Decriminalize Heroin and Cocaine, says top U.K. Doctor

The Star

A debate over the decriminalization of heroin and cocaine has erupted again in Great Britain after a private statement by the one-time head of the Royal College of Physicians was leaked to a drug-reform campaign group and the media.

Sir Ian Gilmore, the former president of the Royal College of Physicians, made the statement about his feelings on the country’s drug policies in a private bulletin to the members of the college.

In it he called for a change in tactics, decriminalizing illicit drug use and treating addiction as a health problem not a criminal problem.

The two-line statement, which was leaked to Transform, a drug-reform campaign group, was private, Gilmore said in a telephone interview Wednesday with the Star. But he was “happy” to defend it.

“My position is since 1971 successive governments have pursued a policy that we should be a society free of hard drugs, stop them from getting into the country and prevent growth in production and if people use them put them in prison,” said Gilmore.

“My point is that it has not succeeded and it is time to have a debate about a more pragmatic approach and treat heroin addiction as a health problem rather than a criminal problem.”

Gilmore made the statement after a recent analysis in the British Medical Journal that convinced him the country’s drug policy for Class A drugs such as heroin had failed, he said.

The editorial said the prohibition of drugs was “counterproductive,” made public-health problems worse, and stimulated organized crime and terrorism.

His call for a re-thinking of the drug laws in Great Britain comes on the heels of comments made by the chairman of the Bar Council of England and Wales, who said last month it was “rational” to consider “decriminalizing personal drug use.”

Gilmore believes that more money should be put into medical resources to deal with heroin addiction, for example, rather than spending money on trying to stop the production or importing of drugs.

He also made the point in his statement that in the United Kingdom there have been a number of encouraging trials with heroin addicts that resulted in those individuals returning to work because they were no longer committed to criminal behaviour to support their habit.

As a physician he has seen all too clearly the medical complications – HIV and hepatitis C – that come from heroin addiction and the use of dirty needles, he said. “I’m not suggesting anyone go down to the street corner and buy heroin.”

Rather he would like to see a regulatory framework set up to allow these drugs to be controlled by law. “It’s not a radical approach,” he said. “Many others have said it.”

Many British politicians and opposition members have expressed that view privately, Gilmore said. But there are huge pressures on government to adopt and continue a tough-on-drugs policy.

Keith Vaz, the chairman of the House of Commons home affairs select committee, has said in the Telegraph that the legalization of drugs “would simply create the mistaken impression that these substances are not harmful, when in fact this is far from the truth.”

But Gilmore rejects the position that his position sends a message that Class A drugs aren’t dangerous. “That’s not our intention,” he said. “Heroin ruins lives, he said. “If there was a change in the way addiction was managed, it would also have to come with an information campaign.”

In 2000 a Royal College of Physicians report, with the Royal College of Psychiatrists, said there were no easy answers to the problem of drug misuse in society.

At the time the report said “three-quarters of the U.K.’s expenditure on drug-related problems is devoted to enforcement and international supply reduction, but that there is little evidence that the money is well spent,” according to a statement on the Royal College of Physicians website.

The report also identified a need for more investment in research to understand the ill-effects of drugs and in-treatment programs for addiction. The authors called for a public debate on the issue.

In a statement the Royal College of Physicians said it plans to review the findings of the report with the Royal College of Psychiatrists under the leadership of its new president.

Gilmore’s statement has been praised by Transform, saying his statement was the “nail in the coffin” on current drug laws in Britain, the Telegraph said.

Drug Experts Defend Methadone Use

BBC News

Leading medical experts have warned that scrapping methadone as a treatment for heroin addiction could lead to a rise in crime, HIV and drug deaths.

 

A group of 40 specialists from around the world have outlined their concerns in a letter to The Scotsman newspaper.

The experts expressed dismay about the "continuing misrepresentation" of the evidence on the effectiveness of the treatment.

They said methadone should be readily available to all addicts seeking help.

The group - which includes university professors and doctors who treat addicts - wrote in the letter: "No treatment in medicine works every time but methadone treatment has helped more people in the world overcome their problems with heroin than any other."

It went on: "If policy makers were to heed the critics' advice to close down methadone treatment or impose an arbitrary time limit on its administration, the community can anticipate more overdose deaths, more HIV and more crime."

The letter is a response to comments from Professor Neil McKeganey, director of the Centre for Drug Misuse Research at the University of Glasgow, who said last week more effort was needed to get people off drugs, including methadone, through abstinence and drug treatment.

Professor McKeganey has defended his views and claimed the signatories to the letter did not understand the extent of the drugs problem in Scotland, where 22,000 addicts are on methadone.

State of dependency

He said: "Much of the methadone programme in Scotland is not about getting people off, it's about continuing them in a state of dependency."

He claimed there were now parts of Scotland where there were more addict deaths associated with methadone addiction than heroin.

