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

The State We’re In; Heroin Prescribing in the UK

Here is the unedited version of an article I wrote for the Drug Fields’ trade magazine, DDN (Drink and Drug News), which was published yesterday. The link to DDN website is here, and they publish both free online versions and hard copy mail-outs. It is an excellent way of keeping bang up to date with what is happening in the UK drug treatment system. Here is the link to the article as appeared and the issue of the DDN magazine.

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

Heroin is still (rarely) provided on prescription in what was known as ‘The British System’

 

The average diamorphine prescription: A long way from street smack.

The average diamorphine prescription: A long way from street smack.

 

 

 

 

 

 

 

 

 

The State We’re In

‘The game of history is usually played by the best and the worst over the heads

of the majority in the middle.’ – Eric Hoffer

“I feel like they are waiting for the last handful of us to die off and that will be the end of heroin prescribing in Britain, as we know it”, I said miserably.

Gary turned and looked at me seriously through his spectacles, “If we don’t try and do something now there will be no diamorphine prescribing left anywhere in the UK”.

Gary Sutton (head of the Drug Team at Release)  tapped away on the computer in front of me, putting the last few lines on a letter to yet another treatment service who had been forcibly extracting a long term client off his diamorphine ampoules and onto an oral medication. It was proving to be a painful and destructive decision for the client, who was experiencing a new daily torment as his once stable life began to unravel around him.

The drug team and its helpline (known affectionately as ‘Narco’), all part of the UK charity Release, receives phone calls from people in drug treatment from all over UK. By doing so it serves as the proverbial stethoscope clamped to the arrhythmic heart of our nation’s drug politik and bears a chronological witness to the fallout from Number 10 affecting the individual, on the street and in treatment. In other words we witness the consequences of policy and treatment decisions, and try and support or advocate for the caller.

 

“...But as winter draws the shades on yet another year in

the drugs field, we find we are bearing witness to a tragedy,  

one of small proportions but with huge implications…”

 

But as winter draws the shades on yet another year in the drugs field, we find we are bearing witness to a tragedy, one of small proportions but with huge implications. It involves the last vestiges of the British System of drug treatment, the ‘jewel in its crown’ – heroin prescribing – and the decline of the NHS, under assault from a mercilessly competitive tendering process and the crude procurement that is defining its replacement. Is that where we are really heading?

It may be true to say that to try and define the old ‘British System’ is to trap its wings under a microscope and allow for a possibly contentious dissection; the late ‘Bing’ Spear, formerly Chief Inspector of the Home Office Drugs Branch, might be the first in line by reminding us that the implications of “’system’ and ‘programme’ suggests a coordination, order and an element of (state) planning and direction, all totally alien to the fundamental ethos of the British approach”. His point being that the essence of the ‘British System’ was that it “allows the individual doctor total clinical freedom to decide how to treat an addict patient”.

John Strang and Michael Gossop, in their thoroughly researched double volume book on ‘Heroin Addiction and the British System’, stated in the epilogue of volume 2, that ‘Amongst the (probably unintended) benefits of [this] approach may be the avoidance of the pursuit of extreme solutions and hence an ability to tolerate imperfection, alongside a greater freedom, and hence a particular capacity for evolution.’

 

“…‘Amongst the (probably unintended) benefits of [this] approach

may be the avoidance of the pursuit of extreme solutions

and hence an ability to tolerate imperfection, alongside a greater freedom,

and hence a particular capacity for evolution.’…Strang/Gossop..”

 

The average diamorphine prescription: A long way from street smack.

The average diamorphine prescription: A long way from street smack.

The British ‘Approach’ (arguably are more appropriate phrase) had once allowed for a level of evolution, of experimentation and pharmaceutical flexibility; three characteristics that are glaringly missing from front line drug treatment today. Although we have no room to discuss clinical guidance here, it is often the case that when presenting services with complex individual cases at Release, we are rebuffed by the response ‘it’s not in the guidelines’, ‘it’s not licensed’, or even, as if drug workers are loyal party backbenchers, ’it’s not government policy’!

Hindsight is a gift, and although many of us could while away the hours pontificating about just how and why it all went so publicly wrong for our ‘unhindered prescribers’ back in the day (think Drs Petro, (Lady) Frankau, and a handful of others), that would be to miss the point. The reality is, once we pick up and examine the pieces of the last 100 years, there are shining areas of light in our British Approach. Marked by both a simple humanity and a brilliant audacity, it permitted a private and dignified discussion between both doctor and patient to find the drug that created the preconditions for the ‘patient’ (today the ‘client’) to find the necessary balance in life.

