Heroin prescription can be a vaccine against a broken society

In the couple of days between the arrest and the charging of Stephen Griffiths this week I made desperate attempts to contact all 3 Bradford MPs, driven by the knowledge that I would struggle to forgive myself if the arrested man was not the killer and if further women were to die.

On reflection I am struggling to convince myself that I'm not partially responsible for their deaths anyway. I've known for over a year now how to prevent young women engaging in street prostitution to fund a drug habit, but in that year I have failed to effect change in our drug policies towards heroin and the poor people who find themselves needing to take it. It's not a happy place to be. But I can't imagine how it must feel to know the solution as I do, have considerably more power to effect the necessary change, but yet choose to say nothing for "political" reasons. Perhaps such people hold the same prejudices that they project onto the population and genuinely see the street prostitutes of the UK as not worth the hassle.

So to the solution. How do we stop young women dependent on heroin from working on the streets to pay for it? It's simple really. We look at the evidence on the most cost-effective way to treat their condition and we apply the solution that we know works. The results of the British trials of maintenance heroin have finally been published and they confirm the results from all of the other trials carried out in the last 10 years. Heroin works. Methadone is a poor second best.

If such disparity was demonstrated between the effectiveness of two drugs for any other medical condition - and the NHS continued to resist offering the more effective option - the sufferers, their families and friends would go nuts. In all likelihood the general population wouldn't be happy either.

Dependent drug users as a group on the other hand might struggle to summon the self-esteem, their families might struggle to break through the stigma and large sections of the population would quite likely express considerable revulsion at "their" taxes being spent on people who have "chosen" to take drugs.

Hang on a minute. If using heroin is a choice is smoking tobacco an innocent mistake? In the interest of consistency should we not cease the treatment of smokers for lung cancer, chronic pulmonary diseases, heart disease, stroke etc? Hmm, how long do we let them burgle, prostitute and generally make a nuisance of themselves to pay for their treatment privately before we decide to give them a chance on the NHS? And smoking is an educated choice. It says it's going to give you cancer on the bloody packet! Surely by Daily Mail comment contributor logic all the smokers visiting GPs saying "I have breathing difficulties" should be greeted with "Well Duh!" and shown the door. No drug dealer is going to last very long in the trade if he passes on similar health warnings to his clients. Imagine "Before you try your first hit I should say that heroin is an extremely physically addictive drug and with your economic and social situation as it is you will likely be considering prostituting yourself to feed your habit within a month." If heroin is a choice, then eating lots and sitting on the couch is a choice. Raising your blood pressure ranting at liberals who want to give junkies heroin on the NHS is a choice. To hate the prospect of heroin on the NHS is to hate the NHS itself and the assistance it gives to all those who need it regardless of colour, creed or the ill-advised choices that cause you to need it.

And it's not just the dependent user who benefits from prescription. Obviously the families of addicts would be saved considerable anguish. The children especially might not be removed by authorities now that the parents have chaotic money and drug-seeking removed from their daily routine. The parents might be able to hold their children as their number one priority.

The communities that dependent users live in might be spared the up to 80% of domestic burglaries that dependent users commit and the over 50% of acquisitive crimes in general. They might be spared the desperate sight of street prostitutes working in their neighbourhood.

Most importantly though, bringing a heroin addict into the care of the state removes a customer for the local dealers. The more problem drug users you treat, the less customers there are for the local dealers and the less viable their occupation. In many cases the dealer will themselves be dealing to fund a habit of their own. Give them prescribed heroin and the need to fund their habit in that way disappears. Give a whole heroin-using community prescribed heroin and the dealers who would seek to expand that community lose their livelihood and need to find something else to do with their time. Effective treatment of heroin addicts can end further recruitment of young people into that lifestyle. The risk of further daughters becoming drug-addicted street prostitutes becomes infinitessimal.