"We don't see the evidence of stabilised addicts. You walk around the streets, you see people in the most desperate of circumstances."

But the man who organised the letter in The Scotsman, Dr Roy Robertson from the Royal College of General Practitioners in Scotland, said removing methadone would cause many more problems.

He told BBC Scotland: "A decrease in availability of methadone would give rise to all sorts of things - increasing sudden deaths, blood-borne virus spread, HIV infection, hepatitis C infection and all that social problem area that ends up with people in custody, and causes violence and criminality.

"There's a huge amount of unhappiness for people and their families and lives and communities blighted and devastated by the problems related to drug use and heroin addiction."

The letter in The Scotsman ends by calling on policymakers to be clear about the value and importance of methadone treatment.

Hard Fight to Kick Heroin Behind Bars

Seattle Post-Intelligencer

LONGVIEW, Wash. -- On Dec. 22, police came to Drew Waldo's Kelso home, arrested him on a warrant, and took him to jail. Waldo, who had used heroin just before his arrest, rode the high through the night, laying on a mattress on the floor of a medical ward cell occupied by six other inmates.

By 6 a.m., he was sweating, waves of hot and then cold washing over him. An hour later, he was crawling across the concrete floor to throw up in a metal toilet in the corner.

"Your body aches. Your bones hurt," Waldo said. "You feel like your legs are growing like you're having growing pains."

He recalls thinking: "I wish I was dead."

The resurgence of heroin addiction has brought an increasing number of detoxing inmates like Waldo into the Cowlitz County Jail's medical unit. The jail books between eight and 12 inmates each week who will become severely ill as they quit heroin and sometimes alcohol the drugs that create the most complications when people stop using them.

The problem has consequences for the jail and society: Withdrawal can spark arguments and fights as jittery withdrawing prisoners stink up cells with vomit and feces and pace through he night. Detoxing inmates sometimes refuse to go to court because they feel too sick to move. Some smuggle in drugs in an effort to avoid the pain altogether. And a few offenders overdose shortly after their release because they are no longer used to high heroin doses.

The jail also regularly admits inmates who are high on methamphetamine, corrections officials said. But in most cases those offenders merely sleep for several days. Heroin and alcohol detoxers are the most tricky, according to jail staff. Their muscles cramp. They sweat. They vomit. They have diarrhea over several days.

"It's just nasty," Marin Fox Hight, the director of the county's Department of Corrections, said of watching an inmate come off heroin.

Withdrawal is the creeping, sinking sensation a heroin addict fights like mad to keep at bay. Break the car window to get the wallet to get the money to score the heroin to stop the withdrawal. Slip the DVDs under your coat and walk out of the store to trade them for heroin to stop the withdrawal. And on it goes.

Invariably they get caught, and they end up facing the thing they hoped at all costs to avoid - this time in a loud, concrete cell with a single toilet, no privacy and no hope of stopping it.

"Jail's the only place I've ever been able to stop using. You know you can't get it." said Kevin Kennedy, 27, of Longview, who detoxed in the lockup last month after being arrested on suspicion of prowling cars and using stolen credit cards to buy thousands of dollars in electronics.

The jail's medical unit can provide detoxing inmates with array of prescription drugs Methcarbamol (a muscle relaxant), Bentyl (for relieving spasms in the digestive system), and Promethazine (to control itching and relieve nausea.) But really, Fox Hight said, there's little the jail's small medical staff can do. The detox simply needs to run its course.

Kennedy, who spent about a week coming off heroin following his arrest, said he avoided the jail's medical unit, which is staffed by a nurse and provides liquids and mild medications to help with muscle cramping and nausea.

"It really doesn't do anything for you," he said.

Instead, Kennedy chose to detox among the jail's general population, where sympathetic inmates who have been through the same thing might help. For the first three days, he said, he couldn't eat, so he gave away his meals. In exchange, inmates provided candy - which detoxers crave to replenish blood sugar. They also shared their coffee, which "is a big thing if you're coming off heroin," he said.

When he was released more than two weeks later, Kennedy said, "I still wanted to use. I wanted to use more than anything in the world."

Kennedy is expected to appear in court on the prowling and theft charges later this month.

"A lot of them are pretty needy," said Maureen Clement, 52, of Kelso, who has worked as a corrections officer at the jail for two decades. "It's sad. They really suffer a lot. The crazy thing is they keep coming back on the same thing."

Some inmates, she said, die of overdoses shortly after they're released, probably because their bodies are no longer accustomed to the high doses of heroin they were taking before incarceration. Others, Clement said, smuggle drugs in to avoid the pain of withdrawal. Corrections officers, she said, sometimes find drugs stuffed into inmates' orifices.

Asked how much heroin and other drugs are being smuggled into the jail, she said, "We have no idea. My personal opinion is there's more than we can imagine."