Are we really back to the days of having to ask to be treated as an individual? Policy in treatment is today interfering to such an extent that the formulation that the patient feels works best for them (physeptone tablets, heroin, morphine, oxycodone, DF118’s etc.) may no longer fit into today’s homogenous and fixated theme of methadone or buprenorphine, one part of a backwards step.

Although the days of unhindered diamorphine prescribing are almost gone, thankfully, there is still a small group of well informed and supportive doctors, some of whom hold the rarefied Home Office licence to prescribe diamorphine (to people who are opiate dependent.) Regrettably,  there appear to be a good number of licensees who don’t use their license to treat opiate users at all possibly having never to have had the good fortune to encounter a suitably needy client in their catchment area.  Is it possible that they remain content to absorb the kudos and ‘super specialist status’ that the licence conveys without doing any of the work?

 

Prohibition, fear

“…Prohibition, politics and the soundbite media means we are doomed to discuss [heroin prescribing] under the umbrella of ‘treating the most intractable…”

 Fear and public ignorance has forced us to collapse any new diamorphine prescribing into a tight wad of supervision, medicalisation and regulation while prohibition, politics and the soundbite media has meant that we have been doomed to discuss this subject under the umbrella of ‘treating the most intractable, the most damaged, the treatment failures, the failures of treatment’.

Why must a treatment that has proven to be the optimum for so many, be left until people have been forced to suffer through a series of personal disasters and treatment failures? Did this narrative help to diminish the intervention? One of the benefits of the ‘old style’ of heroin prescribing has been the ability to take it home and use it like one might use insulin, which permits a level of independence central to any functioning life of work and leisure.  This small although hugely significant freedom can still fit comfortably as part of a transitional route for people progressing through more heavily supervised heroin programmes towards less supervision and as such needs to be retained, and even embraced.

The last few dozen people left on take home diamorphine prescriptions in the UK today, seem to be stable, functioning, often working people who no longer have so much as a ‘drug problem’ but a manageable drug dependence. This last group of diamorphine clients are remnants of the old system with, it appears, no new people taking their places once they leave. Today these are some of the very people who are now ringing the Release helpline to try and save their prescriptions altogether. They are frightened, most of them are in their fifties and having qualified for diamorphine many years ago because ‘nothing else worked’, what now are they to do?

 

In Switzerland, diamorphine prescribing has been so successful; they even have two programmes in prisons. (Now there is a ‘Sun’ headline, if I’ve ever seen one!). Clients in their community programmes pay around 45 Euros (£32) a month for their ‘scripts, something most British heroin users/OST clients would probably agree to in an instant if it meant diamorphine was offered.

In Britain, diamorphine prescribing has been ensconced in a political and clinical debate about the expense and fears of an imaginary tsunami of diversion. Yet what of today’s financial wastage? We have ways to deal with diversion, yet poor and frequent commissioning has a number of serious consequences, including a lack of continuity of care, a slide back to postcode variance, and not least, cost. An exercise to quantify the costs of tendering services over 10 years ago came up with a figure of £300,000 as the sum expended by all bidders and the commissioner, per tender. Money that could be better spent, surely?

A few weeks ago the LSE put on a mini-symposium on diamorphine with a panel of international clinicians, academics and research experts. Everyone present agreed that prescribing diamorphine, albeit in a very controlled supervised manner, had tremendous merit. Taking the idea from the success in Britain (e.g. Dr John Marks), today we see a method that has evolved across Europe; the Swiss, the Dutch, the Germans and the Danes, amongst others, are all doing it, treating thousands of clients, with great results. So it was more than frustrating to hear that our own diamorphine clinical trials had been closed this year with no plans to re-start them

 

“…Diamorphine should not end up marginalised and discarded because a

controversial new ‘system’ finds it far harder to tolerate than the patients

who receive it do…”

 

Diamorphine should not end up marginalised and discarded because a controversial new ‘system’ finds it far harder to tolerate than the patients who receive it do. The benefit is proven. It’s not a choice between maintenance and abstinence, addiction is not reductive to either/or and as treatment is neither just a science nor an art, and our clinicians should not be restricted to methadone or Subutex, or our clients subjected to a binary ‘take it or leave it’ choice in services.

by Erin O’Mara with massive thanks to Release and its intrepid Drug Team: published in Dec 2015 issue of Drink and Drug News

New York City; Drug Use in the Belly of the Beast

Here is a story from an incredible activist from back in the day called Peter VanDerKloot. Peter actually fought to keep open one of NYC’s main methadone clinics from closing, by agreeing to put his entire face (and his boyish all-American good looks) onto a FULL PAGE advert in a NYC newspaper, telling people that methadone had saved his life and was saving the lives of hundreds of others and that it just must not be closed down! It wasn’t, and Pete went on to do some fabulous work in the field and, though I don’t know where he is now, we are lucky to have had a few articles from him. Here is one. From issue 2.