The debate on heroin prescription is currently centred around whether we should make it available as a second-line treatment for people who have failed to cease street heroin use while receiving methadone. The progressive goal here is really uninspiring though. There are tens of thousands of unemployed, vulnerable young people who are at risk of falling into the dependent user lifestyle. I believe we should make a concerted effort to block that path. I believe we should be identifying as many problem drug users as possible and giving them their drug of addiction for free (at least at first). Only then do we have an opportunity to end the culture of street heroin and its capacity to spread into another generation. It is utterly bizzarre that we should tolerate people stealing from us, prostituting themselves and trying to get our children hooked on heroin. We have to consider vaccinating our society to halt the spread of this menace.

We did nothing to improve the way in which we treat addiction after 5 addicts who worked as prostitutes were murdered in Ispwich in 2006. We have done nothing to halt the drug-related death rate doubling in Scotland over the last 10 years. Another 3 addicted women have now been murdered by a serial killer in Bradford. This is not the time to play catch-up with the progressive policies of our European neighbours. It is time to make up for lost time and innumerable lost lives. It is time to treat addicts with humanity, treat addiction as an illness, and credit the British people with the intelligence and the compassion to understand why such action is required.

It's unclear which of Clegg and Cameron most supports drug policy reform.

The Telegraph has uncovered Nick Clegg's past support for drug policy reform http://bit.ly/bxJNC2, but has it uncovered David Cameron's http://bit.ly/c8a9ee

The party leaders are both very sensible on the issue of course... at least they were before they had an election to fight.

I suppose the Telegraph was intending to put Clegg on the back foot with this. He should express no regret. Rather he should ask why David Cameron expressed similar opinions in the past and has chosen to retreat back to the supposedly populist standard political position.

Only the liberal democrats are willing to consider evidence on drugs policy. Gordon Brown has stated clearly that considering evidence is not something he is interested in (http://bit.ly/8UfYgK). And the conservatives remain committed to fanciful notions of enforcement-led intervention and abstinence-based Drug Rehabilitation Orders.

The Telegraph may also kick themselves when they realise they have timed their article (I presume unintentionally) to coincide with a dramatisation of the lives of the five young women murdered by Steven Wright in Ipswich in 2006.

Five Daughters will start tonight at 9pm on BBC1 and its relevance to drug policy is highlighted by executive producer Susan Hogg's words on BBC Breakfast earlier in the week explaining why she wanted to make the film:

"Paula Clennell (one of the murder victims) gave an interview where she talked about having to go out on the streets because she needed the money and I suddenly realised that this was about drugs and not about these girls being on the street. Up until that point everyone had talked about them being prostitutes... there was nothing to do with who they were and I really felt I wanted to explore the victims and who these young women were and particularly because i knew it was about drug addiction and that was really really important."

A TV writer who has seen it already has confirmed to me that the film could have a really big impact on people's prejudices about drug abuse and street prostitution. The Telegraph has handily highlighted Nick Clegg's support for heroin to be made available under medical supervision. I hope many voters will recognise that the best way to ensure more daughters do not end up addicted to heroin and funding their habit through street prostitution is to implement that very policy.

An emergency motion on anthrax-contaminated heroin and draft supporting speech

Conference notes with concern:

That 21 injecting heroin users have contracted anthrax infections from contaminated heroin in Britain since December last year, with 10 of these infections proving fatal.

That the Health Protection Agency advice issued in response to this developing crisis is unlikely to reach injecting heroin users and unlikely to significantly change their behaviour, and that treatment service availability is often insufficient if users do seek help.

Conference further notes:

A growing number of European states are providing treatment-resistant heroin addicts with pharmaceutical heroin for supervised consumption and have observed considerable benefits both to the patient and to the wider community as a result of this practice.

That experience from these countries and from trials in the UK show heroin to be considerably more effective than methadone in improving patient and societal outcomes.

Conference believes:

The enjoyment of the highest attainable standard of health is one of the fundamental rights of every human being without distinction of race, religion, political belief, economic or social condition.

Provision of alternative pharmaceutical sources of heroin to injecting heroin users in the geographical areas affected would not only protect them from the risk of anthrax infection, but protect the communities in which they live from the criminality they are often compelled to engage in to service their addiction.

