I can’t say that I have ever been much of a fan of Russell
Brand. Up until last week I always reckoned he was a representative of the kind
of over hyped celebrity that our tabloids so love to waste news print on.
He certainly never made me laugh, but maybe that is because I am a grouchy old
git from the north. However I was intrigued to tune in to his
documentary about drug addiction in Britain and what answers we might
find to this endless crisis. Before the programme I probably shared Peter
Hitchins’ world weary cynicism about the BBC signing up a wayward celeb to make
a supposedly serious piece of work.
Well, I was pleasantly surprised.
Russell used his hour well and came up with an eminently balanced and rational view of the god awful mess we have got ourselves in over these last forty years.
Russell used his hour well and came up with an eminently balanced and rational view of the god awful mess we have got ourselves in over these last forty years.
The big question is always the same one: what in the name of
Christ are we going to do about heroin? Throughout my adult life the very word
‘heroin’ has had the ring of unspeakable badness. It is the daddy of evil
drugs. Wicked and dirty and deadly. It’s odd to think that this sinister
sounding word was once upon derived from a German version of the word ‘heroic’. Mankind
has dabbled with the sap from poppies for hundreds and hundreds of years. We
have learned it can do things for us that no other plant can come close to. It
can take away pain from both our bodies and our minds. In the time of the
Industrial Revolution when science was all the rage, the pharmacists
seemed to conquer a new Everest every year. They discovered cures for most of the diseases
that had kept the average span of a poor person’s life to well under fifty. One
by one the mass killers were cracked – Dyptheria and TB and Rickets and Cholera
and Typhoid. The new drugs that were brought forth to send these diseases
packing were nick named the 'heroic' drugs. And so it was that in 1898 the Bayer
Corporation of Germany
came up with what they were sure would become the most heroic drug of them all.
Heroin. Diamorphine. The ultimate version of the poppy plant's magic. A hero of a drug that
could master the very worst of pain.
It was tested to the maximum degree in the field hospitals
of the Great War where it brought relief to the millions of men who were burnt
and shrapnelled and blown up in the trenches. And it worked. Just like it still
works. Try telling someone in the last gasp of cancer that heroin is a bad
thing.
From the very get go, the pharmacists figured out that
heroin could also have a pretty profound effect on the brain. Back in those
days chemists sold concoctions for the over worked housewife. Old Ma Betty’s
Pick Me Up! Elegant bottles filled with sweet, syrupy liquid. A spoonful a day to give a
bit of a lift! And some lift it must have been as many of these potions were
laced with heroin and cocaine. It soon became apparent that all too many
grand ladies were getting a tad over fond of their potions and the
pick up mixtures were made illegal.
For the next seventy years heroin was mainly the preserve of
artists. Just like opium always had been. Smack addicted artists have always
tried hard to harness their talents to tell the rest of the world all about the
nirvana of the poppy and let’s face it they have done a pretty good job all the
way from Coleridge to the Stranglers. Never a frown on Golden Brown.
Comfortably Numb. Oh, it’s such a perfect day..I’m glad I spent it with you…..
Then in the early 70’s the great and good, lead by the
visionary Richard Nixon, decided to launch an epic War on Drugs and thereby put a
stop to all the wickedness. In 1970 we had under 500 registered heroin addicts
in Britain .
Then we declared war on the poppy and threw the kitchen sink at it and what a
towering success our four decade war has been: we now have over 300,000
addicts.
The mess we have got ourselves into simply beggars belief.
Conservative estimates suggest that the drug problem now costs us upwards of £20
billion a year. The organised criminals who we have handed the franchise to end
all franchises now control one of the mightiest industries on the planet. Only
oil and weapons command a greater share of world trade than illegal drugs. In a
recent UN report, it became clear that on the day after Lehman Brothers crashed
there were a number of other banks that were about to go the same way. Someone,
somewhere had to go to the counter and stick the thick end of a trillion
dollars into a deposit account. On that desperate day it became clear that
there was only one set of people on the planet who had that amount of ready
cash – the drug cartels. And so a dirty deal was done. They were given a once
in a lifetime opportunity to launder all their cash in one go whilst a blind
eye was turned. They duly took the offer with both hands and rescued the
banking system. Over the last few weeks the extent of the abject corruption in
the City of London
has slowly started to come into focus. Once upon a time Britain doubled
its national treasure by punting opiates to the Chinese. Now we focus our
skills on being the finest money launderers money can buy. No wonder London is such a magnet
to those at the top of the crime cartels. The concept of My Beautiful
Launderette is now represented by the shiny glass towers of Canary Warf.