 

Pic by photographer L. Bobbe 1970's NYC

When the Black Poppy crew asked me to do a column on the dope scene in the States, it got me thinking about all that’s changed in my time as a dopefiend here in the Belly of the Beast. It’s hard to believe it’s been 15 years since Ron and Nancy Reagan cranked up the heat on the War on [Some] Drugs and sold folks on the idea that invasion of ones home by a SWAT team was something that all Americans had a right to expect. Not that this was the first time our fearless leaders had declared war on a molecule. We’ve been through plenty of chemical warfare in this country, from turn of the century campaigns against cocaine-crazed Black men visually raping Southern belles with  their dilated pupils, to drives in the 70s to save pot-head teenage boys from the shame of Dolly Parton-esque breast growth. All along though, it’s been us dopefiends who’ve made up most of the casualties. Hell, we started the century able to buy pure heroin via mail order and now we end it unable to buy dried decorative poppies in the florist’s.

 

Still, the last two decades have been rougher yet. The powers that be seem to have decided that the solution to unemployment in our post-industrial

https://vimeo.com/106919970

The typical sort of NYC_heroin-baggies_ From Graham MacIndoe’s collection, see more in his photographic book, wraps he collected throughout his using days. Fascinating!

economy is to imprison half the population and hire the other half to guard them. At the rate we’re going, we’ll meet that goal soon – as it is, nearly 1% of our adult male population is currently behind bars.  No other Western democracy comes close, and when you factor in the effects of spiraling mandatory drug testing, increased police powers, and ever-decreasing privacy, you can bet that that lead will remain unchallenged – even if our right to call ourselves a “democracy” does not.
Here in my hometown of New York City, the dogs have really been loosed on us. The tanks are filled with public beer drinkers and subway fare-beaters, and you can catch a six month bit just for looking cross-eyed at a cop. And yet when it comes down to copping and getting off, the War on Drugs hasn’t made much headway.economy is to imprison half the population and hire the other half to guard them. At the rate we’re going, we’ll meet that goal soon – as it is, nearly 1% of our adult male population is currently behind bars.  No other Western democracy comes close, and when you factor in the effects of spiraling mandatory drug testing, increased police powers, and ever-decreasing privacy, you can bet that that lead will remain unchallenged – even if our right to call ourselves a “democracy” does not.

 

When I first got turned on to heroin, New York was still the dope capital of the world, and “Alphabet City” was still the capital of New York dope neighborhoods. In the days before the real estate interests moved in and the area was declared an extension of the “East Village” and hence suitable for yuppie inhabitation, the streets belonged to us, and you best believe we made the most of it. Block after block of abandoned buildings and vacant lots were commandeered by major dealing organizations. The streets echoed with the cries of the steerers touting the brand names of different bags: “Red Tape!… Seven-Up…ET!!”  We’d line up to cop in queues stretching around the corner, kept in place by enforcers with golf-clubs in their fists or pistols in their waistbands who’d order us to have our money ready and fanned out just so — reminding us not to linger post-purchase with chants of  “Cop and bop!” Street traffic was heavy too, as the narrow streets were choked with cars with out of state plates down either to supply the driver’s habit or to run a few bundles back for resale.

For the rest of this excellent article, 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.

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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

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…)

What Will the Future Look Like for Drug Users?

Wow, great question huh? And one that Max Daly from VICE Magazine has just answered in its January 13th Edition.  I was really pleased to see an articulation of how I have been feeling about set ups like Silk Road and the Dark Web as well as the hype around NPS’s – New Psychoactive Substances, or research chemicals to you and me.

colouredbrain

I couldn’t help shake the feeling that many of these new research chemicals sound like (and feel like) a bad day in your drugged out teenage bedroom. Chemicals that are – well, just too chemically, with spiky, wired kind of edges, insomnia rather than stimulation, and a strange collection of side effects like twitches, memory loss, anxiety  or nausea or even seizures, arrhythmias, panic attacks and collapsing/black outs. You’re sensing the picture. You’ve probably had experience of the ‘almost’ drugs; ephedrine trying to be amphetamine,  (no good) pheniramine trying to pose as LSD (a trip for sure but…) The old school big sellers are out there as big sellers for a reason.They have risen above the throng.  Surely we would know by now if these new drugs were consistently more like diamonds than mud to experience? But I fear we do know, for the most part. Most of the newbies, 98% of them, aren’t really very pleasant. Now of course there has been fatalities, but what do we expect when we really dont know shit about where these chemicals are coming from, the lab conditions, the chemists making it up, let alone whats REALLY in a particular substance.

