Pubdate: Sat, 20 May 2000
Source: Sunday Herald, The (UK)
Copyright: 2000 Sunday Herald
Contact:  195 Albion Street Glasgow G1 1QP
Fax: +44 (0)141 302 7809
Website: http://www.sundayherald.com/
Author: Stephen Naysmith

DRUGS EXPERT: PRESCRIPTION HEROIN WOULD STOP DEATHS

The man in charge of Scotland's leading charity tackling drug misuse has
warned that prescribing heroin to addicts might be the only way to stop the
growing number of mystery deaths.

"We need to stop people taking the drug, but we can't remove the heroin from
the market. If the deaths continue we may have to prescribe extensively
across the city and kill the market," said Andrew Horne, regional manager of
Turning Point.

Health boards, drug agencies and police are still baffled by the spate of
unexplained deaths from multiple organ failure among Scottish drug users.

The illness, which has affected 25 people and killed 11 since the beginning
of the month, has spread panic throughout the drug-using community and
dismayed those working to help addicts.

However, warnings from health boards in Glasgow, and also Grampian,
Lanarkshire and Stirling, where suspected cases are also under
investigation, that users should smoke rather than inject the drug is
ignored because addicts crave the "rush" of injection.

What is now being discussed is not the sustaining of drug users on heroin
substitute methadone, common practice for addressing addiction, but the
prescribing of diamorphine, heroin in pharmaceutical form and "the next step
up", according to Horne.

Dr Laurence Gruer, senior consultant in public health medicine with the
Greater Glasgow Health Board, said the idea merited serious consideration.

"We know, particularly from controlled trials in Switzerland, that
prescribing heroin can work where other means of treatment have failed," he
said.

However, British doctors must be specially licensed to prescribe controlled
drugs to addicts.

Dr Gruer also admitted there would be enormous practical problems in
addressing the current crisis with diamorphine prescriptions. "The size of
the drug problem is so big that to make a real dent on the market you would
have to set up a huge number of clinics," he said.

Such drastic tactics may be warranted, according to Horne, because the
current situation is putting drug agencies in a quandary. Turning Point's
Glasgow Drug Crisis Centre has been seeing hundreds of addicts a day since
the crisis began. Most say they will not give up injecting the drug, and are
still "skin-popping"-injecting directly into muscle or tissue.

"It is creating some serious dilemmas for us. We are managing the busiest
needle exchange in Scotland and if people tell us they are injecting, what
can we do? If you don't give people needles then they are at risk of
hepatitis and HIV," Horne said.

Scottish Socialist MSP Tommy Sheridan, whose party backed the provision of
legalised heroin for addicts in their manifesto for election to the Scottish
parliament, said: "People are now realising that it is the safest way of
approaching a chaotic drug problem."
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