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Posted: 31 October 2005 : Community Care

writes Maria Ahmed

Agencies are failing hundreds of drug misusers because they are referring them to out-of-area treatment centres without checking if they will receive adequate care, it has been claimed. The concerns have been mooted by MPs and organisations in Weston-super-Mare, which has 10 per cent of the country’s drug rehabilitation places.

John Penrose, MP for Weston-super-Mare, accused referral agencies, including councils and probation services, of failing to inform local social services when referring people to the area. “Referral agencies are not following up hundreds of clients. They are failing in their duty of care,” he said.

Penrose also claimed agencies were not checking whether treatment centres were properly regulated, leaving people at risk. An investigation by Avon and Somerset police earlier this year found that 15 people in Weston-super-Mare who were not in registered rehabilitation centres died of drug-related causes from 1 January 2003 to 31 August 2004.

It also found that offenders referred from other areas of the country for treatment as part of a drug treatment order were being placed in “inappropriate” accommodation without the knowledge of local social and probation services.

Last month, as part of an initiative to tackle the problem, North Somerset Council distributed a national probation notice to prevent the referral of offenders from outside the area to two centres identified as being unsuitable for drug and alcohol rehabilitation.

Another ‘dry house’ in Weston-super-Mare for people overcoming addiction had a £36,000 Supporting People grant withdrawn following issues surrounding its management. Bram Tout, drug and alcohol co-ordinator for North Somerset, said he believed the lack of follow-up by referral agencies was not confined to the area.

“This is happening at a national level,” he said. “It is seen as cheaper to refer people out of area, but many drug referral agencies across the country do not have the capacity to follow people up.” Tout estimated that probation services and councils outside of North Somerset referred 200-300 people every year to registered drug treatment beds in the area without notifying the local social services.

But he confirmed that only two councils had notified North Somerset social services of a total of 29 out-of-area referrals over the past year.

Leah Betts died from taking ecstasy a decade ago. Now her best friend talks for the first time about that tragic night - and tells how she has rebuilt her own life. By Lorna Martin

Sunday October 30, 2005
The Observer

Giggling with pre-party nerves, the two best friends, who were affectionately known as the Siamese twins, put the finishing touches to their outfits and makeup. In the background, Oasis's Definitely Maybe CD played on repeat. Before they went downstairs, they looked excitedly at the four tiny white tablets they'd bought earlier. Unlike the ones they'd taken before, these were marked with an apple motif, indicating a higher purity and strength.
'Perhaps we should only take half,' 17-year-old Sarah Cargill said.

'Don't worry,' her friend reassured her. 'We've had a whole one before.'

Without another moment's hesitation they swallowed one each.

'We were so young and so curious,' Ms Cargill recalled. 'We never thought for one minute that anything bad might happen to us. We'd only ever had fun with ecstasy. We'd never had a bad experience.'

On Tuesday, it will be 10 years since Leah Betts turned 18. Her birthday party the following Saturday was a tragic experience, and one which was shared with the British nation.

In the years following her death, her parents went on to launch a high profile campaign warning of the dangers of drugs. For her best friend, the incident effectively marked an abrupt end to her childhood. She was crippled with guilt, moved away from the area, lost contact with all her old friends and initially found it difficult to form new friendships. Even now, most of her new friends and colleagues are unaware that she had taken drugs with Leah Betts, and was her 'soul mate'. She also said it has had a major influence on how she lives her life now and the way she will raise her own children, admitting that she thinks it inevitable that she will be very over protective. 'I learnt at the age of 17 about the fragility and preciousness of life. Until Leah died I thought we were invincible. Like all teenagers, I thought bad things only happened to other people.'

In her home in Surrey, which she shares with her partner of two years and her eight-month-old daughter, Ms Cargill, who is now 27, has spoken for the first time in almost 10 years about the profound influence the very public death of her best friend had on her. 'My life changed for ever that day. For a long time afterwards I just existed in a state of shock. One minute my best friend was there all the time. The next she was gone. It was very hard and I felt very lonely for a long time.' She said she felt guilty for being alive and because she hadn't said 'no, let's not take drugs'. 'I also felt guilty for her family. I hoped they wouldn't blame me and I was afraid her friends who didn't take drugs might blame me. I also felt so ashamed. My family thought I was a good girl. We both had good upbringings. We weren't stupid or deprived kids. But I felt I'd let everyone down - my parents and my grandparents. It's the worst feeling to let down the people who love you so much.'