15 minutes of Fame, NPS Style

A look on YouTube into NPS /research chemicals/bath salts and overdoses, and you get our wonderful society out there filming their buddy’s or a strangers weird drug overdose. This was when I saw some very disturbing but similar overdose reactions of a type Id never seen before from any other drug. These weren’t seizures of any kind currently understood, they were some kind of altered state where the person (and their were many sharing the same kind of symptoms) was unable to master any lower limb movements -in other words their arms and legs were completely all over the place and they were often unable to walk at all. Not only that, but movement came from a kind of seal like or fish like, flapping, rolling, careering along the pavement. Vocal sounds became an awful guttural kind of noise or a choked up screaming. apparently something does actually happen to the vocal chords so the person cannot use it for normal communication. There has also been videos of police getting out taser and repeatedly, and I mean REPEATEDLY, tasering a person 2,3,4 even 5 times and the person is still able to excitedly respond or get up and still freak out etc. Body temperature supposedly heats up so clothes come off, which again gets all the home grown film makers out, filming another persons terrifying psychosis of some sort for all their workmates and neighbours to see.

 (Note: This is a very disturbing video (think Ill remove it afterwards) of what appears to be the kind of ‘bathsalts’ type of overdose -NOT Krokodil as the heading describes. There are many of chemicals possibly derived from the cathinones that seem to be responsible for some of these responses, in particular MDVP which may be the culprit. People often use way over the tiny dose that is advised of 5-10mg. There are quite a lot of youtube videos like this where people are having some kind of episode but all show strikingly similar side effects, side effects that I for one, in over 30 years on the scene, have never seen before. It isn’t to be hyped, but there is something weird and a bit scary about the effects of some of these unknown new chemicals) .

Click to KFX.org.uk, a really comprehensive website on all drugs but esp NPS, updated regularly.

Click to KFX.org.uk, a really comprehensive website on all drugs but esp NPS, updated regularly.

So yeah, its scary but, to go back to the future of drugs and the Vice article, it was good to hear someone agreeing that the NPS’s wont really take off, that they will remain a teenagers fallback, or for the person that has not yet properly developed real drug taste. That only the good old troopers will remain the most used and the quality will; just get better as more and more people use the Dark Web and networks like Silk Road 3, to really flesh out a safe place to buy quality drugs and, yes ok,  hellishly over inflated prices. But, if your anything like me and, dare I say, a drug connoisseur, you will be happy to pay an inflated fee if the drugs are going to be exactamundo – quality high, packaging clever, weight bang on. Here is a quote from the article:

” Yet the future will not be about the endless procession of legal highs. A smattering of new psychoactive substances (or NPS) will always be around, and to an extent always have been, but they have had their day in the sun. An interesting sideshow, they have served a purpose. Yes,mephedrone is here to stay and maybe 2C-B will hang around too, but now that the ecstasy and cocaine markets have righted themselves, with the purity of both drugs up considerably, the old school drugs are back. Clones of stimulants and other chemicals will still have an appeal to those who are skint, or are unable to get hold of decent drugs or who want to avoid getting caught out in piss tests, but the imminent clampdown on head shops will stifle supply to teenagers and the homeless – two of the keenest buyers of NPS products.

The online drug trade, however, will be blazing a trail into the next decade and beyond, whether the world’s police like it or not.”

Finally a Market to Dream About?

The Future of Drugs: Vice Magazine Issue 531: Written by Max Daly

The Future of Drugs: Vice Magazine Issue 531: Written by Max Daly

Max Daly then relays his meeting with Mike Power, author of what looks to be a great read, called Drugs 2.0: The Web Revolution That’s Changing How the World Gets High. Max asks him about how the online drug trade might fare over the next decade or two. “At the moment, the online trade in drugs is a minority sport, a good way of buying high quality drugs,” he told me. “Even now it’s tipping over from early adopters into the mainstream. It will get bigger, easier to use and more widespread. There will be more sites and more people using them because it is the perfect business model: anonymous, commission-based, peer-reviewed, postal drug dealing. Online dealing is not a replacement for trafficking cartels, it’s never going to work on that level, but if you’ve got a kilo of MDMA it’s the way to go.”  

I would actually add to that, having just a bit of this and that, it can still be a way to go. Sharing in a solid community where a forum is tightly connected to the site itself, so people regularly post about who they bought off and what it was like, along with who to avoid like the plague, all overseen by the sites moderator ensuring there is no bullshit being allowed to fester or take off, its really effective. It has a terrific potential for the future to be a real by the people for the people, kind of drug market, one where quality triumphs! What, what, no I’m not dreaming! This could slowly start to formulate around us. Oh sure I think people will continue to invent chemicals to take, although it does seem like they’ve already exhausted the best feeling drugs from a few main families of drugs: cathinones / phenethylamines, and amphetamines and are already on the dregs of these. Surely there has to be another surprise like a synthetic ‘opioid’ family to discover??