Conference therefore calls for:

The United Kingdom authorities to expand provision of clinics where addicts can use pharmaceutical heroin under medical supervision, with urgent priority given to regions affected by anthrax-contaminated heroin.

Potential speech:

The killer stalking heroin addicts in Britain today is the same killer that provoked me to found Liberal Democrats for Drug Policy Reform last year. There are eerie parallels between the health authority's current pleas to heroin addicts to stop taking heroin and the police pleas in 2006 asking girls working on the streets of Ipswich to “look out for each other”. Both are utterly inadequate in the face of an unfolding tragedy.

The final victim of Steven Wright gave an interview with ITV news 5 days before she disappeared. When Paula Clenell was asked “Despite the dangers, why have you chosen to come out tonight?” she replied “Because I need the money. I need the money.” When someone is a heroin addict, and knows they run a high risk of being murdered if they continue to try to fund their habit, but they work the streets anyway... surely we can learn from this that heroin addiction isn't something you can just stop.

So what is the killer stalking heroin addicts today? Is it incompetence in the relevant government authority? Or is it public indifference failing to demand that action is taken? How much do we really care when a prostitute goes missing or a heroin addict dies? I know I cared a great deal more after watching a documentary that profiled the young women who died in Ipswich. They were just ordinary girls living ordinary lives who made one mistake in taking heroin and couldn't escape its clutches. Heroin addicts aren't feral animals, they are people's sons and daughters, sisters, brothers, mothers, fathers and friends. Their mistake in taking heroin does not exclude them from their right to health laid down in the constitution of the World Health Organisation and restated in the body of this emergency motion.

In order to illustrate what prescribed heroin might bring to our communities I shall now read an excerpt from a journalistic piece written in 1995 by Mike Gray about the closure of a clinic in Widnes. Heroin prescription used to be widespread in the UK, but had been scaled back under diplomatic pressure from the US.

“In March of last year I visited the Chapel Street Clinic and met with several of the patients. I sat in on a group session where eight heroin users discussed their lives and problems with a counselor before picking up their prescriptions for pharmaceutical heroin. Unlike the junkies we are used to seeing, this group was virtually indistinguishable from any other bunch of young adults on the streets of Liverpool. They were well dressed, talkative, energetic -- they had jobs -- and they used heroin daily.

One was a young woman named Juliette who had been an addict for 13 years. She came from a middle-class background, married a rich kid who got her into heroin, then left her with two kids and no money. She tried desperately to kick but couldn't make it. Somehow for ten years she managed to stay afloat through petty theft and prostitution, with the authorities breathing down her neck. Finally, terrified that they were about to take her kids away, she happened to find the right doctor and he sent her to John Marks. Marks gave her a check-up, satisfied himself that she was indeed a heroin addict, and wrote her a prescription.

"For the first time in ten years," she said, "I had spare time. I didn't have to worry that my dealer wouldn't show -- I didn't have to worry about the price or where to steal the money. So for the first time in ten years, I had a minute to look in the mirror. I looked and I said, `Oh, my God.' Then I looked at the kids, and I said, `What have I done?' All these middle-class values came flooding back in on me.

" Today Juliette has a job, a house, and a mortgage. The kids are in school and doing well. Everybody's in excellent health. And once a week she comes to Chapel Street for her prescription. I asked John Marks what will happen to Juliette on April 1 (when the clinic closes). He said, "Well, she'll go down the tubes."

This isn't going to be an easy process. Each addict will suddenly have free time to reflect on the shameful things they have done over the course of their addiction. But tens of thousands of families can be reunited with loved ones they may have thought lost forever.

I suspect there are very few of these people in the audience today (this is a Liberal Democrat conference after all), but if you are ruled by your wallet and not your compassion, then the cost of providing safe heroin to addicts is tiny relative to the estimated £60,000 yearly cost to society that the average problem drug user constitutes at present. They don't want to die a slow, painful death from an anthrax infection. I'm fairly sure they don't want to be stealing, dealing and prostituting themselves either. Provision of safe heroin under medical supervision means they really don't have to.