In the 80’s we all started to get scared to death by heroin.
By now it had moved from the artsy parties of Soho
into the sink estates of Thatcher’s post industrial wilderness. And it became
clear that with heroin came Aids. Edinburgh
was the epicentre and Trainspotting brought it to national attention.
And so it was that two words entered the lexicon of the war
on drugs. Harm Reduction. To stop the spread of Aids, we tore up the rule book
and reluctantly decided to offer heroin addicts a free of charge substitute care
of the NHS.
Methadone.
Methadone is a synthetic version of heroin that offers many
but not all of its unique qualities. It will take away physical pain but it
does not provide the kind of mental nirvana that Lou Reed captured in ‘Perfect
Day’
The NHS methadone mantra has never really changed over the
last twenty five years or so. Methadone saves lives. The theory is really quite
simple. Heroin is really, really addictive. Once you get a habit you need a hit
every few hours or so. If you don’t get what your body needs, you will get
really, really ill. A rattle. Cold Turkey. You’ll vomit and shit yourself and
feel sicker than sick. And very few human beings have it in them to get through
these gnawing days of hell so they will go to almost any lengths to get that
next fix. They’ll shoplift and rob their families and commit fraud and
prostitute their bodies. Anything for the next dunt. No clean needle? Doesn’t
matter. The guy you are sharing with is HIV positive. Doesn’t matter. There is
a chance that the smack you have just scored is contaminated with Anthrax.
Doesn’t matter.
To combat this, we decided offer a choice. Heroin is unbelievably
expensive and only available from organised criminals. So here is a way out.
You can have a daily dose of methadone which is free at the point of use and
available from the NHS: our national treasure.
At first we promised three or four months of methadone. Just
time enough to bring stability to a chaotic life. An escape from the clutches
of the organised criminals. Then there would be help to slowly reduce the daily
dose down to nothing at which point the addict would be abstinent and spruced
up and ready to take a place in society. On this basis it has to be said that Methadone can be a genuinely good thing. We have worked with many clients who found methadone helped them to get some stability into their manic lives. Once they were released from hellish daily routines of committing crimes and then frantically seeking out the next hit they were able to put their fractured lives back together. This is when the methadone programme is at its best, especially when there is lots of help available for someone to reduce their daily dose and then become abstinent. No arguments whatsoever with that.
Sadly the reducing and becoming abstinent idea seems to have got lost somewhere along the
way. Once the politicians started throwing hundreds of millions into drug
treatment they ordered their minions to collect proof that the investment was
indeed bearing fruit. The NHS was asked to provide evidence that the cash was making a
difference. How many drug addicts do you have in treatment? And this soon became
the be all and the end all. In the early days, anyone on the methadone
programme was expected to provide piss tests to prove they were no longer using
any wicked illegal drugs as well as their legally prescribed methadone. When they
failed a test, they were chucked off the programme and they would have to wait
a few months to get another chance. The message was clear. It’s methadone and
nothing else or it’s nothing at all. Simples, as a Meerkat would allegedly say.
But this presented a problem to the NHS, for a person kicked
off the programme meant one less name on the list of drug addicts ‘In
treatment’. And that was not good. For in our brave new world, numbers are
everything. And without numbers on your side, you put yourself in danger of
being down sized. Of being cut. Of becoming an efficiency saving. So a new
philosophy emerged. No longer was it deemed a good idea to put a heroin addict
on a brief stabilisation programme and then help them to abstinence and a new
life. Nope. No good. That meant less people ‘in treatment’. Instead it was
deemed a better idea to prescribe higher and higher doses and thereby lock more
and more into the system.
At First Base we started to notice this about five years
ago. All of a sudden, any client who asked to have their level of methadone
reduced was told that such an idea was quite impossible.
