Trafficking in Drug Users

Hi friends,

I just came across this old article/ presentation I wrote some years back about my own treatment journey (nightmare might be a better word!) and how so much idiocy, money, misguided support and policies, ignorance, do-gooders, moralising shits, and the whole web of the incredibly resourced, career inflating, gravy train that is the current drug and alcohol treatment /criminal justice interwoven system, is stitched up so tight across the globe, that it is going to take a hell of a lot of strategising for us to get out from under the intensity and chains of the current goal of ‘managing and controlling’ people who use drugs, in any way possible -and how carreers and reputations ride on this these days – the research, the papers, the positions in clinics and academy’s, the psychology and the ‘experts’ draining cash from everyone hand over fist with the misguided or embossed descriptions that they will ‘fix’ and cure your loved one, yourself, your child before it has even smoked a cigarette!  We are taught year by year, harder, longer and stronger – that we are weak, we have no control over our desires anymore, that we cannot do it ourselves – we HAVE to have professional help….Yet what of the professional help? The basic, colourless, inflexible, unchangeable, plain and homogenous, evidenceless help….my God, what a load of crock so much of it all is – and still – they never seem to ask us what we need. What would help. We just get encouraged to join into more peer pressure and trot out the same old slogans that we believe are right coz our old peers say so (12 steps etc). 

When is it EVER the right way to provide one solution for everyone no matter what where how when why they use drugs? in 2016, we are still one leg firmly in the dark friends….Sad alright. But it just shows – the only way is to get active – get politicised, get smart.

Hope you like it (bit dated now!)

Here – One of the BEST sites for resources on progressive ideas about drug use / treatment -based in UK – The SMMGP (includes forum, resources, GP chatter and much more).

RCGP Special Interest Masterclass Presentation

Originally entitled ‘Don’t Give Them What They Want’.

EO;  Editor Black Poppy Magazine, Written /presented July 2003

I left my home of Australia 10 years ago trying to find a way to get off heroin. I thought the beautiful scenery in Europe might inspire me, I thought London might show me a new way of looking at life. I thought I might find something that would interest me more than heroin. But I should have known that doing what many of my peers call a ‘geographical’ is very rarely the answer.

I had already been to a variety of treatment clinics and surgeries in Australia. I had hadpoppies_final_black5.jpg habits on heroin, cocaine, benzo’s, and a few other pharmaceuticals, but my treatment options, no matter where I went, were methadone, methadone and more methadone. I felt screwed by the time I came to England. I felt numb and I wasn’t well either. By the time I arrived, I was hanging out, sick, extremely tired and depressed and went to a hospital looking for some relief. I was offered a two week blind detox on methadone. Suffice to say, I remained sick. I felt like I was trapped and my head just kept wanting to be well. I was in a new city and hoping to find a bit of peace of mind, I had to begin to learn the ropes of the British prescribing system. Suffice to say, it has taken me another 10 years to finally land on my feet, with a script that suits me, Erin O’Mara, an individual with individual needs. After almost 20 years I can now look to a future – that’s what a tailored prescription has really meant.

To get to this point, I have attended around 10 different methadone programmes, 2 heroin prescribing programmes, seen numerous GP’s (both private and NHS), and sat with plenty of psych nurses, key workers, social workers, psychiatrists and counselors. I’ve been to rehabs in the country and detoxs in the city, made plenty of attempts at stabilizing and fought to come off completely with concoctions of pills gathered from anyone who would give them too me or suing acupuncture, massages and herbal teas. It wasn’t that I didn’t try. I really did. Everything was riding on it. My life, my health, my liberty. But I just kept coming back to the same old blanket prescribing of methadone linctus – a drug that, while I know it helps many people, it isn’t for all of us. Drug users are not born from the same mold, we all use for different reasons, we all take different drugs, we take differing amounts of different drugs and offering us variations on the same methadone theme, while helping many, is still going to leave thousands of us out in the cold. And how long can we afford to stay frozen out?

For many drug users, getting on the treatment rollercoaster means you are certainly in for a ride and a half. I have learnt that the right prescription is only half of the equation – the other half is the treatment and understanding you receive from your prescriber. It can be so hard to explain to some prescribers that it is the creation of the types of prescribing systems -that can cause so much difficulty in adhering to it. The clinics that offer only a 2 week break or holiday a year (no opportunities to mend familial bridges there then), the confusion or distrust around your intentions, the reducing of your script every time you take something else or have a need to top up your dose, having to turn up for dosing at inflexible times -whether you have to pick up your kids or go to work or uni or like being closely watched as you sit for 3 hours on a toilet to give a urine sample before you’re allowed to get your dose. I’ve been to a clinic where a girl burnt off her tracks with a cigarette because she was afraid the doctor would cut down their methadone if they found out she was still using on top. And, at that particular clinic, sadly she would have been right. Getting the treatment dose right is essential, finding the drug that suits that individual is critical, allowing room for maneuver or looking for other drug treatment alternatives is the most important of all.

chrispolice

Your nicked!

Since leaving Australia where we were all prescribed methadone – no options, no alternatives to coming to the UK where there was some room for maneuver with prescribing has been an interesting experience. Heroin has always been my drug of choice and for me, methadone linctus just didn’t work. It didn’t work for me in Australia and it wasn’t working for me here. I looked everywhere for a more suitable script. I’ve tried morphine, slow release tablets and ampoules – which, while being a welcome relief from methadone, I found it incredibly constipating and uncomfortable and found myself again, unhappy, not wanting to take it and looking for something else. I will never forget that particular doctor who was then the first one to actually sit down with me and talk to me about what it was I felt I needed. But while we both knew it was probably a diamorphine script, he was powerless to offer me it. Thus he offered me what we thought was the next best thing. Morphine. It wasn’t that I didn’t want it to work, I did, more than anything else in the world, but it just wasn’t suitable for me.

It is so important to be able to offer alternatives to drug users when they come in looking for treatment. Generalisations about drugs and drug users are made without considering how cultural differences mediate and transform both the reality and meaning of a persons drug use. Younger users, older users, women, men, mothers, those on parole or probation, those with HIV and or Hep C, injectors, smokers, pill takers and snorters – how can we expect to support an individual with a chemical dependence if we are only prepared to offer them methadone?

It has taken years for methadone to be accepted by doctors, and still it is only by a minority. Without question it clearly works for some people and it certainly has a place in prescribing options. But there are other alternatives. At Black poppy we are receiving many letters about how helpful Subutex has been (mainly for detoxing) but many more letters from people wanting to know how they can encourage their doctor to prescribe it. We all know its out there but where? How can one be prescribed it or is it too a lottery depending on your area or GP?

Morphine also holds an important place but is usually prescribed by private doctors and is prohibitively expensive. I have a good friend who has tried methadone unsuccessfully many times and finally went to a private doctor to try and get MST’s or slow release morphine sulphate tablets. Because he can’t stomach methadone linctus and doesn’t want to inject methadone ampoules, his morphine script has meant every fortnight he has to resort to spending literally his entire benefit cheque on paying his chemist and his doctor and is still fifteen pounds short. His clothes are old, his cupboards are empty and he is fighting off a depression that threatens to jeopardize his whole stability. This is because he cannot find a single NHS doctor in his area to prescribe him morphine tablets – despite his private doctor offering support. The last time I saw him he was eating the only thing he had in his cupboard – tomato paste. Why?

