltrials.gov is not comprehensive."

The FDA does post information, including unpublished studies, for some drugs on its Web site, says Dr. Turner. But information that hasn't yet made it online is hard to come by. Dr. Turner said he made public records requests for information not on the Web site more than a year ago, but the requests have gone largely unfulfilled. He said he was able to get some of the FDA's information on unpublished studies from other researchers who acquired it from the agency through their own record requests.

The 'Effect Size'
In this week's study, the researchers found that failing to publish negative findings inflated the reported effectiveness of all 12 of the antidepressants studied, which were approved between 1987 and 2004. The researchers used a measurement called effect size. The larger the effect size, the greater the impact of a treatment. The average effect size of the antidepressant Zoloft rose 64% by the failure to publish negative or questionable data on the drug, the researchers found.

One leading expert said ‘Clinical data, evidence based and scientifically proven all mean very little in reality, what really counts is how drugs perform in the real world and to establish that we have to listen to the people who use them'. 17.01.08

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Alcohol and cigarettes are more harmful than Ecstasy and LSD, says drugs tsar

Ecstasy, LSD and cannabis are less dangerous than alcohol and cigarettes, the Government's chief drug adviser claims today. Professor David Nutt is calling for a new ‘index of harm' to warn the public about the relative dangers of various substances. He says alcohol should rank fifth, behind only cocaine, heroin, barbiturates and methadone, while tobacco should rank ninth, ahead of cannabis, LSD and Ecstasy.

His comments are likely to prove explosive, given the seniority of his position. Professor Nutt has also courted controversy in the past - by suggesting taking ecstasy was no more dangerous than riding a horse. But, defending his position, Professor Nutt says: 'I think we have to accept young people like to experiment – with drugs and other potentially harmful activities – and what we should be doing in all of this is to protect them from harm at this stage of their lives. 'We therefore have to provide more accurate and credible information. If you think that scaring kids will stop them using, you're probably wrong.'

In a wide-ranging article for the Centre for Crime and Justice Studies, the scientist - who resisted the reclassification of cannabis from C to B - accused - claimed that smoking the drug created only a 'relatively small risk' of psychotic illness. He accused former home secretary Jacqui Smith, who regraded the drug amid widespread concerns about the harmful effects of super-strength skunk - of 'distorting and devaluing' scientific research.

And he attacked what he called the 'artificial' separation of alcohol and tobacco from other, illegal, drugs. Professor Nutt contends that, by ranking alcohol and smoking alongside the abuse of illegal drugs, the public will be better informed of the risks they are taking. He said drug classification based on  research evidence would ‘be a powerful educational tool'. Basing classification on the desire 'to give messages other than those relating to relative harms does great damager to the educational message', he clams.

The comments are certain to provoke a backlash from anti-drug campaigners. They also raise the possibility of the current drug classification system - which puts banned substances into A, B and C categories - being ripped-up. Earlier this year, Professor Nutt earned a rebuke from the Government for suggesting that taking ecstasy was 'no worse than riding a horse'.

Ex-home secretary Jacqui Smith accused the scientist of 'trivialising' the dangers of drugs and showing 'insensitivity to the families of victims' of ecstasy. She instructed him to make apologise to the families of those who had been killed by the dance drug.

But, within days of the row erupting, his ACMD recommended Ecstasy should be  downgraded from Class A to B. The proposal was rejected outright by the Government. A second proposal to give out kits to allow users to test their tablets in advance for purity and strength was also thrown out by the Home Office.

But Prof Nutt remains adamant that 'I think there's very little doubt  that we, the scientists, won the intellectual argument'. In today's paper, he also describes the media's reaction to his horse riding remark as 'extreme'. He is unlikely to find favour with his latest comments. The idea of re-opening the thorny debate about drug classification in the run-up to a General Election will not be embraced by either Labour or the Tories.

But Richard Garside, director of the CCJS, based at King's College London, said, 'Professor Nutt's briefing gives us an insight into what drugs policy might look like if it was based on the research evidence, rather than political posturing and moralistic positioning.' Professor Nutt is chair of  Neuropsychopharmacology at Imperial College London and heads up the  Psychopharmacology Unit at the University of Bristol.

One fact is very clear, drugs are less harmful as far more people die from alcohol and cigarette related illnesses than through drug use. 29.10.09

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Addicted to methadone? - 2009 Drug Statistics

Old habits die hard. The latest figures on drug treatment in England show that despite calls for services to be "more ambitious", despite a new drugs strategy stressing the importance of helping users get clean, the proportion of addicts getting into rehab is stuck at just 2%.

Out of 207,000 problem drug users who were in treatment last year, the official data show that just 4,600 managed to access a residential rehab bed. Meanwhile, the number of heroin users in England prescribed methadone and other substitute drugs has gone up to a record 147,500.

Let me remind you what the National Treatment' Agency's Paul Hayes wrote last November:

"The problem with methadone (the standard treatment for opiate addiction) is not that it doesn't work, but that it works too well. Stability, improved health and reduced crime are necessary steps on the road to recovery and a drug-free life, but not the destination. We need to balance the risk of relapse if people attempt abstinence, against the risk of inappropriately thwarting their ambition to become drug-free."

In arguing that "too often the system is not ambitious enough", Mr Hayes was signalling a change of direction in drugs policy. A philosophy of harm-reduction had seen tens of thousands of heroin addicts effectively parked on methadone for years. Government ministers, embarrassed by my revelations that only a handful of addicts leave treatment drug-free each year, demanded a shift from "maintenance" to "recovery".

So today's statistics will be a real disappointment. The agency wrote to me earlier this week to say that the latest figures "have given us cause for concern as they still show residential rehab not growing at the rate we would expect it to". Now I know why.

The NTA estimates that the treatment system currently has the capacity to provide residential treatment for around 17,300 people a year and, even accepting that the 4,600 users identified today is an under-estimate, it is clear that there are far too many empty beds.

Earlier this week I went to one reputable rehab centre in South London where managers told me they were operating at around 50% capacity. Half the rooms were unoccupied even though there were hundreds of people locally trying to get into the unit. Manager Dave Heywood was particularly incensed that drug teams were not referring addicts because the National Treatment Agency had just spent thousands refurbishing the centre and equipping a new fitness room. He asks: "Would you spend £10,000 redecorating your house and then walk away and leave it empty for six months?"

Nearby I met Mark Dennison, a 44-year-old homeless man who has used heroin for 25 years. He was caught shop-lifting at the beginning of this year and the court gave him a Drug Rehabilitation Requirement Order - basically he had to get treatment or he could be sent to jail. So, Mark spent 12 weeks straightening himself out on methadone, he then went through six weeks of detox. The next step should have been rehab but he didn't get the funding. The consequence was entirely predictable.

"I ended up going back onto heroin. I didn't have anywhere to live and they expected me to go back onto the street, homeless and not take drugs. I'd done all that work and it just seemed ridiculous. It's obvious what's going to happen. And you don't even see the people it goes up in front of, a board which you have no contact with. We appealed it three times. They refused me three times."

Faced with a heroin user like Mark, drug workers have to make a calculation. Residential rehab typically costs between £500 and £1500 a week. Methadone, in contrast, costs virtually pennies. Many addicts won't manage intensive rehabilitation and end up using again.

But methadone is an addictive drug itself and there are real risks. Last year 378 people died from an overdose of methadone. One person every single day. The death toll was 16% higher than the year before and 73% more than in 2004 (Deaths related to drug poisoning in England and Wales).

When it comes to making the choice, drug workers tend to go for the cheaper option, as today's figures show.

The consequence is that only a small proportion of people using treatment services end up clean.

The phrase "no drug use" in the top line means that clients are free from substitute drugs as well as their "drug of dependency" so, while numbers are increasing, this chart is hardly a cue for celebration. Just under 9,000 people out of a total of 207,500 in treatment emerged drug free last year. That is 4.3%.

Quite rightly, the National Treatment Agency will argue that drug addiction is a chronic condition and users are likely to need a few goes at giving up. Just as smokers may quit many times, so might a heroin addict.

And there is some cause for optimism in today's statistics - fewer young people are coming into treatment for heroin and Paul Hayes feels confident enough to claim that "we may have passed the high-water mark for heroin addiction in this country".

But, but, but. More mature heroin and crack addicts are entering the system than ever - 24,000 last year - and if we want to help them get off drugs completely can we be satisfied with a half-a-billion pounds a year system that only managed to get 9,000 people clean? 8.10.09

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Drug abuse costs Scottish taxpayers £3.5 billion per year

Drug abuse is costing Scottish taxpayers £3.5 billion per year according to a new estimate of the burden on the NHS, criminal justice system and wider society. The figures suggest more than 55,000 Scots take drugs, almost 4,000 more than the total three years previously, and they spend £1.4 billion per year feeding their habits.

SNP ministers promised action to reduce addicts' waiting times for drug treatment, but Opposition parties claimed budgets for rehabilitation services are being cut next year. According to the new estimates, more than £180 million per year is spent by the NHS treating addicts and prescribing substances such as the heroin substitute methadone.

The annual cost of drug-related crime is about £610 million, including £190 million of frauds and forgeries, £120 million of thefts from homes and more than £50 million of goods shoplifted.

Care costs, such as employing social workers to look after addicts and their families, amount to £112 million and the estimated loss to the economy attributed to drug users not working is £819 million.

Meanwhile the economic cost of “the emotional and physical pain” endured by addicts, their relatives and friends is put at more than £1.7 billion. On average, problem drug users are estimated to cost the public purse an average of more than £60,000 each per year.

The figures estimate 1.6 per cent of Scots aged between 15 and 64 fall into this category, but this figure increases to 2.5 per cent in the health board area covering Greater Glasgow and Clyde.

About 24,000 Scots are said to be injecting drugs, 0.7 per cent of the total population, an increase of 30 per cent over three years. Seven out of ten problem users are men.

The findings derive from two new reports, commissioned by Scottish ministers and health officials, which analyse data from 2006. David Liddell, director of Scottish Drugs Forum, said: “The figures comes as no surprise and confirm largely what we already know, that Scotland continues to have one of the highest prevalence rates of problematic drug use in Europe.”

Fergus Ewing, the SNP's community safety minister, said: “While progress is being made, it is unacceptable that some people are still having to wait months to get the help they seek. “That is why we are working closely with our partners to develop a waiting times target for services, to improve access to appropriate treatment to promote recovery from addiction.”

But Labour said the SNP's draft spending plans for 2010-11 showed funding for tackling drugs misuse is falling by £200,000 next year, and the community justice services budget is £700,000 less.

Richard Baker, Scottish Labour justice spokesman, said: “These figures are quite simply shocking and it is becoming increasingly clear the SNP are simply not taking action against drug abuse.” Robert Brown, Scottish Liberal Democrat justice spokesman, said the £3.5 billion burden was more than a quarter of the Executive's health budget and nearly three times the justice budget.

Meanwhile, it was revealed drugs with a street value of £6.8 million have been seized by police during a month-long crackdown on organised crime gangs. Strathclyde Police have also recovered £150,000 in cash and arrested 51 people with alleged links to organised crime. 6.10.09

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Injecting drug users rise by 30%

The number of injecting drug users in Scotland is continuing to increase, according to the latest figures. A study by Glasgow University estimated that in 2006, 23,933 people in Scotland were injecting drugs, representing about a 30% rise on estimates for 2003.

Another report estimated that the value of the illicit drugs market in Scotland was £1.4bn, while the economic and social cost was estimated at £3.5bn. Ministers said the figures highlighted why the new drugs strategy was needed.

The new official estimates suggest there are more than 55,000 problem drug users in Scotland , including those being prescribed the heroin substitute methadone. While this figure is in line with previous estimates, the number of people injecting has jumped about 30% since the last time this type of data was compiled, for 2003.The problem is worst in Glasgow where one in every 75 people between the ages of 16 and 64 inject.

West Dunbartonshire , Inverclyde and Dundee also report high levels of injecting, and significant rises since the previous estimates. Meanwhile, another report has for the first time estimated the total value and cost of the illegal drugs market in Scotland. It suggested that heroin holds the largest share of a market worth £1.4bn, at 39%, while cannabis holds the second largest share at 19%.

The total economic and social cost of illicit drug use is estimated at £3.5bn, with problem drug use accounting for 96% of the total costs. The costs are based on five areas; health, criminal justice, social care, costs to the economy and the wider costs to society.

'Working closely'
Communities Minister, Fergus Ewing, said the figures underlined the need for a new approach. "While progress is being made, it is unacceptable that some people are still having to wait months to get the help they seek," he said. "That is why we are working closely with our partners to develop a waiting times target for services, to improve access to appropriate treatment to promote recovery from addiction.

"We have also increased our funding to NHS boards for drug treatment services to support work to tackle waiting times." He said spending on drug treatment services would be 18% higher this year than three years ago.

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Cocaine 'vaccine' could combat addiction – but unlikely

An experimental vaccine against cocaine addiction could be used to wean users off the drug, research has shown. In a US trial of the vaccine around 40 per cent of treated individuals were protected, but only for two months. Many stopped taking cocaine or reduced their consumption after having the jab. Previous research has shown that immune system antibodies can deactivate cocaine before the drug enters the brain.

The new 24-week study involved 115 cocaine-dependent addicts, 58 of whom were randomly assigned to receive five vaccination jabs over three months. The other participants received ''dummy'' placebo injections. Random tests were carried out for signs of cocaine in the addicts' urine.

Of the 55 participants (60 people or 53% dropped out) who completed the course of active treatment, 38% (20 people) attained high enough blood antibody levels to combat cocaine dependency.

Urine tests between weeks nine and 16 of the study indicated that 45% (9 people) of this group had stopped taking cocaine, compared with 35% (7 people) of those given the placebo. Critcs said ' the vaccine worked for 2 more people than in the placebo group, it's hardly an effective vaccine'.

The proportion of participants who reduced their cocaine use by half was significantly greater among those successfully treated with the active vaccine. More than half of the addicts (10 people) with high antibody levels fell into this category but only 23% of the placebo group.

Side effects of the vaccine were mild or moderate, the most frequent being hardening and tenderness of the skin at the injection site. No serious adverse events, withdrawals or deaths occurred.

Because of the short amount of time the anti-cocaine antibodies remained in the blood, a number of vaccine treatments would be needed to break the drug habit, said the scientists.

The research, led by Dr Bridget Martell, from the Yale University School of Medicine in New Haven, Connecticut, is reported in the journal Archives of General Psychiatry.

The authors wrote: ''Optimal treatment will likely require repeated booster vaccinations to maintain appropriate antibody levels. Furthermore, efforts will be needed to retain subjects during the initial series of injections since antibody levels increased slowly over the first three months when patients were immunised according to the protocol used in these studies.

''Other treatments need to be used during this early treatment period to encourage abstinence. As an example, to retain subjects in this study during the initial slow increase in antibody responses, we enlisted cocaine-dependent subjects who were enrolled in a methadone maintenance programme.'' 'Giving people who use cocaine a methadone prescription is pure madness' said one expert, the vaccine is clearly useless'.

They added: ''The goals for future vaccine development will be to increase the proportion of subjects who can attain the desired antibody levels and to extend these periods of abstinence through long-term maintenance of these adequate antibody levels. We look forward to extending our promising findings in a broader population of cocaine abusers as we also reach for these future vaccine development goals.'' 6.10.09

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Shock - 'Addicts offend to get rehab', says Amy Winehouse's father

Crime let users jump the queue
Users must wait year for treatment, committee told

Drug addicts desperate to kick the habit are forced to commit criminal offences to get a place in rehab, the father of singer Amy Winehouse told MPs today.

Mitch Winehouse, who is making a documentary on drug use, was giving evidence to the home affairs select committee on the cocaine trade. He said drug users struggling to get clean had to wait at least a year for treatment while addicts committing other crimes were often given places in residential rehabilitation centres.

Amy Winehouse has struggled with drink and drug problems in recent years. The singer of songs such as Rehab recently returned to live performing after an eight-month stay in the Caribbean and her divorce from husband Blake Fielder-Civil in July. Her father said he had heard stories of people trying to steal their way into rehab after finding themselves unable to get treatment through the normal channels.

"Anecdotally, people are definitely committing offences so they can have a chance, and it's only a chance, of receiving treatment," he said. "The biggest impact on families is that there is very little help available to them, especially if their relative is a non-offending addict. "Their first port of call will be the GP and then they will refer them on to the local health authority.

"The problem that we have found in our research in London is that there is a period of a year before any treatment can be given. It's very difficult, and the reason for this is the majority of funding is taken up by the criminal justice system."

He said that this had happened to his son-in-law – Fielder-Civil – when, as part of a sentence, the judge offered him a period in residential rehab. "So we have a situation where a non-offending addict and his family are looking for help and there are very few resources available to them." However, Winehouse's claims were dismissed by the National Treatment Agency for Substance Misuse (NTA), which is part of the NHS .

It said waiting lists for drug treatment in England had fallen to an average of one week, while 93% of people got the help they needed in three weeks, even when a stay in a residential rehabilitation centre was required. The agency added that, in 2008-09, 207,580 adults in England were treated for drug abuse.

Paul Hayes, the NTA's chief executive, said: "Drug treatment in England has never been more available to members of the public who need it. We think it is important that the public knows that, if they or a family member needs help, they can get it on the NHS."

One expert said 'it shows how bad things are when we have to rely on the parents of celebrities to tell the truth about how bad addiction care is. It's no secret addicts offend to get into treatment as they are desperate. The UK has Europes worst drug and alcohol problems due to treatments being ineffective'.

Earlier, the committee had asked two drug policy experts about the scale of Britain's cocaine problem. Professor Neil McKeganey, from the centre for drug misuse research at Glasgow University, described the rise in the use of cocaine as "very worrying". He said: "In my view, cocaine is one of the most serious threats we are facing. It's not yet on the scale of heroin but it is changing dramatically in terms of misuse."

Asked about the extent to which the behaviour of drug-taking celebrities could be blamed for drug use among the young, he said: "We wouldn't have one of the largest drug problems in Europe if our drug prevention policies had been successful. I think that [celebrity drug use] doesn't help matters, but it doesn't have a substantial impact on young people taking drugs ."

Steve Rolles, head of research at the Transform Drug Policy Foundation, agreed. "It's a red herring and reflects politicians' concerns with tabloid obsessions more than anything else," he said. "There are drug wars in Colombia and we must move on from what Amy Winehouse does on her weekends." 22.10.09

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Girl, 16, died from heroin overdose despite mother's pleas to social services

The parents of a schoolgirl addicted to heroin pleaded with police and social services for help but they did nothing to save her, an inquest has heard. Deborah and Anthony Walsh desperately sought advice from the authorities after their 16-year-old daughter Kate began taking the Class A drug.

However, they say she fell into a 'grey area' - being too old for children's services and too young for adult care services, which begin at 18. Five days after she was reported missing by her parents, the teenager's body was found by workmen boarding up a squat in a red-light district of Swindon. She had died from a heroin overdose.

Yesterday, a coroner heard how Kate, a popular and talented flautist, started taking drugs after meeting addict Alex Charlamow, 25. As she sank into addiction, she was admitted to hospital twice after overdosing and lived in a series of supported lodgings, squats, as well as spells back at her family home.

Mrs Walsh told the inquest that Kate had kept her relationship with Charlamow, who lived in the Salvation Army-run rehabilitation centre close to her home in Highworth, near Swindon, a secret from her family for more than a year and a half. Mrs Walsh, 45, who gave up her job as a postmistress after her daughter's death, said: 'We didn't find out until she was 16 and by then it was too late.'

Although the rehab centre later kicked out Charlamow after finding out he was in a relationship, Mrs Walsh attacked its staff for not doing more. 'They didn't take steps to find out who it was, and they knew it was a young girl,' she said. 'I feel that the manager really failed.

'He failed Alex because Alex was supposed to be rehabilitated. He failed Kate because she could see Alex and he failed us because we lost our daughter.' Mrs Walsh also revealed her despair after Kate left home on May 3, 2003, to drift in and out of 'supported lodging' houses and squats. She said: 'If a 16-year-old wants to leave home there's nothing you can do. You're not allowed to lock them in the house.'

The inquest at Trowbridge town hall also heard how police failed to act despite having a warrant to enter a house Kate was staying in with other users. Mrs Walsh said: 'We told them Kate was in there taking heroin, but they wouldn't execute the warrant. They just went and knocked on the door. They said: "Your parents have reported you as missing" and that was that. 'They knew she was in there taking heroin but they didn't do anything about it.'

And she told the inquest about a failed 'strategy meeting' set up by Michaela Norton, Kate's social services 'personal adviser'. 'The meeting was to decide what was the best way to help Kate,' Mrs Walsh said. 'But no plan was agreed because Kate turned up and said she'd taken various drugs, so it fell apart. 'It was decided the case wouldn't be placed on the child protection register because Kate had access to all the agencies. It wasn't the right help. It wasn't what Kate needed.'

She said that Kate, who was then shoplifting to fund her £150-a-day drugs habit, should have been put into 'secure accommodation' - similar to being sectioned under the Mental Health Act - instead of the 'supported accommodation' she was offered. After her second overdose in November 2003, Kate said: 'I did it on purpose - I don't want to live.'

Mrs Walsh said she then asked staff at Gloucester Royal Hospital to section her daughter but a psychiatric nurse determined Kate was not suffering from a mental health disorder. Kate was reported missing by her parents for the last time on December 30, 2003. Her body was found on January 3, 2004. The inquest was originally opened that month but has since been delayed because of 'serious illness' to an unspecified party. The inquest continues. 21.10.09

First Six Months Of Treatment For Crack Or Heroin, But Not Both, Has High Rate Of Abstinence

The largest ever study of heroin and crack cocaine treatment in England found that the first six months of treatment results in large proportions of addicts of one or the other abstaining, but that the effect is less pronounced for users of both.

The results of the National Treatment Agency for Substance Misuse (NTA) funded study are written up in the 2 October issue of The Lancet by Dr John Marsden of the Institute of Psychiatry at King's College, London, and Colin Bradbury Head of Delivery at the NTA, and colleagues. The NTA is part of the National Health Service (NHS).

Bradbury said in a separate statement that:

"The goal of all drug treatment is for the user to overcome their addiction, and this study shows that although that may take time, it is possible to tackle the harms caused by drugs by investing in drug treatment."

For the study, Marsden, Bradbury and colleagues analyzed data from the National Drug Treatment Monitoring System (NDTMS) covering more than 14,656 patients from all over England who were being treated for heroin or crack cocaine addiction or both. The patients received at least 6 months treatment starting between January and November 2008 and finishing by the end of the study period in May 2009.

The results showed that:

• During the 28 days leading up to review, about two thirds of heroin users stopped (42 per cent) or significantly reduced (29 per cent) their use of the drug.
• This proportion was slightly lower for crack cocaine users (with 57 per cent stopping and 8 reducing).
• Much higher proportions of users of only one of the two drugs abstained than did users of both heroin and crack cocaine.
• Overall heroin use went down from an average of 23 days per month pre-treatment to 8 days at follow up (an average drop in usage of 15 days per month).
• For crack cocaine usage dropped from an average of 13 days per month pre-treatment to 5 days at follow up )an average drop of 8 days per month).
• For clients given drug treatment, reduction in days of heroin use was smaller for those using both heroin and crack cocaine than for those using heroin alone (14 versus 16 days).

The authors concluded:
"The first 6 months of pharmacological or psychosocial treatment is associated with reduced heroin and crack cocaine use, but the effectiveness of pharmacological treatment is less pronounced for users of both drugs."

They suggested new treatment strategies were needed for people with combined heroin and crack cocaine addiction.

Bradbury told the media that:
"Drug treatment has been greatly expanded in the last few years and so it is very encouraging that this study of the most commonly available treatments in England shows that even those with entrenched addiction to heroin and crack cocaine respond well to treatment." "Whilst users are in treatment, we know that their drug use declines and that crime significantly reduces, which is positive for their health and for communities which suffer from the harms caused by drug addiction," said Bradbury.

On Thursday last week, NTA Director of Delivery, Rosanna O'Connor attended the official opening of a large new residential theurapeutic community in Northern England. Withnell House is situated in Chorley in rural Lancashire and was developed by Inward House projects with support from DH Capital grants.

During her visit to the region O'Connor also attended a graduation ceremony for problem drug users in a small urban centre in Stockport, Cheshire. The facility is run by the Alcohol and Drugs Abstinence Service (ADAS) who with support from DH Capital grants is also opening another facility in Rochdale, Lancashire.

O'Connor told the press that:
"The NTA is committed to choice and improving Tier 4 provision is a key part of our Treatment Effectiveness strategy. At its best, Tier 4 service provision can provide effective responses to drug misuse in treating people whose use has been long and heavy, and people with complex needs. It can also enable drug users to move towards long-term abstinence when and where appropriate."

"The aim of all drug treatment is to help addicts become drug-free, leave treatment and reintegrate into society. There is no one-size-fits-all answer to every problem drug user and that is why the NTA advocates a balanced treatment system to allow individuals to access the treatment they need from a range of clinically appropriate services," she added.

In September last year, the NTA issued new guidelines for purchasers and commissioners of residential treatment, urging Drug Action Partnerships to review their arrangements for prolonged and heavy drug users. Tier 4 is a range of treatment services covered by one of around 20 work areas of funded NTA activity.

Tier 4 includes inpatient assessment, stabilisation and assisted withdrawal services, residential rehabilitation services and aftercare as defined by the NTA Models of Care (Update 2006).

In June this year, the Department of Health made available a further 11.8 million pounds of capital money for drug treatment services, and about one quarter of this capital funding will be earmarked specifically for expanding the residential treatment sector.

This is over and above capital allocations of 10 million in 2007/08 and 54.3 million specifically for Tier 4 provision throughout 2006/07-2009/10.

"Effectiveness of community treatments for heroin and crack cocaine addiction in England: a prospective, in-treatment cohort study."
John Marsden , Brian Eastwood, Colin Bradbury, Annette Dale-Perera, Michael Farrell, Paul Hammond, Jonathan Knight , Kulvir Randhawa, Craig Wright, for the National Drug Treatment Monitoring System Outcomes Study Group. The Lancet , Early Online Publication, 2 October 2009 DOI:10.1016/S0140-6736(09)61420-3. 5.10.09

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NTA claims heroin use down - but cocaine abuse is rising

Fewer young adults with a drug problem are using heroin and crack - but the number of young people needing treatment for cocaine abuse is rising. The number of 18 to 24-year-olds seeking treatment for heroin or crack fell by 22 per cent to 9,632 between 2005-6 and 2007-8, official figures show.

But the numbers of young adults presenting for treatment for cocaine dependency rose by more than two-thirds to 2,692 over the same period. Paul Hayward from the National Treatment Agency, which provided the figures, said it was 'reassuring' young people were turning away from heroin and crack.

He told the Guardian: 'The quite significant reduction in the numbers of people seeking help [for those drugs] probably illustrates an actual fall in problematic use because help has never been more available. 'Fewer people using heroin is good news as heroin is the most dangerous of all the drugs that people use. Given it involves a significant risk of overdose, HIV and hepatitis C - and is associated with acquisitive crime - I'm convinced that individuals, communities and wider society will benefit, especially the poorest communities which heroin affects most.'

But Mr Hayward admitted the rise in cocaine dependency was 'very significant' and could be associated with 'health damage and crime.' 5.10.09

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Credibility of the NTA called into question after drug study

Last year the success rate of the addiction services was just 3.6%. However this year the National Treatment Agency (NTA) published a study in the Lancet medical journal [2.10.09] claiming ‘two thirds (66%) of people stopped using these drugs within six months of treatment initiation', either the addiction services have dramatically increased their powers of persuasion or the study is an utter sham.

As it turns out the information published in the Lancet is flawed on many levels the most obvious being the addicts in the study we simply given methadone but this allowed the NTA to claim ‘around two-thirds of people stopped using these drugs within six months'. This sparked a flurry of media interest with headlines such as 'Half of addicts quit after 6 months of treatment'.