They were told that they were not ready. That to reduce their prescription
would be to put them in danger. Methadone would keep them safe and the more they
took the better. We tried to raise this at various meetings only to be shouted
down and told in no uncertain terms that we were trouble causing, bumbling
amateurs who were pretty well a disgrace to humanity for daring to suggest such
a wicked thing.
Then one day we received an invitation to attend a meeting
of a Select Committee up at the Scottish Parliament where the methadone can was
due to be kicked around the room. The NHS fielded a truly formidable spokesman
in the person of a tweed suited Dr Watson. Seldom in my life have I seen a man
hold his corner with such unshakeable confidence. Professor Neil Mckegany, who
played a role in Russell Brand’s documentary, tried all he could do discomfort
the good doctor.
“Dr Watson. In England 29% of those on the
methadone programme come off the drug every year. In Scotland that figure is 4%. Why
such a difference?”
The good doctor swatted away the question much like King
Vivvy Richards once dispatched bouncers over the midwicket boundary. He agreed
that 4% was indeed a problem statistic. 4% in his opinion was 4% too many.
Nobody should come off methadone. Methadone prescribed to heroin addicts should
be seen in the same light as insulin prescribed to those suffering from
diabetes. He was also worried that the average prescription of Methadone in Scotland was 49
ml a day. (10ml would be plenty enough to kill you and I in under a minute,
unless you are a heroin user of course, in which case you’d be fine and dandy) In his view
it would be much better if the average prescription were 200ml a day, enough to
flood the neuro-receptors of the brain and drive away the desire to use ant other
drugs ‘on top’. The fact that 200ml a day is generally enough to render a human
being into a Jeremy Kyle watching zombie capable of nothing more than a daily
shuffle to the chemists seemed to be of little concern. At least they were to
be safe Zombies.
We quoted the good doctor’s thoughts to NHS representatives
at local meetings. We had questions which we felt were perfectly fair. You see,
when a heroin addict first visits a treatment centre, it goes something like
this. OK. We can help you and this is what we will do. We will get you onto the
methadone programme and over the first few weeks we will ease the level up
until we find the right mark. Then we will let you stabilise things for a few
weeks. Then we’ll have a look at helping you come reduce your prescription and
get yourself abstinent and clean. Now Dr Watson had categorically revealed that
such talk was in fact a big fat lie. In our view there needed to be a new and
different narrative. We felt the conversation should have gone along something
like this. OK. We can help you. We can give you a free of charge methadone
prescription which means that you can stop robbing shops and prostituting
yourself and free yourself from the grip of organised criminals. However there
are some downsides you need to consider. If you decide to take this road, it
will in all likelihood mean that you will need to visit your local pharmacy
every day for the rest of you life. Also you need to know that methadone is
very acidic indeed. It will eat away at the enamel on your teeth and in the
next two of three years there is a good chance that most of them will go brown
and drop out. Now if you are happy with both of these downsides, we can go
ahead and get you hooked up. It seemed to us that many might not be over keen
on the idea if they were given these facts. Unfortunately the minions of the
NHS didn’t quite see it that way and we were shouted down and told in no
uncertain terms that we were trouble causing, bumbling amateurs who were pretty
well a disgrace to humanity for daring to suggest such a wicked thing. Oh well.
So much for that.
And so the madness just grew and grew, all in the name of
getting as many names as possible onto the ‘in treatment’ list to be e mailed
to the government once a month. In Scotland we now have well over 20,000
citizens ‘in treatment’. It is scary how far this whole thing now goes. A
couple of years ago I spent a couple of soul destroying hours in the local Sheriff Court on the day of the ‘Drug
Treatment and Testing Order’ hearings. This is a relatively new thing. Let’s
say you have been a heroin addict for five years and slowly but surely your
criminal record has got out of hand. You’ve been given fines and not paid them.
You’ve been given community service and not turned up. You’ve been picked up
and told off and ticked off and issued dire warnings and none of this has had
the slightest effect. And so the time has finally arrived for you to be sent to
prison without passing go and collecting £200. But wait! There is one last
chance in the saloon. You are offered the chance of a DITTO – a Drug Treatment
and Testing Order. If you sign up to be take treatment and be tested twice a week
for wicked illegal drugs for a set period of time, then you can avoid prison.