There are many people who have either dropped out of the prescribing system altogether or regularly have to top up with additional drugs because the system just isn’t geared for those with poly drug dependencies. While years ago many people just seemed to stick to using one or two drugs at a time, these days poly drug use has become the norm. How are doctors going to help support people if they can’t or won’t take on anyone who was multiple drug problems. This is 2003 and this is the way drugs are now taken. Both patients and doctors must be prepared to be open and have the courage to admit when something isn’t working and be flexible when considering alternatives. It isn’t easy. I know drug users can be difficult patients. When that doctor sitting opposite you seems to have the power to change your life – things do and can get emotional. For treatments to work we all have to be open and honest. The system has to let you be open and not punish you for what it sees as ‘not conforming to the treatment’. Relapsing is part of stabilizing as well as part of ‘the cure’.

For me, after years of searching for some stability – I was finally offered the chance to try diamorphine – or heroin on a script. It is extremely rare to get this chance and I believe the deciding factor was because I had recently contracted HIV.

Heroin is provided on prescription in what was known as 'The British System'

Now I’ve had the opportunity to participate in 2 very different approaches to heroin prescribing – and it has taught me a great deal about how the differing structures, regulations and nuances behind the way heroin is administered to users, is critical to the success of the programme. For example: The first heroin script I received was back in 98, through a pilot project in London, whose aim it was to study the effectiveness of prescribing either pharmaceutical heroin, or methadone in injectable form to drug users.

The first error and one eventually admitted, was to limit the amount of diamorphine prescribed, to an unmanageably low 200mg. (The Swiss, The Dutch and others, myself included, have found 400 – 1000mg much more suitable). Pharmaceutical heroin does not have a long half life and to seriously underestimate the dosages required was to become a momentous error and one that would seriously jeopardise a person’s ability to adhere to their prescription. With a median age range of 38 and an average injecting career of 19 years, many clients at this project had other drug problems, such as crack, benzodiazepines, alcohol or cocaine which I don’t fully believe were taken on board at the time. The severely punitive clinic regulations or ‘protocols’, would bear this out. i.e. anyone caught using any other drugs or ‘topping up’ their rather limited dose, would immediately be ‘sanctioned’ by way of a 30mg reduction in ones daily prescription, reducing even further ones ability to adhere to the programme. Once ones prescription began to lower, it was practically impossible not to ‘top up’ with something else, and so clients, myself included, were locked in a constant spiral of script alterations.

A stifling clinic environment would be the clinics 2nd fundamental error, where people would be unable to talk about their other drug issues for fear of a variety of repercussions. This would lead to an even more alarming situation where clients hid serious medical issues for fear of their prescription being stopped or being transferred back to methadone linctus.

The importance of maintaining an environment where users can talk openly and honestly to their keyworkers and consultants is a crucial element in a person’s success on any drug treatment programme and this was no exception. A deeply unhappy client group had nowhere to go to complain about their treatment and having to attend to such a stressful and demoralising project promptly each morning in order to receive ones medication only exacerbated people’s and my own depression and did little if nothing to improve the spirits of those attending.

Two years later, after a desperately unsuccessful period trying an injectable methadone prescription, I had developed a dire crack problem, was drinking alcohol regularly for the first time in my life, and began having regular seizures from increased benzodiazepine use.

It was at this time that, after an enormous effort and support from my GP Chris Ford, my mum, my local MP, (and bailing up the prescribing doctor at a conference I attended), I managed to secure a place at London’s Maudsley hospital, where there was a doctor prescribing heroin to a small group of patients. I clearly remember my sense of complete and total desperation. I felt I could not go on any longer, that if they didn’t help me I would be – I didn’t know where I would be and that was the trouble. I felt that this was my last hope, that I’d tried everything. And I begged…. Most drug users know well the feeling of someone else, a doctor, having the power of your life in their hands, every single day. A script started or terminated making the difference between life and death, or misery and hope. Sometimes you end up having to beg…

I have now been on my heroin script for 2_ years. My health has improved substantially and my HIV doctor is delighted – as is my mum and I. My moods and energy levels have improved considerably and so has my ability to contribute to life and my community. I founded and continue to work on what has become a National drug users’ magazine called Black Poppy, and I am actively involved in drug user politics, journalism and harm reduction issues. It has been a difficult journey, but thanks to my mum, my mates and the open-mindedness of my doctor, who fully engages me in my treatment decisions and doesn’t wave punishments in my face, I have stabilized and am well, for the first time in 18years of using opiates.

Now, I have somewhat of a vested interest in the campaign towards prescribing heroin – both here and overseas. Last year, my mum returned to Australia to live and while I would have liked to go with her, the thought of losing my heroin script after fighting so hard to get it, felt more than I could bear. I am HIV positive. There are going to be times when I will want to be near my family. Yet archaic laws in Australia forbid me from even entering the country with my prescription. How can this be legal? Anyone, on any other medication, would be permitted to continue that medication in another country but these basic human rights do not extend to drug users. The intense and totally unfounded hysteria that surrounds the prescribing of heroin to drug users sadly endures and has made the campaign to prescribe heroin in Australia a momentous task. Yet while campaigners look to the British System for guidance, it would be a mistake not to closely examine both its failings and successes. The potential for problems in importing a system that hasn’t been culturally fine tuned for the British using community are great because to get it wrong, Britain may lose the chance to ever attempt it on a large scale again. The Swiss users have to return to their heroin prescribing clinic 3 times a day to receive their heroin, watched over as they inject by a clinic nurse. Although the Swiss programme has had incredibly positive results, would English users blossom under such a severe restriction of an individual’s freedom? Or if the dosage is not allowed to be adjusted to suit each individual, as occurred before at the London clinic, what chance is there of success?

While there is undoubtedly a role for the prescribing of heroin to heroin users, it is important to remember how crucial the role of the heroin user is in the planning, implementation and evolution of a heroin programme – or any drug treatment programme for that matter. Users must be involved every step of the way and accepted, as other users of health services are, as an integral part of a treatment programmes development, with rights, responsibilities and a mutual respect for experience.

I know I’m fortunate. As an Aussie living in London, there are times when I have to pinch myself that this is real – I have a diamorphine prescription!. That the long and often harrowing road of ‘substitute prescribing’ has finally come to an end – and now I’m free to think about my future. But in the small silences that fall between me counting my blessings, I can’t help but wonder whether it’s all just been a bit to little, a bit too late. I question why it has taken 18 long years to get here? Why did I have to wait until I’d been chewed up and spat out of over 10 different treatment programmes and Dr’s surgeries, of at least 4 rehabs and an uncountable number of detox attempts? Why did I have to wait until I’d ‘finished’ selling my young body to men, til I’d got sick and deeply depressed, til I’d used every vein in my body from my neck to my feet, til I’d contracted both HIV and Hep C? Yet doctors can prescribe heroin to people who are opiate dependent in the UK and indeed they have recently been encouraged to by our current Home secretary, David Blunkett. Are doctors prepared to start looking at other alternatives? Is the government going to stand behind them? Support each other – doctors who are prepared to look at other options – keep each other updated. As a drug user, I know what its like to be on the other side of the fence – and as a drug user, I also know there are courageous doctors out there who are trying to do their best but are often working in isolation, with little support.

bppicnunsmall1.jpgMeanwhile, 96% of all opiate based prescriptions given out to British users, remains methadone and only 449 people currently receive a heroin prescription for opiate dependence. And I am one of them.

