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| A fix on the state | A fix on the state |
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| By Gaetan Portal BBC News A small core of hardened heroin addicts are being supplied with the drug as part of a government backed experiment to help them get clean. The BBC has been given unique access to the scheme to hear the stories of those hoping to turn their lives around. | By Gaetan Portal BBC News A small core of hardened heroin addicts are being supplied with the drug as part of a government backed experiment to help them get clean. The BBC has been given unique access to the scheme to hear the stories of those hoping to turn their lives around. |
| It flies in the face of all official wisdom: heroin, a highly-addictive "class A" drug that commonly destroys lives, saves them. But that's the claim of Gary and Jamie - two long-term users of the drug and volunteers on a radical new treatment programme. | It flies in the face of all official wisdom: heroin, a highly-addictive "class A" drug that commonly destroys lives, saves them. But that's the claim of Gary and Jamie - two long-term users of the drug and volunteers on a radical new treatment programme. |
| What's more, the heroin they believe saved them from an early grave was supplied and paid for by the state. | What's more, the heroin they believe saved them from an early grave was supplied and paid for by the state. |
| If I was on methadone and occasional street drugs... I would have died from liver cancer Gary Heroin clinic 'reduces use' Gary, 45, is one of a small group of hardened heroin users who have been attending clinics for two years as part of a controversial experiment jointly funded by the Home Office and the Department of Health. | If I was on methadone and occasional street drugs... I would have died from liver cancer Gary Heroin clinic 'reduces use' Gary, 45, is one of a small group of hardened heroin users who have been attending clinics for two years as part of a controversial experiment jointly funded by the Home Office and the Department of Health. |
| In London, Darlington and Brighton, users visit clinics daily to inject themselves with diamorphine - the clean, unadulterated form of heroin. | In London, Darlington and Brighton, users visit clinics daily to inject themselves with diamorphine - the clean, unadulterated form of heroin. |
| The addicts take the drugs under the supervision of a dedicated team of nurses and clinicians in a special but simply furnished room. There are four chairs that are screened from each other with a small work surface. It's here that the addicts keep their equipment while they prepare to inject. | The addicts take the drugs under the supervision of a dedicated team of nurses and clinicians in a special but simply furnished room. There are four chairs that are screened from each other with a small work surface. It's here that the addicts keep their equipment while they prepare to inject. |
| HEROIN CLINICS so far cost £2.5mpaid for by Home Office and Department of Healththere are 150 usersa third of addicts use methadone orally, a third inject methadone and a third inject heroin (diamorphine) There are cupboards for storage and a sink. All the addicts must wash their hands before taking their heroin. Compared with the kinds of places where some addicts take their drugs, this is a different - clinical - world. | |
| And this clinical approach is key to the programme's aims. | And this clinical approach is key to the programme's aims. |
| Addicts don't respond | Addicts don't respond |
| Treatment for hard-core addicts tends to have two aims: to stabilise drug use to cut out criminality, or to slowly reduce drug use and ultimately end addiction. The problem is that some addicts do not respond to schemes that try to replace heroin with methadone - and may end up taking both drugs. Others respond to methadone - but remain involved in crime and susceptible to relapse because of a chaotic life. | Treatment for hard-core addicts tends to have two aims: to stabilise drug use to cut out criminality, or to slowly reduce drug use and ultimately end addiction. The problem is that some addicts do not respond to schemes that try to replace heroin with methadone - and may end up taking both drugs. Others respond to methadone - but remain involved in crime and susceptible to relapse because of a chaotic life. |
| Hygienic environment: The cubicles where addicts injectThis controversial experiment aims to help some of the most difficult addicts in the country rebuild their lives by giving them the drugs they crave, for free. But to stay on the scheme, addicts must be clean of street drugs and regularly attend counselling sessions. | Hygienic environment: The cubicles where addicts injectThis controversial experiment aims to help some of the most difficult addicts in the country rebuild their lives by giving them the drugs they crave, for free. But to stay on the scheme, addicts must be clean of street drugs and regularly attend counselling sessions. |
| So does it work? | So does it work? |
| Initial results of the pilot programme have been a big reduction in drug use, according to medical staff at the London clinic. | Initial results of the pilot programme have been a big reduction in drug use, according to medical staff at the London clinic. |
| Gary, an addict since he was 17-years-old, says the effects were profound. | Gary, an addict since he was 17-years-old, says the effects were profound. |
| When he was using street drugs he exposed himself to another type of risk associated with intravenous drug taking: Hepatitis C, which he was diagnosed with in 1983. Now he attends the clinic twice a day, every day, to inject himself - and has just finished a six-month treatment which has cleared him of the disease. He was only given the treatment, he says, because he was part of the supervised heroin injecting trial. | When he was using street drugs he exposed himself to another type of risk associated with intravenous drug taking: Hepatitis C, which he was diagnosed with in 1983. Now he attends the clinic twice a day, every day, to inject himself - and has just finished a six-month treatment which has cleared him of the disease. He was only given the treatment, he says, because he was part of the supervised heroin injecting trial. |
| "Just because I am addicted to one of the most addictive substances on the planet am I to be written off as a human being and not get any respect from the Health Service?" he says. | "Just because I am addicted to one of the most addictive substances on the planet am I to be written off as a human being and not get any respect from the Health Service?" he says. |