Detoxing inmates that have been allowed into the jail's general population are sometimes moved into the medical unit because other inmates complain. Clement recalled a woman coming off heroin who lost control of her bowels in the shower. The other inmates "got real angry and made sure that we got her out of there," Clement said.

Offenders in the general population "don't want someone in there that's real sick because it smells and they're locked in there with them," she said.

Waldo, who detoxed in the jail last month, said cell mates become angry quickly as sleepless, detoxing inmates pace through the night and repeatedly get sick.

"People get pissed off. Arguments it leads up to fights. You're still throwing up and everybody's getting mad at you," said Waldo, who said he's been clean for nearly two months after using heroin for seven years.

Alcohol detox is almost as hard as for heroin, jail staff said. Take the example of Colby Harris, who was arrested after witnesses reported seeing him naked, covered with blood and feces and stealing neighbors' mail, as well as a checkbook and car stereo faceplate in September of 2008.

"I was just blacked out on drugs and alcohol," Harris said. "I don't remember walking around naked with crap all over me, but I can't deny it either."

He said he was so drunk police had him checked out at St. John Medical Center before he was booked into the jail. In the medical ward, he said, his blood pressure spiked. He thought he'd have a heart attack.

"It was horrible. Absolutely horrible," said Harris, who is 39 and drank and used meth until just more than a year ago. "Nightmares. Sweats. It's indescribable. I can't tell you how bad it is. ... You can't stay still and you can't stay warm. They give you a blanket and the mattresses in there are just like a sheet. They're all worn and flattened down."

Harris, who used to work on fish and crab boats in Alaska and now studies journalism at Lower Columbia College, said time lost all meaning as he was "stuck in a concrete box with no clock."

Corrections officers said they check on detoxing inmates about once each hour, depending on how sick they are. But Harris said he wondered if anyone would be there to help him if his body failed.

"Sheer loneliness," he said. "You go through a lot of mental anguish. It's a part of the process. It can last three or nine days. Horrible nightmares. Depression. Vomiting. Nausea. Cold sweats. Heart palpitations. Fear. And then on top of that being confined."

When Harris got out he enrolled in the county's Drug Court program. He said he relapsed on New Year's Eve 2008, then, still drunk, turned himself in five days later. He had to detox in the jail all over again.

"By the third day I was on my knees praying: This is enough for me, God,'" he said.

Program Offers Addicts A Glint Of Hope

Baltimore Sun

When Heather Spiker graduated recently, there was no cap and gown, no pomp and circumstance. But for the first time in her adult life, Spiker said, there was hope.

Spiker, 37, was one of nine people to complete Howard County's drug and DUI court program during a ceremony in District Court. The program was set up in 2004 to give nonviolent repeat offenders a chance to rehabilitate themselves rather than go - or return - to jail.

"We see them when they're sick, down and out," said Bobbie Fine, a former defense attorney and prosecutor who has coordinated the program since its inception. "This program saves the state money [in terms of incarcerations] and it's given these people a life, self-worth."

According to Fine, Spiker is one of the program's biggest successes.

It has given the Baltimore native an opportunity "at life" after years of what she described as an addiction to alcohol and drugs - including heroin - that resulted in nearly two dozen arrests since 2000 and as many incarcerations of varying lengths in detention centers throughout the state.

Asked when she was in jail, Spiker said, "When wasn't I in jail?"

Through court order, Spiker said, she spent 15 months in drug treatment programs, first at the Shoemaker Center in Sykesville and later at The W House, a Hagerstown residential halfway house for women in the early stages of drug-addiction recovery.

She has reunited with her two sons, ages 18 and 14, whom she said she hadn't seen in five years because of her addiction.

The celebrations of Thanksgiving and Christmas this year have special meaning to Spiker, who spent many previous holidays either in jail or homeless.

"Holidays and having family around, and friends and a network and being on the way to recovery, that's a pretty special thing," she said. "You're really in touch with reality and spirituality and just with life. When you get all of that back, and you have time for love, it's a pretty special thing."

Though Spiker twice relapsed after starting the program after an arrest in Howard County in 2007 for possession of heroin, she said that the difference between this program and others she had been at came from the compassion she felt from District Court Judge Neil David Axel and the support she received from Fine and others involved.

"It wasn't just to lock me up and throw away the key," Spiker said. "I would get arrested and there was no help available, at least not through any kind of court. When I reached this program, it was like they had faith in me way before I had faith in myself. This is a hard program to go through, especially for an addict. Structure is what I needed."

The drug rehab programs are set up to take a year, but Fine acknowledge that many, including Spiker, take longer because of their continuing battle with drugs and alcohol.

"It's very difficult to say to somebody, 'From this day on, you'll never use [drugs or alcohol],' " Fine said. "You won't say they will [relapse], but there's a good chance they may. We don't throw them out the first or second time if they're doing everything else that we require of them."