Unfortunately, I still hear the saying, ‘Don’t give them what they want’. But it’s not about want anymore. It’s about need and it’s about our lives. I would just like to take this opportunity to thank those doctors who did go that little bit further and treated me and my needs individually. Their support has got me the prescription I needed and has allowed me to be here today.One day we might have a system that doesn’t insist on me being sick and dysfunctional from the get-go and asks the big questions like ‘Why do we have a society / laws, that push substance users to the brink of insanity and outside the margins of society just because they prefer opiates instead of whiskey, a little stimulation from khat chewing instead of 20 cups of ‘legal’ coffee.

 

Addendum: The drug conventions are based on a lot of hot air and bullshit friends, the more you look back into history and the closer you inspect the world of economics, society, and criminal justice today, the more you unravel a mish-mash of men in suits making decisions decided by money, history, fear and racism, certainly not strong evidence, humanity and common sense.

– Erin

Editor Black poppy Magazine

Drug Consumption Rooms

Here is a video I just wanted to share with you all, it was made in the UK by one of our treasured harm reduction /drug workers Phillipe Bonnet in Birmingham and he presents a very honest (and difficult to watch at times) account of why we need drug consumption rooms all across the world – particularly in the UK today. We have yet to open such a facility in the UK -it makes no sense to shy away from such a simple, straightforward solution. Our pal Neil Hunt talks about cost and why DCR’s are not that expensive and that they could hook onto needle exchanges as they already appear. Why not? How much longer can we look the other way when we have the solution in our very hands -solutions with the evidence base to back it up. As Dr Judith Yates in the film says “A simple intervention like this early on, can prevent all this damage later on”.

A word from the film-makers – Published on 23 Oct 2012

This Documentary invites the audience to see the harsh reality of ‘street injecting’ drug users in the UK’s second city Birmingham. The presenter Philippe Bonnet explores this subject by interviewing outreach workers, health care professionals and current and ex drug-users. The film shows how other countries around the world have found a solution to this and as a result have reduced harms and costs associated with this phenomenon and ultimately helped drug users access treatment and begin their recovery.

 

Citric Acid in Heroin: How Much is too Much?

Hi again,

Now many of you will know about this video -and the information that came out a few years back on citric acid and heroin -regarding ‘How Much is Too Much?’. But there are still many people who didnt see it and many people who are still using too much citric acid, not realising that not only are they damaging their veins more, but they are actually damaging / reducing the quality of their heroin! Yes, it is true readers! If you use citric or vit C (which is the same but slightly less acidic thus you need a bit more when mixing up) when mixing up your brown, black or beige heroin (this does not affect white heroin which should dissolve without heat or citric), and you haven’t heard about this issue or seen the video -then you MUST take 10minutes out of your day and listen up!

 

Citric_sachets_small

Order your sterile Citric sachets to your home in discreet wrapping, from Exchange Supplies, the good guys in business http://www.exchangesupplies.org/shop.php

So, this is a really good video from Exchange Supplies, every users favourite organisation and at the forefront of developing really useful user friendly, health and harm reduction information and equipment for the drug using community and needle exhanges and drug services across the UK and worldwide.

They have made numerous videos but this is one of their most popular. It is a clear video shown in under 10 minutes,  that discusses the issue of citric acid (or vitamin C) -the powder many of us have to add to brown heroin in order to ‘break it down’ and make it work as an injectable solution. Now, we don’t of course need to do this with white heroin, but dark beige, brown or black heroin made up for injecting, will need citric acid or vitamin C added to it.

Now ok, we all know that. But what this video (and the research done at Exchange Supplies), they wanted to look into just HOW MUCH citric was enough.

 

It turns out that we all learnt 2 valuable lessons from ES working in the laboratory! Too much citric over the years -will fuck up your veins -and also your heroin – so there are 2 very good reasons to use less citric:

  1. to save your veins over the short and long term

  2.  To avoid destroying or reducing the quality of your heroin from over acidification

For further reading and to see the famous How Much is Too Much, Citic Video, click here.

World -Take Note! The story of one country unafraid to take risks to better the lives of its citizens-despite overwhelming opposition and ridicule. So who’s laughing now?

 

health-logo

Switzerland, courageous, progressive, humane – junkies around the world thank you!

Dudes and Dudettes, around the globe; As I was just about to write an article for the British press on the demise of the much respected ‘British System’ and the diminishing role of the prescribing of legal, pharmaceutical heroin to opiate-dependent people, I came across this article. Published just last year it gives a brief but interesting look at Switzerland’s incredible journey as an innovator and leader in the field of drug treatment. I hope you may find this as interesting as I have.

Many of us will know something of the Swiss Story, but it is never more pertinent than today, to renew these very important discussions about heroin prescribing, standing up loud and proud and  showing off the very real successes this approach has decades on, across Europe today. We must take a leaf out of Swiss’s History book and, while fanning the flames of the decriminalization and regulation discourse, we can burn a clear and wide road ahead, devoid of the forest and the trees – out of our dangerously out of control illicit drugs market, and hopefully towards sowing some damn busting seeds at UNGASS 2016, in New York City. Once home to the archetypal junkie!!

Switzerland’s fascinating journey from the experimental Needle Park to the development of the most innovative, effective and publicly supported heroin prescribing clinics now available across the country and even in (2) prisons.

Friends, it is time we celebrated and thanked our Swiss comrades in arms -for their bravery in going it alone for so many years; their refusal to condemn junkies to the gutters and prisons of society, for standing so far out in the crowd in the search for humane and pragmatic solutions to the fallout from prohibition, and all at a time when all around was calling for blood; incarceration, isolation and discrimination.

A street heroin epidemic that was to sweep through Europe and the rest of the world during the 70’s and 80’s, while nations governments used tactics and policies that were brutal at worst -and misguided at best – psychiatrists and medical professionals began years of postulating and aggrandising their professions and their careers.

                                              ****************************************************************

PRESCRIPTION FOR SUCCESS?

Article by By Gabriele Ochsenbein

Article reprinted as it appeared on the online newspaper SWISSINFO.CH

At the beginning of the 1990s, pictures of the open drug scene at the so-called “Needle Park” in Zürich went around the world, leading to the introduction of legal heroin prescribing. Strongly criticized at first, it has since been hailed as an example.

The old Needle Park in Zurich, Switzerland; the experiment that led the way to one of the world's most successful drug policies -heroin prescribing.

The old Needle Park in Zurich, Switzerland; the experiment that paved the way towards one of the world’s most successful drug policies -heroin prescribing. Click the image to see more pictures of the era in Needle Park.

Doctor André Seidenberg, who has treated 3,500 patients suffering from addictions in his career, was one of the first to provide emergency help in Needle Park and to call for clean syringes to be given out to addicts. Police and the justice authorities tried to deal with the problem with repressive measures that failed to work. The crackdown even encouraged drug addiction and the drug trade, Seidenberg claims.

swissinfo.ch: Twenty years ago Switzerland became the first country to prescribe heroin to therapy-resistant addicts. Has it been a success story?

André Seidenberg: Yes, although you have to bear in mind that the heroin programme has been marginal and to my knowledge never reached more than 5% of the affected people. It is a kind of show project, a prestige project.

It is however a success because in Switzerland, the majority of people dependent on opioids are in treatment, mostly with methadone, and a small proportion, particularly those who respond poorly to therapy, with heroin. It would be preferable if the proportion of addicts in treatment could be increased. I wish we could have gone further with the medicalisation and legalisation of the market.

Needle Park in Zurich today -heroin use is very clearly on the decline

Needle Park in Zurich today,  heroin use is very clearly on the decline

swissinfo.ch: Would that have had an effect on the black market?