The truth is, a few addicts may have temporarily stopped or reduce their use of 'street drugs' only because they were now using methadone (a heroin substitute) but they were still opiate dependant and after six months of treatment no-one was free of their drug dependency and despite the additional drugs provided by the state, the vast majority were still street drug dependent as well, at the end of the study.

One expert said 'the only thing this study proves is that NTA treatment programs do not work. They treated 14,656 addicts over 6 months and not a single person left the program drug free, it's a waste of tax-payer's money'.

Critics were outraged by this assessment provided by the NTA who are desperate to keep their funding of £800 million a year as Dr John Marsden, of the Institute of Psychiatry, King's College London, said the 'findings justify funding of heroin and crack cocaine treatment programmes costing £3,000 to £5,000 per addict'.

Some say Dr Marsden is clearly delusional if he thinks providing addicts with methadone is curing their addiction, one thing is certain the NTA are a morally bankrupt organisation who need a radical overall, if not totally dismantling. 2.10.09

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Claims that 'treatment cures only one in three drug addicts' are pure fiction & spin

Only one in three drug addicts in treatment programmes stops injecting heroin or using crack cocaine in the short-term, according to the largest study ever carried out. Around one-third claim to have cut their use of street drugs while the others stay the same or get worse after six months.

The study, funded by the National Treatment Agency for Substance Misuse, looked at 15,000 addicts in heroin and crack cocaine programmes in England. Most were on prescription methadone, a heroin-substitute, to stabilise their condition.

Lead researcher Dr John Marsden, of the Institute of Psychiatry, King's College London, said the findings justify funding of heroin and crack cocaine treatment programmes costing £3,000 to £5,000 per addict. The study is published in the Lancet.

But critics, who claim methadone treatment traps people into 'state-sponsored' addiction, said the study was unreliable because the data was based on self-reporting by addicts.

Kathy Gyngell, researcher at the Centre for Policy Studies, said: 'The research shows that after six months of treatment no one is free of their drug dependency and despite the addictional drugs provided by the state, the vast majority are still street drug dependent as well.' Britain spends £800million a year on drug treatment projects.

Other critics said the figures were pure fiction and spin. ‘How can you claim to cure someone of their heroin addiction when they are still dependent on methadone, it's a ridiculous statement and typical of the addiction services who are desperate to claim any kind of success where in reality none exists. The Lancet is supposed to be a respectable publication for clinical studies but their comments about 'two-thirds of people stopped using these drugs within six months of treatment initiation' are seriously flawed and this raises further questions over their integrity'.

'This is a sad indictment of the so called ‘treatment programs' where they take heroin addicts, put them on a methadone prescription and then tell everyone they have cured their heroin addiction. It's a clear example of semantics and moving addicts from one list to another and then claiming a successful outcome, it's criminal,' said one critic. Others said 'the NTA should be ashamed of themselves they have lost all credibility now'. 2.10.09

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Claims that drug therapy record is 'encouraging'

One in three people addicted to heroin or crack cocaine in community drug treatment programmes in England stops using by six months, research suggests. Results from 14,600 people in methadone or specialist counselling programmes suggested the rates were slightly lower for those dependent on both drugs.

There are about 140,000 people in such treatment programmes in England. The study, in the Lancet, showed higher funding for treatment was effective, the Department of Health said. The researchers said the figures were "encouraging".

Eight in every 1,000 15-64 year-olds are heroin users, statistics show. For crack cocaine - the smokeable form of the drug - the figure is five in 1,000.

The latest analysis is the largest study done in England of 1,000 community treatment agencies - not including residential rehab schemes - and may be the largest internationally, the researchers said. Data was collected as part of the National Drug Treatment Monitoring System, where 13,200 people had started on drug treatment such as methadone, and 1,400 people started on psychological treatments - the only current option for crack cocaine addiction.

Among those addicted to heroin, 37% said they were abstinent from the street drug for the month prior to their six-month review but critics point out they are still dependent on either prescribed heroin or methadone so its nothing to get excited about.

Another third were classed as "improving" because they had reduced their drug use, just under a third were unchanged and 3% had got worse. For crack cocaine, 52% had stopped using at six months, 12% had improved, a third were unchanged and 3% had deteriorated.

'Last year the figure free from their addiction was just 3.6% are they now suggesting it has risen to over 30%', I don't think so said one addict.

 Increased capacity
The number of people addicted to heroin and crack in treatment programmes in England has increased dramatically in recent years. It has been estimated that in England around 60% of those in need of treatment are receiving it, at a cost of around £3,000 to £5,000 a year per person.

Colin Bradbury, head of delivery at the National Treatment Agency for Substance Misuse and one of the authors of the study, said: "There's no room for complacency, but we're very pleased and encouraged by the results. "That is despite the fact we have had very rapid expansion in the treatment system, it's retained its quality and effectiveness." He added there would be large local variation and services could use the study to benchmark how they were doing.

Study leader Dr John Marsden, from the Institute of Psychiatry at King's College London, said these were the most "severely addictive" drugs around and users could not stop even when their lives fell apart and it became completely illogical for them to use.

"These are encouraging rates but it is the beginning of a story." He said they would be doing more work on long-term outcomes and different types of treatment. "I think this is good evidence for a return of public investment in treatment."

He called for more attention on those who got worse during their treatment programmes and new strategies for the third of users addicted to both heroin and crack cocaine who seemed more resistant to treatment.

A Department of Health spokesperson said: "This study demonstrates that our strategy of increasing investment in treatment is effective and gives problem drug users faster access to help. "Tackling drug misuse is a priority. High-quality drug treatment is the most effective way of reducing drug harms and every £1 spent on drug treatment saves £9.50 to the rest of society."

In an accompanying paper, Dr A Thomas McLellan, deputy director of the White House Office of National Drug Control Policy in Washington DC , said short-term interventions may not produce long-lasting, positive effects.

"It may be more reasonable to expect enduring improvements through sustained outpatient clinical management with drugs and behavioural therapies - like expectations we have for the management of diabetes and hypertension." 2.10.09

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Hope For Crack Cocaine And Heroin Users

A recent study has shown that there is indeed a way out for users of crack cocaine and heroin. The two A-class drugs are known to cause serious and enduring harm to both addicts and the community at large, through a miserable cycle of addiction and crime.

For every 1,000 people aged 15-64 years in England , around eight are heroin users and five are crack cocaine users. Treatments such as substitute prescription drugs and psychotherapy are now the standard of care for addicts in England .

To work out how effective they are, the National Treatment Agency for Substance Misuse has funded the largest ever study of treatment programmes in England.

The authors of the report said: "In view of the chronic course of heroin and crack cocaine addictions, and the long-term care usually needed for treatment, our results are an important first indication of effectiveness for the English treatment system."

The study, involving 14,656 users across the UK , found that the first six months of treatment leads to large numbers of addicts of one drug or the other abstaining. But the programme was slightly less effective for regular users of both drugs.

The prescribed treatment for heroin is a substitute oral drug known as methadone, along with pyschosocial therapy.

The latter treatment also applies to crack cocaine which, unlike heroin, has no substitute drug treatment. Researchers found that during the last 28 days of the six month treatment programme, around two thirds of heroin users stopped or substantially reduced their use of heroin (42% stopping, 29% reducing).

A similar proportion of crack cocaine users had stopped or substantially reduced their use of crack cocaine (57% stopping, 8% reducing).

But users of both drugs had a lower success rate, suggesting that the use of two such highly addictive substances makes it even harder to make positive changes.

Although researchers stressed that users of both drugs still did well, they added: "The study has highlighted the need for new stategies to treat individuals with combined heroin and crack cocaine addiction."

The success of this assessment has prompted plans for future studies that will also focus on whether these changes in drug use are extended over longer periods, and the effectiveness of addiction treatment for other illicit drugs and alcohol.

The report, published by leading medical journal The Lancet can found on their website or in an upcoming edition, written by Dr John Marsden. 2.10.09

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Scientists: drug treatment does work

Therapy or counselling help heroin and crack addicts to quit their habit, researchers find. Two-thirds of heroin and crack addicts come off street drugs or reduce their use after six months of treatment, researchers report today.

The findings of the largest-ever study of heroin and crack cocaine treatment programmes, published in The Lancet, will come as a relief to drug agency workers who feared their efforts were having little impact. Heroin and crack addicts often lead chaotic lives, fuelled by the proceeds of crime, which are among the hardest to turn around.

However, the findings came with caveats over the robustness of the results, in the absence of a control group and the length of time the benefits were expected to last. Drug addiction typically follows a relapsing and remitting course and many addicts take years to shake the habit.

There are an estimated 330,000 problem users of heroin and crack cocaine in the UK of whom 180,000 receive treatment each year. Heroin addicts are given methadone on prescription, a non-euphoric opiate that removes the craving for a fix but allows them to stabilise their lives. Some also receive cognitive behaviour therapy or counselling. There is no pharmacological substitute for crack cocaine and these addicts receive only psychosocial treatments.

The study involved 14,656 patients from 1,000 community treatment agencies across England who received at least six months' treatment in 2008. The findings showed 42 per cent of the heroin users reported having stopped using the drug and 29 per cent reduced their use in the month prior to their assessment. Among the crack users, 57 per cent stopped and 8 per cent reduced their use. Success rates were lower among addicts who used both drugs. The researchers said this could be because they were the most hardened addicts or that crack may reduce the effectiveness of methadone treatment.

"Heroin and crack cocaine corrupt the way we think, remember, make decisions, plan and behave," said John Marsden, of the Institute of Psychiatry, who led the study. "These people have had their lives messed up big time. This is the largest study of the most commonly available drug treatments in England and unequivocally concludes that present drug treatment for heroin and crack addiction is very effective in the first six months."

Colin Bradley, of the National Treatment Agency for Substance Misuse, which funded the study, said treatment had expanded hugely in the past eight years and waiting times had plummeted from over a year to a few weeks. "We have doubled the numbers in treatment, there is a greater choice of services and psychosocial treatments are much more widespread," he said. "But it's a first step – people do not respond in a uniform way."

Treatment with methadone costs £3,000 to £5,000 per year per addict and the average period in the programme is 10 months. The total national cost is £800m a year.

Thomas McLellan, deputy director of the White House Office of National Drug Control Policy in Washington says in a commentary on the findings in The Lancet that serious addiction is best considered as a chronic condition, like diabetes or high blood pressure. Short-term interventions may not produce long-lasting effects, he warns. "It may be more reasonable to expect enduring improvements through sustained outpatient clinical management with drugs and behaviour therapies," he added. 2.10.09

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UK addicts may be given free foil for 'safer' heroin smoking

UK authorities could give out free foil to protect heroin addicts' health. Heroin addicts could be given free aluminium foil to encourage them to smoke rather than inject the class A drug under plans being considered by government advisers.

Drug treatment experts say that inhaling heroin instead of injecting reduces a user's risk of contracting HIV and Hepatitis C. An addict heats a blob of heroin on the foil in a process known as "chasing the dragon".

The Advisory Council on the Misuse of Drugs (ACMD) is examining whether the law should be changed to allow Britain's 300,000 problem drug users to receive foil as a way of protecting their health. Since last year, the ACMD's 31 members, who advise the Home Office, have been considering whether section 9A of the Misuse of Drugs act, governing "paraphernalia" or equipment used in the consumption of illicit substances, should be amended to allow the UK's network of needle exchanges to supply foil. At present, it prohibits the supply of "articles to be used for the preparation or consumption of illicit drugs".

Critics say the ban endangers users' health because most drug workers are too afraid of being prosecuted to risk giving out something that many see as a sensible harm-reduction measure. An estimated 100 of England's 1,300 needle exchanges already defy the law by providing foil. Some have even had tacit support in the form of "letters of comfort" from their local police force, such as Avon and Somerset, which emphasises that it does not see the pursuit of section 9A as a priority.

The ACMD's technical committee has held two private evidence-gathering sessions on the subject with with Jamie Bridge of the International Harm Reduction Association, which backs legalisation, and drugs treatment researchers Neil Hunt and Rachael Pizzey. It is due to hear on 29 October from veteran Dutch drugs worker John-Peter Kools, who has issued foil in the Netherlands. Both Holland and Spain issue foil through needle exchanges without any major problems.

The full ACMD is to debate the issue in November and is expected to suggest setting up a pilot study on the effects of foil provision. It hopes to advise ministers of its views soon – possibly before the end of the year – on whether the law should be changed. Bridge said: "Smoking drugs is by no means safe, but is a great deal safer than injecting drugs – which is particularly associated with overdose, blood-borne viruses, drug-related litter, greater dependency, abscesses and vein damage.

"The law has unintentionally put us in a strange position whereby we can give someone clean needles to inject with, but we face arrest for giving them aluminium foil to smoke with. Providing foil in this way is such a common-sense approach – with huge potential benefits and little opposition or potential costs – that we hope the law will change soon." Significantly, the Association of Chief Police Officers, which represents the country's most senior officers, is neutral on whether the law should be amended. But it would support a change if the ACMD recommended such a move on public health grounds, sources told the Observer .

Harry Shapiro of Drugscope, which represents 800 drug projects, said: "It's important to do everything possible to discourage Britain's 300,000 problem drug users from injecting their drugs, and we should allow injecting heroin users to be provided with foil as part of a harm-reduction programme. As the law now stands users' health is being compromised and it would be better if section 9A was repealed."

But James Brokenshire, the Conservative shadow home affairs minister, said: "I'm cautious about these sort of moves, which progress harm reduction rather than focus on getting people drug-free. In recent years there has been insufficient focus on getting people off drugs and too much on just maintaining people on drugs through methadone and other measures.

"I would need to be swayed that there are clear and compelling public health arguments to make such a change [in the law]. I want to promote abstinence-based rehabilitation. There needs to be a greater emphasis in getting people off their drug habit rather than maintaining their addiction."

Paul Hayes, the chief executive of the NHS's National Treatment Agency, which funds drug treatment, said: "Any way of using heroin is dangerous and likely to lead to addiction. However, injecting the drug is far more dangerous than other means of ingestion, such as smoking. Currently, the provision of foil is not legal. The NTA cannot advise drug treatment services to follow a course of action which is illegal and could have adverse consequences for provider services." 21.9.09

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Straw moots heroin prescription

Prescribing heroin on the NHS may be the best way to treat the "most problematic" addicts, Jack Straw says. The justice secretary's comments follow trials which showed big reductions in the use of street drugs and crime. "It may be the best means of reducing the harm they do to themselves, and of stamping out the crime and disorder they inflict," the Blackburn MP said. Writing in the Lancashire Telegraph, he says the potential benefits of trying alternative approaches are huge.

'Imaginative'
Mr Straw says he has been part of the "tough" approach in the past, which has seen a large proportion of offenders jailed after committing crimes to fund their addiction. But he believes the overriding objective must be to reduce the harm caused by drugs, to users, their families and to the victims of crimes they commit. "So we need to keep an open mind on alternative approaches, not dismiss them if they don't fit in with the adjective 'tough'.

Last week it emerged that a scheme in which heroin was given to addicts in supervised clinics had led to big falls in their use of street drugs, and in crimes committed to pay for them. More than 100 users took part in the four-year pilot in London , Brighton and Darlington , which was partly funded by the government.

They either injected heroin or received the drug's substitute, methadone. About three-quarters of those given heroin were said to have "substantially" reduced their use of street drugs.

The National Treatment Agency for Substance Misuse (NTA), which administers drug treatment in England , said the results were "encouraging". Mr Straw says the prescription of heroin would only ever be applied to a minority of problematic addicts. "The prescription of heroin is not a magic bullet. It's a drastic step," he added. 21.9.09

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Former health Secretary Patricia Hewitt's son, 21, charged with cocaine possession

The son of former health secretary Patricia Hewitt has been charged with possessing cocaine, it emerged last night. Nicholas Hewitt Birtles, 21, whose father is a judge, was allegedly caught with the Class A drug near his home in Camden, North London, on Saturday night. Police arrested the MP and former cabinet minister's son after spotting three men - including Mr Hewitt Birtles - acting suspiciously near his parents' £1million home

They are understood to have found wraps of cocaine and arrested the men before taking them to nearby Kentish Town police station at about 8.15pm. Mr Hewitt Birtles spent a night in the cells after having a mugshot, DNA sample and fingerprints taken by police. If found guilty, he faces up to seven years in prison and an unlimited fine.

The revelation will come as a shocking embarrassment to the 60-year-old Labour MP and former health secretary and her husband William Birtles, who is a senior judge. Two years ago he objected to plans for a late-night pharmacy in his local area. In a letter to council officials, he said: 'We have a serious drug problem throughout Camden which is well-known by the local police.

'We have got dealing at the end of my road. I don't feel it's appropriate for a local pharmacy to do that (provide a needle exchange).' On Saturday night Mr Hewitt Birtles, a sales representative, spent more than two hours at the station before leaving at 11am. His 22-year-old friend was bailed pending analysis of the substance and left the police station at 1.15am.

Miss Hewitt, MP for Leicester West, announced she will quit Parliament at the next election to spend more time with her family and focus on charitable work for India. As Health Secretary she pledged to help families affected by drug abuse. She said: 'We will continue to reduce the effects damage caused by the most dangerous drugs by ensuring effective treatment is available.'

Her spokesman said last night: 'This is a private matter that the family are dealing with.' A Metropolitan Police spokesman said last night: 'Nicholas Hewitt Birtles, 21, of NW1, will appear at Highbury Corner Magistrates' Court on bail on September 30 charged with possession of a Class A drug, namely cocaine, at Camden Square NW1 on Saturday September 19. 'A second man aged 22 years is bailed to return on 6 November pending analysis of substance seized.'

A source told the Sun: 'A police patrol saw them sitting in the car. They were not actually taking drugs but their behaviour was not quite right. They were asked to get out and officers became suspicious that they had been taking drugs. 'The paddy wagon was called and the boys were taken to the local station. 'Nicholas was very upset about the embarrassment to his parents.

'Police decided to charge Nicholas, but his 22-year-old friend was released on bail. 'Nicholas also had a DNA saliva sample, mug shot and fingerprints taken. He may well be the son of a former cabinet minister and judge but he was treated like any criminal suspect.' Patricia Hewitt's daughter Alexandra Birtles, 23, hit the headlines as a teenager, when a schoolgirl at Camden School for Girls.

She complained to Higher Education Minister Margaret Hodge during a question and answer session that the Government's new AS level syllabus was 'too confusing' and causing them sleepless nights. In 1997, Jack Straw's son William was arrested and cautioned by police after he sold cannabis to an undercover reporter while aged just 17.

After the episode Mr Straw, then Home Secretary, protected his son, saying: 'I hope that the media will continue to agree that he should not suffer additionally simply because he is my son.' William went on to study at Oxford University. 21.9.09

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Withdrawal from heroin is a trivial matter

Dr Theodore Dalrymple is outraged by the mollycoddling of drug addicts coming off heroin and the notion that their predicament is a matter of human rights.

We live in Keynesian times: the answer to the economic problems created by a mountain of debt frittered away on trifles is clearly a whole mountain range of debt frittered away on trifles. In the circumstances it is good to know that a judge has done his bit to stimulate the general improvidence — sorry, the British economy. He has awarded £11,000 each to three prisoners in Winchester Prison who underwent withdrawal from heroin without benefit of further doses of heroin or of methadone and other heroin substitutes. It was against their human rights, he said.

This is indeed odd. It is doubtful whether anyone ever dies from withdrawal of opiates alone. In reviewing the medical literature between 1875 and 1968, the doctors and researchers Glaser and Ball were unable to find a single case of death from withdrawal of opiates, despite the fact that the literature covered many thousands of cases.

Indeed, such withdrawal is medically trivial, unlike that from alcohol and barbiturates (and sometimes even benzodiazepines such as valium). Let me quote Niesink, Jaspers, Kornet and van Ree's book, Drugs of Abuse and Addiction: Neurobehavioral Toxicology: ‘[Withdrawal] is time limited... and not life-threatening, thus can be easily controlled by reassurance, personal attention and general nursing care without any need for pharmacotherapy.'

By contrast, 2,845 people died of methadone poisoning in Great Britain between 1996 and 2005. In 2006, 241 died of methadone, and 713 of heroin or morphine poisoning. In 2007, the figures were 325 and 829 respectively. In Dublin , more people die of methadone poisoning than of heroin poisoning.

I repeat, no one dies of opiate withdrawal. I might add also that doctors have a very long history of treating the trivial condition of withdrawal from opiates in a dangerous, indeed fatal fashion.

It goes without saying that we are all furious at Mr Putin's treatment of Georgia, but few of us realise that the drug addicts of the country whose president brokered a ceasefire between Russia and Georgia — France — have caused far more harm to the population of that country than Mr Putin's Russia.

They have systematically diverted the drug with which their heroin addiction is ‘treated', buprenorphine, to Georgia (as well as to Finland , incidentally), where scores of thousands of Georgians have addicted themselves to it. The fact that the French addicts have diverted it in this fashion is eloquent testimony to how much they needed it in the first place, and how easily they were able to deceive doctors.

It might, I suppose, be argued that such drugs as heroin, methadone and buprenorphine are potentially safe when given under strict medical supervision; but such supervision is extremely difficult to enforce, given the levels of duplicity, deviousness and dishonesty among the population for whom they are prescribed. In one Canadian case, for example, a woman in a prison prescribed methadone for her withdrawal symptoms vomited it to sell it to another prisoner, who then died of an overdose. Guess whom the relatives of the dead woman sued?

The evidence is pretty conclusive that the great majority, though not quite all, of the suffering caused by withdrawal from opiates, insofar as it is real and not feigned, is psychological in origin and caused by the mythology surrounding it. In the 1930s, experiments were done demonstrating that morphine addicts could not reliably distinguish between injections of water and morphine: when they received water thinking it was morphine, their symptoms abated, but when they received morphine thinking it was water, they grew worse.

It has also been established that the distress of withdrawal is not correlated with the physical severity of withdrawal symptoms, and is often at its worst before, not during, withdrawal.

Even accepting the ludicrous, corrupt and corrupting doctrine of human rights, it is difficult to see how it can be a human right to have a non-life-threatening condition transformed into a life-threatening one by supposed (and ineffectual) treatment. The old medical adage, first do no harm, ought to take precedence, and therefore the presumption must always be against, not for, treatment for withdrawal. That so evident and unassailable a point did not prevail in court, instead landing the British taxpayer with a total bill that no doubt ran into hundreds of thousands of pounds, is deeply emblematic of the moral and intellectual decadence into which we have fallen.

This is not an isolated instance of it, either, even in the relatively small question of how we conceive of heroin addiction. The Sentencing Guidelines Council last week suggested that first-time offenders who steal from the vulnerable should be given stiffer sentences than they currently receive, but that courts should not send drug addicts who steal to ‘feed their habits' to prison, but should consider instead drug or alcohol treatment programmes.

The Sentencing Guidelines Council was attempting, as it has so often done in the past, to mislead the British public into thinking that the law has become harder on criminals when in fact it is becoming more lenient. The class of the former type of offender — the first-timers who target the vulnerable — is of course very much smaller than the second class, the addicted thief, robber or burglar.

Thus, despite the impression given by headlines that say ‘Stiffer sentences for first-time offenders', what is being proposed is a reduction in severity of sentencing.

Now it does not follow from the fact that many thieves and burglars are drug-addicted that they are thieves and burglars because they are addicted. In fact, the evidence suggests that the relationship is the other way round: that whatever causes them to become criminals causes them to become addicts.

In a survey in the prison in which I worked, I found that the great majority of heroin addicts sentenced to imprisonment had been imprisoned for the first time well before they ever took heroin. Since most people are convicted about ten times before they are sent to prison, and the clear-up rate of crimes is about 5 per cent (and even that, thanks to police dishonesty, is an exaggeration), it is likely that many of them had committed dozens, perhaps hundreds, of crimes before they ever took heroin. Therefore, it cannot be that they are criminals because they are addicted.

Heroin addicts are not ‘hooked' by heroin, as fishermen take fish; they ‘hook' heroin. Most of them take it intermittently for quite a time before they take it regularly and become physiologically addicted to it. Moreover, taking opiates by injection is not incompatible with normal working. In the 1930s, the majority of morphine addicts in America went to work normally.

Moreover, the Sentencing Guidelines Council must know that the Audit Commission recently found that 75 per cent of addicts did not even comply with the kind of community sentences that they recommend, and that Home Office research found that the re-conviction rate within two years of people given such sentences was 90 per cent, i.e. the re-offending rate must be close to 100 per cent.

The Sentencing Guidelines Council is therefore aiding and abetting crime on a huge scale, and ought to be disbanded forthwith. Addiction should be treated as an aggravating circumstance, and an automatic additional five or ten years ought to be added to addicts' sentences: that is, if the peace of the poor, who are the primary victims of crime, is to be protected by the government and the criminal justice system. 1.0.09

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Heroin clinics would help few addicts, says agency head

Pilot scheme that provided heroin in supervised clinics cut drug use and related crime. However only a "very small proportion" of the 160,000 heroin addicts in treatment would benefit from a scheme providing them with the drug in supervised clinics, the head of the government's drug treatment service said today.

Paul Hayes, of the National Treatment Agency, said three government-funded clinical trials had produced encouraging results, but involved only chronic long-term addicts who had failed to respond to other treatments. "No one is suggesting that this should be the frontline treatment for heroin addiction. Heroin has been available on prescription since the 1920s to a very limited number of addicts, and these pilots are simply to explore whether controlled prescribing of heroin will be effective in overcoming their problems."

Hayes said the pilot schemes involved the use of pharmaceutical diamorphine imported from Switzerland in a supervised clinic prescribed by a doctor. The practice should not be confused with the use of illicit street heroin in legalised consumption rooms known as "shooting galleries".

"The pilots need to identify how many individuals might benefit from this treatment, but at most we are talking about a very small proportion of the 160,000 addicts in treatment."

The independent expert group running the pilot scheme has recommended that it should be expanded to further demonstration sites. Hayes said he was not calling for a national rollout of shooting galleries, as suggested by some reports.

The interim results of the four-year trials, held in London, Brighton and Darlington, were being reported today at a National Addiction Centre and Action on Addiction conference. Three-quarters of users "substantially reduced" their use of street drugs, and their spending on drugs fell from £300 to £50 a week. The number of crimes they committed fell from 1,731 in three months to 547 in six months.

Professor John Strang, who led the trials, said the results were "very positive" because the scheme had helped to cut crime and avoid expensive prison sentences among a group that were the hardest to treat.

"It's as if each of them is an oil tanker heading for disaster and so the purpose of this trial is to see: 'Can you turn them around? Is it possible to avert disaster?' And the surprising finding – which is good for the individuals and good for society as well – is that you can," he told the BBC .

The pilots, known as the "randomised injecting opioid treatment trials" – or Riott – were run by the National Addiction Centre and the Action on Addiction charity, under an advisory group that included the NTA, Department of Health and the Home Office.

During the pilots, one-third of the 127 chronic heroin addicts were given Swiss heroin, one-third were given the heroin substitute methadone orally, and the remainder injected methadone under supervision. They were also given psychological counselling and help with their housing and social needs. 16.9.09

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No surprise - Free heroin supply clinic 'cuts crime'

A scheme in which heroin is given to addicts in supervised clinics has led to big reductions in the use of street drugs and crime, the BBC has learned. More than 100 users took part in the pilot - part funded by the government - in London , Brighton and Darlington . They either injected heroin or received the drug's substitute methadone.

Those given heroin responded best and an independent panel which monitored the scheme over six months are advising ministers to set up further trials. About three-quarters of those given heroin were said to have "substantially" reduced their use of street drugs. Research suggests that between half and two-thirds of all crime in the UK is drug-related.

