Heroin to be prescribed to addicts in plan to starve criminal gangs of cash

UK police commissioner says addiction a public health issue and 'our approach to drugs is failing'

Alex Matthews-King

Health Correspondent

Monday 12 February 2018 10:53 GMT

Consumption rooms are being explored in the West Midlands to provide clean equipment and medical supervision to users (Getty)

The official in charge of the UK’s second largest police force signalled a radical new approach to the war on drugs on Monday, including plans to keep some drug offenders out of criminal courts and provide users heroin on prescription.

David Jamieson, West Midlands Police and Crime commissioner, said drugs were costing £1.4bn of public money a year in his region alone, and “fresh ideas” were needed to tackle the problem.

Mr Jamieson, who sets the region’s policing priorities and budget, said the time has come to treat addiction as a public health issue – a move that has been welcomed by charities and medical experts.

This will include schemes that provide heroin as part of treatment, to reduce petty crime and stop money being funnelled to criminal gangs – a move with some government support.

It will also include a review of heroin consumption rooms, which already run in EU countries including France, Spain and Portugal but are opposed by the Home Office.

These are medically supervised spaces providing clean needles and equipment for users. They have been shown to significantly lower overdose rates and increase use of rehab programmes.

The schemes are backed by MPs, as well as medical groups, such as the British Medical Association and the Government’s own policy advisers, the Advisory Council on the Misuse of Drugs (ACMD).

Experts have said the Government must “accept responsibility” for rising drug deaths driven in part by austerity, with 3,744 people dying of overdoses in 2016 – about 70 per cent of which were overdoses of illicit drugs.

The West Midlands’ intervention is aimed at doing away with the failed enforcement tactics associated with the war on drugs, and plans to introduce several other initiatives, some of which are already working in other parts of the UK, including:

A formal alternative to the court system that will direct users to treatment programmes rather than jails.
This could be similar to the Checkpoint programme run by Durham Constabulary, which offers offenders, including low-level drug dealers and consumers, the chance to avoid prosecution if they avoid reoffending and complete community service and restorative justice programmes over four months.
City-centre testing for recreational drugs used by night clubbers, a scheme that has previously been run at festivals and provides information on the strength and purity of drugs being taken.
Training and equipping police officers to deliver anti-overdose drug naloxone.
Seizing more money from large criminal gangs, and reinvesting it in drug prevention programmes.

“Despite the good work being done by many, collectively our approach to drugs is failing,” Mr Jamieson said.

“Drugs are costing the West Midlands £1.4bn each year. It means people are forced to live with more crime, public services are put under strain and not enough is done to reduce the suffering of those who are addicted.

“If we are to cut crime and save lives there’s one thing we can all agree on; we need fresh ideas.

“These are bold, but practical proposals that will reduce crime, the cost to the public purse and the terrible harm caused by drugs.

“These proposals tackle the drugs market head on, hitting the organised criminals profiting from the misery of others.”

Campaigner Rose Humphries, of the Anyone’s Child project, welcomed the change of direction for police forces.

Ms Humphries lost two sons to heroin overdoses, and she said: “Bitter experience has taught me that current drugs policy didn’t protect my children, and it won’t protect yours.

“If their drug use had been treated as a health issue instead of a criminal one, Jake and Roland would probably be alive today.”

The commissioner’s office reports that every three days in the West Midlands somebody dies from drug poisoning, while organised criminals are profiting.

Global commission call for legalisation of drugs

Half of all burglary, theft, shoplifting and robbery is committed by people suffering from serious addiction to drugs including heroin and crack cocaine.

Transform Drug Policy Foundation, a group that backs the regulated role for medically supervised drug taking as treatment, told The Independent there is a “rising tide” of recognition that criminalising those experiencing addiction was not working.

It added that the Government will have to rethink its opposition to drug consumption rooms as support grows.

The organisations’ director of campaigns, Martin Powell, said: “Our failed approach to drugs cannot be allowed to continue. Drug deaths are at a record high, while young people’s drug use has risen from 15 to 24 per cent in three years.

“We welcome the PCC’s recommendations, which are a sensible, real-world response to drug use and supply in the West Midlands, which we hope everyone will get behind.

“The benefits will be huge: crimes committed to fund drug use will fall, as will profits for organised crime gangs, while overdoses, HIV infections, and ambulance call-outs will be cut.”