A.S.: Of course. The black market is a market that is encouraged by repressive measures and ultimately produces poor products that are harmful to people. I wish we could have a less hypocritical approach to drugs.

swissinfo.ch: Then you are in favour of a general legalisation of drugs?

A.S.: I am in favour of better market control. It is an international problem, because we still have a very active drug wars in many regions.

Appropriate control of the drug market is not a trivial matter either. One cannot for example just legalise cocaine and think that all problems will be swept away. It would have to be introduced very carefully.

swissinfo.ch: How is life different for a person who doesn’t have to seek out heroin in the back streets anymore but receives it regularly as a medicine?

A.S.: A person who receives their fix twice a day is in psychologically better condition, is more stable in every way. Of course there are side effects and even lasting impairments. Those who take this substance daily suffer from decreased libido, sleep problems or a limited capacity to experience emotional states in between euphoria and sadness.

People who take part in a heroin programme are also freed from the necessity to finance their existence through illegal activities. Delinquency, prostitution and social deviance of all kinds have decreased.

swissinfo.ch: So they can lead a normal life?

A.S.: The possibility of procuring drugs in this [legal] way makes a big difference, because in illegally procured drugs tend to be consumed in more dangerous ways. Most addicts are not in a position to always inject themselves carefully, which can lead to infections and infectious diseases. Overdoses also happen much more easily with drugs bought on the street.

When we are able to look after people medically, these risks are avoided to a larger extent. With controlled distribution people are able to lead a mostly normal life, although there are more people getting disability benefit among those taking part in the heroin programme, compared to the methadone programme.

swissinfo.ch: So from a medical point of view the focus is on limiting harm and stability rather than abstinence?

A.S.: The priority for doctors is to avoid serious harm to the body and death. Healing the soul comes, in medical terms, just after the body.

swissinfo.ch: Should abstinence not be the goal of a state drugs policy?

A.S.: That was the goal of politicians and society, and many doctors still nurture this illusion. But it’s a very dangerous strategy. Heroin addiction is a chronic illness. Only a small, shrinking minority of opioid addicts will become abstinent long-term. And most of them suffer during their abstinence.

With heroin – as opposed to alcohol – abstinence doesn’t improve well-being and health. The death rate is three to four times higher for abstinent patients, compared to those prescribed heroin or methadone. Repeated attempts to come off the drugs can trigger psychological difficulties, that can then lead to self-harm.

swissinfo.ch: Is heroin still an issue today?

A.S.: Thankfully we rarely see young people taking up heroin. Consumption has fallen massively. One per cent of those born in 1968, the Needle Park generation, became addicted and many of them died because of their addiction or are largely still dependent.

The average age of a heroin addict in Switzerland is now around 40. If we hadn’t stopped this development at the beginning of the 1990s, young people born in the following years would have been affected to the same extent. There are societies, for example the countries of the former Soviet Union or Iran, where a significant percentage of the population is dependent on opioids.

swissinfo.ch: You tried out various drugs, including heroin. Why didn’t you become addicted?

A.S.: Maybe I was just lucky. When I was young I tried out almost all kinds of drugs. I was able to satisfy my curiosity and maybe also learnt certain things that could be useful for my patients. I also got to know the danger of drugs: I lost many friends, even before my medical studies began.

swissinfo.ch: Do you have to have taken drugs to be a good drugs doctor?

A.S.: No, I would not recommend that. When dealing with problems that have to do with the psyche, it is definitely helpful to have an open mind. But you don’t have to try out everything for that, because that could be harmful and dangerous.
(Translated from German by Clare O’Dea), swissinfo.ch

Swiss drugs policy -A Timeline

  • Since 1991 Switzerland has implemented the so-called four pillar policy of prevention, therapy, damage limitation and repression.
  • This pragmatic policy was developed largely in response to the extreme drug-related misery in Zurich in the 1980s and 1990s.
  • The controlled prescription of heroin was first introduced in 1994.
  • In 1997, the Zurich Institute for Addiction Research came to the conclusion that the pilot project should be continued because the health and living situation of the patients had improved. There had also been a reduction in crime.
  • In 1997 the people’s initiative ‘Youth without Drugs‘, which called for a restrictive drugs policy, was rejected by 70% of voters.
  • In 1998 74% of voters rejected the ‘Dro-Leg’ initiative for the legalisation of drugs.
  • In 2008 68% of voters accepted revised drugs legislation. Since then controlled heroin distribution has been anchored in law.
  • The new law came into force in 2010.

Further reading; (docs come in German, French, Italian and English

Federal Office of Public Health; Click here for survey loads of interesting information on results of all the Swiss studies going back over a decade

The Challenge of addiction The basics of a sustainable approach for drugs policy in Switzerland

Interesting Doc on how the Needle Park experiment became the road into heroin on prescription -and discusses how the first studies were set up and the results

Abscesses – A Major Update

Identification, Treatment and Prevention

Abscesses are something most of us have encountered before and they can be everything from hardly noticeable, to extremely painful. Medical care can be hard to come by for many of us around the world who inject drugs and so some people resort to treating themselves, for reasons of cost, access, stigma or fear. This can lead to some serious complications as the toxicity of an abscess can vary considerably. Here are a few things to remember when it comes to getting to grips with an abscess -and whether you can really treat it yourself.  Yes, you may think you know what to do if you have an abscess, but there is new guidance in terms of treating them these days, to ‘pack or not to pack’ , antibiotics everytime or just some of the time? Yes, this is a big article and has had a major update, and we will edit it down in the coming weeks, but for now here is all the information we have collected to help you make the most important decision -when to get help. Yes, it is worth reading the whole thing if you are concerned about abscesses, or at least read the summary!

A fairly typical large abscess on a heroin user who seemed to have skin popped heroin.

A fairly typical large sized infected abscess on a heroin user who is said to have skin popped heroin recently.

 

here is one where it was recommended to just cut and drain, and not necessarily dispense antibiotics

This is a pic of an infected abscess, but one where it was only recommended to just cut and drain, and not necessarily dispense antibiotics.

A Sterile Abscess is caused by injecting either an irritating or insoluble substance into a vein – and if some of the cut in your drugs are insoluble, a sterile abscess is sometimes formed. It is basically a milder form of the same process of an infected abscess, caused not by germs this time but by nonliving irritants such as drugs. If an injected drug is not absorbed, it stays where it was injected and may cause enough irritation to generate a sterile abscess—sterile because there is no infection involved. Sterile abscesses are quite likely to turn into hard, solid lumps as they scar, rather than remaining pockets of pus. It will not usually show signs of heat although there may be a touch of redness and it can feel like a solid nodule under the skin and isn’t likely to be sore. Soreness will depend on the volume of substance under the skin. Don’t try to squeeze or poke it as it will usually go away in its own time and squeezing it could induce an infection.

A Septic or  an Infected Abscess can occur anywhere in the body. In the injecting community in which we are referring to here, these can be caused by either using non-sterile injecting equipment or by bacteria from your skin entering under the skin via the injecting process. An infected abscess will soon come up as a swollen lump on or near the injection site. Appearing inflamed and red, it feels hot to the touch and soon becomes very painful. The abscess may come to a ‘head’ or ‘point’ and be filled with pus. Sometimes a deep abscess will eat a small channel (sinus) to the surface and begin leaking pus. It can be tempting to squeeze or burst it now – but DON’T! This will only spread the infection, driving it deeper and wider, and it could head for the bloodstream making you very ill by giving you blood poisoning which can be fatal!

For a much more in depth look, click here for the rest of the article which covers topics such as Antibiotics -Yes or No?, Prevention, Treatment, Home Treatment, click here.