In the meantime, it could well be as VICE, and Max state. That NPS’s will die a slow death or remain in relatively low numbers as adults go old school and teens grow out of it, and bans catch up and overdoses get publicised. Mephedrone and a few relatives are here to stay of course, and although I think Spice and the synthetic cannabinoids are a bit creepy, even scary, that will always attract some who think it’s a cheap and easy cannabis alternative (just buy real pot and avoid the brain damage!).

goodies to buy. But there are no new vendors on SR2 these days, only old vendors from Silk Road are permitted to sell these days, seems it is safer that way...

All those goodies to buy! The old silk road online shop. It seems the FBI busts only served to force the dodgier online set ups out of business and tightened up safety protocols for the remainders.

I saw the wonderful JP Grund so a recent presentation on NPS’s at a conference in Amsterdam and he talked about the 3 D printer and that we will, one day in the near future, have drug recipes that are made for our genetic makeup and they will be sent to you with the computer programme and I presume the associated chemicals, that you administer to your 3D printer and it makes you your own, personal drug of choice. Now how nice could that be friends?

Read the full Vice article here (more…)

Does England Need a Drug User Union?

IDUD_2014Hi, I received a comment from Joe (hi Joe!) who said he was writing an aricle on why Britain needs a drug user union and could we help? Well, it happens to be good timing Joe, because it is a discussion on many peoples lips – how to unify and strength the voice of the drug user in the UK enabling it to become more effective addressing issues that routinely affect the lives of drug users. For England however, it is even more pertinent as we are currently adrift  in what might be a diverse and eclectic drug user movement, but it is one without a unified voice, or indeed a mechanism to sift and reflect back through the real concerns of the drug using community at large. So what do we do? Well, we can start by answering Joe’s question. Do we need a drug user union in the UK? (Note: this is pitched at a newcomers look into the drug user union movement so does not go in depth into some of the issues that are bubbling away for the movement).


Union2_Hi Joe,
We do need a drug user union in the UK, just like they do in many other parts of the world. Whilst a trade union’s primary role is to represent their members on employment issues, a drug user union has often emerged in a country to focus on issues affecting drug users in treatment. And just like a workers union would fight for better pay and working conditions, a drug users union focuses at least half of their energy on ensuring drug users in treatment get treated fairly, humanely, and equally – like anyone else who is a consumer of a health service.

union5Historically and no different from many other countries,  drug treatment in the UK has varied widely in its ability to reflect the needs of its client group and has often been modelled on extremely punitive, isolating and demoralising approaches to treating drug use. The most widely used approach has always been the ‘Carrot and Stick’ model, where users are rewarded with privileges for compliance. This often means permitting take home doses of methadone if users choose to ‘get with the programme’ and show it by presenting no positive urine samples. The Carrot.

The stick happens when users are punished punitively when they ‘fail’. This has varied from the inexplicable; a reduction in ones prescription (just when they are showing they perhaps need an increase) to the common; drink your methadone supervised -which can mean rather humiliatingly drinking it at the chemist in front of everybody (including your children’s friends parents). But anyone who fully understands drug dependence in all its complexity, will know that punishments make no hay when it comes to the decision, or the overwhelming need to use drugs. In fact punishments often simply isolate the person further and drive them deeper into their dependence/addiction. People become resentful, unable to confide in the people who are supposed to be supporting them, and simply lose the resources, the motivation and the knowledge about how to make the changes they wanted to when they started the programme.

Tunion3wenty years ago when ‘user involvement started in the UK, we were coming out of the dark ages in terms of drug treatment. Today, with a high degree of user involvement around the country, things have been much better for the average drug user in treatment. But success in the UK has been patchy to say the least, and todays political ideology that directs the funding wand has caused not only cut backs in drug treatment but has created a whole series of new problems, problems which are ripe for a drug user union to tackle.

The UK needs independent union/s for drug users simply because they must have an independent voice in their treatment which affects, like a work union1or a trade union, a huge part of ones daily life. Much of todays user involvement is now suffering from the left turn it took many years ago to follow the money (and sometimes the support as well, both are understandable to some degree) and get into bed with the same health authorities they needed to have clear heads about. This has not only influenced some of the decisions such groups have made, sometimes at the expense of their communities, but has now left them defenseless to big budget cuts in the health service, money which is no longer ring-fenced to protect drug treatment. Drug User Groups that have spent years working, often for no pay, sometimes doing or supporting much of the work of professionals, have, at the stroke of a pen, been vanquished. Thanks for all the work mate, but seeya later.