The Home Office says on its website that about three-quarters of crack and heroin users claim they commit crime to feed their habits. Professor John Strang, who led the project, said the results were "very positive" because the scheme had helped cut crime and avoid "expensive" prison sentences.

Professor Strang, who is based at the National Addiction Centre, part of King's Health Partners, said the individuals on the programme were among those who had been the hardest to treat. "It's as if each of them is an oil tanker heading for disaster and so the purpose of this trial is to see: 'Can you turn them around? Is it possible to avert disaster?' "And the surprising finding - which is good for the individuals and good for society as well - is that you can," he said.

The Randomised Injecting Opioid Treatment Trial (RIOTT) programme - which is funded by a number of agencies, including the Department of Health - began in 2005. It involved 127 chronic heroin addicts for whom conventional types of treatment had failed. Many of the addicts were also using other substances, including crack cocaine.

During the trials, a third of addicts were given the heroin substitute methadone orally and another third injected methadone under supervision. The remainder, observed by nurses, injected themselves with diamorphine - unadulterated heroin - imported from Switzerland .

National roll-out?
Those on the programme were also given psychological support and help with their housing and social needs. The results showed that addicts in all three groups cut the amount of heroin they obtained illicitly from street dealers. According to researchers, more than half of the heroin injecting group were said to be "largely abstinent" and one-in-five did not use street heroin at all.

Before they began the programme, the addicts in the heroin injecting group were spending more than £300 a week on street drugs. After six months, this had reduced to an average of £50 a week. There was also a big drop in the number of offences addicts admitted committing to obtain money to feed their habit.

In the previous month before the scheme started, addicts in the heroin injecting group reported carrying out 1,731 crimes. After six months, this had fallen to 547 offences - a reduction of more than two-thirds. One of the heroin addicts on the programme, a 34-year-old man called John, had been addicted for eight years when the trials began. He fed his habit by dealing.

"My life was just a shambles... waking up, chasing money, chasing drugs," he said. But John said the scheme had transformed his life "100 per cent" and he now had a part-time job. "It used to be about chasing the buzz, but when you go on the programme you just want to feel comfortable," he said. "I've started reducing my dose gradually, so that maybe in a few months time I'll be able to come off it altogether, drug free totally."

In its drug strategy, published last year, the government said it would "roll out" the prescription of injectible heroin, subject to the findings of the pilot scheme. The National Treatment Agency for Substance Misuse (NTA), which administers drug treatment in England , said the results were "encouraging". The NTA said an independent expert group, set up to advise the government, had concluded that there was enough "positive evidence of the benefits" of the programme to merit further pilots.

The NTA is understood to be keen to evaluate the financial implications of the scheme. At £15,000 per user per year, supervised heroin injecting is three times more expensive than other treatments.

But critics have called the scheme an utter failure and another example of state sponsored addiction rather than actually stopping the addiction. This policy only servers those in the addiction services, getting people off drugs altogether would have a greater impact on society and for the individual as well. 'You don't have to be Nostradamus to predict giving addicts free heroin on the NHS reduces the amount of street heroin they have to buy from dealers' said one comedian, 'what's next, free sex for sex addicts?'. 15.9.09

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Antidepressant Seroxat tops table of drug withdrawal symptoms

Seroxat, the British-made antidepressant which outsells Prozac, causes more people distressing withdrawal problems when they try to stop taking it than any other drug in the UK.

The committee on the safety of medicines, which receives reports of drug side-effects from doctors and pharmacists, has received an avalanche of complaints about Seroxat, one of the class of drugs known as SSRIs (selective serotonin reuptake inhibitors). The SSRIs, including Prozac, have always been marketed as safe medicines which are supposed not to cause the dependence problems that emerged with older drugs such as Valium and Ativan.

Seroxat - known generically as paroxetine - leads the top 20 table of drugs causing withdrawal problems, with 1,281 complaints from doctors under the "yellow card" scheme set up for the reporting of medicines' side-effects. More reports have been filed about Seroxat than about the rest of the top 20 put together. In the top six, five of the drugs said to be causing withdrawal problems are SSRIs - second after Seroxat comes Efexor (venlafaxine), with 272 complaints.

The figures were obtained from the medicines control agency, the regulatory authority which takes advice from the CSM, by the campaigning group Social Audit.

Charles Medawar of Social Audit has complained to the MCA and the CSM about the patient information leaflet supplied with Seroxat which he says is misleading and wrong. "These tablets are not addictive," the leaflet states, adding that the withdrawal problems some patients experience "are not common and are not a sign of addiction".

However, many people in the UK have consulted lawyers over the unexpected problems the drug caused them when they wanted to stop taking it. Mr Medawar drew to the MCA's attention the hundreds of postings on the group's website from people who have suffered and continue to suffer distressing symptoms as a result of trying to give up Seroxat. They complain of sensations that feel like electric shocks in the head, dizziness, mood swings, upset stomachs and unpleasantly vivid dreams, all of which are only alleviated by going back on the drug.

"I've been on Seroxat for about 10 years," wrote one woman in January, "and have tried to come off them on many occasions, only to find myself back to my original dose of 30mg because of the horrible withdrawals ... I was assured when talked into taking anti-depressants in the first place (that they) were one of the mildest and non addictive so-called 'wonder-drugs' in modern psychiatry!"

The SSRIs are commonly prescribed by GPs - not psychiatrists - to people who consult them with mild depression and sometimes other conditions, such as ME, anxiety and phobias.

Mr Medawar points out that the GPs are not warned of the withdrawal problems the drug can cause and often think the symptoms their patient suffers when stopping the medicine are just a return of their original ailment.

In a letter to Keith Jones, director of the MCA, he said that "the categorical and repeated assurance that Seroxat/paroxetine is not addictive seems to me completely unwarranted and highly likely to mislead and confuse patients and doctors alike. My view is that the MCA and CSM have failed the public and continue to fail the public - a gross dereliction of duty and responsibility to users, I would say".

In its response, the MCA acknowledges that the UK yellow card data shows a similar pattern to that of the World Health Organisation adverse drug reaction monitoring centre in Uppsala, Sweden, which put paroxetine at the top of the list and venlafaxine second in a table of withdrawal problems.

June Raine, who has responsibility at the MCA for the safety of licensed medicines, gave a clear indication that the agency may break with tradition and take into account complaints that come from patients as well as those from doctors and pharmacists. 27.2.02

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Cocaine death toll up 20% in a year: Fatalities from all illegal drugs at an 8-year high

Deaths from cocaine are up by a fifth in a year, figures show. The tragic toll lays bare the lie that it is a safe, middle-class 'dinner party' drug.

Some 235 deaths were linked to cocaine last year, up from 196 in 2007. This is the fifth year in a row that the number of victims has risen. Deaths from all illegal drugs have also hit an eight-year high in England and Wales.

Many of those dying are middle-aged, with the steepest rise among people in their 40s. With a line of cocaine now often costing less than a glass of wine, there has been a huge increase in the number of users. About a million Britons are thought to take the drug  -  up a quarter in a year.

Martin Barnes, chief executive of the charity DrugScope, said: 'Every drug-related death is a tragedy and many could have been avoided. It is extremely concerning that deaths related to illegal drugs are at their highest since 2001. 'The steady rise in deaths linked with cocaine use underlines the drug's harm at a time when use of the drug is again increasing, particularly among 16 to 24-year-olds.

'The fall in the price of the drug and evidence of its increased availability may be reasons for this increase.' There were 1,738 deaths linked to all illegal drugs in 2008, up 8 per cent.

As well as the ready supply of cheap drugs, experts have blamed celebrity users for making cocaine appear glamorous. Government policy has also come under fire with a UN report naming Britain the cocaine capital of Europe earlier this year. Norman Lamb, the Liberal Democrat health spokesman, said: 'These are horrifying statistics. The toll of damage from drugs is immense and the cost to the NHS is enormous.

'The Government's punitive policies and heavy-handed rhetoric on drugs are failing. 'Ministers must make sure that schools and public services work together to make sure that the message gets out that drugs kill. Ministers have been very good at talking tough when it comes to drugs, but this isn't working. 'They must urgently rethink their strategy before even more lives are lost.'

In 2004 there were 154 deaths from cocaine abuse, including crack cocaine. The latest Office for National Statistics figures show that this toll has risen by more than 50 per cent in four years. Heroin and morphine account for almost a third of all drug-related deaths.

Mr Barnes said: 'The fastest rise in drug-related deaths is among older users and heroin remains the most commonly linked substance. 'This trend could reflect the fact that the heroin using population is ageing, with fewer younger people using the drug.

'While it is right to focus on drug use among young people, the need is for public health and overdose prevention interventions across all age groups.' Deaths from the 'liquid Ecstasy' drug GHB doubled from nine to 20 in 2008. Deaths involving antidepressants rose 14 per cent to 381.

A Department of Health spokesman said: 'No death is acceptable and that is why we have significantly increased investment in treatment programmes and support for those who are drug dependent or at risk of self harm.' 27.8.09

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Herbal drug 'Spice' set to be banned for being stronger than cannabis

A legal 'high' which is even more potent than cannabis should be banned, the Government's drug adviser said today. Pouches of the drug Spice, which are widely available on the internet and in smoking paraphernalia shops, are marketed as 'natural' and nicotine-free and sell for around £20. 

The Advisory Council on the Misuse of Drugs chairman, Professor David Nutt, said although it was sold as a 'natural' high, Spice was created using dangerous chemicals. He said: 'Spice and other synthetic cannabinoid products are being sold legally as harmless "herbal legal highs".

'However, the herbal content is coated in one or more dangerous chemical compounds that mimic the effects of cannabis. 'These are not harmless herbal alternatives and have been found to cause paranoia and panic attacks. 'That is why we are advising the Government to bring a large number of synthetic cannabinoids under the Misuse of Drugs Act.'

Spice and other so-called 'synthetic cannabinoids' escape existing drugs laws because they do not contain marijuana and are not chemically related to it. But by spraying synthetic additives on to herbs, dealers can create similar intoxication in users to that caused by THC, the active ingredient in cannabis. Analysis of samples of Spice show it has a 'higher potency'  than THC, the ACMD warned.

It said Spice could be 'more harmful' because of the quantity of chemicals in the drug is 'unknown to the user'. Home Secretary Alan Johnson is expected to legislate later this year to ban Spice. It is likely to be made a class B drug, alongside cannabis. A Home Office spokesman said: 'We are determined to crack down on those so-called "legal highs" that pose a significant health risk.

'To this end, earlier this year we asked the ACMD to look into the harms caused by so called 'legal highs' and recently received its advice on this group of man-made chemicals that act on the body in a similar way to cannabis. 'These have been recently found in herbal smoking products, including products sold under the brand name 'Spice'. 'We will publish our response shortly, along with the proposed controls for a range of other substances.

'We remain committed to tackling drug use in all its forms through tough enforcement, education and, where required, treatment. And it remains important that we continue to adapt our drug policy to tackle the changing environment in order to protect the public, especially our young people, from drug harms.'

The review of legal highs was requested by former Home Secretary Jacqui Smith earlier this year and follows moves to ban Spice in Germany, Austria and France. At around £20 for three grams of Spice - sold under brands such as Spice Silver, Spice Gold, Spice Diamond and Spice Yucatan Fire - prices are similar to cannabis.

The ACMD's report said herbs listed on the packets of the drug were often not found inside, but they did discover large amounts of Vitamin E used to hide other chemicals. The council admitted there is little detailed information about the size of the Spice market but it is clearly 'extensive' and distribution networks 'well developed'. 12.8.09

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Cocaine abuse hits a 12-year high with one million UK users

Shocking figures today revealed sharp increases in cocaine use across Britain. The number of working age adults snorting the class A drug last year hit a 12-year high, with nearly a million confirmed users. Almost half of those are aged between 16 and 24 - an age group that saw huge growth in user numbers. There are now around 439,000 cocaine users in their late teens and early 20s, up by 1.5 per cent in just a year.

Drug experts said the increases were of 'significant concern' and blamed falls in price and increased supply. Martin Barnes, chief executive of charity DrugScope, said: 'These figures show a marked and worrying increase in the use of cocaine powder, in the adult population as a whole and among 16 to 24-year-olds. 'While this is not necessarily a surprise given the drug's decrease in price and increase in availability over recent years, it is of significant concern, particularly the rise in use among younger people. 'Cocaine use is now at its highest level among adults since 1996 - one in eight 16 to 24-year-olds now report having used the drug.'

Figures from the British Crime Survey showed cocaine use by 16-24 year-olds in the last year went from 5.1 per cent to 6.6 per cent between 2007/8 and 2008/9. The survey showed three per cent of all adults admitted taking coke in the previous 12 months, up from 2.4 per cent - meaning there are an estimated 974,000 users.

The BCS figures also revealed a surge in ketamine use among 16 to 24-year-olds. Around 125,000 young people used the horse tranquilliser last year. The document revealed, for the first time, an official acceptance that use of Class A drugs is on the increase in the long term.

Analysis of the figures between 1996 and last year showed a 'slight underlying upward trend' which is 'significant over the long term', Home Office statisticians wrote. Over the last year, among all adults, there were increases in the use of cocaine powder, ecstasy, anabolic steroids and ketamine. In the longer term, cannabis use is in gradual decline, with from around ten per cent of the adult population in 1996 to just under eight per cent now.

Shadow home secretary Chris Grayling said the figures revealed the scale of social decay in Britain. He said: 'Hardly a day goes by without yet another depressing set of statistics about the scale of Britain's social problems under this Government. 'Drug addiction causes family breakdown, is linked to a substantial proportion of crime and causes long-term damage to people's health. We have to turn this round.'

Home Office Minister Alan Campbell said overall drug use was 'historically low'. He said: 'It is encouraging that overall drug use remains historically low and that use of the most harmful drugs is stable. 'However, we are not complacent. We are taking comprehensive action to tackle cocaine use, from increased enforcement to reduce the supply, along with effective treatment, education and early intervention for those most at risk.

'Police and their partner agencies are seizing record numbers of drugs and cocaine purity is recorded at an all-time low. When people think they are taking cocaine, in some instances the actual purity is as low as four per cent. 'Police are increasingly seeing drugs cut with a hazardous cocktail of chemicals which include phenacetin, a known carcinogen. 'Cocaine can cause serious damage to health and these chemicals can, in themselves, cause significant harm to the user.' 23.7.09

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More than 11,000 under-16s 'treated for drug and drink addiction'

More than 11,000 under-16s were treated for addiction to alcohol and drugs last year, including hundreds under the age of 12. The official figures also show that 10 children under 12 needed treatment because they were dependent on heroin. The extent of the problem was revealed as a survey showed that one in four 16- and 17-year-olds said that they drank alcohol "for something to do".

In total, 11,294 children under the age of 16 were treated for alcohol and drug dependency last year. Of these, 4,005 were being treated for alcohol addiction, 57 of them under the age of 12, in 2007-08, the figures obtained by the Conservatives from the National Treatment Agency for Substance Misuse (NTA) show. Another 6,075 were treated for cannabis dependency, including 102 under-12s, and 93 for heroin addiction, including 10 under-12s.

In 2006 it was revealed that four children under 11 had been treated for heroin addiction in Scotland, after a 11-year-old girl collapsed in her school classroom after taking the drug. One in four 16- and 17-year-olds say that they drink alcohol "for something to do", a new survey shows.

More than two thirds, 71 per cent, said they drank at least once a week, while three fifths, 60 per cent, said that they had started to drink alcohol because it was part of "being young and socialising". On average, teenagers said that they had their first drink at 13 and were just 14 the first time they became properly drunk.

The teenagers were less concerned about getting drunk than about leaving education without any qualifications, having unsafe sex or taking recreational drugs, the survey, by the charity Drinkaware, which is funded by the alcohol industry, found.

Andrew Lansley, the shadow health secretary, said: "It's a sad indictment of our broken society that so many are turning to things like drug and alcohol abuse at such a young age. "The Government needs to take action now, before it's too late. "Tackling these problems has been low on their priority list and Labour's irresponsible decision to roll out 24-hour drinking on our towns and communities has not helped."

Norman Lamb, the Liberal Democrat health spokesman, said: "These figures are horrific and serve as a stark warning of the scale of drink and drug use amongst our children. "Labour's policies have been completely ineffective at stemming the tide of young people's addictions. "We now have thousands of children whose long-term health is being put at risk by this culture of drink and drug dependency".

Chris Sorek, chief executive of Drinkaware, said: "Many young people unintentionally put themselves at risk when they drink alcohol and it is crucial that young people are given the facts about drinking and its effects. "Under-18s need to know what drinking does to their body and appearance – as well as how to avoid peer pressure and stay safe."

However critics point out 'awareness campaigns simply don't work and current treatments are ineffective and have absolutley no bearing on the number of people quitting drink or drugs each year'. 8.7.09

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400,000 Britons 'have serious drug problem', says UN

Britain has the highest number of dangerous drug abusers in Europe, a United Nations report says. It claimed this country has more than 400,000 'problem drug users' who are permanently intoxicated or regularly bingeing on illegal substances. The drug abuse analysis also revealed Britain has the highest number of heroin and amphetamine consumers in Europe.

The UK remains the cocaine capital of Europe with an estimated one million users, according to the study from the UN Office on Drugs and Crime. Data given to the UN by the UK's Serious Organised Crime Agency (Soca) shows wholesale prices have risen to record levels. The cost of a kilogram of cocaine has increased by 50 per cent from £30,000 to £45,000 since 2007.

The portrait of Britons as the greatest consumers of illegal drugs in Europe is in contrast to declining drug use worldwide. UN officials are urging governments to encourage this trend by resisting calls to legalise or decriminalise drugs. The UN has long been critical of the British Government for downgrading the criminal status of cannabis in 2004. The shift of cannabis from category B to C was reversed this year.

Antonio Maria Costa, director of the UN drugs agency said: 'Drugs are not harmful because they are controlled. They are controlled because they are harmful.' He added that 'past runaway growth has flattened out and the drug crisis of the 1990s seems under control'. The report said that cannabis consumption is declining, globally and in Britain.

UK analysts have suggested this is because of growing evidence linking cannabis to mental health problems. The report added that Britain has up to 434,000 users of heroin and other opiates, double the number of users in France and nearly treble that of Germany. Not all heroin users are classed as addicts, and problem drug users include those who abuse other substances.

Shadow Home Secretary Chris Grayling said the report 'underlines just how ineffective the Government's strategy on dealing with the drug problem has been'. 25.06.09

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The middle-class mothers with a class A cocaine habit

They snort it in the loo as their children play downstairs - and do the school run still crazed from their £300-a-week habit. While her two eldest children did their homework in the kitchen and her youngest slept in his nursery upstairs, Francesca Keane seized the opportunity to steal two minutes of rare 'me' time. 

Safely locked inside the bathroom, she rolled up a £20 note, knelt on the floor and snorted a line of cocaine from the toilet seat. Instantly she felt her energy levels soar, and she returned to the kitchen to check on dinner feeling like a different woman.  It's a depressing scenario, but it's becoming a frightening reality in many middle-class households as women turn to cocaine to cope with the exhausting daily grind of juggling their professional and family lives.

An alarming report has revealed that the number of women abusing cocaine is almost at the same level as men for the first time, with 750,000 Britons having used the Class A drug in the past year. And one in 15 women under 25 admits to using it. Addiction experts report a huge rise in the number of ordinary, middle-class mothers like Francesca using the drug, where once it was the preserve of those who worked in media, legal and City circles. 

'I feel dirty when I look back at how I used cocaine to prop myself up when I was so exhausted from juggling a part-time job in promotions with running a family and a large home,' says Francesca, 42, who is married to Simon, 44, a musician. The couple live in a five-bedroom detached house near affluent Sunningdale, Berkshire, with their children aged 15, 13 and five.

'I'd taken cocaine socially when I was in my 20s, but when I married Simon and we had a family I assumed I'd never take it again. But when my second child was born I began to feel overwhelmed. I worked part-time because I wanted to maintain my identity outside the home, but it was tough juggling work with two small children and a large house.  'It gave me the energy to cope with domestic life'

'When the eldest children were about eight and nine, we went to Los Angeles with some friends whom we'd taken cocaine with in our younger years, and foolishly we succumbed to the temptation again. It was exhilarating to get that sudden rush. I realised it could give me the energy to cope with domestic life. So I started to take it regularly.

'At weekends, I'd feel I deserved cocaine, much the same as people go to the pub after work on a Friday night for a well-earned glass of wine,' says Francesca, who is in the early stages of recovery having sought professional help for her cocaine use a year ago.  'But then I started using it in the week, too, snorting lines in the loo while the kids were busy with other things. Simon had no idea. 'After I did it, I'd soon feel as though I could take on the world. I'd clean the entire house, firing on all cylinders. But when I came down from that high I'd be ratty, depressed and feel physically awful.

'There were times I went to the school gates while coming down from a high, which is shameful, I know. But I wanted a bit of escapism. 'Of course I felt guilty, and I wonder why the hell I couldn't cope the way millions of other mothers seemed to. 'At my worst, early last year, I was snorting £300 worth of cocaine a week. Thank goodness my children never caught me doing it. But they were becoming wary of my mood swings. One day it hit me that my children could actually be taken away from me. 

'I contacted an addictions clinic for help and confessed everything to my husband, who has been tremendously supportive. We've been honest with our children about my problems, too, and with help I have weaned myself off this horrible drug.'  Frightened to come forward for fear of losing their jobs

Paul Spanjar, treatment director at addictions rehabilitation clinic Providence Projects, based in Bournemouth, Dorset, says he treats an increasing number of middle-class women like Francesca for cocaine abuse. 'My fear is that  there are many more who are frightened to come forward because they are scared of losing their jobs or, worse, that social services will intervene with their children,' he says.

Sophie Finnie's reliance upon cocaine destroyed her marriage. The 39-year-old marketing manager lost her husband James, 43, a company communications director, and custody of their children aged seven and five. 'The irony is that I'd always been so against drugs,' says Sophie, who attends a weekly recovery meeting for addicts, and lives alone in Islington, North London.

'When we had our children, I had to continue to work because we had a big mortgage. But I found it utterly exhausting. James was away a lot with work, and both our families live in the Midlands, so I didn't have a support network around me. 'But I still felt I should be able to manage a career and family life. We'd been promised that our generation could have it all, so why couldn't I?'

Then in January 2008, Sophie broke down in tears while talking to a friend about the pressure, and the friend said she had felt the same until she'd discovered cocaine. 'She explained that she just took it occasionally as a way of pepping herself up,' says Sophie. 'Put like that, it didn't sound so bad.

'Two weeks later, we met at a wine bar in London and I took my first line of cocaine with her in a toilet cubicle. I suddenly felt energy I hadn't had since my early 20s, and it was intoxicating. I went home that night feeling like my pre-motherhood self, and even had sex with my husband  -  something we'd not done for months as I was always too tired. 'From then on, every time I was feeling rotten, I'd just buy some cocaine from a colleague.

'Within six months, I was secretly taking it when I got home from work just to get me through the chores. But after the huge highs came crashing lows. I couldn't sleep, I'd feel shaky and sick and my husband started to ask questions. 'Then, one day, I took cocaine in the loo at home, but forgot to wipe the traces from my nose. James exploded, and even though I broke down and tried to explain how I'd started using it only as a pick-me-up, he said our marriage was over.'

Former TV director Sarah Graham, 40, spent nine years and more than £100,000 in thrall to an addiction that almost killed her. She now runs a clinic, Sarah Graham Solutions, to help other addicts. Sarah says: 'Cocaine is a Class A drug for very good reasons. Even taking it just once puts you at considerably greater risk of a heart attack or stroke, and long-term use can damage your liver and mental health.

'At my clinic in the Surrey countryside, and on my new addictions website, a third of my cocaine-using clients are women  -  and they are getting younger. 'So many women get to the end of the working week and they don't have the energy even to have a quick drink with colleagues straight from the office. They're exhausted, and they still have to go home to clean and cook and look after their family.

'Then someone suggests that snorting a line of cocaine would help, so they take it. Before they know it, it's become a regular crutch against the grind of their lives.  'It's so much cheaper now, too  -  as little as £25 a gram compared to £70 back in 1992 when I took my first line.'

Sarah's cocaine use spiralled into a weekly habit when she landed a job as TV director on The Big Breakfast in 1996 where the crew had a work-hard/party-harder ethos. 'I'd go to work on the Tube on a Monday morning feeling absolutely deathly, but also gripped by anxiety and depression, another side-effect of abuse. I'd vow never to have another weekend of partying. But come Friday night, I'd be taking cocaine again.

'In 2000, I went freelance as a director, doubling my income and cocaine usage overnight. On the outside, I had the perfect life, but it was an empty, fake existence. 'Then my dad died of cancer in November 2001 and my loss was too much to bear. The night of the funeral I hit the vodka and then rang my drug dealer. From then on I spent £1,000 a week on cocaine, snorting up to 30 lines a day. 'My face was bloated, my nose bled, my skin was ashen. Then a friend who was a recovering addict suggested I needed professional help.'

In December 2001, Sarah checked into The Priory's treatment centre in Surrey. When she left rehab in autumn 2002, she got a job as a postwoman and completed The Priory's Professional Addiction Counselling Diploma. Now she helps women just like Francesca and Sophie.

'I have so many clients who wish that, as they'd crouched down over a toilet seat to snort their first line of cocaine, they'd have known what the consequences to their health and family life would be,' says Sarah. 'I've met one lady in her 20s who rarely took cocaine, but the few times she did take it was enough to trigger a stroke. She's now permanently brain-damaged.

'The great irony for her  -  and thousands like her  -  is that you take cocaine believing that it will enhance your life, but it can actually end up destroying it. And when you are looking after a husband and children, that is a very dangerous game to play.' 18.6.09

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Labour's 'phoney war on drugs is a costly flop'

Labour has waged a 'phoney war' on the drug problem by squandering billions on ineffective treatment while presiding over Europe's most liberal drug regime, a damning report claims today. The study highlights rising levels of drug use, fewer prosecutions and a treatment system which has 'trapped' thousands of people on the heroin substitute methadone.

The report, from the Centre for Policy Studies, urges ministers to return to tough enforcement of drug laws, and copy nations such as Sweden and the Netherlands which are widely seen as liberal but in reality take a far firmer line than the UK.

Drugs expert and author of the report Kathy Gyngell says Britain spends £1.5billion a year combating drugs, but enforcement operations are underfunded and costly treatment programmes do not work. More than £800million a year is spent on treatment projects, the report states, compared with £380million on trying to keep drugs out of the UK.

And while ministers boast of 200,000 addicts in treatment, less than three per cent of them have become 'clean'. Around 147,000 are simply kept on prescribed substitutes, such as methadone, and only 6,700 have undergone residential detox treatment. Spending on methadone has trebled in the past five years to around £300million a year.

The study is scathing of the Home Office's 'FRANK' online drugs advice service. It says the website 'effectively endorses' drug-taking and 'epitomises the Government's low aspirations' in keeping young people off drugs. Over the last decade consumption of Class A drugs has risen dramatically.

The Government claims that overall cannabis use is falling but Britain still tops the European league for use among school pupils with 29 per cent admitting to having taken the drug --compared with an EU average of 19 per cent. In 1998, 3.8 per cent of UK adults admitted having tried cocaine. By 2007 that had risen to 7.7 per cent, more than double the EU average.

The UK suffers 47.5 drug-related deaths per million adults a year compared to 22 in Sweden and 9.6 in the Netherlands.

'The UK drug problem is the worst in Europe,' the report says. 'The UK leads in "recreational" drug use with the highest levels of cocaine, ecstasy and amphetamine consumption.' Miss Gyngell says the Government must focus its efforts on stopping drug use rather than reducing the harm drugs cause.