| Avoid underworld | Avoid underworld |
| "If I was just on methadone and occasional street drugs I wouldn't have been given that and I would have died from liver cancer in the next few years." | "If I was just on methadone and occasional street drugs I wouldn't have been given that and I would have died from liver cancer in the next few years." |
| In June, the chief constable of Tayside police called for 'legal heroin'As with all those on the scheme, Gary takes the drugs under the supervision of a dedicated team of nurses and clinicians. While this may in itself be controversial, one of the effects is that the addict who sticks to the rules avoids the underworld of crime and drug dealers that dominated their lives when they were reliant on street drugs for their daily fix. | In June, the chief constable of Tayside police called for 'legal heroin'As with all those on the scheme, Gary takes the drugs under the supervision of a dedicated team of nurses and clinicians. While this may in itself be controversial, one of the effects is that the addict who sticks to the rules avoids the underworld of crime and drug dealers that dominated their lives when they were reliant on street drugs for their daily fix. |
| Jamie too says the state-sponsored heroin saved her life. | Jamie too says the state-sponsored heroin saved her life. |
| For the 39-year-old the memory of what life was like before she took part in the trial keeps her on the straight and narrow. | For the 39-year-old the memory of what life was like before she took part in the trial keeps her on the straight and narrow. |
| "It was horrible, I was miserable, I was self harming all the time. I lost all me belongings, I lost my children because of drugs, my family had enough because of what I was doing. I had put them through the mill and they couldn't cope." | "It was horrible, I was miserable, I was self harming all the time. I lost all me belongings, I lost my children because of drugs, my family had enough because of what I was doing. I had put them through the mill and they couldn't cope." |
| She has been to prison 28 times, mainly for theft to feed her habit. But she says she has not committed an offence since she started getting her heroin on the NHS and knows that the trial has turned her life around. | She has been to prison 28 times, mainly for theft to feed her habit. But she says she has not committed an offence since she started getting her heroin on the NHS and knows that the trial has turned her life around. |
| "I was like a bag of bones when I come here. So when they brought the clinical trials out... well it saved my life really. I don't know what I would have done without it." | "I was like a bag of bones when I come here. So when they brought the clinical trials out... well it saved my life really. I don't know what I would have done without it." |
| Such results don't come cheap. | Such results don't come cheap. |
| More expensive | More expensive |
| The costs for treating each addict works out at between £9,000 and £15,000 a year, three times as much as treating them with heroin substitutes like methadone. | The costs for treating each addict works out at between £9,000 and £15,000 a year, three times as much as treating them with heroin substitutes like methadone. |
| 'Shooting gallery' in Vancouver: Other countries have similar methodsDr Nicola Metrebian, who manages the clinical trials, acknowledges that supplying the addicts with the specially imported heroin is a heavy financial investment. | 'Shooting gallery' in Vancouver: Other countries have similar methodsDr Nicola Metrebian, who manages the clinical trials, acknowledges that supplying the addicts with the specially imported heroin is a heavy financial investment. |
| "It is more expensive than standard treatment," she says, "but what we do know is that standard treatment, although it is cheaper, is not effective for this group of people." | "It is more expensive than standard treatment," she says, "but what we do know is that standard treatment, although it is cheaper, is not effective for this group of people." |
| An addict for 20 years, Christine says her daily routine when she was on street drugs was fraught with risk. | An addict for 20 years, Christine says her daily routine when she was on street drugs was fraught with risk. |
| "You got to go to places, certain housing estates and certain areas that are not exactly nice places to go. You are at risk of being mugged or being sold rubbish by other addicts." | "You got to go to places, certain housing estates and certain areas that are not exactly nice places to go. You are at risk of being mugged or being sold rubbish by other addicts." |
| The final results of the programme won't be known for another year, but in London doctors and nursing staff say they have seen lives stabilised. | The final results of the programme won't be known for another year, but in London doctors and nursing staff say they have seen lives stabilised. |
| Politicians will have to judge if the benefits of supplying free heroin outweigh the costs. They will also have to consider whether the scheme risks undermining the government's hard line drug strategy. | Politicians will have to judge if the benefits of supplying free heroin outweigh the costs. They will also have to consider whether the scheme risks undermining the government's hard line drug strategy. |
| For the time being, the clinic will remain open seven days a week, 365 days a year. It is a labour-intensive scheme - but supporters think it could ultimately help 5% of all heroin addicts. | For the time being, the clinic will remain open seven days a week, 365 days a year. It is a labour-intensive scheme - but supporters think it could ultimately help 5% of all heroin addicts. |
| Jamie is convinced that for addicts like her supervised drug injecting rooms are the way forward. | Jamie is convinced that for addicts like her supervised drug injecting rooms are the way forward. |
| "It's just going to save the government so much money in the long run. So I say yeah, do open up as many clinics as you can, all over the world. I think it's a brilliant idea." | "It's just going to save the government so much money in the long run. So I say yeah, do open up as many clinics as you can, all over the world. I think it's a brilliant idea." |
Add your comments on this story, using the form below. | Add your comments on this story, using the form below. |