Perhaps if we had set up as unions, even to the extent where users who wanted to join could pay their dues with the knowledge that they were getting something for their money; positive change, we would have a strong lead and vision for the way we want drug treatment to go in this country, a direction which is centred around the needs of the client, not the government, and not the key-worker or consultant. The client who is, after all supporting a massive industry of jobs, careers and reputations.

But drug user unions have a much bigger part to play in civil society. Unions can offer educational, lifelong learning and training opportunities to their members, just like real unions.

But drug user unions have a much bigger part to play in civil society. Unions can offer educational, lifelong learning and training opportunities to their members, just like real unions. Historically, unions have not only negotiated for and championed better workplace rights with employers but for a better deal for working people in the wider world. Having battled to extend the right to vote, it was the unions that created a political party that working people could vote for – the Labour Party. It is perfectly possible, as is reflected in perhaps one of the world’s most brilliant Drug User Unions, The Swedish User Union, for drug users to become directly influential in a country’s national politics; becoming to Go To organisation on drug related issues: Nothing About Us Without Us – the slogan for the drug user movement.

union4So yes, the collected strength and political ability of the English user movement is perhaps at a bit of a crossroads, or on a cliff edge, or even a sinking boat. It has only to look to its brethren in Scotland and Ireland (north and south) to see shining examples of cohesive and effective partnership working and union values, forging better and more humane drug policies in various sectors like health, criminal justice, treatment etc. But the space is empty for a unified user voice in England, the seat is up, the pantry littered with almosts and nearlies. Yet the values of a drug user union are urgently needed today. For those drug users still struggling with substandard or punitive treatment, poor engagement opportunities, or one size fits all care, it is just as much-needed for the society we live in, the drug policies that desperately need our thoughts, creativity and input, the solutions to community drug issues that only we as drug users can really pinpoint and tackle effectively. But that’s not all. What about unions at work?

All the unpaid hours we do to better our communities as harm reduction and recovery workers, all the glass ceilings we encounter despite our enormous skill and ability. Indeed Canada has recently ensured its harm reduction workers have been able to come together under a union banner as the Harm Reduction Workers Union, a really marvellous idea that is also primed as a template for other countries to adopt. And while history tells us that England, indeed Britain, has always been a rather tribal country, with tribal interests and cultures that still affect the way shires and counties do things, it will be basic union values that are able to touch a common core through all that diversity, and hopefully, bring us home to a unified drug user movement. A movement that is solid and secure with our UK brethren, allied in defence of ever more humane drug policies for our societies. And a vision of innovative and responsive drug treatment that is driven forward by equally by ex/current drug users and a diverse orchestra of dedicated others forever fine tuning our treatment and information response. All leading our communities down the right road ahead, across the changing landscape of drug using Britain today. Erin O’Mara

World First! – Harm Reduction Worker’s Union Takes off in Toronto

Harm Reduction Workers Union Takes Off in Toronto

OMG! I just LOVE  these Canadian drug users! 

 

NEWS: TORONTO HARM REDUCTION WORKER’S UNION

(THRWU) – A World’s First!

12 NOVEMBER 2014

Black Poppy and INPUD, are more than pleased to report on THRWU,  the world’s first ever harm reduction workers’ union which went public on 11 November 2014.  Members of INPUD have been involved in this campaign, with a major shout out going to Torontonian Raffi Balian – (a long time friend of both Black Poppy and member of INPUD since its beginnings).  Raffi has been a serious mover and shaker on the East Side of Canada for about 20 years now, setting up CounterFIT, which has consistently  brought us all innovative, user led and drug user centric projects while inspiring people from all over the world that there is a time to stop thinking and just do it! So it was no surprise to see Raffi,  (the guy kneeling down with the green jacket on the left in the  picture below) at it again, enthusing, organising, promoting and supporting his fellow junkies, workers, and of course the community.

Toronto Harm Reduction Workers Union -What are you waiting for -give your local union leader a call and start talking!

Toronto Harm Reduction Workers Union -What are you waiting for -give your local union leader  (IWW) a call and start talking!

The Toronto Harm Reduction Workers Union  is a city-wide organization, representing over 50 employed, unemployed, and student workers. At the launch workers at two of the city’s largest harm reduction programs went public with their affiliation to the Union which is a part of the Industrial Workers of the World (IWW). The IWW is a fighting union for all workers that organizes workers regardless of skill or trade and it is member (not staff) run, with a long history of fighting for the most oppressed and marginalized workers in society

The majority of these workers have been hired for their lived experience of using drugs, incarceration and homelessness and are continuing to organize with the goal of unionizing all of the city’s harm reduction workers.