For information concerning users of steroids and performance enhancing drugs, and abscess, click here.

The Incidious Spread of Big Pharma

Hi guys, now you know we are always the first to understand that things are complicated and never just black and white and that a junkies relationship with their doctor/s is something pretty unique (we could all write a book right?) and we are not saying we want all prescribing doctors arrested – that is not the point here, and its a very long way from it.

But just like when you scratch at the ugly scab that is the war on drugs and you find governments’ lying, scheming for their own economic ends, even wheeling and dealing in the very drugs they lock thousands of their citizens up for..and you scratch deeper still and you see the roots of these global drug laws rooted in fear and racism, xenophobia and cultural ignorance, economies and GDP’s, total monopolies by companies and the ever larger monolithic pharmaceutical industrys’ that orchestrate and lobby for the very laws they securely tie up ever tighter still, seeking global domination and a pill for everything we could never even imagine we needed one for….- there is certainly no concern for our youth or environment,  – …..Well, I thought you might like to read this article that gives some background into the explosion in Oxycontin in the USA today. How big pharma is raking it in, how the doctors are earning billions as well, how USA overdose rates continue to rise and rise year on year, how prisons keep increasing their numbers of paid lobbyists at Capitol Hill to make sure that, although violent crime is, and has gone down (yes that’s right) in the USA for many years now, more and more laws keep getting introduced to ensnare the illegal immigrant, the petty criminal etc, so society can pay for these ‘Titan prisons’ and maintain the jobs within them, in the cities that the bureaucrats would flourish because of these disgusting, concrete jungles of inhumanity..

But let’s just get a glimpse of how big pharma do things – or rather – how little pharma can grow into HUGE pharma, courtesy of the American taxpayer, and another drug dependent generation – paying the ‘Right Man’ this time, not the junkie down the street….

 PS – Remember, we don’t always dig the journo’s language when describing people who use drugs, but we will overlook that somewhat for the sake of the piece. Always write in to the editor to challenge their language if you see or feel that oit is inaccurate, sweeping, or causes offence.

Poison Pill:  How the American opiate

epidemic was started by one

pharmaceutical company 

Written by MIKE MARIANI FEB 23, 2015

(The link to complete article above and at the end of this text – thanks in advance to Mike Mariani – Here is an extract)

PURDUE_oxyThe state of Kentucky may finally get its deliverance. After more than seven years of battling the evasive legal tactics of Purdue Pharma, 2015 may be the year that Kentucky and its attorney general, Jack Conway, are able to move forward with a civil lawsuit alleging that the drug maker misled doctors and patients about their blockbuster pain pill OxyContin, leading to a vicious addiction epidemic across large swaths of the state.

A pernicious distinction of the first decade of the 21st century was the rise in painkiller abuse, which ultimately led to a catastrophic increase in addicts, fatal overdoses, and blighted communities. But the story of the painkiller epidemic can really be reduced to the story of one powerful, highly addictive drug and its small but ruthlessly enterprising manufacturer.

On December 12, 1995, the Food and Drug Administration approved the opioid analgesic OxyContin. It hit the market in 1996. In its first year, OxyContin accounted for $45 million in sales for its manufacturer, Stamford, Connecticut-based pharmaceutical company Purdue Pharma. By 2000 that number would balloon to $1.1 billion, an increase of well over 2,000 percent in a span of just four years. Ten years later, the profits would inflate still further, to $3.1 billion. By then the potent opioid accounted for about 30 percent of the painkiller market. What’s more, Purdue Pharma’s patent for the original OxyContin formula didn’t expire until 2013. This meant that a single private, family owned pharmaceutical company with non-descript headquarters in the Northeast controlled nearly a third of the entire United States market for pain pills.

OxyContin’s ball-of-lightning emergence in the health care marketplace was close to unprecedented for a new painkiller in an age where synthetic opiates like Vicodin, Percocet, and Fentanyl had already been competing for decades in doctors’ offices and pharmacies for their piece of the market share of pain-relieving drugs. In retrospect, it almost didn’t make sense. Why was OxyContin so much more popular? Had it been approved for a wider range of ailments than its opioid cousins? Did doctors prefer prescribing it to their patients?

Because there was simply so much OxyContin available for over a decade, it trickled down from pharmacies and hospitals and became a street drug, coveted by teens and fiends and sold by dealers at a premium

_oxycontin_600During its rise in popularity, there was a suspicious undercurrent to the drug’s spectrum of approved uses and Purdue Pharma’s relationship to the physicians that were suddenly privileging OxyContin over other meds to combat everything from back pain to arthritis to post-operative discomfort. It would take years to discover that there was much more to the story than the benign introduction of a new, highly effective painkiller.

In 1952, brothers Arthur, Raymond, and Mortimer Sackler purchased Purdue Pharma, then called Purdue Frederick Co. All three men were psychiatrists by trade, working at a mental facility in Queens in the 1940s.

The eldest brother, Arthur, was a brilliant polymath, contributing not only to psychiatric research but also thriving in the fledgling field of pharmaceutical advertising. It was here that he would leave his greatest mark. As a member of William Douglas McAdams, a small New York-based advertising firm, Sackler expanded the possibilities of medical advertising by promoting products in medical journals and experimenting with television and radio marketing. Perhaps his greatest achievement, detailed in his biography in the Medical Advertising Hall of Fame, was finding enough different uses for Valium to turn it into the first drug to hit $100 million in revenue.

The Medical Advertising Hall of Fame website’s euphemistic argot for this accomplishment states that Sackler’s experience in the fields of psychiatry and experimental medicine “enabled him to position different indications for Roche’s Librium and Valium.”

Sackler was also among the first medical advertisers to foster relationships with doctors in the hopes of earning extra points for his company’s drugs, according to a 2011 exposé in Fortune. Such backscratching in the hopes of reciprocity is now the model for the whole drug marketing industry. Arthur Sackler’s pioneering methods would be cultivated by his younger brothers Raymond and Mortimer in the decades to come, as they grew their small pharmaceutical firm.

oxycodone-oxycontinStarting in 1996, Purdue Pharma expanded its sales department to coincide with the debut of its new drug. According to an article published in The American Journal of Public Health, “The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy,” Purdue increased its number of sales representatives from 318 in 1996 to 671 in 2000. By 2001, when OxyContin was hitting its stride, these sales reps received annual bonuses averaging over $70,000, with some bonuses nearing a quarter of a million dollars. In that year Purdue Pharma spent $200 million marketing its golden goose. Pouring money into marketing is not uncommon for Big Pharma, but proportionate to the size of the company, Purdue’s OxyContin push was substantial.

Boots on the ground was not the only stratagem employed by Purdue to increase sales for OxyContin. Long before the rise of big data, Purdue was compiling profiles of doctors and their prescribing habits into databases. These databases then organized the information based on location to indicate the spectrum of prescribing patterns in a given state or county. The idea was to pinpoint the doctors prescribing the most pain medication and target them for the company’s marketing onslaught.

That the databases couldn’t distinguish between doctors who were prescribing more pain meds because they were seeing more patients with chronic pain or were simply looser with their signatures didn’t matter to Purdue. The Los Angeles Times reported that by 2002 Purdue Pharma had identified hundreds of doctors who were prescribing OxyContin recklessly, yet they did little about it. The same article notes that it wasn’t until June of 2013, at a drug dependency conference in San Diego, that the database was ever even discussed in public.