World's 10 deadliest street drugs

Show all 10

1/10World's 10 deadliest street drugs

World's 10 deadliest street drugs

Whoonga

Whoonga is a combination of antiretroviral drugs, used to treat HIV, and various cutting agents such as detergents and poisons. The drug is widely available in South Africa due to South Africa’s high rate of HIV sufferers, and is believed to be popular due to how cheap it is when compared to prescribed antiretrovirals. The drug is highly addictive and can cause major health issues such as internal bleeding, stomach ulcers and ultimately death

Getty

World's 10 deadliest street drugs

Scopolamine

Scopolamine is a derivative from the nightshade plant found in the Northern Indian region of South America (Ecuador, Colombia and Venezuela). It is generally found in a refined powder form, but can also be found as a tea. The drug is more often used by criminals due its high toxicity level (one gram is believed to be able to kill up to 20 people) making it a strong poison. However, it is also believed that the drug is blown into the faces of unexpecting victims, later causing them to lose all sense of self-control and becoming incapable of forming memories during the time they are under the influence of the drug. This tactic has reportedly been used by gangs in Colombia where there have been reports of people using scopolamine as way to convince victims to rob their own homes

World's 10 deadliest street drugs

Heroin

Founded in 1874 by C. R. Alder Wright, heroin is one of the world’s oldest drugs. Originally it was prescribed as a strong painkiller used to treat chronic pain and physical trauma. However in 1971 it was made illegal under the Misuse of Drugs Act. Since then it has become one of the most destructive substances in the world, tearing apart communities and destroying families. The side effects of heroin include inflammation of the gums, cold sweats, a weak immune system, muscular weakness and insomnia. It can also damage blood vessels which can later cause gangrene if left untreated

World's 10 deadliest street drugs

Crack cocaine

Crack cocaine first came about in the 1980’s when cocaine became a widespread commodity within the drug trafficking world. Originally cocaine would have attracted a high price tag due to its rarity and difficulty to produce, but once it became more widespread the price dropped significantly. This resulted in drug dealers forming their cocaine into rock like shapes by using baking soda as a way of distilling the powder down into rock form. People were doing this because it allowed for them to sell cocaine at a lower quantity and to a higher number of people. The side effects of crack cocaine include liver, kidney and lung damage, as well as permanent damage to blood vessels, which can often lead to heart attacks, strokes, and ultimately death

World's 10 deadliest street drugs

Crystal meth

Not just famous because of a certain Walter H White, but also because it is one of the most destructive drugs in the world. First developed in 1887, it became widely used during the Second World War when both sides would give it to their troops to keep them awake. It is also believed that the Japanese gave it to their Kamikaze pilots before their suicide missions. After the war crystal meth was prescribed as a diet aid and remained legal until the 1970s. Since then it has fallen into the hands of Mexican gangs and has become a worldwide phenomenon, spreading throughout Europe and Asia. The effects of crystal meth are devastating. In the short-term users will become sleep depraved and anxious, and in the long-term it will cause their flesh to sink, as well as brain damage and damage of the blood vessels

World's 10 deadliest street drugs

AH-7921

AH-7921 is a synthetic opioid that was previously available to legally purchase online from vendors until it became a Class A in January 2015. The drug is believed to have 80% of the potency of morphine, and became known as the ‘legal heroin’. While there has only been one death related to AH-7921 in the UK, it is believed to be highly dangerous and capable of causing respiratory arrest and gangrene

World's 10 deadliest street drugs

Flakka

Flakka is a stimulant with a similar chemical make-up to the amphetamine-like drug found in bath salts. While the drug was originally marketed as a legal high alternative to ecstasy, the effects are significantly different. The user will feel an elevated heart rate, enhanced emotions, and, if enough is digested, strong hallucinations. The drug can cause permanent psychological damage due to it affecting the mood regulating neurons that keep the mind’s serotonin and dopamine in check, as well as possibly causing heart failure

World's 10 deadliest street drugs

Bath salts

Bath salts are a synthetic crystalline drug that is prevalent in the US. While they may sound harmless, they certainly aren’t the sort of salts you drop into a warm bath when having a relaxing night in, they are most similar to mephedrone, and have recently been featured throughout social media due to the ‘zombification’ of its. The name comes from the fact that the drug was originally sold online, and widely disguised as bath salts. The side effects include unusual psychiatric behaviour, psychosis, panic attacks and violent behaviour, as well as the possibility of a heart attack and an elevated body temperature