THRWU speak about the need to organise around many of the issues affecting the industry – of which many harm reduction workers who come from a drug using background, will know a lot about. THRWU point to some of the main areas on their website:

  • Discrepancies in wages, with workers doing similar work taking home vastly different pay.
  • People work for years without raises, and have limited to no access to benefits, vacation and sick days.
  • Management depends on social assistance to provide the basic benefits that workers need (such as emergency dental and drug benefits). This is especially detrimental for those of us hired because we live with HIV and/or Hep C, or use opiode substitution therapy.
  • Workers are discriminated against based on the lived experience they are hired for.
  • Many positions are extremely precarious, with grants and funding threatened by conservative and anti-science ideology, and austerity budgets that endanger public health.

These are very real issues affecting the daily lives of people who’s work is not just a job, but a ’cause’,  a life, based on their lived experience and a way to put their heart and soul back into their communities, funneling years and years of privileged insight into their work, which has gone such a long way towards stemming the HIV epidemic in the drug injecting community. And damn right they deserve paid work or a raise along with everyone else! Damn right their should be the chance of promotion from volunteer to worker, to team leader to manager. Let’s all be clear here, harm reduction would not work saving the lives it does, reducing the harm it does, stemming the tide of infectious diseases that it does, without the world’s harm reduction workers and many of these are our peers. People who use drugs, used drugs, are on prescriptions etc.  The majority of work is unsung, underpaid and under acknowledged for the real impact it has on the community.

So who are we talking about exactly? Well, let’s let THRWU speak for themselves!

We are the workers that make harm reduction work.  We are the kit makers, outreach workers, community workers, and coordinators that reduce the harms associated with bad drug laws, poverty and capitalism.  As working class people, our communities have been hard hit by the War on Drugs, the epidemics of HIV, Hepatitis C and overdose deaths. We are organizing to better our working conditions and improve the services we provide. And we are organizing to fight for a society free of oppression and injustice.”

Below is THRWU’s mandate and definition of harm reduction:

“THRWU is an organization of Harm Reduction Workers who are united together in solidarity, to improve our working conditions and to strengthen equality in the workplace for the betterment of the workers and those who access the services. We are a union of employed and unemployed workers committed to harm reduction with a range of skills, education and lived experience. We have come together in our common concerns to form a non-hierarchical democratic labour union with a commitment to mutual aid, social justice and the principles of harm reduction.”

“Harm reduction is an evidence-based and practical approach to dealing with the harms associated with drug use…Harm reduction also aims to respond to harm experienced on a structural or societal level (such as stigma, discrimination and criminalization). This work should be grounded in the values of respect, non-judgment, and in the promotion of self-determination and self-empowerment for folks involved!

We recognize that many healthcare and social service providers endorse a ‘harm reduction framework’ in name only. Our union will prioritize those workers who are actively engaged in harm reduction work, as defined above!”

INPUD, the International Network of People who use Drugs are positive about the future as more drug users self organise. In a statement of support INPUD said, “In the context of the War on Drugs, in which our fellow workers are the casualties, an organizing campaign of this nature is exciting. The THRWU is setting itself up to be a powerful voice for harm reduction workers in the workplaces as well as in broader political struggles”. Last word to THRWU: “We need to organize ourselves to demand an improvement in wages and in workplace conditions. We love the work we do but we also know we need to be treated more equitably. There are many of us working in harm reduction and we can work in solidarity with each other to improve this.”

Boy oh boy, lets wish them luck with their new unionised labour force and their further organizing efforts!

How do I organize a Harm Reduction Workers Union in my city?

If you are interested in building a Harm Reduction Workers Union in your city, get in touch! thrwunion@gmail.com

For more information don’t miss visiting their website www.thrwu.org or by email  and  – if you are in Toronto – JOIN UP!!

Check out more of their news and events on their FaceBook page herehttps://www.facebook.com/thrwu

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The History of Drug User Activism in Australia; by an Aussie Activist Superstar

Dont Miss this!!! If you want to find out the story of drug user activism in Australia by a woman who was not only there but integral to the very essence of active drug users doin’ it for themselves, setting limits in the sky and rockin right up to parliament house itself to get the job done – then you cannot miss this production!! From WHACK; Victorias Drug User Magazine; Annie Madden, the firebrand of an Aussie cog in the Aussie activist wheel, was asked to write about he years of experience and knowledge around the evolution of the Australian drug user history movement – and it is compulsory reading my friends! The History of Drug User Activism in Australia by AIVL’s Chief Exec and Superwoman incarnate, Annie Madden – get out your reading specs, sit back with your favourite tipple, and IV the contents of this fabulous issue….