Purdue's Oxycontin - reformulated: Pic - Oxy's crushed by a mortar and pestle: reformulated to deter injecting...

purdue_reformulated_oxy_Pic – crushed by a mortar n pestle: reformulated to deter injecting…

Combining the physician database with its expanded marketing, it would become one of Purdue’s preeminent missions to make primary care doctors less judicious when it came to handing out OxyContin prescriptions.

Beginning around 1980, one of the more significant trends in pain pharmacology was the increased use of opioids for chronic non-cancer pain. Like other pharmaceutical companies, Purdue likely sought to capitalize on the abundant financial opportunities of this trend. The logic was simple: While the number of cancer patients was not likely to increase drastically from one year to the next, if a company could expand the indications for use of a particular drug, then it could boost sales exponentially without any real change in the country’s health demography.

Read the rest of the fascinating article here – Poison Pill:  How the American opiate epidemic was started by one pharmaceutical companyMIKE MARIANI FEB 23, 2015

(more…)

Naloxone – the big hit with the long wait

Id like to discuss a campaign involving many members of the drug using community across the world. As far as campaigns go, this one should be a done deal. In fact it should of been snapped up as a central component in all our national and community drugs strategies years ago.  The benefits and results to be reaped from rolling out similar campaigns is nothing less than saving life itself and the prevention of repeated tragedy, trauma, gut-wrenching grief and endless pain and loss. What is the campaign? To get Naloxone, the drug that instantly brings a fully overdosed and dying person back to life in seconds, into the hands of every single heroin user and ideally, into the hands of their family and partners.

The reasons to implement and progress this campaigns’ agenda are, at first glance so crystal clear, so straightforward, so blindingly obvious that the average person could be forgiven for asking, “Just what is taking so long? – We need to empower people to save lives, naloxone works, its cheap and simple to use, so let’s do this!”

But, after we remove the blindingly obvious common sense and our societies desperate need to rollout these programmes in the face of rising overdose figures, we must question why we still have unacceptable dithering by authorities and a worrying lack of will to progress the agenda.

It must be considered that such delays carry the familiar hallmarks of the common ‘junkie stain’ or rather, the agenda that is stained or dismantled or even left to rot, simply through its association with drug users. However, this particular campaign, which has come in all sorts of shapes and guises, is gaining traction in areas all over the world and recently, finally, here in the UK too. It has the fangs of drug user activists in it all over the place, with programmes that are getting naloxone into the trained hands of policemen and women, family members and partners, pushing forward the idea of Naloxone as a free item or a purchase from a pharmacy by people, even bringing a used one back to get a new one etc.

There is bound to be something you can do in your own community to help push this agenda forward and to get Naloxone into the trained hands of at least every single heroin user in your neck of the woods, in the rollout towards Naloxone being in every hand, in every city across the world.

The International Doctors for Healthier Drug Policies is also taking up the mantel to push the Naloxone agenda, this article appeared the other day and gave a useful global overview. 

Naloxone*

Naloxone_banner

 

WE COULD INSTANTLY REDUCE THE NUMBER OF

OVERDOSE DEATHS IF THIS MEDICINE

WERE MORE WIDELY AVAILABLE

 

What do we do with a medicine that prevents certain death for people with a particular condition—and is safe, cheap, and easy to administer?

  1. Immediately make it accessible to those who can administer it when such a life-or-death situation arises.
  2. Make it available to no one except doctors and emergency room workers.
  3. Endlessly debate the particulars of how and when it should be widely introduced.

If you picked number one, that would seem to be a reasonable choice. Unfortunately, it would also be incorrect. With few exceptions, answers two or three apply in the vast majority of the world when it comes to the medicine naloxone.

Overdose remains a leading cause of death among people who use drugs, particularly those who inject. Increasing the availability and accessibility of naloxone would reduce these deaths overnight.

Naloxone is an effective opioid antagonist used to reverse the effects of opioid overdose. On a global scale, however, exactly how and where naloxone is used remains unclear. International Doctors for Healthier Drug Policies (IDHDP) is seeking to learn why this is and what can be done to change it.

Some form of community-based distribution programs for naloxone exist in over a dozen countries. But the quality of data pertaining to how naloxone is used is highly variable. Enhancing our knowledge about the use of naloxone will help us to better reap its benefits.

What we do know is that the availability of naloxone is growing in several countries. Scotland implemented a national program in 2010, and outcomes there have demonstrated its effectiveness in reducing drug overdose deaths. In China, it is available in an increasing number of hospitals. Canada and Estonia have pioneered programs on take-home naloxone.

And in the United States, policymakers called for greater availability and accessibility of naloxone after opioid overdose deaths more than tripled between 2000 and 2010. In some states, distribution expanded from emergency rooms, paramedic services, and needle-exchange programs to police stations. In Quincy, Massachusetts, all police began carrying naloxone [PDF] in 2010, leading to a 70 percent decrease in overdose deaths.

Last November, guidance from the World Health Organization recommended increased access to naloxone for people who use opioids themselves, as well as for their families and friends. Naloxone is also included on the WHO’sEssential Medicines List.

The role of naloxone in addressing opioid overdose was recognized for the first time in a high-level international resolution in March 2012. Members at the UN’s 55th commission on Narcotic Drugs unanimously endorsed a resolution promoting evidence-based strategies to address opioid overdose. Recently, the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) published a very useful literature review of the effectiveness of take-home naloxone.

To build on these gains, we need more data. IDHDP wants to find more out about the availability and accessibility of this life-saving intervention. To that end, we’ve created the Global Naloxone Survey, an attempt to compile information about where naloxone is available, who can use it, and where it can be accessed with or without a prescription.

We then will analyze the results with the short-term goal of obtaining as much information as possible on how widely and readily available naloxone is. Subsequently, we intend to work to maximize both the availability and the accessibility of naloxone, particularly to those who are most likely to be present where and when an opioid overdose takes place.

This post first appeared on the website of International Doctors for Healthier Drug Policies

This talk on Naloxone was given at a local TEDx event, produced independently at one of the TED Conferences. In 2011, fatal drug overdoses in the UK (3,338) exceeded the number of road accident deaths (1,960). These deaths are preventable. Jamie Bridge talks here about how rethinking both product design and service design have the potential to save lives in the administration of overdose medication. Naloxone was developed in the 1960s to counter the effects of heroin overdose. It’s a staple part of ambulance crew kits, but those who need it face barriers to the drug at the point at which it could save their lives. Recently, there has been a shift in focus and design to ensure that naloxone is available to those likeliest to witness an overdose – drug users, their families and friends. The evidence shows that naloxone works, and that drug users can be empowered to save the lives of their friends.

Jamie Bridge is a passionate advocate for drug services and drug policy reform in order to protect the rights, health and well-being of vulnerable people around the world.

* Naloxone is the generic term, it is also known by its brand name which is Narcan.

 

Living the great ‘Edinburgh AIDS panic’ of ’85.

Part 2 of David Graham Scott’s harrowing portrayal of

a junkie’s life on the streets of Edinburgh, Scotland’s

capital city and in 1985, known as the ‘AIDS CAPITAL OF

EUROPE’.

Written by David Graham Scott   (pic above – back in the day…)

(part one is the blog below this)

The only reason people went to ‘The City Hospital for Infectious Diseases’ was essentially for their methadone and free needles which at the time were very hard to come by. It was the carrot they dangled in front of us in order to encourage all the city’s junkies to attend, and thereby get tested for HIV/AIDS.

 

So data could get collected, clumsy attempts at healthcare would be given to all those with a positive result, and then we would all leave clutching leaflets about safer injecting together with possibly the first needle and syringe packs in Scotland.