The death of Leah Betts sparked a controversial new anti-drugs movement, but despite its shock tactics it has done little to reduce the number of young people experimenting with drugs. Home Office figures released last week showed that 45 per cent of 16-to-24-year-olds had tried illicit drugs at least once, and more than a quarter had taken them in the past year. Other data, published last month, found that ecstasy use had risen dramatically in cities and provincial towns across the UK, where it is now much cheaper and easier to get hold of than a can of lager.

Mike Linnell from the charity Lifeline told The Observer that children as young as 10 were bingeing on the pills, taking up to 20 a day.

'We are seeing kids of 12 and 13 who are buying it very cheaply - between 50 pence and £1 - and using it on a fairly regular basis. It's no longer a hedonistic drug taken in nightclubs. Kids are taking it because of its empathogenic qualities. They sit around in little groups on estates and chat. It's like their therapy session. They are taking it in some cases simply to relieve the boredom and trauma of their daily lives.'

The number of people whose deaths were blamed on ecstasy has increased sixfold from 12 in 1996 to 72 in 2002, when the last accurate figures were available. But the risk of an ecstasy-related death has been exaggerated in the media, according to the charity Drugscope, which points out that there are far more fatalities associated with the use of heroin, cocaine, tranquilisers and even aspirin. The charity is one of many organisations that have called for the drug to be reclassified from class A to class B on the basis that they do not believe it poses the same health risks, or related crime problems, as other class A drugs such as heroin or cocaine.

Ms Cargill is disheartened but not surprised that young people are taking drugs in ever-increasing numbers. She is deeply sceptical about the government's drugs strategy. But she is not in favour of decriminalisation or deregulation. Following the tragedy, she felt it was her duty to tell everyone not to touch drugs. 'I thought if I told everyone what happened to Leah it would stop all children from taking drugs.' Before too long, however, she realised it was a futile exercise.

'I have never touched any drug since that night and I wouldn't be friends with anyone who takes drugs,' she said. 'But I think the sad truth is that it is impossible to stop children experimenting with drugs. Teenagers are naturally rebellious. Even if they have a good upbringing, it is natural for them to rebel. If you simply tell children drugs are bad, while their friends are telling them they're great, then the chances are they're going to listen to their friends.'

Despite this, she said she planned to sit down with her daughter before she started secondary school to discuss the issue with her. She also said one day she would tell her about Leah.

The two friends had been inseparable since they met at the age of 14. They went to clubs and pubs together, on holiday together and, when they started college, Leah stayed at the Cargill home during the week. 'She became like the sister I never had.'

It was when they started further education - Ms Cargill was doing a diploma in travel and tourism and now works in the industry, while Leah was taking A-levels and planning to go to university to study psychology - that they decided they wanted to try drugs. Ms Cargill said there was no peer pressure. Instead, she said it was simply a matter of curiosity. They wanted to try cannabis, but when they tried to buy it they were offered ecstasy instead.

On the night of Leah Betts's 18th birthday party - Saturday 11 November 1995 - around 30 guests were crammed into the front room of her parents' remote farmhouse near Latchingdon, Essex. Both her parents had remained in the house during the party specifically for the purpose of stopping any drug taking. They stayed in the kitchen while the teenagers danced to Oasis, Nirvana and Green Day. Some drank, others smoked cannabis, a handful took ecstasy.

Ms Cargill first realised something was wrong when Leah complained of serious pains in her head and legs.

'She was hanging over the washbasin being sick, then she said she couldn't see and collapsed. She was screaming for her mum to help her.'

As Leah was transferred in a coma to intensive care at Broomfield Hospital, Chelmsford, a police officer was reading Ms Cargill and the other guests their legal rights. Five days after her party, Leah's life-support machine was switched off. An inquest found that her brain had swollen, which experts said was a result of her drinking a large amount of water in accordance with the advice given to ecstasy users at the time.