It should focus treatment on detox and rehabilitation rather than substitute drugs, and draw up 'a tougher, better-funded enforcement programme to reduce the supply of drugs'. Her comments were welcomed by final-stage detox providers. 18.5.09

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Drugs advice helpline FRANK to be investigated after teenagers were told to use cannabis and ecstasy

Ministers launched an investigation yesterday into the Government's drugs advice hotline after teenage callers were told to use drugs. Advisers at the FRANK helpline condoned cannabis smoking by a 13-year-old, and it was suggested to a 15-year- old who said she had experimented with ecstasy that she could go on taking it. Young teenagers were told alcohol is more dangerous than cannabis and one worried caller was repeatedly counselled not to tell the parents of a cannabis smoker about his drug use.

The £6.5million-a-year FRANK service has for six years been one of the Home Office's main weapons for alleviating the damage drugs can do to the young. Advice given by supposed experts manning the organisation's 24-hour helpline criticised government drugs policy and encouraged youngsters to break the law.

A spokesman for the Home Office, which runs the FRANK operation in tandem with the Department of Health and the Department for Children, Schools and Families, said: 'It is completely unacceptable for a FRANK adviser to be giving out wrong, misleading and inaccurate information.

'We are urgently looking into the matter and will identify the person or persons involved and take action.' She added: 'FRANK is an important resource for young people who need help and advice about drugs.'

The service has been controversial since its launch in 2003. Designed to communicate the dangers of drugs to the young in their own language, it has been regularly attacked by critics who say it takes a liberal line and downplays dangers. Its website, for example, suggests cannabis carries mental health risks only for those with an existing history of these problems.

But a series of calls to its helpline by newspaper reporters posing as teenagers found some of FRANK's 75 advisers actively encouraging drug use. One caller pretending to be worried about a 13-year-old boy using cannabis was told: 'If you use it a couple of times it doesn't have to cause any problems.'

A caller posing as a 15-year-old girl who had tried ecstasy was told: 'It's not going to affect your health.' The adviser did not know that ecstasy is a Class A drug. The caller was also told that she could smoke cannabis after taking ecstasy: 'It wouldn't spin you out like another powder or a pill.'

The advice given to callers from the Sunday Telegraph provoked anger among opposition politicians and drug experts. Shadow Home Secretary Chris Grayling said: 'The idea that the Government's helpline should be saying to young people "go for it" shows that the Home Office is all over the place in its approach to drugs.'

Campaigner Mary Brett of Europe Against Drugs said: 'When I was a teacher my pupils were getting these sorts of answers when they called FRANK. 'These advisers seem to be completely ignorant. They do not seem to have been trained at all. I cannot imagine where the Home Office found them. 'This is incredible advice for a government service to be giving.' 20.4.09

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Britain now official drugs capital of Europe as more youngsters use cocaine, ecstasy and amphetamines

Drug abuse in Britain is worse than anywhere else in Europe, a devastating analysis showed yesterday. Young people in the UK are more likely to take cocaine, Ecstasy and amphetamine than those in any other country on the Continent, it said. They are using cocaine in quantities and with a frequency unmatched anywhere else in the world apart from the U.S., the report found.

One in 20 schoolchildren of 15 and 16 - around 200,000 teenagers - have used the drug, it said. The analysis, by the European Union's drug agency, also pointed to levels of deaths from drugs that are higher here than in any other major nation in the EU. Only four small European countries - Luxembourg, Estonia, Norway and Denmark - lose a higher proportion of their young people in drug-related deaths, the report
said.

Deaths linked to drug abuse in Britain are, the figures suggest, running at double the rate of those in Germany and four times those in France. Ecstasy use 'remained consistently higher in the UK compared to other countries', said the report, from the Lisbon-based European Monitoring Centre for Drugs and Drug Addiction. It suggested that young Britons who would in the past have used amphetamine are switching in large numbers to cocaine.

The report said that four European countries now have a higher level of cocaine use than Australia, which has high levels. But only Britain 'reports a lifetime prevalence estimate that is similar to that of the U.S.A.'. The 5 per cent of teenagers and young adults who use cocaine in Britain is now ahead of levels in Spain, where links to South America have produced a cocaine boom in recent years.

Britain has seen cannabis use decline. The report noted that the UK had highest cannabis use in the mid-1990s but now ranks third. Eighty per cent of those who had stopped using cannabis 'cited a lack of interest', the report said.

The report came as a rebuke to ministers, who are trying to paint a picture of declining drug use among young people. They point to the controversial British Crime Survey as evidence of lower drug abuse. The European report showed that even the real good news for Home Secretary Jacqui Smith is qualified.

While cannabis use in Britain has been going down, young people in this country remain more likely to use the drug than those in any EU country apart from France and Denmark. Shadow Home Secretary Dominic Grieve said: 'This report confirms Britain's status as the cocaine capital of Europe, not to mention the fact we also have the highest prevalence of amphetamine and Ecstasy use amongst adults.

'It is particularly disturbing that we have the highest proportion of 15 and 16-year-olds using cocaine - the Government's failure is betraying a whole generation of young people.' He added: 'This is due to Labour's chaotic, confused and staggeringly complacent approach to drugs. Drugs wreck lives, destroy communities and fuel crime - the fact Labour do not recognise this make them part of the problem, not the solution.'

The Advisory Council on the Misuse of Drugs, which advises Miss Smith, is holding an inquiry into whether Ecstasy should be downgraded from the most serious legal status of class A. Committee chief Professor David Nutt has indicated it could even be shifted to class C, the current category for cannabis, where police tend not to arrest users caught in possession. Links with tobacco smoking and with schizophrenia and other mental illness helped persuade ministers to return cannabis to class B next year. However, police chiefs have said they will not instruct officers to arrest users, which means the reclassification decision will have little effect. 7.11.08

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One in ten adults admits taking illegal drugs in the past year

One in ten adults admits using illegal drugs in the past year, startling new Home Office figures reveal. The statistics show that more people are taking the most harmful Class A substances than ten years ago. Of the three million people aged 16 to 59 who have taken at least one illegal drug over the past 12 months, almost a million admit using the hardest drugs, including cocaine, heroin and ecstasy. Almost 750,000 have snorted cocaine.

Critics say the figures expose the Government's failure to make inroads into the level of use of the most harmful drugs. But Ministers say the overall trend in illegal drug abuse is down and point to a fall in the numbers taking cannabis. Cocaine use has grown dramatically since 1997, and there are worrying signs that a generation of older drug-takers are continuing their habits into middle age.

Opposition critics blamed the growth on what they called Labour's 'mixed messages' on drug use and a failure to pursue effective treatment strategies. While some 200,000 drug users enter treatment each year, only around three per cent are drug-free at the end of their course.

The drug statistics are based on household surveys and officials admit they are almost certainly a significant underestimate of total use as they ignore under-16s, the homeless, students in halls of residence and addicts with chaotic lifestyles. More than a third of the 32million adults in Britain admit having used illegal drugs at some time of their life.

The proportion using hard drugs in the past year is three per cent, up from 2.7 per cent in 1998. They include 740,000 who admit snorting cocaine and 470,000 who took ecstasy. More than 9.6million people now admit using cannabis, of whom almost 2.4million - 7.4 per cent of adults - have taken it in the past year.

The highest rates of drug taking are in the 16-24 age group, where 42 per cent admit taking illegal drugs, including 21.3 per cent in the past year. Around 15 per cent have taken Class A drugs, and 18 per cent have used cannabis in the past year. There are worrying signs of increased use among older users, particularly of cocaine. The proportion of adults aged 25 to 29 admitting using Class A drugs has risen from 3.9 per cent in 1996 to 6.3 per cent.

For those aged 30 to 34 the figure has doubled to 3.8 per cent, and for 35 to 44-year- olds it has more than trebled, from 0.5 per cent to 1.7 per cent. Trends in overall drug use are more encouraging, mainly driven by a fall in past-year cannabis use - from 9.5 per cent of adults in 1996 to 7.4 per cent. The proportion of adults who admit taking any illegal drug over the past 12 months fell from 10 to 9.3 per cent last year. In 1996 the figure was 11.1per cent.

The Home Office released separate figures boasting of a record number of drug seizures, up from 161,000 to 186,000 last year. Recent increases, however, are mostly down to a huge rise in on-the-spot cannabis warnings by police. Users have their drugs confiscated but do not face arrest or a criminal record.

Home Office Minister Alan Campbell said last night: 'These statistics show that overall drug use continues to fall and is now at its lowest level for ten years. Our efforts in tackling drugs are clearly delivering results.' But Shadow Home Secretary Dominic Grieve said: 'No amount of spin can hide the fact that Class A drug use and drug crime have risen under this Government, leaving Britain with the worst drug abuse problem in Europe.' 31.10.08

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Drug crime up as Home Office admits police have been under-recording serious offences for the past 10 years

Public trust in crime statistics has been dealt a devastating blow after ministers admitted the figures have been downplaying serious violence for up to a decade. The Home Office admitted that as many as one in five of the worst attacks has been wrongly classified in published figures.

As many as 4,000 serious assaults each year were mistakenly recorded as minor incidents - and officials conceded they 'simply do not know how far back it goes'. The tightening of the rules has seen figures for serious violent crimes rocket by 22 per cent compared to last year - and confusion over the figures makes it impossible to say how much of the rise is genuine. Ministers blamed the blunders on police officers, who were wrongly classifying cases of 'grievous bodily harm with intent' as minor assaults.

But if this is the case it is unclear why the practice was allowed to continue for so long unchecked. Police have been placed under severe pressure by ministers to reduce the level of serious violence on the street. Critics may claim this provided an incentive for officers to downplay the gravity of assaults where - while the intent was grave - the actual injuries suffered were minimal. In a sign of the chaos the Metropolitan Police yesterday took the unprecedented step of halting publication of its violent crime figures to check whether they meet the guidelines.

Senior police chiefs admitted the problems affected all 43 forces in England and Wales. Critics claimed the revelations were another serious blow to the credibility of Government crime figures following years of complaints of spin and statistical manipulation. The confusion makes it impossible to tell whether serious violence rose or fell last year - although there are indications of a significant increase in serious knife attacks.

There are also grave questions over repeated statements by ministers in recent years stressing the minor nature of many recorded offences. The blunder centres on the way vicious attacks are logged at police stations. Officers generally class an assault as grievous bodily harm if the victim suffers a cut to their skin or a broken bone. But the rules also state that where an attacker tries but fails to inflict such an injury police should record the assault as GBH rather than a lesser offence - in the same way that attempted murder is treated as a serious offence even if the intended victim is unharmed. Where a thug tries to smash a bottle in a victim's face but causes only a nosebleed, for example, police should recorded the incident as GBH.

It now transpires many officers had been downgrading such incidents to lesser charges of actual bodily harm or common assault - which fall outside the Home Office's definition of 'most serious violence against the person'. In the latest quarterly figures published yesterday the category of 'most serious violence against the person' had leapt by 22 per cent year on year. It rose from 4,500 in the second quarter last year to 5,500 in the same period this year, equivalent to around 60 a day.

But ministers said the startling rise was largely because police across the country were ordered earlier this year to follow counting rules more rigorously when logging crimes. This 'clarification' by the Home Office quickly revealed that many serious assaults were being wrongly recorded.

The Home Office's head of statistics Paul Wiles said: 'We simply don't know how far back this goes. The people doing the recording are constantly changing and retiring.' He said there was evidence that two-thirds of the 22 per cent increase in serious violence was caused by the new counting rules. Warwickshire Chief Constable Keith Bristow, for the Association of Chief Police Officers, said: 'This is an issue that affects all police forces to a greater or lesser degree.' Home Office police minister Vernon Coaker denied the blunders were embarrassing, saying: 'I want the statistics to be as clear as possible.'

But Shadow Home Secretary Dominic Grieve said: 'These figures fatally undermine government spin that violent crime was getting better. Labour should now face up to the reality of their failure and realise that if you can't count a problem, you can't combat it.'

STABBINGS SOAR
Violent crime was broadly stable in the year to June, according to the Home Office. But confusion over the figures means the department cannot be sure whether serious violent assaults were also stable or whether they rose as much as 7 per cent since last year. There are signs that more serious knife crime did increase.

Figures for serious stabbings rose 29 per cent, from 1,253 in the second quarter of 2007 to 1,616 in 2008 - equivalent to an extra 1,500 stabbings each year. Home Office statisticians said a third of that increase was due to the tighter recording rules, but that still leaves a 20 per cent year-on-year rise.

Use of knives in sexual offences was counted separately for the first time, revealing there were 8,610 incidents in the three months to June - equivalent to 34,440 per year, or almost 100 offences per day. Recorded gun crime was down 6 per cent, from 9,862 in the year to June 2007 to 9,306 the following year.

DRUG CRIME UP 8%
Drug offences continue to buck the trend of falling overall crime. Between 2007 and 2008 recorded drug crimes were up 8 per cent, with 59,000 cases logged by police in the second quarter of this year, up from 55,600. The rise is equivalent to an extra 17,000 drug offences each year, and continues a long-term upwards trend.

Recent quarterly crime bulletins have shown year-on-year rises of 14, 21 and 22 per cent. In contrast, overall crime fell 6 per cent year-on-year, from 1.3million offences in the second quarter of 2007 to 1.2million in 2008. Ministers claim the rise in drugs crime reflects greater use of formal warnings for possession of cannabis, which do not carry a criminal record or any other punishment. The warnings have been popular with frontline officers because they count as a 'solved' crime, helping hit Government targets, without taking up hours of their time. 24.10.08

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Drug policies just make addiction worse

The fruitless battle to access help for her drug addict daughter convinced Kate McKenzie that heroin should be prescribed on the NHS. To most people looking at my life from the outside, I seemed to have a pretty perfect existence. Two beautiful daughters, now aged 18 and 21, my husband a finance director on a good salary and for me an interesting career designing interiors for historical buildings. We lived in a beautiful Georgian property in Brighton overlooking the sea – picture perfect!

Yet when I sat next to people at dinner parties and was asked what my children did, my answer shattered that picture. My eldest daughter Hannah has been a heroin addict now for over three years, a fact I have never tried to hide.

Shocking people with my answer, it always provoked a response, yet never the one I expected. Many people would then confide that their son, daughter, niece, nephew or friend had drug problems too, and then the whole sorry tale of addiction poured out. It seemed to me that there is a large sector of society that keeps this pain hidden, too embarrassed to admit to having a drug addict in the family. Somehow, we believe that drug addiction only happens on sink estates in the deprived areas of large cities. But heroin takes no notice of income, class, race or religion. It feeds on vulnerability and that can be found anywhere.

During the past three years spent trying to get help for my daughter I became enmeshed in the most complex, bureaucratic and punitive system involving social services, housing, hospitals and, of course, the police. To someone like me, reasonably intelligent, articulate and not off my head on drugs, it was an absolute nightmare to navigate around the system; for a confused addict it was impossible. I spent my days arguing with the various agencies trying to access help and support, and my nights rehearsing my daughter's funeral in my head. No wonder that after two years I had a breakdown. Fortunately, it was probably the best thing that happened to me and allowed me at last to take a step back and look at the wider picture.

It was at this point that Hannah and I met Jane Treays and decided to take part in the Cutting Edge documentary, Mum, Heroin and Me, which will be broadcast on Thursday night. We both felt very strongly that the film would dispel many of the myths surrounding heroin, highlighting just how awfully depressing and dull the life of an addict really is.

I wanted people to know that the bureaucratic systems were simply unworkable when dealing with people who could not or would not work within their constraints. I began to realise that if heroin was prescribed to long-term addicts it would remove the pressure of how to obtain the money for the next fix. This would then allow addicts to access the help they really need, and so doing would benefit the rest of us who are victims of their life of crime. Ultimately, I hope that the government will change its policies on drugs in order to protect our vulnerable teenagers from this epidemic and to help those already in its grip.

For Hannah, seeing her life unfold on film has at last made her realise how sordid it had become, and she flew to South Africa last Saturday to start a five-month detox. For me, the last year has seen my marriage disintegrate and my health suffer. To have my daughter back fit and whole is all I ask. Channel 4 23.10.08

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The bureaucracy of drug addiction needs drug addicts far more than drug addicts need the bureaucracy of drug addiction.

For the past 14 years, I have worked as a doctor in a large general hospital in a deprived area of Britain , and in the even larger prison next door. In that time, I have seen heroin addiction rise from an infrequently encountered problem to a mass phenomenon. It has now become so widespread that the city council has politely asked residents not to put used needles and syringes in the weekly rubbish collections. No stairwell in any housing estate is complete without the discarded paraphernalia of drug abuse.

If an increase in the number of heroin addicts such as Britain has experienced in the last few decades - up from a very few in the 1950s (there were only 62 known cases in Britain in 1958, 67 in 1968, and as late as 1978 there were only 859, when heroin addicts were still few enough to be registered individually by the Home Office, which no doubt underestimated the numbers, but not by orders of magnitude) to well over 100,000 by the year 2000 and up to 195,000 in 2007 - constitutes an epidemic, it is an epidemic of a very strange kind, one that is spread by the psychological contagion of bad ideas and bad desires rather than by the physical contagion of bad germs.

Drug-addiction services have also grown massively. In our society, every problem calls forth its equal and supposedly opposite bureaucracy, the ostensible purpose of which is to solve the problem. But the bureaucracy quickly develops a survival instinct, and so no more wishes the problem to disappear altogether than the lion wishes to kill all the gazelle in the bush and leave itself without food. In short, the bureaucracy of drug addiction needs drug addicts far more than drug addicts need the bureaucracy of drug addiction. The propaganda, assiduously spread for many years now, is that heroin addiction is an "illness". This view serves the interests both of the addicts who wish to continue their habit while placing the blame for their behaviour elsewhere, and the bureaucracy that wishes to continue in employment, preferably for ever and at higher rates of pay.

Viewing addiction as an illness automatically implies there is a medical solution to it. So, when all the proposed "cures" fail to work, addicts blame not themselves but those who have offered them ineffectual solutions. And for bureaucracies, nothing succeeds like failure. The Government spends £384m a year on drug treatment alone, despite there being little evidence of any reduction in the number of addicts and only achieving a 3% success rate, however the true cost is much more startling:

Since the bureaucratic solution to waste is to waste even more, you don't have to be Nostradamus to predict that funding in Britain will continue to rise. Before the expansion of heroin addiction in my city, I knew little about it. I'd known a few addicts in the higher echelons of society, but they had been peculiar even before their addiction. I had briefly run a drug-addiction clinic in a famous university town, at a time when I accepted what I now know to be myths about heroin addiction. But as more addicts came to my attention – I see up to 20 new cases a day in prison – I began to think about it more.

The medical perspective, that these people were ill and in need of treatment, seemed less and less convincing. I discovered that most addicted prisoners stopped taking heroin in jail, even when it was available. They came into the prison starving and miserable, and went out relatively healthy. But within a few months, many were back in their former condition, and when brought once more before the courts, some would beg to be imprisoned. When, soon after their return, I asked them whether they intended to give up taking heroin, some would reply: "I'll have to, I've got no choice." Asked why, they would offer replies such as: "Because my girlfriend's just had a baby and she won't let me see it unless I do."

This answer was a strange one if these addicts truly thought of themselves as ill and in need of treatment. Instead, they clearly believed a purpose in life was enough to enable them to abstain. This is not how pneumonia, for instance, is cured. No one would say: "I must stop having pleuritic pain each time I breathe deeply because I have just had a baby." Yet the medical services allow addicts to focus exclusively on the physiological aspects of addiction, which in practice means the prescription of a drug such as methadone.

It's very hard work to become an addict

Going cold turkey is quite easy

People choose to get hooked...

There is a strenuous, almost outraged, rejection of the idea that addiction is, at bottom, a moral problem, or even that it raises any moral questions at all. Of course, addiction to heroin and other opiates has serious medical consequences. I often saw addicts with deep vein thromboses or multiple abscesses; they would have TB; they would be malnourished and infected with Hepatitis B or C, or both, and HIV. It would be difficult to obtain blood from the veins in their arms or legs because they had injected so often. But medical consequences do not make a disease. Many mountaineers get frostbite, but mountaineering is not a disease. To conceive of heroin addiction as such seems to me to miss the fundamental point: it is a moral or spiritual condition that will never yield to medical treatment.

Having started with a vague supposition that the medical approach to addiction must be right, I came to a different conclusion: that such an approach, having started no doubt as an honest attempt to help addicts, now represented a combination of moral cowardice, displacement activity and employment opportunity. The therapeutic juggernaut rolls on. It is easier, after all, to give people a dose of medicine than a reason for living. That is something the patient must minister to himself. In coming to these conclusions, I felt I was living in a world in which the plainest of truths could neither be said out loud nor acknowledged.

Every day I saw addicts selling their prescription drugs or continuing to take heroin and any other drug they could get; addicts who, despite their "treatment", continued to commit crimes; addicts openly contemptuous of attempts to help them, who lied to and manipulated their helpers shamelessly; and addicts who had, without any assistance, given up heroin completely. Above all, I observed the true triviality of heroin withdrawal symptoms. Yet my observations did not seem to matter. It was almost impolite, and increasingly impolitic, to mention them to colleagues who dealt with addicts, though they must have observed the same things.

I felt like a heretic who had better keep his beliefs to himself. Had I not been lucky enough to work with three eminent physicians who had observed precisely what I had, and drawn the same conclusions, I might have broken down. The orthodox view of addiction is that a person is somehow exposed to heroin more or less by chance. It has a pleasurable effect, and he or she keeps taking it. Before long, the person is addicted and, to avoid the terrible suffering of withdrawal, must take more. Of course, to pay for this, addicts usually resort to crime, for their addiction precludes normal paid work but requires a large income. All powers of self-control are destroyed by heroin, and unless they take a substitute drug, such as methadone, or enter a lengthy rehabilitation programme, addicts cannot give up. They are hooked for life and need help – from the drug-addiction bureaucracy. There is only a tiny grain of truth in all this. That physiological addiction exists is indisputable. But in practically all other respects the standard view is wrong, a masterpiece of rhetorical tricks.

It is to heroin addicts what Marxism was to the Politburo of the former Soviet Union : a systematic pseudo-scientific justification for everything they do. The orthodox view is self-serving for addicts because it implies no possibility of self-control and so no blame. What, perhaps, is more surprising is that many doctors, therapists and social workers swallow such nonsense. The truth is people who are genuinely exposed to strong opiates by chance, such as after an operation, rarely become addicted to them. It might once have been the case, before awareness of the addictive properties of heroin was so general, that unsuspecting people were introduced to the habit by others and were thus "hooked". Whatever may have been the case in the past, this is not a plausible explanation now.

Children may no longer know the date of the Battle of Hastings, but they know heroin is addictive. Many addicts say they did not know what they were getting themselves into when first they took heroin, but this is not credible; they could not have failed to know. Again, the standard view is that the process of becoming addicted to heroin is swift. The future addict has to take the drug only a couple of times and then – hey presto – his willpower is gone. He is hooked forever. But actually, you have to work quite hard to become a heroin addict. It is not something that creeps up on you unnoticed. In fact, addicts are people intent on rebelling against received norms. They enjoy the feeling of swimmy calm that heroin produces and make a free choice to become an addict. Nor are the withdrawal symptoms from heroin anywhere as terrible as normally painted. In the popular conception, going "cold turkey" is dreadful beyond all description, involving cramps, insomnia, vomiting, shaking and sweating.

But not a single addict has ever caused me as a doctor to feel anxiety for his safety on account of his withdrawal. And all the genuine symptoms, which are never severe, such as muscular aching, diarrhoea, crying, sneezing and insomnia, have been relieved by simple, non-opiate medication. Certainly, most withdrawing addicts have portrayed themselves to me as being in the grip of dreadful suffering. They writhe in agony, claiming they have experienced nothing as bad in their lives, and they make all kinds of threats if I do not prescribe "something" – they mean an opiate – to alleviate their suffering. The threats range from damaging their cells to killing themselves, others or even me. (Withdrawing alcoholics never make such threats.) In fact, heroin addicts rarely carry out their threats. Those who say they are suicidal quickly admit they were merely trying to get methadone when I suggest they be put in a cell so bare that there is nowhere from which to suspend a noose.

My counter-threat produces in most cases the most miraculous improvement in their mood. Not all the addicts I see exaggerate in this fashion. Some admit with a laugh that anyone who says cold turkey is terrible is lying and more than likely trying to bluff his way to getting methadone.

As long ago as the Thirties, experiments showed that salt solution could be substituted for morphine without the addicts' knowledge, and they could be deceived out of their withdrawal symptoms. Yet the established fact that withdrawal from opiates is not a serious medical condition is a truth universally ignored by doctors. The great glory of withdrawal agony, from a career point of view, is that where suffering exists, it is necessary to employ more and more doctors, nurses, psychologists, social workers and counsellors to relieve it. Yet consider what happened in China after Mao took power in 1949. At the time, China had more opiate addicts than the rest of the world put together – about 20million.

But Mao gave them a strong motive to give up: he shot the dealers and any addicts who did not give up their habit. Within three years, Mao produced more cures than all the drug clinics in the world before or since, or indeed to come. He was, indeed, the greatest drug worker in history. The point of this story is not to advocate a repetition of Mao's methods. It is to demonstrate that, when a motive is sufficiently strong, many millions of addicted people can abandon their addiction without the paraphernalia of help considered necessary today.

It demonstrates that people take heroin out of choice, ultimately, and so can stop out of choice. Addicts are not blameless victims of some terrible illness they have no control over.

Almost everything you know about heroin addiction is wrong.

Based on his experience as a prison doctor and as a psychiatrist in a large general hospital in Birmingham, Dr. Dalrymple argues that addiction to heroin is not an illness at all, and that doctors only make it worse. They deceive both the addicts and themselves by pretending that they have something to offer.

In this brilliant, entertaining and provocative book, Theodore Dalrymple explains how and why a literary tradition dating back to De Quincey and Coleridge, and continuing up to the deeply sociopathic William Burroughs and beyond, has misled all Western societies for generations about the nature of heroin addiction. These writers' self-dramatizing and dishonest accounts of their own addiction have been accepted uncritically, and have been more influential by far in forming public attitudes than the whole of pharmacological science. As a result, a self-serving, self-perpetuating and completely useless medical bureaucracy has been set up to deal with the problem.

With scathing wit, implacable logic and savage denunciation, Dr. Dalrymple exposes the mythology surrounding heroin addiction. Moving seamlessly between literature, pharmacology, history and philosophy, he demonstrates what happens when the nature of a social problem is so thoroughly misunderstood, and when human beings are regarded as inanimate objects rather than as agents of their own destiny. His scintillating, iconoclastic little book has an importance far beyond its immediate subject matter.

Junk Medicine: Doctors, Lies And The Addiction Bureaucracy, by Dr Theodore Dalrymple, is published by Harriman House Publishing on August 27, 2007 , priced £14.99. Click here to order . 18th August 2007

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Perpetuating the Addiction Myth

The book, The Truth about Addiction and Recovery makes a very compelling argument that the "disease theory" of addiction, especially for alcohol and drugs, is completely wrong. Common dogma says that "Addiction is a disease." Researchers explain addictions are caused by endorphins, chemicals the brain secretes in pleasurable moments. Addicts chase the high from endorphins, as the theory goes. There's just one problem: It's never been proven.

"Addicts can't stop themselves." "They'll be addicted for the rest of their lives." "They must never smoke or drink again!" Again, all are myths. Smokers, drinkers and even drug users have stopped on their own or with effective treatment.

As for drug users, there have been several studies affirming that people do quit drugs and don't give into temptations to use them; one study followed Vietnam vets: Many used heroin while in combat, but few continued using it after they came home. Consider how many people experimented with drugs during the '60's, yet this did not lead to mass addiction in the 70's.

Addicts are "cured" by treating them in hospital-based programs. Yet, there's no evidence that they don't get people off drugs or alcohol any faster or more effectively. In fact, they may even hinder recovery. The typical hospital-treatment program for drug and alcohol addicts imposes these premises on the patient: "You have a disease", "You are an addict", "You will be addicted for the rest of your life", "You are in denial", "You must turn to other addicts for guidance". Many of these programs impose a coercive environment so that addicts can "come to terms" with their addiction. Many of these programs are physically abusive, but the worst part of treatment, though, is the way that clients have their identities forced upon them. No longer are they housewives, teachers, executives or writers–they are addicts! Forever.