All in all, a pretty sound idea, especially if it can save us the £5000 a month
it costs to lock an addict up. Once a month you have to stand up in front of
the sheriff to hear a report from the treatment centre as to what your twice
weekly tests have shown. Oh dear, oh dear. I’m afraid you tested positive for
naughty, wicked heroin. All bets are off! So it is jail for you sunshine and you
will not pass ‘Go’ and you will not collect £200.
But it wasn’t like that. There were about 15 cases to be
dealt with. The accused would shuffle into the dock and hang their head. At
which point their lawyer, thanks to £100 or so from the Legal Aid fund, would
stand up and address the Sheriff. They would tell a tale of woe in which their
client had got a bit down and depressed and spent their dole money on a couple
of bags of smack. But they were quick to assure the Sheriff that their clients
were really very sorry indeed and would try harder from here on in. They really
would. And the Sheriff would let out a sigh and continue the case for another
month. Every single one of them. Not one had managed to stay clean. Not one got
sent to jail. A few lawyers earned a few hundred quid for a few minutes work
and world moved on. But at least those in the dock were very much ‘in
treatment’. They were taking their methadone every single day.
A few weeks after my afternoon in the DITTO court, a lad
came into the Agency with a different kind of tale of woe. He had been on the
smack for over five years and was sick to the stomach with it. His family had
disowned him and he was very much at rock bottom. When he was offered a DITTO,
he jumped at the chance with enthusiasm. Here was his chance to put it all
behind him and start a new life. Once he had agreed to the offer, he needed to
keep two appointments. First he called round to the Criminal Justice people and
signed on the dotted line to promise to attend all appointments. He agreed that
if he missed appointments he would be sent to jail. Then he made his way to the
NHS treatment centre who would look after the day to day treating and testing
side of things. They told him that things would be absolutely fine and that
they would get him started on his Methadone programme. Oh no he said. He
explained that he had always promised himself that he would never go down the
Methadone road. He wanted to keep his teeth and not be tied to going to the
chemist every day for the rest of his life. No way. Not that. He explained that
he wanted to make the very best of his DITTO. He wanted to do his cold turkey
and get tested twice a week for a year to prove to his family that he was clean
of all drugs. Good idea surely. The kind of outcome we all want.
Nope.
They told him that it was Methadone or nothing. They had a
duty to keep him safe. He said he didn’t want Methadone. He just wanted to get
clean. And to stay clean. They told him that he was just wasting their time. So
he went back to court where the Sheriff shook his head sadly and regretted the
fact that treatment had been refused. A refusal of treatment meant that the
offer of a DITTO was no longer on the table. And so it was that my man was
packed off to jail. For nine months. For refusing to take Methadone. Now if
that ain’t scary, I don’t know what is. Doesn’t it smack just a teensy weensy
bit of Soviet Russia to you? Or does that kind of thing not really count when
it comes to dealing with junkies? Maybe so.
At least over 60,000 of our fellow Brits are being kept safe
by the NHS thanks to their daily dose of Methadone. That was what a GP patiently
pointed out to Russell Brand when he asked the same questions we have asked
over the years. Her body language suggested she considered him a trouble
causing, bumbling amateur who was pretty well a disgrace to humanity, but she
managed to smile for the camera.
But there’s a problem.
It was highlighted rather vividly last week when the
Scottish Government released the annual figures for drug deaths. 585 deaths. A
figure that has basically doubled over the last few years. Dead from Valium –
190. Dead from Heroin – 220. Dead from Methadone – 275. Hang on a minute. Run
that by me again. I thought the idea behind prescribing all this Methadone was to
keep people safe? That’s right, isn’t it? So how come it has killed more people
than any illegal drug? How come it has killed almost as many people in Scotland in twelve
months as British soldiers killed by the Taliban over the last ten years? How come the treatment designed to keep
people safe ends up topping one in every hundred? But we mustn’t ask such questions. For the
NHS is a national treasure and our doctors are wise and they know best. And
they are doing a terrific job. Just look at the figures. Look how many addicts
are ‘in treatment’! Over 20,000! Only trouble causing, bumbling amateurs who
are pretty well a disgrace to humanity would dare question such an epic
achievement.
So that’s you and me both Russell.
It seems there is indeed Methadone in their madness.