The day after she died, her father, Paul, a former policeman, called for her drug supplier to be tried for murder and if found guilty sent to the gallows. In the atmosphere of heightened emotions that gripped the nation after her death, it seemed to many an understandable comment. The family released a photograph showing Leah connected to a ventilator and on the verge of death. It was splashed on front pages across the country and the media started a feeding frenzy. Their message: E is for evil.

Ms Cargill said she was haunted by that image. 'Whenever I tried to sleep, that picture flashed through my mind. Even now, I can still see it vividly.' She also said it took weeks for the news of Leah's death to sink in. 'I visited her in hospital on the Sunday and even although she was in a coma and connected to a life-support machine, I was convinced she'd be all right. I thought only heroin addicts died.'

Eventually, when the truth did hit her, she said she felt crippled by guilt and contemplated suicide. Every weekend she visited her friend's grave, taking flowers, chocolates, letters and poems she had written for her. In the years that followed, her walls were adorned with photographs of the two girls together. She no longer has them, but still keeps some of Leah's jewellery. For around two years, she remained in close contact with Leah's parents, saying it was mutually beneficial and a huge source of support. However, she is no longer in touch with them. 'I had to move on,' she said quietly. She said she thinks it took her about eight years to come to terms with what happened.

These days, she seems settled and content living a quiet family life. She has a new circle of friends and said she wouldn't have survived without the immense support of her family

As she prepares for the 10th anniversary of her friend's death, Ms Cargill said she felt indebted to her. 'What happened to Leah could have saved my life. Because if she hadn't died, I think I might have carried on with the drugs. For five years I visited her grave every week, but I had to stop it so I wrote her a letter and buried it at her graveside. I said I couldn't visit her any more because it was tearing me apart. I said I had to get on with my life. But I said I wouldn't ever forget her and I told her that she would always be my best friend.'

Ecstasy use in Britain

Ecstasy is a street name given to the tablet form of 3,4-methylenedioxymethamphetamine (MDMA). Tablets can be purchased for as little as 50 pence and the drug has just been overtaken by cocaine as the most commonly used class A drug in the UK. Last year, 5 per cent of 16 to 24-year-olds had used ecstasy in the previous year and an estimated 700,000 people take it every week.

Legal uses In the late 1970s, MDMA was used by US psychotherapists as a therapeutic drug. It was nicknamed 'Adam', as it seemingly returned to patient to a natural state of 'innocence'.

Illegal uses MDMA became known as the 'yuppie psychedelic' and was banned in 1977. It is now an illegal class A narcotic. MDMA re-emerged in pill form in the 1980s and became the drug of choice for rave culture. Since then the drug has become synonymous with dance music culture.

Celebrity use

Celebrities who have admitted taking ecstasy include Oasis frontman Noel Gallagher, who claimed that taking drugs is 'like having a cup of tea', boyband star Brian Harvey and Blur's Damon Albarn.

Come-downs

Ecstasy can cause the body temperature to rise to dangerously high levels, and short-term effects can include anxiety, panic attacks, first-time epileptic fits and paranoia. Long-term effects are still unclear, but can include depression, personality change and memory loss.

Blair insists on 'unworkable' smoking ban

Patrick Wintour
Thursday October 27, 2005
The Guardian

The health secretary, Patricia Hewitt, was forced into a retreat yesterday when she announced that the cabinet was now leaning towards the introduction of a smoking ban that is against her own advice and which her aides only days ago described as unworkable and weak.
After days of unprecedented rival briefing from inside the cabinet, Mrs Hewitt said a bill would be published today banning smoking in workplaces, restaurants and pubs that serve food. Many observers saw the settlement as a victory for the defence secretary, John Reid, and a testimony to the support he enjoyed from the prime minister. Tony Blair made it clear that he did not want a total ban on smoking.

In line with the May Labour manifesto proposal advocated by Mr Reid, a former health secretary, smoking will now be allowed in pubs that do not serve food, so long as it is not close to the bar area, in order to protect bar staff. Smoking in private members' clubs will be permitted.
Mrs Hewitt kept the door open for her position of "sealed smoking rooms" in bars not serving food by stating that "smoking in the bar area will be prohibited everywhere", adding: "We shall consult further on the best method to achieve this, including on discrete smoking rooms or areas to protect staff."