World's 10 deadliest street drugs

Purple Drank

One of the more unusual drugs around at the moment, purple drank was popularised in 90s hip hop culture, with the likes of Jay Z and Big Moe all mentioning it in their songs. It is a concoction of soda water, sweets and cold medicine, and is drunk due to cold medicines high codeine content, which gives the user a woozy feeling. However it can also cause respiratory issues and heart failure

World's 10 deadliest street drugs

Krokodil

Krokodil is Russia’s secret addiction. It is believed that over one million Russians are addicted to the drug. Users of krokodil are attracted to the drug due to its low price; it is sold at £20 a gram while heroin is sold for £60. However, krokodil is considered more dangerous than heroin because it is often homemade, with ingredients including painkillers, iodine, lighter fluid and industrial cleaning agents. This chemical make-up makes the drug highly dangerous and likely to cause gangrene, and eventually rotting of the flesh

Shirley Cramer CBE, chief executive of the Royal Society for Public Health, said the recommendations were welcome. “We know that diverting people suffering as a result of harmful substance use away from the criminal justice system and into treatment leads to better outcomes for the individual and for society, and we know that pragmatic harm reduction interventions, such as drug consumption rooms, heroin assisted treatment and drug safety testing, can play an extremely helpful role in that process,” she added.

“It is heartening to hear more influential voices, with on-the-ground experience of these issues, give these measures their backing.”

A Home Office spokesperson backed the move to bring together police and health partners, but added: “This Government has no plans whatsoever to introduce drug consumption rooms. There is no legal framework for the provision of drug consumption rooms in the UK.

“A range of offences is likely to be committed in the operation of drug consumption rooms. We expect local police forces to enforce the law in such circumstances.

The Insite supervised injection facility in Vancouver, Canada, provides clean equipment and medical supervision — The Insite supervised injection facility in Vancouver, Canada, provides clean equipment and medical supervision (Vancouver Coastal Health)

What’s the evidence base for drug consumption rooms and why aren’t they in the UK?

Seventy-eight consumption room facilities are in operation across seven EU countries, as well as Canada and Australia, and while the Home Office backs heroin assisted treatment it has opposed consumption rooms in the UK.

Home Office minister, Victoria Atkins, in a Westminster debate last month, said: “We have no intention of introducing drug consumption rooms,” and claimed they were not always evidence backed.

This followed efforts, by council and health chiefs in Scotland, to establish a consumption room for heroin users in Glasgow, which is currently prevented because of the risk of legal prosecution of staff.

But an evaluation of the supervised injection site “Insite” scheme in Vancouver, Canada – seen by The Independent – found it cut overdoses by 35 per cent, increased uptake of detoxification services by users, and saved more than $17m (£10.12m) by reducing new HIV infections.

It led to fewer cases of drugs consumers injecting in public spaces, and less spending on needle clear ups.

It was also not shown to increase the numbers of heroin users or crime in the area – with vehicle break-ins falling.

Canadian health chiefs involved with the scheme wrote to Ms Atkins following her suggestion that it was not evidence backed, saying her arguments were “neither factually nor legally accurate”.

In a letter seen by The Independent, they added: “We invite you and your colleagues to visit Vancouver, tour Insite and other harm reduction facilities in the city (and elsewhere in the country), and see for yourself how such facilities operate.”

Richard Elliott, one of the signatories and executive director of the Canadian HIV/Aids Legal Network, told The Independent that they too had struggled to introduce the first drug consumption rooms.

“They were a hard sell in Canada, dating back to the late 1990s, but lots of advocacy by people who use drugs, human rights advocates, public health people, some enlightened municipal people in Vancouver, eventually broke through – and significantly, this was against the unfortunate backdrop of the last major overdose crisis,” he said.

However, protests, legal action and “backsliding” under the previous Conservative federal Government have shown that progress can be wiped out.

“We’re in a very different place now when it comes to harm reduction, including drug consumption rooms – but nothing can be taken for granted,” Mr Elliott said.

“What appears to be happening in the UK now is reminiscent of what has happened over the last 20 years in Canada.”

In Scotland, the Glasgow Health and Social Care Partnership is continuing to push for a treatment room site. A spokesperson said: “Discussions are ongoing on how we can best secure the legislative framework needed to ensure the facility can open legitimately.

“With HIV infection still rising among drug injectors and drug-related deaths a persistent issue for the city, the case for the facility in Glasgow remains as compelling as ever.”