People need treatment in the context of their lives, and encouraged to overcome their addictions among family and friends. Well-balanced people, rather than addicts, are their models. Most importantly, people under treatment develop an identity of their own, without coercion.

Claims that the 12-Step/Disease Concept of recovery is the most successful treatment ever devised are what we hear. The reality is that these treatment paradigms have consistently demonstrated outcomes ranked lowest among the various options studied. The Ditman Study provided evidence that AA is no more effective than no treatment at all. The AA itself conducts surveys. The AA Monograph, Comments on AA's Triennial Surveys, revealed this surprising result regarding new member dropout rates:

At one month, the percentage of those that have remained is 19%, at 3 months 10%, and at 12 months 5%. This is a 5% success rate at the one-year point if success is simply defined as continuing AA membership. Because AA considers addiction a chronic, progressive disease, these findings make it ironic that the 12-Step model is described as a “program for life”.

There is an opposing viewpoint to that of Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and all other twelve-step mutual-help support groups, that these groups, unfortunately, are part of the problem, not the solution. They only serve to perpetuate myths that have clearly been proven false based upon the vast amount of research that has been done in the field of substance abuse.

All twelve-step support groups teach the disease model of addiction, which was popularized by AA and adopted by professional organizations and government agencies. The disease model of addiction is intellectually sloppy and unscientific. This model does much more harm than good because it undermines peoples' feelings of self-control. Here are its basic premises: Addicts inherit the disease of addiction. They are born with this disease and are therefore already addicts long before they ever use drugs/alcohol.

Their disease is characterized by loss of control and progression. In other words, addicts can never control their drug/alcohol use and their disease inevitably gets worse and worse. Their only hope is to remain completely abstinent from all drugs and become a lifelong member of a twelve-step support group. This definition of the 'disease concept' is from the book of Narcotics Anonymous.

Counsellors, AA members, and other disease proponents often talk about inheriting "the gene for alcoholism." These genes have never been found (although a lot of time and money has been spent looking for them). Most researchers, in fact, agree that it is highly unlikely that any such genes exist. A study was published in the Journal of the American Medical Association (JAMA) on April 18, 1990, linking alcoholism to a specific gene. The study was accompanied by press releases, news conferences, and interviews with the researchers. Eight months later another study was published in JAMA that reported a lack of association between alcoholism and this gene (the dopamine D2 receptor gene). Of course this study was not publicized like the original study and most people never heard of it. They still believe that the alcoholism gene has been found.

All scientific attempts to define an addict have failed because the concept itself is fundamentally flawed. Addicts exist in our minds but not in the objective world around us. The DSM-III-R, which is the authority on psychiatric disorders, contains two categories of pathological patterns of substance use: abuse and dependence.

It's important to note, that the criteria used to diagnose alcohol problems is exactly the same as those for all other substances. The American Psychiatric Association (APA), therefore, doesn't appear to believe that alcohol abuse is any different from that of other substances. Once the person stops using the substance, he no longer meets the criteria for abuse or dependence. In other words, he is no longer an addict or an alcoholic. This is what is known as all-or-nothing thinking, either you are or aren't an alcoholic or a drug addict.

Experts claim the trouble with the drug and alcohol treatment industry and twelve-step support groups is, they take those people with the worst success in controlling their own behaviour and allow them to tell the rest of us what our attitudes should be. If you tell people enough times that they have no hope of controlling themselves, they will eventually start to believe you and prove you right.

Loss of control over drugs and alcohol is much more a cultural phenomenon than it is a symptom of a disease. Take for example the Italians. They respect their alcohol. They drink beer or wine at every meal but only drink one or two glasses. They think of alcoholism as a problem over which people can exert control and they object to those who become intoxicated. The Italians have the lowest alcoholism rates.

Another reason that the disease concept is so popular is that it gives people an easy way out. They believe that they inherited their addiction, therefore they're not responsible for their own behaviour. At first glance this practice may seem helpful. The argument is that it absolves substance abusers of blame and therefore makes them more likely to enter treatment to get help. But keep in mind two things about calling addiction a disease:

1. It's not true.
2. It doesn't help and keeps the individual from doing things that really would help.

People believe that alcoholism and drug addiction are diseases because they want to believe it. It makes them feel better to think that their problems are beyond their control. Most people desperately search for something outside of themselves to blame things on. Real solutions to real problems, however, will never result from ignorance and misinformation.

The truth is most drug and alcohol 'treatments' is ineffective, and therefore a waste of money. Substance abuse is a problem that is never going to be completely prevented and it's never going to be solved using current ineffective treatment methods.

What goes on in treatment anyway? Patients in treatment centres are coerced by the counsellors and other patients to "discover" that they have the disease of addiction. They are shown a list of symptoms (blackouts, loss of control, progression of the disease, etc), and told to admit that they have them. If they claim that they never experienced one or more of these symptoms they are harassed in an effort to combat their denial.

The concept of denial is a dangerous one because as soon as people claim they don't have a problem, it means they really do have it. Denial is viewed as a symptom of the disease. People who have the worst substance abuse problems, on the other hand, are often those who cannot gain a foothold in life. They more often come from deprived environments or from seriously disrupted homes, or have severe personal or emotional problems. Drugs do not make people indolent, antisocial, or delinquent. Rather, people choose to use drugs because drugs allow them to feel and act in ways they need or want to.

New statistics suggest that while more money is being thrown at drug treatment programmes, the number of people leaving them free of their dependency on drugs has barely increased. According to figures from the National Treatment Agency (NTA), spending on drugs services reached £384m last year, up from £253m in 2004-05.

In 2004, 5,759 people left drug treatment free from their addiction, compared with 5,829 in 2006, that's an extra 70 people for the extra £131m spent. The proportion of people who are completely drug-free after treatment is actually falling, down to a lowly 3 per cent. However the rate of 3% is nothing more than the natural rate of remission, meaning that, at least 3% a year will quit using drugs because they have simply had enough and want to be drug free, with this in mind the actual success rate and the sum total of all spending on drug treatment services equals a 0% success rate.

A source said, 'the only way to change the present system is to change their pay structure, if the drug bureaucrats were paid for results and a bonus system for each person who 'recovered' then all manner of treatment would be used to try and achieve this goal, instead the current pay structure offers no incentives for recovery, in fact, it's just the opposite, for example the restructuring of pay scales in dentistry has seen a dramatic fall in unnecessary dental work'. 15.10.07

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Drink and drugs 'key' to suicide

Alcohol and drug misuse means Scots are almost twice as likely as people south of the border to take their own life or kill, a new report has said.

Research from Manchester University also showed the number of mental health patients killing themselves or others was proportionately higher in Scotland. The report found that the north-south divide was highest among teenagers. It said alcohol and drugs were the "most pressing mental health problems in Scotland". The Lessons for Mental Health Care in Scotland report was commissioned by the Scottish Government. Researchers found there were 500 killings north of the border over five years and 5,000 suicides over six years. Suicide rates in Scotland were 18.7 per 100,000 of the population, compared with 10.2 per 100,000 in England and Wales.

Of the 1,373 patient suicides in the report, there was a history of alcohol misuse in 785 cases, an average of 131 deaths per year. There was a history of drug misuse witnessed in 522 cases, or 87 deaths per year. About 28% of people who took their own life and 12% of killers had recently been mental health patients, the report said.

Louis Appleby, professor of psychiatry at Manchester University, said the findings suggested that alcohol and drugs lay behind Scotland's high rates of suicide and homicide. He called the frequency with which they occurred as antecedents as "striking". Professor Appleby added: "Alcohol and drug misuse runs through these findings and it appears to be a major contributor to risk in mental health care and broader society.

"Our findings support the view that alcohol and drugs are the most pressing mental health problems in Scotland and mental health services can play their part."

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£1.85m to get each person off drugs - Drug services make slow progress

Treatment services in England have made slow progress in increasing the numbers of people they get off drugs, despite a £130m rise in their budget. Spending on drugs services rose from £253m in 2004-05 to £384m last year, National Treatment Agency figures show. Yet the numbers emerging from treatment free of addiction has barely changed. Three years ago, 5,759 left drug-free compared with 5,829 last year. The Department of Health said the figures "distort the true picture".

BBC home editor Mark Easton said fewer than 3% were drug-free after treatment. The government had always maintained treatment was not just about getting people off drugs - it also cut crime, improved health and helped users get their lives straight, our correspondent added. The government is committed to getting people into "effective treatment" which can do something to make their lives better which has "benefits for wider society".

However, he said analysis of the recently published figures showed the proportion of people getting off drugs after treatment had fallen from 3.5% three years ago to less than 3% now. And the figures meant that the cost of getting each person off drugs over this three-year period worked out as £1.85m.

Mr Easton also said that the government's ten-year strategy, due to be launched next April and about which a statement is due soon, is "about getting more people off drugs". Earlier this month, it emerged that heroin and cocaine addicts on the same government treatment programme were being given drugs as a reward for clean urine samples.

The National Treatment Agency's own survey of almost 200 clinics in England found users were being offered extra methadone, a heroin substitute, or anti-depressants for good behaviour. It admitted the practice was "unethical" and offering drugs for anything other than clinical need was wrong. Health minister Dawn Primarolo asked for a report into the survey.

A spokesperson for the Department of Health said: "In the last few years, there has been a massive expansion in the numbers entering drug treatment. "It generally takes between five and seven years for an addict to successfully complete their treatment, and therefore it would be unrealistic to expect to see the results of this expansion in treatment immediately.

"Getting users into treatment and keeping them there is the best way to save their lives and reduce the harm they cause to people around them and to society. "We have made important progress in recent years. There are now over 195,000 people accessing drug treatment every year, 130% more than in 1998." 30.10.07

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Drug success rate of 3% is nothing more than the natural rate of remission

Drug Treatment services in England have made little to no progress with 5,829 addicts leaving treatment drug-free last year. There are now over 195,000 people accessing drug treatment every year which equates to just a 3% success rate.

Paul Hayes of the NTA says “ the £400m the Government invested in drug treatment last year has to be judged against 195,000 individuals whose treatment has protected them from early death, reduced the criminality and provided opportunity to rebuild their lives. To judge treatment solely on the small numbers that finally leave the treatment system in a given year is misleading and dangerous to the drug users, their families and society”.

But critics argue Mr Hayes is missing the point, treatment is all about getting people off drugs and back into society and this figure of 3% is nothing more than the natural rate of remission, meaning that, at least 3% a year will quit using drugs because they have simply had enough and want to be drug free, with this in mind the actual success rate and the sum total of all spending on drug treatment services equals a 0% success rate, which is simply not good enough.

A source said "Newer and more effective forms of treatment are required than the ones presently used which are clearly not working and those in charge of providing treatment need to be held more accountable for their poor results". 2.11.07

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Are Government drug treatment programmes a waste of taxpayers' money?

Why are we asking this now?
Because new statistics suggest that while more money is being thrown at drug treatment programmes, the number of people leaving them free of their dependency on drugs has barely increased. According to figures from the National Treatment Agency (NTA), spending on drugs services reached £384m last year, up from £253m in 2004-05. In 2004, 5,759 people left drug treatment free from their addiction, compared with 5,829 in 2006, thats an extra 70 people for the extra £131m spent. The proportion of people who are completely drug-free after treatment is actually falling, down to a lowly 3 per cent. That has led some to suggest that the Government's current policy on treating those with drug addictions is flawed, and that public money is being mis-spent.

How has the Government reacted?
The Department of Health has defended its increased investment in drug treatment services by saying that the effects of the heightened spending have not been felt yet. It says that it can take as much as seven years for an addict to complete their treatment successfully, meaning that it is too early to make any judgements about the effects of the extra money.

It also points out that the number of drug users receiving treatment is at a record high, meaning that the Government's target on treatment has been achieved two years early. There are now more than 195,000 people accessing drug treatment, which is 130 per cent more than in 1998. Health minister, Dawn Primarolo, said that achievement was "remarkable". She said: "Many thought that the targets set in 1998 were aspirational and unrealistic. We have made massive strides in tackling the harm that drugs cause to both individuals and society as a whole. Through the drug strategy we will continue to ensure that effective drug treatment is available to those who need it."

Who should we believe?
It probably is too early to make any definite judgement on the Government's drug treatment strategy, as there are interesting statistics about the number of people now staying in their drug-treatment programmes. The NTA figures showed that the number of drug users completing early treatment or being retained on treatment increased from 76 per cent in 2005-06 to 80 per cent in 2006-07. This could be a sign that the increased investment is beginning to have an impact.

Does drug treatment serve any purpose?
For some, it is life-changing. There are more than 5,000 people each year who are given the opportunity of a drug-free life due to the drug-addiction programmes. The economy and society also benefit, as addicts can again become productive members of their community. But with the cost of getting each one off drugs reportedly reaching £1.85m over the past three years, questions are bound to be asked about whether it is worth the burden on the taxpayer.

Others argue that drug treatment should not just be measured by the number of people who leave it drug-free. "You cannot get heavy drug users off drugs over night," said the chair of the all-party Parliamentary Drugs Misuse Group, Labour MP, Brian Iddon. "A lot of drug treatment is about stabilising users, so they can function normally, get a job and sort themselves out. It is a complicated issue, but it is not all about abstinence."

Is the UK's drugs policy failing?
When seen in terms of the number of people now accessing drug treatment, there has been a vast improvement over the past decade. That suggests that drug addicts are much more aware of the help that is available to them. And anti-drugs messages might be having a greater effect more generally. According to the British Crime Survey, the number of people reporting to have used drugs in the past year is falling. Now, 8 per cent of 16- to 24-year-olds say that they have taken a Class A drug, down from 8.6 per cent in 1998. And 24.1 per cent say that they have taken any illegal drug in the past 12 months, down from 31.8 per cent in 1998. But as the new figures have confirmed, trying to get people off drugs permanently is a lengthy and costly process – and one on which there does not seem to be much progress.

So what's going wrong?
Part of the problem is the nature of drug addiction itself. While it takes years to kick the habit, a relapse can happen in a second. For many drug users and former drug users, it is an on-going battle, rather than a clean break from their drug habit. According to some, too much attention has been paid to getting people into treatment, rather than focusing on the quality of treatment given to each patient. "The Government has gone for targets – on the quantity of people receiving treatment rather than the quality of treatment," said Brian Iddon. "We are now beginning to see the quality of treatments improve as well, including wider use of psychological treatments for cocaine addicts."

What are the policy alternatives?
Some say that a radical change is needed in the form of an end to the policy of prohibition. That is the opinion of drugs policy think-tank, Transform. It believes that drug prohibition itself is the prime cause of drug-related harm to both the individual users and society as a whole. It believes that proper government regulation would cut out criminal involvement in drugs, as well as decriminalising thousands of users.

"The Government has created a rod for its own back by over-hyping the usefulness of drug treatment," said Danny Kushlick, the director of Transform. "Becoming totally drug-free is only possible for a tiny minority of drug users of any type. Only around 5 per cent will be able to totally stop taking drugs.

"The reason that the Government gives so much money to the issue is because it wants to be seen to be tackling drug-related crime. If it really wants to tackle that, it needs to get rid of prohibition, which is the greatest cause of drug-related crime. Drug treatment should not be about making people drug-free. It should be about public health."

Will anything change?
Any movement away from the prohibition of drugs is unlikely, as it is an extremely politically sensitive issue. If anything, the Government is moving in the other direction. Gordon Brown has already said he is opposed to the legalisation of drugs, and has hinted he wants to reclassify cannabis.

Early next year, the Government will launch a new 10-year drug strategy, which could see a slight change in philosophy. It is already thought that a greater focus will be placed on getting people off drugs, rather than focusing on improving access to drug treatment services. 31.10.07

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Number of drug-addicted teens increases by a third in two years, figures show

The number of 16 and 17-year-olds being treated for drug addiction has soared by 30 per cent in two years. And cocaine is fast catching up with cannabis as the drug of choice for teenagers, figures out today show. There were 7,857 youngsters aged 16 and 17 on drug treatment programmes in England in 2007/08 - up from 6,058 the year before. Worryingly, there was also a significant increase in the number of under-16s receiving treatment, up 17 per cent to 6,840.

The statistics, released by the National Treatment Agency, showed that cannabis was still the most popular drug among the under-18s, with 12,865 of this age group treated for its misuse. However, there has also been a huge rise in the number treated for cocaine addiction. Some 861 were treated last year for cocaine, up 67 per cent. Cocaine has now overtaken heroin in the league of drugs, while small numbers were treated for crack, amphetamines and ecstasy.

The figures back up the findings of an international study by the World Health Organisation which showed that British children lead the Western world in both drug addiction and alcohol misuse.

LibDem health spokesman Norman Lamb said: 'The horror is that cocaine is fast becoming a fashionable drug of choice even for the under-18s. 'There is an unfortunate sense that because of the glitterati interest in cocaine, there is a real risk it is being seen as acceptable - More needs to be done to get across the fact that the health consequences are horrific.'

A spokesman for drug charity Addaction said: 'Cocaine is relatively cheap and easily available, so it is not surprising to us that more young people are in treatment for cocaine use.' The National Treatment Agency figures show that overall the number of people being treated is higher than ever. Across all ages in 2007/08, a record 202,666 were treated, a rise of 4 per cent on the previous year.

The agency was set up in 2001 to improve the availability and effectiveness of drug misuse treatment. But there are questions over whether the drug treatment programmes it promotes and funds are effective. The figures show that very few people of all ages entering treatment programmes in England left them cured of their addiction.

Only 11 per cent of the 69,612 discharged from treatment during the year left because they were drug-free, or just 3 per cent overall. This meant they had overcome their dependency on the drug they were treated for, were not using any other illegal drugs, and some were also meeting demands imposed on them not to use alcohol.

Mr Lamb said: 'The Government is losing the fight against drugs. There needs to be a National Audit Office investigation into the cost effectiveness of current treatment. 'The current record of failure is disastrous both for those in treatment and the wider community, who are placed at risk because of the close links between drug addiction and crime.'

Tory home affairs spokesman Dominic Grieve said the drug treatment budget had risen by £145million since 2004. But despite this, the proportion of addicts going clean had risen by only 5 per cent.

Mr Grieve said: 'This shows the Government's entire approach of simply trying to manage addiction is wrong. 'We would abandon Labour's failing policy and replace it with an abstinence-based approach. This will have the objective of actually getting people off drugs for good.' 3.10.08

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Millions of pounds 'wasted' on drug treatment, Tories claim

Millions of pounds have been wasted on Government-funded drugs programmes to get hardened addicts off drugs, the Tories claimed. New figures show that a record 202,000 people went through drug treatment programmes in England last year. But just 7,324 - four per cent - were released free of drugs.

This compares with 3,632 three years ago in 2004-05. Over the same period, the Government's drug Treatment Budget rose by 57 per cent to £145million. Shadow Home Secretary, Dominic Grieve, said that "the Government's entire approach of simply trying to manage addiction is wrong". He said: "Drugs wreck lives and destroy communities but these figures show that despite a significant increase in investment there has been a paltry increase in the number of addicts going clean. "This failing approach is compounded by Labour's mixed and confused messages on the dangers posed by cannabis and ecstasy. The fact the Government won't acknowledge this makes them part of the problem not the solution."

Paul Hayes, chief executive of the National Treatment Agency for Substance Misuse, said his agency could do better. He said: "The treatment sector as a whole, and the NTA as an organisation, must again raise our game, ensuring our staff are skilled enough, our resources are allocated appropriately, and that we better communicate what we are doing to the public." Other statistics from the NTA also showed that more than 64,000 people remained in treatment for 12 weeks.

Mr Hayes added: "Most users do not want to be in treatment for the rest of their lives. They see treatment as a means to help them overcome addiction and gain control of their lives.

"The NTA's role is to help services to enable that process, and support users to leave treatment safely, free of dependency." But critics argue 'Mr Hayes and NTA have had long enough to make a difference but have failed, so sweeping changes need to be made'. 3.10.08

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The new 2008 drugs strategy explained

The problem
There are an estimated 332,000 problem drug users in England.
Class A drug uses costs the country £15.4bn a year in crime and health costs.
Between a third and a half of theft and burglary is estimated to be drug-related.
24% of people aged 16 to 24 have used an illegal drug in the past year.
10% of people aged 16 to 59 have used an illegal drug in the past year.
The UK illegal drug market is estimated to be worth between £4bn and £6.6bn a year.

Crime measures
Police to have the power to seize cash and assets belonging to suspected drug dealers on arrest, rather than on conviction. "Those who buy 'bling', plasma screens and other household goods, to avoid circulating cash, will have their assets seized before they have a chance to disperse them."

A greater range of goods will be subject to the asset recovery programme, which enables convicted drug dealers to have their assets seized. The 12-year time limit governing asset recovery will also be abandoned. Asset seizure agreements to be negotiated with other countries, starting with the United Arab Emirates in April 2008, "so dealers can't channel proceeds abroad".

Antisocial behaviour orders to be imposed on drug dealers after conviction. These could ban them from entering certain areas, or engaging in certain behaviour linked to drug dealing. Further drug screening at airports. Police to be encouraged to make greater use of the powers they have to close crack houses. Wider use of drug intervention programmes, which involves offenders having to take treatment programmes.

Benefit measures
Drug users to be threatened with benefit cuts if they do not participate in drug treatment programmes. "We do not think it is right for the taxpayer to help sustain drug habits when individuals could be getting treatment to overcome barriers to employment." Increasing support available to drug users to help them get housing and work. Trial projects to "explore the potential of a more flexible use of funding to address individual needs".

Drug treatment services
Programmes involving prescription of injectable heroin and methadone to addicts who do not respond to other forms of treatment to be rolled out, "subject to the findings, due in 2009, of pilots exploring the use of this type of treatment". "New and innovative treatment approaches" to be investigated. Programmes using "positive reinforcement techniques" to be piloted. Addicts to be encouraged to make wider use of mutual aid support networks. Prison drug treatment programmes to be improved.

Support for families
Family members such as grandparents who take on caring responsibilities in the place of drug-using parents to get additional support through a programme in which councils can pay those caring for children classified as "in need". More support for parents with drug problems so that children do not fall into "excessive or inappropriate caring roles". More family-based treatment services to protect young people.

Drugs education
Improved information and guidance to be available to all parents. Schools and colleges to be encouraged to see what they can do to identify and support. Further action to be taken to reduce underage sales of alcohol and cigarettes. 27.2.08

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Drug treatment 08 - success or failure?

Drug treatment officials were busy rubbishing my journalism yesterday afternoon, telling anyone who would listen that the man from the BBC had got his figures wrong. I wouldn't burden you with details of the statistical spat, except I think the episode goes to the heart of the debate over what England's half a billion pounds a year drug treatment programme is for.

The National Treatment Agency (NTA) yesterday published its annual figures showing yet another big increase in the numbers of people who were on the drug treatment programme last year - 202,000 altogether. (Trebles all round - government target achieved in style.) Not mentioned in the press notice, discretely lodged in a table near the bottom of the data release, was the number of people who left the treatment programme drug-free last year - 7,324

What I did, and what so infuriated the people at the NTA, was to compare the two. The arithmetic was pretty simple. Just 3.6% of those in treatment were discharged free of illegal drugs.

They didn't like that - not one bit. An email was sent out from the press office steering other journalists away from doing the same sum. "Just in case anyone is tempted to follow the BBC 's 3.6% figure", warned Director of Communications Jon Hibbs, "we think this is a misleading way to interpret the data: it's like measuring a school's GCSE success by counting the number of A grades as proportion of the total school population".

The NTA prefer to focus on the number in treatment and the number retained for 12 weeks - the government's measures of success, strangely, there is no target for getting people off drugs.

If pressed, they will argue that the data shows that those who left drug-free represent 11% of those who were discharged from treatment. That looks a bit better. But do you see what they've done? They have ignored the tens of thousands of people who are in drug treatment but were not discharged. People like Andrew Walters who I met in Sunderland this week who has spent ten years on methadone for his heroin addiction.

Andrew is supposedly part of the drug treatment success story. He has appeared in the statistics for a decade but he says no-one seems interested in trying to get him clean. "It's like everyone's give up on you", he tells me. Andrew pleaded to be allowed to get into residential rehab, but each time he was turned down. "On five separate occasions I asked them. Five times. I just got put to one side." Methadone may have helped him untangle some of the chaos in his life, but in his view it has got him no nearer getting off drugs. He's just been parked. "They like giving methadone out", he says. "If you ask to top up your methadone they'll put it up without any questions." But he doesn't want to be on methadone - a "vile drug" he calls it. It has rotted his teeth and ruled his daily routine. "I was just topping off with heroin", he admits.

When I first pointed out the very small proportion of users who left England's treatment programme drug free on the BBC Today programme last year, in the words of one academic in the field, it set off a small nuclear explosion in the drugs world. The system had been patting itself on the back for getting lots of people signed up for treatment but people had not noticed what happened afterwards. The focus was on inputs not outcomes.

A debate many had thought won and lost a decade ago was reopened. Should the aim of drug treatment be to reduce harm or get people off drugs?

The harm reductionists had long ruled the roost with a philosophy of helping people who misuse drugs get their lives straight so crime and health risks were reduced. It is a worthy aim but some in the drugs field believed the system needed to be more ambitious. In a report sent to drug teams this week, the NTA itself bemoans the way that residential services are too often used "as a last resort rather than as a concerted attempt to achieve long-term abstinence earlier in a drug-using career." "This has led to unsatisfactory outcomes for all involved", it notes.

It was more than 'unsatisfactory'; it was very nearly fatal for Andrew who attempted suicide after being turned down for rehab. "The only reason they found me was my room in the bedsit place was above the office and they heard me hit the floor" he tells me. "They come in and I still had the needle in my body."

If you look at the figures published yesterday you see that last year 79,619 people were in treatment for the whole year. One of those was Andrew. The vast majority will be heroin addicts who are on prescriptions for methadone or another substitute. They may be in treatment for a long time to come. With present treatments, it is not easy to get someone off drugs. It can take years and there may well be many false dawns on the way. But that doesn't mean we shouldn't try.

Professor David Best, an internationally renowned expert on drugs, is about to publish new research into what helped a cohort of ex-addicts get clean. "The only type of formal treatment service that was often cited as being among 'the key things that finally helped you to become abstinent' was residential rehabilitation", he reports.

Professor Best goes on to criticise the lack of ambition in the system. "The experiences of this population are at odds with the 'chronic, relapsing condition' mantra which pervades UK drug services", he writes.

The latest figures show that 147,000 of the individuals in treatment were being given prescribed medication - 74% of all those on the programme. How many accessed residential rehab? The data shows it was less than 5,000 - around 2% of the treatment population. So I make no apology for comparing the total number of people in treatment with the number who leave the system drug free. To do otherwise would be to ignore the plight of those, like Andrew, who want to get clean but are not given the help. 3.10.08

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Rise in drug use sees more than 1,200 children hospitalised last year

Britain's 'bleak' drugs problem has been revealed as it emerged that more than 1,200 children have been hospitalised for taking illegal substances in the last year. The figure is an almost 45 per cent increase on a decade ago, leading to accusations that Labour had failed to tackle the country's drug problem.

More than three million adults are estimated to have taken banned substances last year and one in three British adults now admits that they have taken illegal drugs at some point in their lifetime. The percentage of young people taking cocaine has also soared to record levels.

Andrew Lansley, the shadow health secretary, said: "Labour should not underestimate how bleak a picture these figures paint. "As drugs get stronger, the harm they are doing to young peoples' mental health is increasing. The Government needs to wake up to the scale of the problem we face on drug misuse." But ministers highlighted that the record numbers of people in treatment for addiction and said the number of drug-related deaths had fallen.