This methadone and HIV testing clinic was really isolated from the main hub of Edinburgh city and was surrounded by vast woodlands.

1985; David in Edinburgh, in the flat arond the corner from the cop shop.

To get there we would have to board a public bus that took us towards the hospital which we shared with housewives heading back to their genteel homes in the wealthy southern suburbs of Edinburgh.  Each time they disembarked they would glance back at those of us left on the bus; the dregs of humanity, and everyone knew exactly where we were going; The Infectious Diseases Clinic at The City Hospital.

As the bus drove us further down the narrow meandering roads towards the clinic itself, it only seemed to  exacerbate our sense of alienation and fear, heading towards ‘that clinic’.

The Fear

There was an incredibly deep climate of fear at this time which is hard to fully explain today. It was 1985, the height of the HIV/AIDS ‘panic’.  People may remember the time, and God knows we all remember it was confusing and frightening enough, but actually  living within it, being terrorised by the label AIDS JUNKIE in your own community, there really are few words to describe what living through that time was like.

There were two ostracised communities (gay men and IV drug users) and sadly in those days neither group managed to find common ground with the other, such was the fear , ignorance and stigma from all those involved. People stuck tightly to what they knew.

A Slow Death by Newsnight

1985: Edinburgh

By early 1986, my girlfriend and I were asked if we wanted to appear on Newsnight to talk about being an injecting drug user in Edinburgh. Newsnight is the well respected current affairs programme which was (and still is) broadcast across the UK. The journalists involved offered us money, a paltry (but useful) £50 each to basically sell our souls to the ignorant masses. To be fair, the money wasn’t the reason we did it, it merely sealed the deal, both of us being broke and on heroin.

Naturally, we got totally stitched up. They edited the show to make us look irresponsible as they could. The idea was not to expose our status either way, but just to talk about the reality of life for drug users confronting the spectre of HIV/AIDS in Edinburgh.

However, the whole thing rapidly turned into a nightmare that had immense repercussions for us for months and years to come.

My girlfriend’s ex boyfriend was also appearing on the show, claiming to be the man who brought ‘AIDS’ to Scotland from Canada. He had kind of given up on himself I think, and although a very talented guitarist and session musician known by many major bands of the time, I think he ultimately felt jealous and lonely. It felt like his exposure on Newsnight was designed to draw my girlfriend and I into his own private hell. He knew he was dying…

We thought we were just trying to explain to viewers what was going on in Edinburgh among drug users, however pointed questioning from the journalist, who, looked from their body language to be quite fearful and disgusted by these three Scottish junkies sitting before them, soon had us saying things we didn’t set out to say.

True to the Style of Jeremy Kyle…*

My girlfriend soon began to respond to her ex boyfriend’s issues  goaded by the journalist, which meant she began feeling the need to explain her own positive status, something neither of us anticipated. I was negative but it didn’t matter. We had ‘AIDS by default’ of being junkies.

Today, I am a documentary filmmaker and as such, as I sit here and reflect back as I have done many times over the years, I know we were manipulated in an irresponsible, careless and insidious manner. Christ we were only 20 and 22 years old!

As for repercussions, they were horrific. We were both abused and spat at in the street regularly. The local police always gave us a hard time and because we lived around the corner from the local police station, regularly we would get a battering ram smashing through our door and our flat turned upside down for no reason. We were on prescription methadone and they never found anything. It was shameful.

David: Outside the doctors surgery, 1987, Edinburgh

David: Outside the doctors surgery, 1987, Edinburgh

Shameful!

 

It was a different era. We were vilified by the public. Even though I didn’t have HIV, I was positive just by association. When I went back to my family’s home in the highlands I was quickly approached by the local environmental health officer and rudely advised not to have sex with any women in town and it would be a good idea if I left town as soon as possible.

Even years later I was arrested on a trumped up charge when i returned home again, kept in jail overnight and later told that the cell was literally fumigated after I left. Completely unbelievable.

I haven’t put in to this story some of the worst things that happened to us because it is just to difficult to talk about and I don’t want to drag things up especially for my ex girlfriend who is happily still well and is really getting on with her life.

I think now in my life as a documentary film maker I continue to try and write the wrongs of that kind of shoddy, sensationalist journalism by trying to be as sensitive as I can and letting the person feel comfortable enough to talk freely but never to feel that false sense of security that people can do when they let their guard down. It is a big responsibility and I know personally how it feels to be completely exploited and to suffer the repercussions when one goes back into their community.

It was a terrible time for so many of us back then. So many deaths, so much fear, so much gossip,  people drowning others to save themselves, all pressured by an insane media appetite for sensationalist stories that just ruined people’s lives and spread fear and hate like poison. We cannot forget these days. We can never forget these days. We must all do whatever we can to stop the kind of scapegoating society is so apt to do when it is frightened by some unknown quantity. At the end of each day, it is always about people’s lives.

DGS

David today winning an award for Iboga Nights, his powerful film following people struggling to get off heroin using the iboga root.

Iboga Nights trailer from John Archer on Vimeo.

 

HIV/AIDS in 1985; No Really, We Will Never Forget…

It was 1988, in Wick, a small highland town in the far north of Scotland. My wife’s ex boyfriend had been diagnosed as being HIV positive. We knew we had to get tested. My wife was from the infamous period in Edinburgh period of shooting gallery’s where it was so hard to find works (syringes) that people would stand in a line and the dealer would cook up the hits using te same syringe on everyone.

There was a prototype of a needle exchange that had been running from an area called the Grassmarket in Edinburgh but the police were routinely arresting people who visited it. The police eventually closed it down in the early 1980’s. The cops were very hard on junkies who were injectors.

It was a strange time where you could be busted for having traces of gear or even a needle packet on your person. But the drug that was the real gold dust for the using community was Diconol which were bright pink tablets (I think that were made by Roche -dipionone hydrochloride).

Opus Morphia from David Graham Scott on Vimeo.

This film was made by David around the time (1985). Incredibly, he did not go to film school.

It was a really strong opiate analgesic, a mixture of Cyclomorph and a sort of anti-emetic) and the rush was the reason people bought it. It was like a religious experience, you generally felt you were in the company of God for a few moments,  it was a truly beautiful sensation, the best I have ever had in my life.

So anyway, my girlfriend and I went to get tested. I wasn’t really bothered about it, I never even thought I’d be positive, and neither did my girlfriend.

Three weeks later the results were in and it was my girl that got the bad news. She was positive and  I wasn’t. I said I would stick behind her no matter what happened; and typical of her (remains anonymous), she took it all in her stride. God only knows how, as things would get a lot, lot worse.

I would go with her to the HIV clinic and all the positive people had to sit along a wall. There was those old-fashioned weighing scales measuring height and weight, and without any privacy whatsoever, they would announce your weight, like at school, and because everyone always went there  coz they had to for their methadone (there was almost nothing on offer then), it was like some cattle market.

Gallows humour would run loose among the patients, as is the Scottish way, topped off with small junkie self platitudes such as ‘thank fuck I ain’t as bad as him’ .  Comments bounced around the echoing hospital hallways like” Oh, he is going down….61Kilograms today laddy, that’s quite a drop to tell ya ma” or “Oh,lookee there, she has that whatsimacallit, the scabby things, she must be getting AIDS nurse, right or no? “, and on and on it went. People just wasted away in front of you, on parade for all of us to see.

 

Episode 2 will tell you more from David of the shameful story of Edinburgh and HIV/AIDS in the 1980’s and should be about a week behind this.  

HOWEVER!!!