As for Spiker, who was chosen as the heroin addiction treatment program participant to speak at the graduation ceremony, Fine said, "We knew how hard Heather was trying, and she proved us right. We had faith in her, we thought she could do it. She had been doing so well, when she did relapse. But she had the determination. We didn't want to give up on her."

Spiker said that her problems with addiction began shortly after graduating from high school in Woodstock, Va., where she had gone for her senior year after leaving Catonsville because her mother was having her own problems with an addiction that would eventually kill her.

"She died in my arms when she was 44," Spiker said.

Returning to Baltimore, Spiker got a job doing clerical work, but to earn extra money, began bartending on The Block. Spiker said that the bartending job led to her becoming an exotic dancer and later a prostitute. Her first arrest came when she tried to buy drugs while she was a prostitute.

"The last 10 years were pretty crazy," she said. "I lived on the streets in Baltimore. I worked Wilkens Avenue, Washington Boulevard, all those areas, for years. I lived in abandoned houses, in alleys in the summer, wherever I could. I was going in and out of jails and institutions."

Kerri Robinson, the lead addiction counselor at The W House, said that Spiker had "hit rock-bottom" when she arrived and was "ready to surrender, knowing that she was totally powerless to overcome her addiction by herself."

Since her graduation, Spiker has moved to Jersey City, N.J. She starts a new job in New York on Dec. 15.

She knows her battles aren't over, but she is confident that she will not relapse. Spiker knows what the alternative is. "There's no going back. If I go back, I will die," she said.

Heroin Addict Begs For Prison Detox Treatment

from the Border Telegraph

A PETTY criminal who claimed he got hooked on heroin after being sent to prison begged a Sheriff to send him back so he could rid himself of the drug.

At Selkirk Sheriff Court on Monday, Campbell Ledgerwood, 37, of Whitefield Crescent, Newtown St Boswells, admitted stealing a bottle of whisky - worth £20.49 - to fund his habit from Somerfield supermarket in Galashiels on August 31.

He claimed he only got hooked on the Class A drug after being sent to alcohol detox at Saughton Prison in Edinburgh to recover from his alcohol addiction while serving a custodial sentence for another offence earlier this year.

However, Sheriff Kevin Drummond, who claimed the public would be "comforted" to know drugs were "in abundance" at the high security jail, refused his request and instead fined him £200.

Passing sentence, he told Ledgerwood: "It's not for you to decide the appropriate disposal. There are facilities in the public domain to deal with drug addiction.

"The only appropriate disposal in this case is a financial penalty." And he added: "It would have been £300 but for your early guilty plea."

The court heard the convicted thief had previously sought help to get clean from The Borders Community Addictions Team (BECAT), a local health board initiative which offers a service to residents in the region who are having problems with substance misuse.

But, despite recovering from his alcohol addiction, he is still in need of Heroin addiction treatment.

Ledgerwood's solicitor Hannah Jones explained: "He stole the whisky to fund a heroin habit which he developed while serving a custodial sentence earlier this year and he's asked whether a custodial sentence would be considered today so he can detox inside.

"He's 37-years-old and has been in and out of custody most of his life.

"Since he came out of jail in April, he has made contact with BCAT and been in Huntlyburn (hospital) but the detox wasn't working for him and now he wants to go cold turkey."

Procurator fiscal Morag McClintock revealed the bottle of whisky was recovered by police. She said: "He (Ledgerwood) admitted he stole it to fund his drug habit. He told police that he wanted to be locked up so he could get off drugs."

However, despite walking free from court, Ledgerwood could still find himself back inside. Leaving the dock after being fined, he retorted: "I'm not paying it."

The Scottish Prison Service revealed more than 2000 drug finds were recorded in the country's jails in the 15 months up to March 2009. But it insisted it was working hard to cure the problem.

A spokesman for the Scottish Prison Service told the Border Telegraph: "Drugs are a problem in prison in the same way as they are a problem in society as a whole.

"However, SPS tackles the issue with vigour through the use of sniffer dogs, intelligence and the use of sophisticated technology to find or intercept drugs.

"New legislation which the government has proposed will tackle the use of mobile phones which are used in prison in drug trafficking. Mobile phone possession will become an offence and SPS will also take steps to block their use.

"But SPS also work hard with other agencies to tackle addictions while people are in prison and to support those prisoners keen to leave prison addiction-free."

The Scottish Government said it does not comment on individual cases and pointed out sentencing was a matter for the courts. However, a spokeswoman said it was investing record funding in alcohol treatment programs to help more people recover from drug misuse.

Local MSP Jeremy Purvis, a former member of the Scottish Parliament's Justice Committee, said: "Radical reforms are needed to reduce the availability of drugs in our jails where we expect security to be tighter."