The figures, released by the NHS Information Centre, also revealed the number of teenagers needing hospital treatment because of drugs rose last year by more than 10 per cent to nearly 10,000. The number of under-16s hospitalised because of drugs last year was 1,241, up from 868 in 1996-97 while the number of 16 to 24-year-olds receiving hospital treatment increased from 8,508 to 9,657.

More than six per cent of 16 to 24-year-olds admitted that they had used cocaine over the previous year, while 11 per cent admitted that they had used cocaine at some point in their lives. Among 15-year-old boys 42 per cent admit having taken illegal drugs - including 32 per cent in the past year

Dominic Grieve, the shadow home secretary, said: 'This is a shocking indictment of Labour's failure to tackle the scourge of drugs. They allow drugs to flow in through our porous borders, tie our police up in red tape and then only seek to manage people's addiction as opposed to ending it.'

A spokesman for the Department of Health said: "The high-quality drug treatment that is being provided is the most effective way of reducing illegal drug misuse, improving the physical and mental health of drug users, as well as reducing the harm they cause to themselves and society." 15.8.08

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Number of children hospitalised for taking illegal drugs rises 50% under Labour

The number of children admitted to hospital with drug-related mental problems has soared by nearly half in the past decade, disturbing new figures show. The admissions for drug-affected children rose by 48 per cent between 1996/7 and 2006/7, surging from 272 to 402.

The rise was well ahead of a simultaneous 17 per cent increase in admissions of people aged 16 to 24 suffering from behavioural problems linked to illegal drug use. In 1996/7, hospitals saw 5,964 youngsters in that age group but in 2006/7 they admitted 6,983. In all the number of children and young people admitted to hospital with such problems has risen by around a fifth - 18 per cent, from 6,236 to 7,385, the NHS data shows.

The figures for 25- to 34-year-olds were perhaps even more shocking - nearly doubling over the decade, from 8,229 admissions to 15,330.

The data covers NHS hospital admissions in England where the main or secondary diagnosis was drug-related mental health and behavioural disorder. The same round-up of NHS statistics shows that among 16- to 24-year-olds, the proportion who admitted using cocaine in the previous year topped six per cent - well over one in 20 - for the first time. The proportion who admitted using cocaine at any stage in their lives rose above 11 per cent for the first time. Cannabis use fell, but was still admitted by 21 per cent - more than one in five.

There are marked variations between the sexes, however, with men (4,715) more than twice as likely as women (2,019) to be admitted to hospital for drug-related mental problems in 2006/7. During the same period, 5,491 men and 4,554 women were admitted with drug poisoning - for a total some 30 per cent higher than the overall figure for 1996/7.

Today's report also showed that men accounted for 79 per cent of the 1,573 deaths from illicit drug use in 2006. In 2006/07, 13.2 per cent of men also reported taking drugs during the last year, compared with 6.9 per cent of women.

NHS Information Centre chief executive, Tim Straughan, said: 'This bulletin paints a picture of wide discrepancy between the number of men who take, are treated, or even die from drug use compared to the number of women. 'The fact more than 1,500 people died due to drug use in 2006 is extremely saddening in itself, but the fact so many of these deaths are male raises many questions about gender and drug misuse.'

Surprisingly, hospital admissions where the primary diagnosis was a drug-related mental health disorder fell slightly during the ten-year period, from 7,584 to 6,743. But admissions where the secondary diagnosis was drug-related pushed the overall figures up from 19,018 to 38,170.

The North-East SHA (strategic health authority) handled the highest proportion of admissions for drug poisoning - 38 people for every 100,000 admitted. It was followed by North West SHA, with 32 per 100,000.

The number of people listed as in drug treatment more than doubled over the ten years, from 85,000 to 195,464, according to the National Drug Treatment Monitoring System but critics argue 'their treatments aren't working'. 14.8.08

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Police losing fight against drugs trade despite billions spent

Police and customs are fighting a losing battle against the illegal drugs trade despite billions of pounds being spent every year on fighting it, according to a new report. The price of cocaine has halved in some areas since 2000 while heroin has fallen in price by 35 pc and the "extremely resilient" drugs industry is now worth 41 per cent of the legal alcohol market, it says. A crackdown that has seen seizures of class A drugs more than double since 2006 to nearly 40,000 has had little impact on the supply of or demand for drugs.

An estimated 60 to 80 pc of all drugs would need to be regularly removed from the streets in order to put major traffickers out of business, the report by the UK Drug Policy Commission warns. Seizure rates on this scale have never been achieved in Britain, with an estimated 12 pc of heroin and 9 pc of cocaine in Britain being impounded between 1996 and 2005, or anywhere else. Last year 1.5 tonnes of heroin and 4.4m ectsasy tablets were sezied by the Serious Organised Crime Agency, according to the report.

But each year 20 tonnes of heroin, 18 tonnes of cocaine and 16 tonnes of crack change hands on the British drugs market, while 412 tonnes of cannabis and 60 million ecstasy tablets are thought to be bought and sold. The Commission suggests that traditional crime-fighting tactics are simply not working and that the £5.3bn British drugs market is "too fluid" for law enforcement agencies to deal with.

It also claims that even high-profile swoops on "drugs factories" and significant convictions of leading dealers usually fail to have a noticeable impact on supply, due to the industry's ability to adapt quickly to disruption. Dealers simply reduce purity to maintain their profit margins, the report says.

In 2005/06, the Government spent £380m just on reducing supply in England, the report says, while the annual cost to the criminal justice system of dealing with Class A drug alone is thought to be more than £4 billion. Tim McSweeney, one of the authors of the report, said: "We were struck by just how little evidence there is to show that the hundreds of millions of pounds spent on UK enforcement each year has made a sustainable impact and represents value for money."

The report calls for more resources to be devoted to reducing the "collateral damage" of drugs on communities, by tackling gang violence and prostitution. Its authors say this would have a greater impact on the drugs trade than traditional hauls. David Blakey CBE QPM, from the UK Drug Policy Commission, said: "All enforcement agencies aim to reduce drug harms and most have formed local partnerships to do this, but they still tend to be judged by measures of traditional supply-side activity such as seizure rates.

"This is a pity as it is very difficult to show that increasing drug seizures actually leads to less drug-related harm. Of course, drug dealers must be brought to justice, but we should recognise and encourage the wider role that the police and other law enforcement officials can play in reducing the impact of drug markets on our communities."

Responding to the report, a Home Office spokesman said that seizures were only part of the Government's approach to fighting drug crime. He said: "Many of the report's recommendations are already being implemented. Our drugs strategy encompasses enforcement, prevention, education and treatment." He added that "intervention" programmes were seeing 1,000 offenders each week move into drug treatment. 30.7.08

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Cocaine and Ecstasy deaths up 1,200% since records began in 1993

Death from 'middle class' drugs glamorised by celebrities are at their highest level since records began, government figures revealed today. Party drugs Ecstasy and cocaine now claim nearly 300 lives a year, an increase of over 1,200 per cent since figures were first recorded in 1993. The statistics, released by the Office for National Statistics, also reveal that far more men than women are dying from drug abuse and are taking them later in life, often into their 40s.

Experts believe that cocaine's 'dinner party' image is masking its true dangers. The high number of cocaine deaths are thought to be the result of mixing the drug with alcohol which produces a potentially-deadly compound called cocaine-ethynyl. There have been a number of high-profile deaths involving the drug in recent years.

Actress Natasha Collins, 31, died in a scalding hot bath in January after taking large amounts of cocaine, wine, vodka and sleeping tablets.  Flamboyant German aristocrat Count Gottfried von Bismarck died last July after injecting cocaine every hour during the day and night before his death. Yesterday drug charities warned of an 'epidemic' of recreational drug deaths as young Britons emulate stars such as Kate Moss, Pete Doherty and Amy Winehouse.

Clare McNeil, of drug treatment charity Addaction, said: 'Cocaine is seen as a middle-class drug associated with success and money. 'People think they can copy celebrities and do a quick line because it doesn't have the same stigma as other class As but it's actually just as destructive. 'People are often ignorant of the risks of combining alcohol with cocaine for example, which can increase the risk of liver and heart disease, strokes and epilepsy.

'The increase in deaths among men in their 30s and 40s is worrying. It suggests that more people are continuing to experiment with drugs well into adulthood. 'At one time young people would dabble then stop as they settled down but these kind of figures suggest an epidemic." 

Deaths from all drugs rose by 2.7 per cent last year - the highest figure since 2002. The figures show the total number of deaths in England and Wales from drugs poisoning in 2007 was 2,640, up 2.7 per cent from the 2,570 in 2006. The majority of those were male - 1,914 last year compared with 1,782 in 2006.

Meanwhile, female drug poisoning deaths fell by eight per cent from 788 deaths in 2006 to 726 in 2007. Cocaine claimed 196 lives in 2007 and Ecstasy 97, a combined total of 293. This is a staggering 1,274 per cent increase since 1993, when just 23 people died after taking the drugs.

The highest number of drug deaths were among men aged between 30 and 39. Deaths among 20 to 29-year-olds, which was previously the highest group, continued to increase but at a slower rate. David Gilbert, chief executive of drugs charity D.A.R.E., called on families to become more involved in the war on drugs.

He said: 'Parents need to play a much bigger role in setting children on the straight and narrow when they are young. 'Childhood is when views of drugs are formed and it is the best time to educate people to avoid them. 'We obviously have a massive problem and the different agencies and charities need to pull together to tackle it.'  Class A drugs heroin and morphine caused 829 deaths in 2007, compared with 713 in 2006.

Methadone deaths also shot to their highest levels since 1999 with 326 deaths - an increase of 35 per cent compared with 2006. Party towns Blackpool and Brighton top the list of black spots for drug deaths hitting 233 a year.

Blackpool topped the list with 120 people in every 100,000 being killed every year between 2000 and 2006. The seaside town was closely followed by Brighton and Hove with 112 deaths and Camden, in London, with 83. Deaths involving antidepressants, paracetamol and aspirin were all at their lowest levels since records began in 1993. 29.8.08

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Warning cocaine will be bigger problem than heroin

COCAINE will soon become a bigger problem than heroin in Edinburgh , according to Edinburgh 's outgoing drugs and alcohol tsar. Tom Wood said the falling cost of the drug – now around the price of a glass of wine – means it is no longer the preserve of professionals, but is already being used together with heroin in some parts of Edinburgh. He said this would lead to the same antisocial problems associated with heroin, such as crime and prostitution.

Mr Wood is handing over to the council's director of health and social care, Peter Gabbitas, at the end of the month. He told councillors: "In this city, we are living with the legacy of heavy heroin use in the 1980s.

"Drug-taking and heavy alcohol use is normal in many parts of society in our city. We are not at the top of the bell curve yet, and there will be a huge increase in child protection referrals and drug deaths for the next five or six years. It's a long road ahead.

"Cocaine is here, and in some parts of the city it is already a bigger problem than heroin. In five years time, it will be the major problem in Edinburgh and east Scotland . It won't be restricted to the wine bars – it will permeate throughout and it is really difficult to treat."

Mr Wood said a heavy cocaine habit is just as addictive as heroin. But he also said that a "reality check" is needed, because the level of heavy alcohol abuse is 20 times higher than drug use. 14.5.08

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Cocaine overdose hospital admissions rise 400 per cent in just four years

The number of drug users being admitted to hospital with cocaine overdoses is four times higher than it was eight years ago, new figures reveal. Just 161 people were admitted to hospital in England for cocaine-related emergencies in 1999. But 740 users needed treatment in 2007, most of them men and with an average age of 29 years, according to the magazine Druglink.

Among hospitals that have seen a huge rise in cocaine poisonings is St Thomas's Hospital in Lambeth, South London. It dealt with 138 cocaine-related cases between April 2006 and March 2007. In the second half of last year alone, the hospital treated 121 patients in its Accident and Emergency department in connection with cocaine use. Drug use in the UK is at an 11-year low but cocaine abuse has been on the increase since 1998.

While use of most drugs has remained stable, the proportion of adults who admitted using cocaine has risen from 1.2 per cent ten years ago to 2.6 per cent last year. Campaigners said last night that celebrity figures such as Amy Winehouse made the drug look 'cool' among wealthy young professionals but the health dangers include heart attacks and strokes. Almost 200 Britons a year are killed by the class A drug.

Models Nina Campbell and Kate Moss, along with former Eastenders actress Danniella Westbrook - who had to have her nose rebuilt - are among those who have been treated for addiction. A survey found one in three young men attending A&E at a London hospital with suspected heart attacks were cocaine users. However, experts believe it causes more deaths than appear in official statistics because it may not be acknowledged as being involved in a heart attack or a stroke.

Druglink editor Max Daly said 'Cocaine use constricts blood vessels and can result in a rise in body temperature, burst blood vessels and, in extreme cases, death from brain seizures, heart failure and respiratory problems.' Tony D'Agostino, a leading expert on cocaine use, said 'This provides yet another warning to the government that it must spend money on an awareness campaign and on special health services if it is serious about tackling the dangers of cocaine use.'

As cocaine poisonings have risen, cannabis poisonings dipped from 171 in 1999 to 96 last year and heroin overdoses also slumped from 1,962 in 1999 to 1,530 in 2007. Mary Brett, spokesman for Europe Against Drugs, said celebrity users of cocaine sent out the wrong message. She said 'We were supposed to see cocaine use being targeted as a class A drug, instead it's going through the roof.

'Young people think it's cool to use cocaine, that it's a safe recreational drug but it can have dramatic effects on the body and cause psychosis. We need more health campaigns and some way of getting the message through that celebrities are not role models, they can afford the rehab unlike some of those who get addicted.' Norman Lamb MP, Lib Dem shadow health secretary, said 'These  figures highlight an epidemic in hard drug use, which will  have grave consequences for the NHS.

'Years of casual celebrity endorsement has led to cocaine being seen as a fun thing to do on a Saturday night when in reality it puts users at severe  risk of overdose, which can lead to death. 'A and E wards are having to cope with the increasing strain and are not able to offer the immediate support services which many hard drug users need.' 16.7.08

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Current drug policy has 'limited impact'

The UK has an unusually severe drugs problem and the government's strategy has had a very limited impact on drug use, a new watchdog body has been told. The report for the independent UK Drug Policy Commission said more addicts were being treated. But it added that the benefits were limited, and there was little evidence education schemes had had an impact.

The Home Office insisted the strategy was working - with a 16% decline in drug use since 1998. BBC home affairs correspondent Danny Shaw said the report was part of the debate about the government's 10-year drug strategy, which is due to be updated next year. Attempts to restrict the availability of drugs by arresting dealers and seizing supplies were failing and drugs prices on the street were falling, the report argued. And the benefits of drugs treatment programmes were limited because some users relapsed and many went untreated, it added.

The UK Drug Policy Commission (UKDPC) - chaired by Dame Ruth Runciman - has been set up to analyse drug policy in the country and is being funded with a three-year grant from a charity, the Esmee Fairbairn Foundation. Twelve experts have been recruited from the drug treatment and medical research sectors, as well as some from policing, public policy research and the media. They include homeless charity Shelter's chief executive Adam Sampson and the head of the Medical Research Council, Professor Colin Blakemore.

The report says that as well as having the highest level of problem drug use in Europe, the UK has the second highest number of drug-related deaths. The study found about a quarter of people in the 26-to-30 age group had tried a Class A drug on at least one occasion.

The value of the illegal drugs market in the UK is put at £5bn a year, and the cost of drug-related crime in England and Wales is estimated at more than £13bn. About one in five people arrested is a heroin addict, the report adds. Drug addiction rates in the UK are double those in France, Sweden, Germany and the Netherlands.

There has been a 111% rise in the number of people jailed for all drug-related offences between 1994 and 2005. However, street prices have dropped - with heroin falling from £70 a gram in 2000 to £54 in 2005. The report said: "Tougher enforcement should theoretically make illegal drugs more expensive and harder to get.

"The prices of the principal drugs in Britain have declined for most of the last 10 years and there is no indication that tougher enforcement has succeeded in making drugs less accessible." But the report's authors, Professor Peter Reuter and Dr Alex Stevens, say policies are succeeding in tackling certain illnesses and some aspects of criminal behaviour linked to drug use.

Dame Ruth said: "The commission does not start from the position that all UK drug policy has failed, but rather that we do not know enough about which elements of policy work, why they work and where they work well." The debate on drugs was often "sensationalised and polarised", she added. 18.4.07

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UK drug crime strategy criticised

The government strategy for cutting drug-related crime has been severely criticised in a report by the influential UK Drug Policy Commission. The independent panel said evidence to show what worked in drug treatment was "seriously weak or absent". More than £330m is spent in England and Wales on treating offenders annually.

The panel said some treatment services risked doing more harm than good. It criticised the Carat service, which took on 78,000 new prisoners last year. In a report seen by BBC home editor Mark Easton, the commission said the treatment service cost £31m to run but "there are no evaluations of its effectiveness".

It found for the 40,000 prisoners who go through detox while in jail, a lack of proper aftercare meant many went straight back to using hard drugs when they left prison. And that one in 200 injecting heroin users would be dead from an overdose within a fortnight of being released.

There was also a lack of evidence for the effectiveness of drug-free wings in prisons, it said. "Given the considerable ongoing investment in criminal justice system drug interventions, it is striking that we still know so little about the effectiveness of many of them, especially those in prisons and crucially whether they represent value for money", it added.

While community programmes appeared to work better, they were no magic bullet. In February, the government launched its 10-year drugs strategy, which saw more money focused on drug-dependent offenders. But the commission said: "We simply do not know enough about which programmes work best for whom. "Answers to even basic questions are not freely available and the weakness of the evidence base severely hampers good practice."

The report was highly critical of the quality of treatment in jails, where "provision often falls short of even minimum standards... a major concern for the health and well-being of prisoners and the subsequent impact on crime". But the government said there was a growing body of evidence treating offenders could reduce drug-related crime. Its new drugs strategy made "proactively targeting and managing drug-misusing offenders" a key element.

An additional £25m a year will be spent on treating offenders by 2011. Justice Minister David Hanson welcomed the commission's report. He said it recognised the challenges, difficulties and recent improvements in drug treatment. He said 53 prisons would benefit from health funding for enhanced clinical drug services by April.

The £175m Drugs Intervention Programme treated 40,000 offenders in the community last year. Six months later, 47% had reduced their offending. But 28% had increased. The report said plans to widen treatment to drug users whose habit was not directly related to their offending was "likely to be inefficient and could be harmful".

The risk was that younger recreational drug users would fail to complete some treatment programme and would end up being further criminalised. The law of diminishing returns could kick in, making the scheme less effective and more expensive, it warned. Chairman of the British Medical Association's forensic medicine committee, George Fernie, said the prison system lacked a "comprehensive care package" from when someone entered the custodial chain to when they were released.

"Technically, it is not that difficult to get somebody off drugs," he said. "It is the follow-through that we have to have, with stable housing, employment and family support." He backed community treatment, saying: "Prisons are perhaps not awash with drugs, but illegal substances are readily available. "We would like people treated effectively in the community if the alternative is a short prison sentence." 17.3.08

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Anti-Depressants taken by thousands of Brits 'do NOT work', major new study reveals

Anti-depressant tablets taken by millions of Britons may be a waste of time and money, research shows. An analysis of dozens of studies involving thousands of patients revealed that some of the most widely-prescribed anti-depressants work little better than dummy pills. The drugs studied - including Prozac, Seroxat and Efexor - were little more effective than placebos in improving the mental health in the majority of cases, the University of Hull research showed.

Only in the most extreme depression did the tablets, which are taken by around two million Britons and have been linked to a host of sideeffects including suicide, prove substantially superior in improving mental health.

Dr Tim Kendall, of the Royal College of Psychiatrists, described the results as "fantastically important". He added that one of the study's strengths lay in the inclusion of data which drug companies had chosen not to publicise - perhaps because it was less favourable than they would like. The study, published in the respected journal PLoS Medicine, suggests hundreds of thousands of Britons are needlessly taking powerful - and potentially dangerous - drugs.

As well as suicide and suicidal thoughts, side-effects associated with the drugs studied and other SSRI (Selective Serotonin Reuptake Inhibitor) anti-depressants range from self harm to anxiety, insomnia, nausea, headaches and vomiting. Seroxat alone has been linked to at least 50 suicides - both adult and child - in the UK since 1990.

The research comes as prescriptionsfor anti-depressants are at record levels, with 31million written in 2006 at a cost to the NHS of almost £300million. Around half of these were for Prozac, Seroxat, Efexor and other SSRIs. Research which showed the most widely prescribed anti-depressant pills are ineffective was gathered by combining the results of 35 clinical trials involving 5,000 patients

Researcher Professor Irving Kirsch said: "Given these data, there seems little evidence to support the prescription of anti-depressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide benefit." Professor Kirsch, a psychologist, reached his conclusion after combining the results of 35 clinical trials involving more than 5,000 patients with depression. The data on Prozac, Seroxat, Efexor and a fourth drug not used in the UK had been submitted to the U.S. drug watchdog ahead of the antidepressants being licensed for sale.

Two-thirds of those taking part in the studies were prescribed the SSRIs, while the remainder took placebo tablets. Comparison of the two groups showed that in the majority of cases the mental health of those taking anti-depressants improved little more than those on dummy pills. Only those who were extremely depressed - a very small proportion of those studied - fared substantially better when on medication.

The results suggest that those taking the tablets mainly benefit from the "placebo effect" - in which symptoms are eased not by medication but by relief in diagnosis and the simple expectation a treatment will work. Professor Kirsch emphasised that patients should not change their treatment without speaking to their doctor, but said other approaches include physical exercise, psychoanalysis and self-help books.

Richard Ley, the Association of the British Pharmaceutical Industry, the drug industry's trade body, said all medicines have to be proven to be more effective than a placebo before they are put on sale. A spokesman for the National Institute for Health and Clinical Excellence, which draws up guidelines on the treatment of illnesses, said routine use of anti-depressants is not recommended for mild depression. He added that Professor Kirsch's results would be taken into consideration when the existing guidelines are reviewed later this year.

Hailed as a miracle cure for depression when they were first prescribed in the late 1980s, the "happy pills" known as SSRIs work by keeping the moodboosting chemical serotonin in the brain for longer. Kate Charles spent seven years on anti-depressant drugs after suffering severe depression as a teenager. It was only when she took up running that she was able to stop taking the pills after finding that exercise was better at lifting her mood.

Speaking about her experiences three years ago, the 35-year-old writer from Dorset, said: "I have always felt quite low but my depression really hit when I was a teenager. "By the time I was 15, my GP was prescribing betablockers to relax my nerve impulses, slow my heartbeat down and make me feel calmer. Then, before my A-levels, I was put on anti-depressants. "In my final year at Sussex University, my GP moved me on to Prozac, which was the wonder drug at the time.

"Although it improved the depression, I felt detached and numb. I had other terrible side-effects -painful, aching joints, sleeplessness and anxiety. "Somehow, I managed to get a job in a finance company and struggled on but Prozac was my constant companion." Things changed when she set herself the challenge of training for a marathon.

She said: "Running was so much more effective at lifting my mood than Prozac that I consulted the doctor and spent eight months weaning myself off the drugs. "The withdrawal was painful but I was determined. I have no doubt that running took me out of my depression." 26.2.08

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GPs still handing out antidepressants linked to birth defects

GPs are still prescribing an antidepressant known to cause birth defects in unborn children to thousands of women every year, it emerged last night. Pills such as Seroxat may result in babies being born with malformed hearts if taken in the first few weeks of pregnancy - a time when many women are still unaware they may have conceived.

Several scientific studies have suggested that the class of drugs known as SSRIs, which also includes Prozac, could double the rate of birth defects. Seroxat is believed to be prescribed to 4 million people in Britain a year and it has been particularly marketed towards women as a drug to relieve anxiety and depression.

But both the Medicines and Healthcare products Regulatory Authority (MHRA) and the National Institute for Clinical Excellence ( NICE ) watchdogs have warned of the drug's potential dangers and urged GPs not to prescribe them to pregnant women unless completely necessary.

Last night leading doctors warned that the pills were still being routinely handed out to mothers-to-be and women of a childbearing age without warning of the risks. Dr Tim Kendall, joint director for the National Collaborating Centre for Mental Health, which develops guidelines for treatment, said that many psychiatrists no longer prescribed Seroxat.

Dr Kendall told the Guardian: "But in primary care it is still quite widely prescribed. GPs are quite flooded with advice. It is unlikely they will have picked up a specialist piece of advice from Nice about mental health." American doctors have been given strict instructions by the Food and Drug Administration "not to prescribe Paxil (Seroxat) in women who are in the first three months of pregnancy or are planning pregnancy, unless other treatment options are not appropriate".

A series of legal actions is about to begin in the US against GlaxoSmithKline, the British manufacturer of Seroxat. Lawyers representing the women involved claim the drugs firm knew about the birth defects 10 years ago - but GlaxoSmithKline deny this is the case.

David Healy, professor of psychiatry in Bangor, Wales, who will give evidence in the US cases, said the rate of birth defects is doubled from 2 per cent in the general population to 4 per of those on the drugs. The rate of major defects rises from 1 per cent to 2 per cent for women on Seroxat while the rate of miscarriages also doubles from 8 per cent to 16 per cent.

Mr Healy said: "From the late 1980s there was work which very clearly showed that the SSRI group of drugs ought to be regarded as posing a high risk of birth defects to women in the early stages of pregnancy or when they didn't even know they were pregnant,"

Last night lawyers suggested that there may be a case for legal action in the UK. Emily Jackson, professor of law at the London School of Economics, said the cases could potentially be brought against either the GP or the manufacturer for a failure to warn of potential risks.

In 2006 researchers in Toronto found that women prescribed Seroxat and Prozac could be twice as likely to give birth to stillborn or underweight babies. A study by the Ottawa Research Institute claimed that the products can increase the risk for a range of problems, including premature birth and seizures in newborns. 8.8.09

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Depression pills 'double suicide risk in young adults'

Young adults taking antidepressants have twice the risk of suicidal thoughts or behaviour as those taking 'dummy' pills, research has shown.  Adults aged under 25 were as much at risk as children and adolescents, according to a review of more than 100,000 patients in the British Medical Journal. 

Researchers analysed 372 studies and looked at 12 anti-depressants, including selective serotonin reuptake inhibitors (SSRIs) such as Prozac and Seroxat.  They found that the suicidal risk was 'strongly related to age', with no increase recorded for those aged 25 to 64 and a reduction in people over 65. 

Professor John Geddes, from Oxford University, said in an editorial in the BMJ that there were also important differences emerging between anti-depressants.  'The odds of suicide behaviour on sertraline [an SSRI], for example, is around half that on placebo,' he said.  'It is becoming apparent that anti-depressants vary in both their efficacy and adverse effects.'

'Although different mechanisms might lead to clinical relief of symptoms and increased suicidality, a more likely mechanism for the effects of sertraline is that it is simply better tolerated and more likely to be effectiive.' Doctors are advised not to prescribe many anti-depressants to under-18s, and instead to recommend cognitive therapy, which teaches patients to change behaviour patterns.

Suicide warnings are now included on medication in the U.S. and the British drug safety watchdog advises doctors to 'carefully monitor' young adults during treatment for any worsening of symptoms of suicidal behaviour. Doctors are advised not to prescribe the majority of SSRIs to under-18s and NHS guidelines recommend cognitive therapy, which teaches patients to change behaviour patterns, as first-line treatment for mild to moderate depression.

The researcher who led the review, Dr Marc Stone of the U.S. FDA, said the increased suicidal risk was greatest in young people with psychiatric disorders other than depression. He said 'The findings support the idea that antidepressant drugs can have two separate effects: an undesirable effect in some patients that promotes suicidal thoughts or behaviour, with a risk that appears to diminish with age, and protective effect in others that alleviates depression and reduces any suicidal risk.'