You can see more about David Graham Scott’s exemplary career in filmmaking, covering various issues but covering brilliantly his experiences as a junkie, or indeed battling ‘junkdom’.

In particular the famous ‘Detox or Die (his personal experience of undergoing an Ibogaine detox on film a decade ago (available to view today free online and on DGS’s Vimeo channel to this blog on INPUD’s webpage. This just released film (which you can read about on the link provided) called Iboga Nights. It is the culmination of three long years of in-depth research into the drug Iboga and the lives and detoxes of the accompanying clutch of courageous, wonderful characters involved in the film, the much called for sequel Iboga Nights (google it but we will review it shortly) was a big success on the documentary film circuit recently winning much deserved awards and acclaim.  BP will cover this next in more detail. If this has whetted your appetite, look for David Graham Scott on Facebook and speak to him directly! Or you will find much covering both films and more by googling it.

 

Oh God, My Anxiety’s Back!

Hey readers,

I just saw this piece on a really fab website/blog created it seems to people who are getting out there and doing it for themselves  -kinda like us with our drug thing, they push onward and enlighten others around mental health issues. Many of us in the drug using world are intimate friends with ‘the shrink’, and many of us have suffered from being pushed backwards and forwards from the drug clinic to the psych ward and back again…‘No! You just use too many drugs. Stop them and then we can talk!’…Actually, Ill just piss off now then instead of stroking your ego or being mummified under your useless labels…

Their fabulous sites link…http://slamtwigops.wordpress.com/category/resources/.

follow pic to a terrific blog where this artwork lives as does an anxious person who can help us laugh at ourselves a bit more...

follow pic to a terrific blog where this artwork lives as does an anxious person who can help us laugh at ourselves a bit more….

In any case, if one hasn’t got a mental health thing going on that is truly making your using life difficult, then you will still understand the dreaded anxiety and panic you can get used to feeling when our life has taken a turn for the worse. So much of the time anxiety bubbles just under the surface creating obstacles for us and preventing us from doing something -it can really be crippling and often we don’t even really know it is there. We think it is just us being crap. Its the drugs. Im procrastinating again….Anxiety appears to us in so many forms, I think it is worth having a wee read of this just to see if it feels like it could be helpful. Just the mere fact of beginning to ‘understand’ what is happening to us, is a huge weight lifted of our shoulders. If we understand how our mind structures itself, we can actually liberate ourselves by re-wiring a bit here and there! Its what therapy is basically. We can help ourselves as well you know!

 

How to Train Your Brain to Alleviate Anxiety

Our thoughts affect our brains. More specifically, “… what you pay attention to, what you think and feel and want, and how you work with your reactions to things sculpt your brain in multiple ways,” according to neuropsychologist Rick Hanson, Ph.D, in his newest book Just One Thing: Developing A Buddha Brain One Simple Practice at a Time. In other words, how you use your mind can change your brain.

According to Canadian scientist Donald Hebb, “Neurons that fire together, wire together.” If your thoughts focus on worrying and self-criticism, you’ll develop neural structures of anxiety and a negative sense of self, says Hanson.

For instance, individuals who are constantly stressed (such as acute or traumatic stress) release cortisol, which in another article Hanson says eats away at the memory-focused hippocampus. People with a history of stress have lost up to 25 percent of the volume of their hippocampus and have more difficulty forming new memories.

The opposite also is true. Engaging in relaxing activities regularly can wire your brain for calm. Research has shown that people who routinely relax have “improved expression of genes that calm down stress reactions, making them more resilient,” Hanson writes.

Also, over time, people who engage in mindfulness meditation develop thicker layers of neurons in the attention-focused parts of the prefrontal cortex and in the insula, an area that’s triggered when we tune into our feelings and bodies.

Other research has shown that being mindful boosts activation of the left prefrontal cortex, which suppresses negative emotions, and minimizes the activation of the amygdala, which Hanson refers to as the “alarm bell of the brain.”

Hanson’s book gives readers a variety of exercises to cultivate calm and self-confidence and to enjoy life. Here are three anxiety-alleviating practices to try.

1. “Notice you’re all right right now.” For many of us sitting still is a joke — as in, it’s impossible. According to Hanson, “To keep our ancestors alive, the brain evolved an ongoing internal trickle of unease. This little whisper of worry keeps you scanning your inner and outer world for signs of trouble.”

Being on high alert is adaptive. It’s meant to protect us. But this isn’t so helpful when we’re trying to soothe our stress and keep calm. Some of us — me included — even worry that if we relax for a few minutes, something bad will happen. (Of course, this isn’t true.)

Hanson encourages readers to focus on the present and to realize that right now in this moment, you’re probably OK. He says that focusing on the future forces us to worry and focusing on the past leads to regret. Whatever activity you’re engaged in, whether it’s driving, cooking dinner or replying to email, Hanson suggests saying, “I’m all right right now.”

Of course, there will be moments when you won’t be all right. In these times, Hanson suggests that after you ride out the storm, “… as soon as possible, notice that the core of your being is okay, like the quiet place fifty feet underwater, beneath a hurricane howling above the sea.”

2. “Feel safer.” “Evolution has given us an anxious brain,” Hanson writes. So, whether there’s a tiger in the bushes doesn’t matter, because staying away in both cases keeps us alive. But, again, this also keeps us hyper-focused on avoiding danger day to day. And depending on our temperaments and life experiences, we might be even more anxious.

Most people overestimate threats. This leads to excessive worrying, anxiety, stress-related aliments, less patience and generosity with others and a shorter fuse, according to Hanson.

Are you more guarded or anxious than you need to be? If so, Hanson suggests the following for feeling safer:

  • Think of how it feels to be with a person who cares about you and connect to those feelings and sensations.
  • Remember a time when you felt strong.
  • List some of the resources at your disposal to cope with life’s curveballs.
  • Take several long, deep breaths.
  • Become more in tune with what it feels like to feel safer. “Let those good feelings sink in, so you can remember them in your body and find your way back to them in the future.”

3. “Let go.” Letting go is hard. Even though clinging to clutter, regrets, resentment, unrealistic expectations or unfulfilling relationships is painful, we might be afraid that letting go makes us weak, shows we don’t care or lets someone off the hook. What holds you back in letting go?

Letting go is liberating. Hanson says that letting go might mean releasing pain or damaging thoughts or deeds or yielding instead of breaking. He offers a great analogy:

“When you let go, you’re like a supple and resilient willow tree that bends before the storm, still here in the morning — rather than a stiff oak that ends up broken and toppled over.”

Here are some of Hanson’s suggestions for letting go:

  • Be aware of how you let go naturally every day, whether it’s sending an email, taking out the trash, going from one thought or feeling to another or saying goodbye to a friend.
  • Let go of tension in your body. Take long and slow exhalations, and relax your shoulders, jaw and eyes.
  • Let go of things you don’t need or use.
  • Resolve to let go of a certain grudge or resentment. “This does not necessarily mean letting other people off the moral hook, just that you are letting yourself off the hotplate of staying upset about whatever happened,” Hanson writes. If you still feel hurt, he suggests recognizing your feelings, being kind to yourself and gently releasing them.
  • Let go of painful emotions. Hanson recommends several books on this topic: Focusing by Eugene Gendlin and What We May Beby Piero Ferrucci. In his book, Hanson summarizes his favorite methods: “relax your body;” “imagine that the feelings are flowing out of you like water’” express your feelings in a letter that you won’t send or vent aloud; talk to a good friend; and be open to positive feelings and let them replace the negative ones.

#RT via Bridget via http://psychcentral.com

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