Please click this link for the easy to read online magazine, which you can print out.

http://hrvic.org.au/docs/historyofIDUactivism/index.html

A Word About Ms Annie Madden…

Annie Madden, Chief Exec, AIVL Australia; Australia's Own Superstar Activist!

Annie Madden, Chief Exec, AIVL Australia; Australia’s Own Superstar Activist!

Australian Injecting & Illicit Drug Users League (AIVL)

Annie Madden is currently the Executive Officer of the Australian Injecting & Illicit Drug Users League (AIVL) which is the national peak body representing state and territory drug user organisations and illicit drug users at the national level. Prior to her current role, Annie was the Co-ordinator of the NSW Users & AIDS Association (NUAA) for six years. She has an honours degree in Social and Political Sciences. She is on numerous national, Commonwealth Government and research committees including the recently appointed Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis C and regularly takes extremely effective roles in global United Nation and WHO reviews, committees, global guidance publications and drug related recommendations. She has been working in the areas of illicit drug use, HIV/AIDS and hepatitis for over 14 years, has been an injecting drug user for over 18 years and on methadone for many years also. Annie is one of the world’s most inspiring women user activists who has worked tirelessly day in and day out to challenge the discrimination and human rights violations occurring to people who use drugs. And not just in Australia where she works at the top of her game, going head to head with politicians and Charity heads, doctors and do-gooders, parents and always her peers – drug users, but around the world, wherever she gets the chance to fight against ignorance and discrimination, for women who use drugs, for all of us, of any colour. Annie Madden is a woman we should all be proud of, especially, as drug users, we are lucky enough to have her on our side. Coz she is a truly kind and caring person, humble, hard working, smart and emphatic. Thanks for all you’ve done Annie Madden, and all your future will bring. We send you thanks, light and love.

Your friends at BP and around the world, those who know you, love you, and those who haven’t yet had the pleasure, thank you.

Succinct Explanation about the Many Misconceptions About ‘Addiction’

Check out another neatly defined, succinct and straightforward explanation of the roots of ‘addiction’ and just how society became laden with so many misconceptions about drug dependence or ‘addiction’. Dr Cart Hart has a new book out called High Price. Just 20 minutes long, this is a very useful listen for people wanting to know a bit of history around how we came to view ‘out of control drug addicts’ as the norm. He also mentions his fascinating research delivered over a few years around crack and crack users, which challenged many of our most deeply ingrained ideas about crack users. Get your facts up to date and have a listen..

Thanks to Vox.com for the article and video, though I think it originally appeared on TedsTalk.

Carl Hart is a neuroscientist and drug addiction expert at Columbia University. In a recent TEDMED talk, Hart spoke about drug addiction and the many misconceptions surrounding the topic — and how those misconceptions can mislead drug policy.

Hart went into neuroscience to cure the drug addiction he blamed for causing crime and poverty in his old Miami neighborhood. But when he began to work on the issue, he learned that his assumptions were wrong.

About 80 to 90 percent of the people who use illegal drugs don’t turn out addicts, Hart explained. As an example, Hart pointed to the three previous presidents, all of whom used drugs when they were younger. “Their drug use did not result in an inevitable downward spiral leading to debauchery and addiction,” Hart said. “And the experience of these men is the rule, not the exception.”

THE FINDINGS SHOW THE PROBLEMS ARE MUCH MORE COMPLICATED THAN SOME BELIEVE

As Hart explained, many of the current assumptions about drug addiction are based on old animal experiments from the 1960s and 1970s. In these tests, animals were put in a cage with a lever that they could pull for a shot of a drug. Researchers found the animals would pull the lever until they died from an overdose.

Hart said these animals were never presented with an alternative, though. In other experiments, animals were given another option: a mate or a sweet treat. At that point, the animals began choosing the non-drug alternative, and they didn’t take the drug until they died.

Hart followed up on these experiments with human participants in 2000 and 2012. His lab recruited meth and crack cocaine addicts, and the addicts were given the option to choose between a small amount of money or their drug of choice. When the money option was $5, they chose the money about half the time. When the money option was $20, they chose the money about eight out of 10 times.

The results, of course, don’t diminish the real problems of crime, poverty, and drug addiction in some of America’s communities. But the findings show the problems are much more complicated than some, including a younger Hart, believe.

 

Check out the useful flip cards and the rest of the article here.  Listen to Dr Carl Hart give a clear account of the many misconceptions around drug use and where they sprang from. 

 

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