Latest figures show in the UK in 2007 there were 34 million prescriptions for antidepressants because doctors are handing them out too freely, of which 18 million were for SSRI. Between 1993 and 2002, there were 4,767 deaths in England and Wales involving antidepressant drugs, according to the Office of National Statistics.

A spokesman for the Medicines and Heathcare Products Regulatory Agency said the UK's Yellow Card system recorded side effects and adverse reactions associated with medicines. She said: 'We monitor the Yellow Card reports so we can look for any trends in this area.' 12.8.09

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More than 200 heroin addict prisoners forced to go 'cold turkey' win £4,000 damages each for human rights breach

MPs condemned the Government after it was revealed that nearly 200 prisoners received £3,807 each in compensation - because they were forced to give up heroin in jail. The convicted criminals claimed their human rights were infringed when they were deprived of the heroin substitute methadone and had to go "cold turkey".

A High Court test case involving six prisoners was given the go-ahead but the Government agreed to settle out of court and pay £750,000 to 197 inmates. When lawyers' fees are taken into consideration, the total cost to the taxpayer is well over £1million. The payouts were branded "disgusting" today as full details of the settlement emerged for the first time.

Andrew Rosindell, Tory MP for Romford, said: "This is astonishing. It's an outrageous waste of public money. "You go to prison to receive punishment and drug addicts are supposed to be taken off drugs."

Matthew Elliott, chief executive of the TaxPayers' Alliance , said: "It's disgusting that law-abiding taxpayers are being forced to pay money to these drug-addled criminals. "If you are in jail of course you should be forced to be clean. The prison system is failing precisely because meddling bureaucrats and foolish legislation stops prison guards doing their job." The former heroin addicts claimed the cash from prisons around the country.

The prisoners had all been using methadone - paid for the the Government - to combat their addictions. They claimed their human rights were breached when this approach was ditched in favour of a cold turkey detox. The group claimed breaches under Articles 3 and 14 of the European Convention on Human Rights - which ban discrimination, torture or inhuman or degrading treatment or punishment - and Article 8, which enshrines the right to respect for private life. They also claimed they were the victims of trespass in the form of unwanted treatment and accused the Prison Service of "clinical negligence".

A test case involving six of the 197 prisoners was given the go-ahead after a preliminary hearing at the High Court in May 2006. The prisoner's barrister Richard Hermer, a human rights lawyer specialising in group actions against the Government, told the court: "Many of the prisoners were receiving methadone treatment before they entered prison and were upset at the short period of treatment using opiates they encountered in jail.

"Imposing the short, sharp detoxification is the issue." Inmates claimed their drug treatment was "handled inappropriately" so they suffered "injuries and had difficulties with their withdrawal". The full month-long hearing was due to take place in November 2006 but the Government settled out of court shortly before it was due to begin.

The money was then paid out through a set up called the "opiate dependent prisoner litigation scheme". Among those to receive payouts are six inmates at HMP Altcourse in Fazakerley, near Liverpool , seven at Blakenhurst, near Redditch , Worcestershire, nine at Exeter , Devon , and 11 in Hull .

A Prison Service spokeswoman yesterday said the payments made were a minority of the claims made against the Government by lags but refused to give out details. She said: "We successfully defend the majority of contested claims. "We make payments only when we are instructed to do so by the courts or where strong legal advice suggests that a settlement will save public money.

"Each compensation claim received by the Prison Service is treated on its individual merits. "Legal advice is sought and, on the basis of that advice, a decision is made on whether or not the claim should be defended. "We cannot therefore comment on individual cases or the reasons that they were settled, as the terms of each settlement vary and may be subject to confidentiality clauses."

There are legal precedents to the settlement. In 2004, Lord Bonomy awarded armed robber Robert Napier awarded £2,400 for enduring the same treatment at Barlinnie prison in Glasgow. During the same year, gunman George Knights, 46, given nine life sentences for shooting three police officers, repeatedly sought compensation after being refused extra luxuries for his cell.

The Government has paid out £9million in compensation to convicted offenders for a huge range of claims over the last few years. Pay-outs were made for incidents including assaults by fellow lags, medical negligence and even sporting injuries while exercising in jail. 15.4.08

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Crystal meth could become middle Britain's crack cocaine within four years

Crystal meth could become a problem on the same scale as crack cocaine within the next four years, according to a new police report. The investigation carried out by the Association of Chief Police Officers (ACPO) has predicted the drug has grown in popularity and could become a major problem. Use of the drug, which is a form of crystallised amphetamine, has reached epidemic levels in parts of America and Australia.

The report compares UK growth and patterns of use to that in each of these countries. ACPO expert on the drug, Detective Sergeant Andy Waite, told the Today programme on BBC Radio 4 "in the last two or three years" police had seen "a gradual rise in the reporting of the use and manufacturing of the drug" in the UK. He also warned UK production of the drug is "something we are alarmed about" and is being monitored by police but pointed out the problem is "still relatively minor" in this country.

Regarded as a class A drug since January 2007, crystal meth is highly addictive and can cause paranoia, kidney failure and internal bleeding. It also ages the skin and rots gums. If prosecuted, users can face up to seven years in jail. Also known as Tina and Ice, meth can be snorted, smoked, eaten or melted and injected depending on whether it is bought as a powder or crystal "rocks".

The price varies from region to region but half a gram costs approximately £25 on the street. Dr Rebecca McKetin, from the National Drug and Alcohol Research Centre at the University of New South Wales (UNSW), in Australia, said to the BBC: "People are thinking, 'it's OK to go out and smoke it with my friends on a Friday night when I go to the club'. But it kind of creeps up on them and quite a lot of those people are starting to experience problems with their methamphetamine use. "And I think people here are starting to learn that this is not typical of a recreational kind of drug. It is actually a very addictive and potentially very dangerous drug." This is not the first time fears of the drug's growth have been voiced. In January 2007, a barrister based in a prosperous East Anglian town told the Mail: "Crystal meth? I've seen more addicts through the courts here in the past few months than heroin users. This time last year, I had never heard of the stuff. Now suddenly it's taking over." A detective who was part of a team that exposed an Isle of Wight factory producing the drug last year also highlighted how destructive it can be. He said: "It has had devastating effects on rural communities and can completely wipe people out because it is extremely addictive - ten times more than other amphetamines - and only six per cent of those who take the drug ever manage to come off it."

Meth makeover: US mugshots show the physical effects the drug can have.

Last month, a man was jailed for four years for causing a car crash while high on crystal meth that left a mother and daughter needing leg amputations. Alberto Ramos, 32, snorted a gram of the drug the night before the crash, and then drove home the following day through London rush hour traffic. He lost control of the vehicle on Regents Street and Victoria Reeve and daughter Kayleigh were on the pavement when the car hit them. On a shopping trip to celebrate the latter's 21st birthday, Mrs Reeve saw her foot being wrenched from her leg as she was hit by the car and lying 3ft away. Her daughter could not remember the crash.

Sentencing him, Judge Rivlin warned of the dangers of crystal meth - which at the time of the incident had just been reclassified from a Class B to a Class A drug. He said: "This drug is similar to amphetamines, but the effects are much stronger. "It is a potent, dangerous stimulant which causes drivers to drift off the road and out of their lane. It also causes excessive sleeping and depressive symptoms." 15.2.08

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Britain's first drug 'shooting galleries' hailed a success

A trial scheme which set up "shooting galleries" in three cities, enabling heroin users to obtain drugs and inject them under supervision, has dramatically cut crime rates and stopped addicts buying their supplies on the streets. Yesterday's preliminary results from the £2.5m pilot project sent a ripple of excitement through the treatment community, because long-term heroin users are among the hardest addicts to treat. They lead chaotic lives, often robbing and stealing to fund their habits. According to official figures, 10 per cent of drug addicts commit 75 per cent of the acquisitive crimes in the Britain.

But the number of offences committed by the heroin addicts taking part in the shooting gallery scheme fell from an average of 40 each per month before they were admitted to "about half a dozen a month" after six months of intensive therapy, according to Professor John Strang, the head of the National Addiction Centre at the Maudsley Hospital, who is leading the study.

Instead of buying street heroin every day, the 150 volunteers are now buying it only four or five times a month on average – while a third of them have completely stopped "scoring" the drug on the streets. Professor Strang said: "This is genuinely exciting news. These are people with a juggernaut-sized heroin problem and I really didn't know whether we could turn it around. We have succeeded with people who looked as if their problem was unturnable, and we have done it in six months."

The scheme is modelled on one in Switzerland, where the introduction of injecting clinics "medicalised" heroin use and transformed it from an act of rebellion to a treatable illness. Similar clinics operate in France, Germany and Canada.

The first British injecting clinic opened in south London two years ago, funded by the Home Office and the Department of Health. Two more were opened, in Darlington last year and in Brighton two months ago. During the trial, a third of the volunteer addicts take the heroin substitute methadone orally, while a third inject it under supervision. The remaining third, observed by nurses, attend twice a day to inject themselves with diamorphine – or pure heroin – which is imported from Switzerland and provided by the clinic. Professor Strang said: "The rules are incredibly strict. There is no 'take-away' at all [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 fix twice a day. The nurses have become quite involved, telling users off about their bad practice or lack of hygiene. I was quite surprised how, after decades of injecting, some users were still so bad at it."

There are an estimated 280,000 users of hard drugs in Britain, most taking heroin and crack cocaine, and about 2,500 deaths a year. The shooting gallery scheme, targeted at long-term heroin users, operates seven days a week, 365 days a year and costs £15,000 per year for each addict – three times the cost of providing oral methadone treatment.

Jamie, 39, heroin addict: 'I have got no warrants hanging over my head'. Since the age of 16, Jamie has been to jail 28 times. She has lost her children, her possessions and very nearly her life when she was hospitalised for six weeks in 2004. All because of heroin. "It started when I was 14. I kept running away from home and got involved with some older kids who were using 'skag'. I wanted to know what it was like. By 16 I was addicted." Much of her life since then has been spent on the run from police and in treatment programmes, none of which succeeded in weaning her off the drugs.

In 2005 she was one of the first addicts to be taken on by the injecting clinic in south London. It has transformed her life. "I am no longer out shoplifting. I have got no fines or arrest warrants hanging over my head and I am not in prison. I have a better relationship with my family and I feel great."

Now 39, she injects diamorphine every morning and afternoon and wants to start reducing her dose soon. "My plan is to go to college and get a job. Heroin addiction is an illness – it has been my illness since I was a teenager." (What utter rubbish) 20.11.07

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£2.5m to treat drug addicts - with heroin

Drug addicts have received £2.5million of free heroin and nursing care in NHS 'shooting galleries', it was revealed yesterday. They are allowed to inject themselves with a pure form of the Class A drug under the supervision of round-theclock nursing staff. Despite the cost, and the fact that many of the addicts are still committing crimes, leaders of the project say the results are encouraging and three pilot schemes may be extended nationwide.

But critics questioned the decision to plough so much NHS money into treating criminals when law-abiding citizens are denied vital treatments. Matthew Elliott, chief executive of the Taxpayers' Alliance , said: 'It shows a pretty warped sense of priorities.' The joint Home Office and Health Department project began two years ago in London, Brighton and Darlington. Trial leader Professor John Strang said it had cut crime and kept users away from drug dealers.

About 40 per cent of users in London had 'quit their involvement with the street scene completely', he said, and others had reduced it dramatically. Professor Strang, of the National Addiction Centre at the Institute of Psychiatry in London, added: 'Their crimes have gone from 40 a month each to perhaps four a month. The reduction is not perfect but it is a great deal better for them and, crucially, a great deal better for society.'

The cost of the treatment, including providing the speciallyimported heroin, is between £9,000 and £15,000 per patient - three times as much as a year's course of methadone. It is restricted to hardcore addicts, who experts say cannot be helped in other ways.

But critics contrasted the spending to the decisions not to fund some Alzheimer's drugs, which cost just £2.50 each day, and restrict treatments for some types of cancer, arthritis, bone disease and the prevention of blindness in older people. Mr Elliott said: 'Free healthcare shouldn't be about getting high at taxpayers' expense. Drug users should be given help to kick their habit and lead an honest life. We shouldn't aid and abet their personal failings.'

Shadow Home Secretary David Davis said: 'This is a white flag approach. The Government are effectively conceding that the war on drugs is not winnable and instead spending millions trying to "manage" addiction. 'We believe they should spend the drugs budget on ending addiction. We would do this by expanding abstinence-based rehabilitation programmes, which have proved far more successful than the Government's approach. 'By simply giving addicts drugs the Government is betraying the people in our society who so desperately need our help.'

The Victims of Crime Trust said: 'We need to get criminals off drugs and stop them reoffending, but it should not be at the expense of people whose only crime is to be gravely ill. We are allowing Class A drug addicts to hold us to ransom.' Dr Nicola Metrebian, who manages the clinical trials, said: 'It is more expensive than standard treatment, but standard treatment is not effective for this group of people.' 20.11.07

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MPs demand reform of drug rationing body NICE - Call for quicker drug decisions

A faster, more streamlined system of assessing treatments for the NHS in England , Wales and Northern Ireland should be introduced, MPs say.

The National Institute for Health and Clinical Excellence should adopt a "rough and ready" approach, similar to Scotland , a Commons committee said. The health committee said an in-depth review of new drugs and technologies could be done later if needed. It is now up to ministers to consider the findings.

NICE was set up in 1999 to make recommendations to the NHS about which treatments should be made available by assessing their cost effectiveness. The directives apply to the whole of the UK , except Scotland which has its own advisory body, the Scottish Medicines Consortium.

The Scottish system has often been compared favourably to NICE as it carries out much more simple appraisals and as a result decisions are often made within a few months.By comparison, the fastest appraisals NICE carries out take between nine months and a year on average.

The MPs also called on NICE to carry out appraisals on all new treatments - at the moment it just tends to focus on the most expensive, such as cancer drugs used in hospitals. The report said this meant NHS trusts were overly focused on these expensive treatments often at the expense of the cheaper, but highly effective, drugs that could be prescribed by GPs.

MPs also questioned the method used by NICE to assess treatments. New treatments are generally only used if they cost under £30,000 for each year of good health they provide, a measurement known as a Quality Adjusted Life Year (QALY). They said there was no scientific basis to the threshold, which had not changed since NICE was set up. They said this needed to be reviewed and a two-stage assessment process introduced.

The initial "rough and ready" assessment could use tougher criteria meaning only the most effective treatments were recommended. The idea would be to do this as soon as a treatment received a licence so that any recommendations would be in place by the time the drug was put on the market - normally four months after licensing. Another assessment could then be carried out if evidence suggested it needed to be, but this would use a higher QALY threshold decreasing the risk a treatment would be taken out of NHS use once it had been recommended.

Health Committee chairman Kevin Barron said NICE had a vital role to play in the future with the prospect of expensive new treatments coming on to the market at a time when the rises in the NHS budget were falling. But he added: "We have concerns about how NICE does its job. No healthcare system can deliver everything... but more cost effective treatment means more treatment."

Joyce Robins, of Patient Concern, said: "We would welcome faster assessments. "But we would be concerned if the two-stage assessment process meant treatments were taken out of use when patients were on them."

NICE chief executive Andrew Dillon said the organisation would consider the report along with the government, but described the criticisms as "constructive". He added: "The committee has identified some of the key challenges we face as we move into our 10th year of operation."

The Department of Health said it would be considering the findings in the coming months. 10.01.08

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Patients get poor deal from slow NHS, say MPs

Patients in England, Wales and Northern Ireland are getting a poor deal from the NHS because the system of assessing drugs and other treatments is too slow and inefficient, MPs said today. The health select committee said the National Institute for Health and Clinical Excellence (Nice), which decides what treatments the NHS should be provided, should introduce a faster and more streamlined system for assessing treatments.

The highly critical report identified several other flaws in Nice's appraisals, warning that its guidance was often not based on empirical evidence nor took into account the pressures on the NHS budget. But most criticism was reserved for the time taken to assess new medicines and treatments, which has led to repeated protests by patients, drug companies and MPs.

The report advised Nice to adopt a similar approach to its Scottish counterpart, which carries out more simple appraisals that allow it to issue guidance within a few months. In contrast to the speed of the Scottish Medicines Consortium, the fastest appraisals carried out by Nice take around 9-12 months. The committee recommended that Nice assess all medicines when they were launched, so doctors could prescribe useful and cost-effective drugs as soon as they became available.

The chief executive of Nice, Andrew Dillon, said it would be possible to speed up assessments as long as the Department of Health promptly decided which drugs it wanted appraising. "I think we are too slow at starting our evaluations of some of the things that are referred to us," he told the BBC Radio 4 Today programme. "We have to move more quickly to make sure that we get the requests from the Department of Health to start work on the treatments we look at."

It said Nice's current approach was to prioritise the assessment of the most expensive new treatments, such as cancer drugs, over cheaper but highly effective drugs that could be prescribed by GPs. The MPs said that as a result many NHS trusts felt forced to fund Nice-appraised drugs at the expense of other treatments.

The study said: "The affordability of Nice guidance and the threshold it uses to decide whether a treatment is cost-effective is of serious concern. "The threshold is not based on empirical research and is not directly related to the NHS budget." The study noted that some NHS trusts struggled to balance the need to provide drugs approved by Nice with the need to treat many patients.

The NHS Confederation, which represents 90% of NHS organisations, told the committee that many of the treatments examined by Nice were only just within the defined limits of cost-effectiveness. It said: "As a result, the paradox arises that NHS funding is mandated for a marginally cost-effective drug and local NHS organisations may have to achieve this by not spending on treatments which may be very much more effective and could benefit more people."

Nice should also review the use of older medicines that may no longer be cost effective, said the committee of MPs. The report also stressed the importance of Nice's work remaining free from political interference by ministers. It highlighted the intervention of former health secretary, Patricia Hewitt, who in 2005 said trusts should not refuse to provide breast cancer drug Herceptin on cost grounds alone, even though Nice had not finished its appraisal of the drug.

The report said: "We note that it is not the role for ministers to directly or indirectly seek to influence the Nice decision-making process." 10.1.08

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Cocaine: The Hidden Epidemic

COCAINE use in Greater Manchester reaches far beyond bars and clubs and into the area's police HQ, hospitals and a Manchester crown court, an M.E.N. investigation can reveal. A team of M.E.N. reporters used the same testing kits employed by police to spot check toilets - the place where users most commonly prepare and snort cocaine - across the area.

Positive results were produced in the women's toilets in the reception area of Chester House, the headquarters of Greater Manchester Police.
And traces were found in four sets of hospital toilets and at Manchester's Minshull Street Crown Court . As part of the testing, a random sweep was also done of the toilets in the M.E.N. Media building in Scott Place. This, too, produced a positive test.

The test swabs used by our reporters turn blue due to a chemical reaction produced by the presence of cocaine. The areas tested were always flat surfaces within toilet cubicles, where people might prepare and sniff cocaine. These ranged from toilet seats and cistern lids to toilet roll holders and window sills. Drug experts say that lower prices and greater availability mean that cocaine powder use is on the up.

Former cocaine addict Tom Kirkwood said use of the drug has spread across all levels of society. He said: "People's general view of alcoholics and drug addicts are the guy on the park bench with his trousers held up with string or the guy with the needle hanging out of his arm. "In fact we are doctors, we are lawyers, we are policemen, we are factory workers and we are also the guys on the street. We represent every class and creed."

Mark Gilman, north-west regional manager of the national treatment agency for substance misuse, said: "It is spreading like wild fire. The problem is getting these people into treatment. "The findings confirm what I thought. Cocaine use is now not restricted to those on nights out looking for a quick high. It has infiltrated society and has spread across all environments. In some cases people are using it regularly just to get through the daily nine to five and to cope with stress in the workplace.

"Most powder cocaine users don't think they've got a problem. They don't see themselves as addicts because they don't identify with Big Issue sellers, it's more Kate Moss and Amy Winehouse to them. "There's a lot of reference to two grades of cocaine - the premium stuff at around £50 per gram and a cheaper lower-quality type for £25 to £30 a gram.

"The fact that two markets can be sustained shows something about how much use there is." Of eight city-centre bars and hotels tested by the M.E.N. only one - Panacea - revealed traces of the drug.

The toilets in three hospital A&E departments - Manchester Royal Infirmary, Stepping Hill in Stockport and Fairfield hospital in Bury - and the ones in the MRI's main reception area did prove positive.

Mike Linnell, from the Manchester drug charity Lifeline, said he wasn't surprised. "A number of the people who end up in A&E are drunk or off their faces on drugs," he said. "They've got five hours to wait and some cocaine in their pocket - they're going to take it."

GMP uses the swabs to test for drug use when assessing licence applications. They are also used by forces across the country, by customs staff and in prisons. Dave Rigg of Crackdown Drug Testing Ltd produces the kits and was a policeman in Oldham for 18 years. He said: "The swabs are very reliable, they'll detect milligram levels.

"This means if there were traces of cocaine on somebody's clothes or fingers and they touched the tested surface it wouldn't pick it up unless there was a substantial amount. "The levels they detect means that it is the presence of the drug on that surface they are showing."

Although it is impossible to say whether employees or visitors are responsible for the drug use in the places tested, experts said employers must be aware they have a legal obligation to keep premises drug free.

Gary Beeny, drugs advice worker for Lifeline, said: "Under Section Eight of the Misuse of Drugs Act, it is illegal for people who own, manage or control a building to knowingly allow drug use. But in terms of support, if people are using drugs at work then you would have to say they have more of a problem than those people using it on Friday and Saturday nights.

"Employers should encourage people to seek advice. They can do that in confidence. If people come to Lifeline then they don't even need to give their name." 5.11.07

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Quarter of young adults take cocaine or cannabis

Nearly one in four young adults took drugs last year in spite of an overall fall in the amount of misuse, Home Office figures revealed today. Cannabis was the most common substance taken with more than 1.3 million 16-to 24-year-olds smoking it.

Cocaine was taken by 375,000 young adults — slightly up on the previous year's total and equivalent to more than six per cent of the under-24 age group. The figures, drawn from the Home Office's British Crime Survey, cover the year ending in March.

They also show that the percentage of those aged between 16 and 59 who took at least one illegal substance fell from 10.5 per cent the year before to 10 per cent. Prime Minister Gordon Brown recently ordered a review of the classification of cannabis, which is expected to revert to class B status. A separate Home Office report also published today shows that drug seizures have risen sharply.

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Cocaine Dieters: Women who turn to illegal drugs in their struggle to lose weight

One in seven women is using drugs such as cocaine or speed in a desperate attempt to lose weight, according to a survey. Many others take slimming pills or laxatives to try to shed the pounds. Yet both drug-taking and drastic dieting are largely ineffectual, with the great majority regaining any weight they may have lost within weeks or even days.

Nearly three out of ten women who took part in an internet survey by the celebrity magazine Now admitted they had made themselves sick after eating. One in ten said they would have an operation to fit a gastric band to control their eating. Now, which has a young readership, also said that one in seven of those responding to the survey claimed they had taken Class A drugs to lose weight. Fewer than one in ten who lose weight by dieting manage to keep it off, according to the survey of 2,000 women with an average age of 35.

Experts said last night that women were playing a dangerous game by using drugs to get thin. They warned the glamorous image of cocaine masked health risks such as heart attacks and strokes. Several dozen deaths are attributed to the use of cocaine and amphetamines every year. The survey, carried out by online analysts Demographix, found more than eight out of ten of those questioned had dieted.

Thirty seven per cent had taken slimming pills, 15 per cent had taken speed or cocaine and 26 per cent had used laxatives as slimming aids. Almost a third counted calories all the time. Three-quarters opted for 'faddy' crash diets - with many feeling unwell because of them - and two-thirds feared they had lost the ability to eat normally. More than a third raided the fridge in secret, almost half lied about the amount they ate and a quarter hid food in 'secret places'.

Three out of four said they spend their lives 'snacking' while two thirds starved themselves before a big night out. Fewer than one in five never tried to diet and only 2 per cent claimed to be happy with their body. Women would spend on average £11,000 for a better one. A third of women said they would give up sex to be slim for ever while 86 per cent said they would rather drop a dress size than sleep with David Beckham.

Dr Ian Campbell, medical director of Weight Concern, said it was alarming that women were using illicit drugs in ill-fated slimming attempts. "There is no evidence that they have any long-term effect on weight but a great deal of evidence that they are harmful to health," he added. "The only long-term solution to weight control is lifestyle changes, including dietary modification and more exercise. There is no substitute for effort."

David Raynes of the National Drug Prevention Alliance said cocaine-use could kill and cause facial disfigurement. "I fear that women are using drugs as an excuse for attempts at slimming, much like women say they smoke in an effort to keep their weight down," said Mr Raynes. "But its a cop- out and women should be aware of the very real dangers."

Now's editor Helen Johnston said: "Women today have a shocking relationship with food and are living a binge/purge lifestyle. "Sadly this survey shows once a woman starts on the path of fast faddy diets they become her companion until the day she dies. "Body image is the female curse of the 21st century. Whatever a woman's achievements in life, her whole self-image is totally bound up in her body shape." 16.10.07

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Drug addicts to be given i-Pods if they beat their habits

Drug addicts could be offered food vouchers and the chance to win prizes such as i-Pod music players by the Government body refusing treatment to Alzheimer's sufferers. The National Institute for Clinical Excellence (Nice) wants to offer heroin and crack addicts 'incentives' to quit their habit.

The users - many of whom commit crime to feed their habit - will be offered vouchers if they test clean for the illegal substances. The size of the taxpayer-funded gift will - on offer to as many as 50,000 addicts - increase with each successful test...starting at £1.50 and rising to £10 a week. Under draft plans, they could also be offered tickets for a prize draw each time they return a 'clean' test at their local clinic.

Increasing numbers of tickets would be awarded, raising the chance of winning the prizes. There could be a one-in-two chance of winning a small prize but a one-in-200 chance of winning a main prize - worth up to £100. Nice has not specified what types of prizes would be on offer - but clinics could decide they should include MP3 players, such as an i-Pod, or other electrical items.

The quango, which is in charge of rationing the treatment available on the NHS, believes that offering incentives to drug addicts will provide the taxpayer with value-for-money. By getting a user clean, society saves large sums of money in treatment costs and crime. But campaigners last night questioned the wisdom of lavishing funds on heroin users - whose condition is self-inflicted - while denying drugs to Alzheimer's sufferers, and those with other conditions

Alzheimer's sufferers are currently awaiting the verdict of a High Court challenge to Nice's decision to halt the prescription of £2.50-a-day tablets which alleviate the devastating symptoms of the disease. Katherine Murphy, of the Patients Association, said: "Why should these people with self-inflicted problems be given priority over people who have a genuine illness? Some people with genuine disease are being forced to sell their homes for the medicines they need."

Matthew Elliott, chief executive of the TaxPayers' Alliance, said: 'When women are going without life-saving drugs for breast cancer thanks NICE, the decision to give drug users lavish freebies clearly can't be justified. 'This programme will waste vital resources which could be better used for people with genuine illnesses rather than self-inflicted problems. It is a complete waste of money.'

Norman Brennan, director of the Victims of Crime Trust, said: 'Many of these drug addicts will have stolen to pay for their drug habit. It sends out completely the wrong message to then offer them a reward. People on the verge of taking drugs need to be discouraged - this does the complete opposite.'

The 'incentives' will be on offer until doctors are satisfied the addict's condition is 'stabilised'. People who returned to their habit would have to start again, at the bottom of the scale for the vouchers. Typically, they will undergo three tests each week, so the value could increase rapidly. Nice has said international trials have shown modest financial incentives could help hardened addicts stay off drugs.

Research by the University of Connecticut found cocaine and methamphetamine users stayed drug free for longer when they had the chance to win prizes such as telephones, stereos, DVD players and televisions. Every time addicts gave a negative drugs test they were given tickets for the draw. They "earned" an increasing number of tickets for every week that they remained drug free. A Nice spokesman declined to comment on the final version of the guidelines, ahead of their expected publication later this week. 23.7.07

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Britain is now cocaine capital of Europe

Britain is now the cocaine capital of Europe with soaring numbers of young people taking the drug, a United Nations report has revealed. It revealed more than 900,000 Britons buy cocaine, which means the country has overtaken Spain as the biggest user in the continent. In addition, Britain's 350,000 heroin users are the largest number in any country in Europe.

The annual survey from the UN's Office on Drugs and Crime said that across most of the world drug abuse is holding steady or is in decline because of successful law and order campaigns to prevent their distribution, sale and consumption.

But the falling tide in many countries is leaving Britain exposed as a thriving drugs market where millions remain addicted to or repeat users of illegal substances.

The report found cocaine use had gone up in Britain and added: "In absolute numbers estimates suggest that the UK's cocaine market, some 910,000 people, is even marginally larger than the market in Spain, some 890,000 people." It added "cocaine is now the second most widely used illegal drug in the UK after cannabis".

But it noted that cannabis use in this country had diminished since the reclassification of the drug - from Class B to less serious Class C - in 2004. The change made it rare for police to arrest anyone for possessing the drug.

The UN said the fall was "probably because extensive discussion about rescheduling cannabis brought new scientific findings on the potential harm of cannabis into the limelight". "Growing awareness of the dangers of cannabis use among young people went in parallel with declining cannabis use," it added.

The growth in cocaine use came alongside evidence that the drug is now available more cheaply than ever before. Drugscope said after a survey last year that prices have dropped to £44 a gram, nearly a third down on £65 a gram in 2000. Tory home affairs spokesman David Davis said: "This is yet more evidence that Labour continues to fail on drugs." But Home Office minister Vernon Coaker claimed success in cutting drug abuse.

He said: "I welcome the report which shows that tough enforcement is having an effect on cutting drug use. "We have achieved a great deal through our strategy of enforcement, early intervention, education and treatment: in England and Wales drug use has fallen by 16 per cent since 1998 while drug-related crime and the harm caused by illegal drugs have fallen." 27.06.07

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I vowed not to date men who use cocaine 18 months ago - I've been single ever since

The evening had been great. The wine had flowed, the conversation was effortless, and the man sitting opposite me in a London pub extremely handsome. As a first date, it could hardly have been better. But at the back of my mind was a nagging question. Steeling myself, I brought up the subject of drugs, and how I'd sworn never to date a cocaine user again.

His face fell. With just one look, I knew it was over before it began. But this wasn't any rock star, a model or even someone in the media - the stereotypical cocaine users. No, he was just a goodlooking builder. Hardly the glamorous type. But I wasn't surprised to discover he had a habit. Over the past few years, I've come to realise cocaine is not just a problem in the well-documented 'showbiz' circles of the capital, but across every class and occupation in Britain.

It was really brought home to me at a 30th birthday bash last month in Essex when one guest, a schoolteacher from York, told me about a dinner party she'd gone to where food wasn't on the menu. "If I'm invited to dinner," she said, "I prefer mine to be with a little nutritional value off a plate, not a powder off a mirror. I made my excuses and went home." At the same table around me that night were 20 or so people from all areas of Britain, with social backgrounds as varied as their addresses, their careers ranging from solicitor to ski rep, marketing rep to mother. In short, a selection of Middle England's finest. And out of all those people, I joined my teacher friend in being the only two who have never taken the illegal Class A drug cocaine.

Another guest at the party, a no-nonsense estate agent from the North-West, had recently returned to see her family one weekend and arranged to meet up with some old acquaintances in a bar. While she was out, she bumped into several of her stepmother's girlfriends. These fortysomething women are all outwardly respectable and vibrantly healthy - the type who do not eat red meat, but drink wheatgrass juice and eat only organic food. In the queue for the ladies - now longer than ever in nightspots throughout the country because of the number of women going to the loos in twos to powder their noses - my friend realised that her parents' pals had exchanged one type of vacuuming for another.

While a toilet attendant rushed to wipe down seat covers (employed by any place remotely trendy in case of spot checks by council officials), these super-mums were maintaining their super-high while their 11-year-olds slept at home in the hands of teenage babysitters. Bear in mind, too, that those babysitters themselves may well be familiar with cocaine.

While I was in Edinburgh last year catching up with a friend, she told me how her supposedly straight-laced teenage stepsister had been snorting the drug. "She told me if she didn't, she would be a social pariah. She hadn't been included in nights out with her friends before because they knew she'd fade late at night if she didn't use cocaine." Harry Shapiro, spokesman of the charity Drugscope, confirms the trend: "The celebrities on the front pages mask the reality that it's not just them taking cocaine." And he emphasises that abuse of the drug is far from the sole preserve of London's champagne and canapÈs set.

Thanks to its free-falling price over the past five years - National Criminal Intelligence Service figures show the price of a gram of cocaine fell from £80 in 1995 to as little as £40 today - the cost of a "line" can be less than a cocktail. Britain has the fastest-growing cocaine consumption in the world, and Shapiro says: "It used to be like heroin, but that taboo has gone now. Cocaine has become a fairly unremarkable aspect of a night out for a lot of people."

Meanwhile, a Southampton-based girlfriend of mine, who is a sales rep, told me: "If someone asked if they could take heroin in front of me, I'd be horrified. "But I'd be left with precious few friends if I complained every time someone did a line of coke." Certainly, statistics bear out the fact that the young are using cocaine more than ever. Its use has more than doubled among 16 to 24-year-olds over the past seven years.

Twenty-four hour drinking has contributed, too, because revellers are using drugs to keep the party going long into the night. For them cocaine, which keeps you alert and awake, is the perfect solution. Paul Broadbent, Chief Superintendent of South Yorkshire Police, has warned that the open-all-hours culture has led to a rise in cocaine and amphetamine use. His officers have noted the trend in Sheffield, a city that has encouraged a round-the-clock drinking culture. So more people are doing it, you might say, but surely they're not people you come into contact with? Well, don't be so sure.

The latest figures show that cocaine is now the fastest-growing drug problem among the middle classes. A UK Drugs Unlimited survey published last year found that nearly half the young professionals questioned had used the drug, a fourfold increase from a decade ago. The frightening truth is that these days, it's not just the Pete Doherty types who are using the drug, it's your dentist and that nice man who does your tax returns. Look closely enough and someone you know is almost inevitably more than familiar with cocaine.

A 36-year-old female GP I know - whom I'll call Clare - privately admits that until recently she was a regular user. Such behaviour is surprising for a medic, especially when you consider that cocaine is the cause of 50 per cent of weekend emergency hospital visits for heart and chest problems: it tightens up blood vessels, making the heart work harder and raising blood pressure.

As little as two 100mg lines (a fraction of an ounce) is enough to cause chest pain. Professor John Henry, a leading drugs expert, says: "People need to know not only that they can die from first use of cocaine, but that they're also going to end up with arteries like a 60-year-old and have brain damage." Then there are the other side effects of collapsing nostrils, suffered by the likes of EastEnders actress Danniella Westbrook and Tara Palmer-Tomkinson, kidney and respiratory failure, strokes, gastrointestinal complications and mental disorders.

So why on earth would my GP friend join the ranks of coke users, inanely repeating themselves and looking like warped versions of AA Milne's Tigger, bouncing around jerkily with runny noses, bulging eyes and sweaty skin? If you look carefully when you're out in a bar or pub - or even at your office - they're easy to spot. Users are the people who think they're the life and soul, sprinkling their conversation with sparkling wit, when actually they are unable to focus on anyone or converse with any sense.

They will also be making regular trips to the bathroom, and if they're not, they will suddenly get so paranoid-that they are even more of a nightmare to be around. That was certainly true of Clare's lover, Trevor, a fiftysomething who thought he was still a bit of a rocker. Trevor was an eerily thin, cheating, flaky liar who, when he wasn't high, was tired and depressed - classic cocaine side effects. While the drug gives women the libido of a nymphomaniac, too much of it can have the opposite effect on men, so Trevor was also a failure in the bedroom and could not give her the baby she desired. She finally ditched him after he turned violent thanks to the drug and broke her arm - and her heart.

Such bitter experiences have convinced me it's impossible for a non-user of cocaine to date a user. The world of the "cheeky line" has all the unfortunate aspects of a secret society, a destructive third person in any relationship. My New Year's resolution of 2006 was giving up men who use cocaine and, yes, I have been single ever since. But this is not because I never leave the smart enclave of clubs in Chelsea where one might assume you'd find scores of stereotypical cocaine users. On the contrary, my standard nights out are in pubs visiting my school friends in north and east London, and my weekends are spent with my university pals in towns around the country. As well as the handsome handyman-I also recently had to turn down the advances of a cute trainee chef because of his hideous drug habit.

Today, at 30, I find it easier to bring it up in conversation on the first date - always in a jovial way but so they know I'm serious. It's rare when I've made my stance clear that a man will bother to call me again, although I once almost wavered with a beautiful boy who got persistent and with whom I felt a massive spark of attraction. However, the memory of being let down on a number of occasions, including a birthday not so long ago, by an amour who was off doing cocaine instead, remains too fresh in my mind, and for self-preservation's sake, I know I must keep it that way. Cocaine use is so widespread that I have been unable to find a remotely attractive, decent male who doesn't snort the stuff.

The very fabric of UK society is in serious straits, thanks to this snowstorm. On a wider scale, as the film Traffic shows, the cocaine trade is handing over money, power and legitimisation to the most violent and corrupt forces in Latin America. UK users, no doubt a significant number of whom are card-carrying Amnesty International children's charity supporters, are also causing the death of children.

It is not Cambodia or Afghanistan that has the world's highest rate of injuries due to landmines, but Colombia, where insurgents from the Revolutionary Armed Forces of Colombia plant them to protect the coca fields and processing labs that produce the drug. It is time for an anti-cocaine crusade led by a politician or a personality with all the evangelical fervour associated with the ecological or world poverty cause. But can you see Bono or Bob Geldof campaigning to cut off the import of cocaine. Not very cool, is it? And as for government: David Cameron has notoriously kept his mouth shut on drugs, and in the wider political sphere, well, just remember that a couple of years ago, the toilets at all three party conferences all tested positive for cocaine.

So no, I won't be holding my breath waiting for the day when cocaine is neither cool nor ubiquitous. I fear I may be single for some time to come. 15.7.07

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Growing numbers of housewives and professionals are becoming addicted to over-the- counter drugs, doctors have warned.

Tens of thousands of "ordinary people" are thought to be dependent on tablets such as Solpadeine and Nurofen Plus, which contain the painkiller codeine.It is a narcotic, which makes users feel relaxed - so even after their pain has gone, some will keep taking it for the calming effect. As the body becomes accustomed to the codeine, addicts must start taking more and more. Some of those hooked are taking more than 70 pills a day, placing themselves at risk of liver dysfunction, gastrointestinal disorders, gall stones, chronic constipation, depression and constant headaches.

Writing in the British Medical Journal, a GP has called for more research into the problem and for larger labels to be placed on packets to warn of the dangers. London-based Dr Christine Ford said her warning was inspired by the rising numbers coming to her for help. In the past three months she has seen three patients with addictions to Nurofen Plus. They all started using it as a painkiller but became addicted to the codeine.

She said: "I think addiction to over-the-counter medicines has been going on for a long time but many doctors do not pick up on it, partly because their patients do not mention it. It is a bit like having an alcohol problem -you tend to keep that a secret. You are not going to tell someone that you are taking 13 Nurofen Plus a night." In 1999, comedian Mel Smith was rushed to hospital with a burst stomach ulcer after becoming addicted to Nurofen Plus. He had taken more than 50 pills in one go. Yesterday the largest organisation helping over-the-counter addicts, Overcount, said the numbers it was helping had almost doubled in three years to 15,000.

Project director Davie Grieve said: "The worst affected classes in order are married housewives, single mums and then people in professional jobs, because their type of lifestyle causes them stress. "We've got doctors, nurses and teachers on our books. "We're not talking about the typical addict on the street corner wearing jeans and with his baseball cap on backwards. It's ordinary people." The problem is getting worse, he said, because many of the drugs used to require a prescription but are now freely available.

Mr Grieve said that while male addicts tend to be using cough medicines containing codeine, women are falling victim to pills. He added: "It's a combination of government rules on prescribing and more marketing by the manufacturers, particularly towards women. "There are lots of adverts for painkillers in women's magazines and during daytime programmes because the companies see women as their target market."

In 2005, the rules on drugs containing codeine were strengthened. Pack sizes were limited to 32 pills, and manufacturers were obliged to place warnings on them stating the dangers of addiction, advising that if they are using the drug for more than three days at a time they should see a doctor. But the Medicines and Healthcare products Regulatory Agency decided not to introduce prescriptions for drugs containing codeine, saying the reports of misuse were "exceedingly small". Helen Darracott, of the Proprietary Association of Great Britain, which represents manufacturers of over-the- counter medicines, said the drugs should not lead to addiction if instructions are followed.

GlaxoSmithKline, which makes Solpadeine, said it took any reports of misuse of the medicine seriously. The company said in a statement: "Hundreds of thousands of people benefit from safe and effective use of Solpadeine every year." 5.7.07

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Addicts turn Lemsip into 'crystal meth'

Addicts are turning flu drugs like Lemsip and Benylin into the lethal street narcotic crystal meth , the government has revealed.

"If methylamphetamine did secure a hold in the UK, the consequences would undoubtedly be very serious," Caroline Flint

Health Minister Caroline Flint said police were increasingly anxious that pseudoephedrine and ephedrine - found in many decongestants - can be extracted "relatively easily" and used to make methylamphetamine. She warned of "very serious" consequences if methylamphetamine - known as crystal meth or " ice" - secured a hold in the UK . And she added that "most" of the conditions needed for it to do so were already in place.

Methylamphetamine was reclassified by the Home Office last January as a Class A drug . A highly-addictive stimulant which affects the central nervous system, it can cause serious physical and psychological harm.

When smoked in its crystalline form it produces effects similar to, but longer-lasting than, "crack cocaine". Evidence suggests chronic use can lead to psychosis, including paranoia and violent behaviour.

Ms Flint explained in a Commons written answer tonight: "Although the prevalence of misuse of methylamphetamine is believed to be currently low in the UK, the Association of Chief Police Officers are receiving increasing levels of intelligence about the prevalence of methylamphetamine.

She added: "If methylamphetamine did secure a hold in the UK , the consequences would undoubtedly be very serious. 25.4.07

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Labour's ten-year drugs war has achieved nothing but lower street prices, says experts:

A decade of Labour's war on drugs has done nothing to curb the misery and crime caused by abuse, a research group declared yesterday. Propaganda campaigns, law enforcement and imprisonment for drug dealers have had no effect on levels of drug use, it said. Police activity against drug markets and seizures of smuggled drugs have resulted only in lower street prices.

The scathing criticism came in a report by the UK Drug Policy Commission, an independently funded group which intends to press the Government to try harder to tackle huge levels of damage caused by drug users. It said that one in four people in their late 20s have tried a hard drug such as heroin or cocaine at least once; that nearly half of all young people have used cannabis; and that the drug addiction rate in Britain is more than twice the levels of France, Germany, Sweden or Holland.

The report added that there is a drugs market worth an estimated £5billion a year, that the cost of drug-related crime is thought to be £13 billion, and that one in five of all people arrested for crime are dependent on heroin. The verdict comes at a time of growing pressure on the Government for change in the drugs laws that were last radically overhauled more than 35 years ago. Ministers are due to consider the effects of Labour's ten-year drugs programme - which began bullishly-with the 'war on drugs' in 1998 - next year.

Tony Blair's war on drugs appeared to be reversed spectacularly in 2001 when then Home Secretary David Blunkett announced the reclassification of cannabis, a move which downgraded the criminal status of the drug so that users are unlikely to be arrested. The chairman of the new Commission, Dame Ruth Runciman, was one of the key figures behind the cannabis reclassification.

She said yesterday: 'We are an independent organisation that will provide objective analysis of drug policy. The debate on drugs is often sensationalised and polarised. Our mission is to improve political and public understanding of the strengths and weaknesses of policies for tackling drug misuse.' Yesterday's report praised 'harm reduction' policies - which broadly accept the use of drugs and attempt to cut the damage addicts cause - while dismissing the effects of enforcement law and imprisonment.

It said: 'Government policies have only limited impact on rates of drug use itself. However, the UK has introduced evidence-based measures, notably the expansion of treatment and harm reduction, that have reduced the harms that would otherwise have occurred. On the other hand it operates measures, such as classifying drugs to deter use and increasing use of imprisonment, that have little or no support from available research.'

The Commission includes a number of academics and researchers who have advocated liberalisation of drugs law. Among them are Professor Colin Blakemore, head of the Medical Research Council, who is a longstanding advocate of decriminalisation of cannabis, and Roger Howard, former head of the Drugscope charity and a supporter of softer laws against all drugs, who is the body's chief executive.

Yesterday's report, An Analysis of UK Drug Policy, was prepared by academics including Peter Reuter of the University of Maryland, who has also written in favour of decriminalisation of cannabis.

Tories said the report was 'a shocking indictment of the Government's failure.'

Shadow Home Secretary David Davies said: 'It shows that Tony Blair has utterly failed in his pledge to get tough on the 'causes' of crime. The consequences of this failure are not just that hundreds of thousands of young lives are being ruined - drugs also fuel much of the gun and knife related violence on our streets today, thus destroying communities.' Anti-drug campaigners were less impressed by the Commission.

Mary Brett of Europe Against Drugs said: 'The members include the usual suspects who promote decriminalisation.

'The problem is not that people are not aware of the effects of drugs policy but that they are not aware of the effects of drugs. People just don't know how dangerous cannabis is.' 19.4.07

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The UK has the biggest level of problem drug use in Europe and the second highest number of deaths from them, according to a report.

Despite successive Governments' attempts to control the demand and supply of illegal drugs, the report says drug policy appears to have had 'minimal' impact on the overall level of use in the UK. However, they do credit drug policy with succeeding in addressing certain illnesses and aspects of criminality associated with problematic drug use.

The report, by experts Professor Peter Reuter of Maryland University in the US and Alex Stevens of the European Institute of Social Services at Kent University, has been commissioned for the launch of the independent UK Drug Policy Commission.

The commission aims to 'improve political, media and public understanding of drug policy issues and the options for achieving a rational and effective response to the problems caused by the supply of and demand for illegal drugs'.

It brings together 12 experts drawn from the drug treatment and medical research fields along with senior figures from policing, public policy and the media. Speaking ahead of the launch, the commission's chair Dame Ruth said: 'At the outset of our three-year work programme, UKDPC is agreed upon one thing - we currently do not know enough about which elements of drug policy work, why they work and where they work well.'

Marjorie Wallace, chief executive of the mental health charity Sane, said: 'Cannabis, particularly skunk, is finally being recognised as having potentially devastating effects on the developing brains of some young people.

'Figures show that 50 per cent of 16-34 year-olds admit to using the drug, which means that if only a small proportion develop psychotic symptoms, there could still be a worrying increase in the number who may have to endure lifelong mental illness such as schizophrenia.

'We hope this new commission will be able to provide guidance which takes account of all the evidence so that in future those potentially at risk and their families could be saved the anguish and heartbreak we hear about every day.' 18.4.07

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Health chiefs accused of blocking new therapy for heroin addicts

HEALTH chiefs are blocking a revolutionary treatment for heroin addicts because of their "obsession" with the replacement drug methadone, experts claimed last night. Scotland on Sunday can reveal that officials are refusing to offer the treatment to Scotland's 20,000 addicts, claiming they need more proof that it works.

But organisers have now claimed their real reason is to save face over methadone. They say methadone is ruining the lives of thousands of addicts across Scotland, condemning them to modern-day "slavery". The row has broken out in the wake of the trial, held at a secret location in Scotland, which appears to have successfully weaned two hardened Scots addicts off heroin and methadone within the space of a week. The men claim their lives had been ruined by having been put on the highly addictive methadone.

Doubts over methadone re-emerged late last year after a new study showed that only 3% of heroin addicts had managed to kick their habits after being prescribed the replacement. The concerns prompted First Minister Jack McConnell to ask health officials at the Chief Scientist Office to study alternatives to methadone. But any hope the treatment might be used has now disappeared. Scotland on Sunday has obtained details of a series of meetings held last year at which, according to some, officials sought to obstruct their proposals.

First, the CSO declared that "insufficient information" was available to enable it to take it on. At a subsequent meeting in November, it then decided that new treatments should be trialed on nicotine - an exercise which backers say will be a waste of time because it will prove nothing about heroin. A large-scale trial is required before the NHS will adopt a new treatment, but some say the bureaucratic hurdles imposed by the CSO have left them with no hope of continuing.

Lorne Patterson said: "They are not a proactive organisation. If a research proposal is put to them then they consider it, but they are not going to go out of their way to find evidence." Patterson added: "There is huge difficulty in getting them to accept that the responsibility is theirs to get this to start." John Mullen, director of the Third Step charity said: "The people who talk it down are the very ones who promoted methadone. Methadone has been a complete disaster but those people behind it are not going to let their reputations be tarnished."

A source close to the First Minister admitted that the health chiefs had the final say over the matter. "Part of the problem is that for this to be approved for wide-scale use, you have to go through trials in order for doctors to accept it. The First Minister has given it his political support, but we need more to get it used more widely," the source said.

But a spokesman for the Scottish Executive denied that the CSO was blocking the treatment: "We are not slowing down the evaluation process. Advice from experts was that small-scale preparatory studies designed to test the basic method might be the best starting point, possibly initially based on nicotine."

Maxie Richards, a longstanding campaigner against drug misuse in Glasgow, said: "When you are on methadone, you can't work; you can't drive; it is a minor sedative so you can't work with machinery. You can't get away because you have to go to the chemist every day. I thought William Wilberforce got rid of slavery 200 years ago, but we have a whole new generation of slaves here in our midst." She added: "Everything is being stalled. They [the CSO] are not prepared to act because the general public don't know the whole story. They are stalling. If they wanted a big trial they could."

A Scottish doctor associated with the trial said: "I believe it works because I have seen it work. Putting people on methadone just gives them two addictions. But it isn't a cure. "This works by reducing the cravings. It means that when an addict wakes up in the morning his or her first thought is not 'where do I get my fix?' It makes them much more amenable to counseling and finally breaking the vicious circle for good."

4th Feb 2007

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Drug free treatment for heroin addicts.

Jack McConnell, Scotland's First Minister, has called for a radical shake-up in Scotland's drug rehabilitation policy after witnessing a new heroin addiction treatment in action.

He said that Scotland must seek to abandon the methadone programme and look instead for new, 'drug-free' methods of kicking heroin.

His comments came after he visited a trial of a drug-free addiction treatment. At the trial, Mr McConnell met six female heroin users who are undergoing a seven-day course of treatment.

Laura, 28, a mother of two, has been a heroin user for seven years, but has failed to quit using methadone. She told the First Minister she had been "amazed" by how quickly her cravings for heroin had disappeared while undergoing treatment.

Afterwards the First Minister spoke of his desire for a full clinical trial, with a view to making it available on the NHS.

He said, "I'm very keen that we find a way of progressing to a proper research proposal so that this treatment can be tested in the conditions that will meet the standards of the National Health Service.

"If this is successful, then this treatment could operate on a scale that can make a huge difference to people's lives.

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Methadone '96.6% ineffective'

FEWER than 4 per cent of heroin users beat their habit by using methadone, new research has revealed. Neil McKeganey, professor of drugs misuse research at Glasgow University, found that only 3.4 per cent of drug users on the heroin substitute remained drug-free after three years.

Treating heroin users in residential rehabilitation had a far higher success rate, Prof McKeganey found. The report's findings were based on interviews with 695 drug users who began treatment for their addiction in 2001. Most were given methadone-based treatment, while some were placed in residential care.

Interviewed nearly three years later to find out whether, over a 90-day period, they were off drugs, only 3.4 per cent of methadone users were clear. The figure was 29 per cent for those who had been in care.

Annabel Goldie, the Scottish Conservative leader, said: "Methadone, which is meant to be a bridge, is no such thing, as these findings sharply and disturbingly reveal. The way forward if we are serious about reducing drug addiction in Scotland and helping to keep more people off drugs, is to expand rehabilitation facilities.

"Taking addicts off drugs is not just good for them, it is good for their families and the whole of society as drug misuse fuels so much of the crime in this country." The Scottish Executive said that there was no "one-size-fits-all" approach for those seeking to come off drugs.

A spokesman said: "We are committed to expanding the range of available treatment options."

The Scotsman PETER MACMAHON SCOTTISH GOVERNMENT EDITOR 3.11.06

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Britain's drug laws should be scrapped in favour of fresh laws which acknowledge smoking and drinking are also harmful, a study has said.

The report says many drug laws are 'not fit for purpose' and are 'driven by moral panic'. They do not recognise that illegal drugs can be 'harmless'. The RSA Commission on Illegal Drugs, set up in January 2005, also says drugs education should start at primary school level. Current laws, the panel claims, have been 'driven by moral panic' with large amounts of money wasted on 'futile' efforts to stop supply rather than going after the criminal networks behind the drugs on British streets.

The report, which aims to influence a Government review of drug strategy next year, also calls for only those guilty of the most serious drug offences to be jailed. Chair of the Conservative Social Justice Policy Group and former party leader Iain Duncan Smith described it as 'worryingly complacent' and accused the members of the commission of failing to do their homework.

He said: 'I find it most disappointing that the RSA report appears to endorse the failed harm reduction strategy of recent years and to ignore extensive evidence that residential rehab can lead to full recovery from drug addiction. 'The RSA has also failed to do its homework by not surveying the views of drug addicts - who want recovery and drug-free lives - not managed dependency on methadone.

'Nor has it looked abroad to the treatment programmes of countries such as Sweden and Holland, where levels of drug abuse are much lower than the UK.' 8th March 2007

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Consumer group slams hidden promotion of drugs

An international consumer group called for governments on Monday to crack down on drugmakers marketing practices, which it said were leaving patients misinformed about the benefits of medicines. London-based Consumers International said there was a "shocking" lack of publicly available information about the $60 billion (33 billion pounds) a year spent by pharmaceutical companies on drug promotion.

"The pharmaceutical industry spends nearly twice as much on marketing as it does on research and development, yet consumers know next to nothing about where this money is going," Richard Lloyd, director general of Consumers International, said.

"Marketing regulation must be revised to demand more transparency from drug companies," he added in a statement at the launch of a new report criticising industry practices. In most markets outside the United States, direct-to-consumer advertising of prescription medicines is banned.

But Lloyd said firms were increasingly finding inconspicuous ways to influence consumer opinion, such sponsoring patient pressure groups, funding disease awareness campaigns and offering hospitality to medical experts.

Many drug companies argue it is important to communicate with consumers about products and say their marketing activities are strictly controlled by government-appointed regulators, as well as having to comply with the industry's own guidelines. 26.6.06

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Costs of drug abuse in the United Kingdom of Great Britain and Northern Ireland

According to results from a study released by the Home Office in February 2002, the annual economic costs of drug abuse in the United Kingdom are between £3.7 billion and £6.8 billion.

Most of these costs fall upon the criminal justice system as a result of drug-related criminality in the form of organized crime, burglaries and robberies and violence. Other social costs are borne by the health system (about £235 million) in 2001 on primary care services, accident and emergency admissions, drug abuse treatment, the workplace, schools and families, total social costs were estimated at £10.9 billion to £18.8 billion.

It is estimated that 99 per cent of the costs are associated with problem drug abusers. As the study estimated that there are 280,000 problem drug users in the United Kingdom, each problem drug user could cost about £30,000 a year. These figures are now out of date and the costs have no doubt increased.

Source: United Kingdom of Great Britain and Northern Ireland, Home Office, "Drugs minister highlights savings in criminal justice: costs of drug treatment expenditure", press release, 12 February 2002.