She said a review would be held within three years, whichever policy is adopted. Mr Reid argues that he has been trying to strike a fair balance between health and individual rights.

David Taylor, the Labour chairman of the all-party parliamentary group on smoking and health, said Mr Reid's fingerprints were all over the deal. "It is perverse that, apparently, an MP for a Scottish constituency is weakening a bill which will not affect his own area, which will be benefiting from March 2006 from comprehensive smoking legislation of the sort we are seeking in England."

Tom Sanford, director of the Royal College of Nursing, said: "The government proposals for a partial ban are unworkable, unenforcable and, bearing in mind the introduction of total bans in Scotland and Northern Ireland, totally illogical."

The anti-smoking group Ash said 90 % of the 50,000 people who responded to the government's consultation had rejected Mr Reid's proposals, adding it would add to health inequalities, since pubs in poor areas tend not to serve food.

Smoking ban is unworkable, says pub industry

· Exemptions 'threaten trend for more food sales'
· Health gap between rich and poor areas 'will widen'

Simon Bowers
Friday October 28, 2005
The Guardian

The English and Welsh pub industry, which has been rapidly expanding its food trade in recent years, has called the government's health bill exempting non-food pubs from a proposed smoking ban "unworkable and grossly unfair".
Patricia Hewitt, the health secretary, has abandoned her efforts to include provision for smoking rooms in pubs in the public health bill, which was published yesterday. After intense cabinet debate, the government retrenched to its previous, much-criticised, proposals for a ban on smoking in offices and public places, with an exemption for non-food pubs as well as for private members' clubs.

Pub industry leaders said they feared such an exemption would arrest what many campaigners for responsible drinking regard as the progressive trend in the number of public houses offering customers a balance of food and drink.
Karen Jones, chief executive of Spirit Group, has written to all MPs calling on them to oppose the exemption, which would create a "tilted playing field". Almost all Spirit's 2,000 pubs serve food and the firm expects to lose some smoking customers to rival non-food bars should the bill be passed. The bill is designed to come into force in summer 2007.

On exempting private members' clubs, Ms Jones said: "We cannot understand how such an exemption can be justified on public health grounds, the very reason that this bill exists. We believe that it is clearly anti-competitive and could threaten the future of many small rural and suburban community pubs."

The Portman Group, an industry-funded safe drinking organisation, said: "We strongly believe that alcohol consumed with food is much more responsible. We feel quite strongly about that."

'Flawed'

According to the British Beer & Pub Association, in the last 10 years food sales in Britain's 30,000 managed pubs have risen by 165%. In the 30,000 smaller tenanted pubs, the increase is thought to be lower but still substantial. Some 80% of all British pubs now offer food compared with about half in the mid-1990s.

A spokesman for Mitchells & Butlers, which operates about 2,000 pubs, including the O'Neills, Harvester and All Bar One chains, said: "From a standpoint of protecting the health of pub workers, and from a standpoint of providing clarity to the public, we think this proposal is badly flawed and quite illogical." Food sales at M&B are expected to overtake sales of beer next year. John Hutson, chief executive of JD Wetherspoon, which has converted 50 of its 600 pubs to non-smoking venues, said he too expected to lose smokers to non-food pubs. "We want a simple solution: either a ban or no ban," he said.

'Shambolic'

Ted Tuppen, chief executive of Enterprise Inns, which owns more than 8,000 tenanted pubs, has been arguing for separate smoking rooms in pubs. Yesterday he described the government's change of tack as "shambolic" and driven by political pragmatism. "There are huge numbers of rural pubs which provide a great service for their local community, providing a bit of food and a bit of booze. Pubs like that are going to be more at risk."

One senior pub industry director, who declined to be named, said: "This [bill] is driven by political expediency rather than the rights of pub workers to live longer. They [ministers] are playing fast and loose with public health."

He said the proportion of liquor-led pubs likely to qualify for the exemption was higher in less affluent parts of the country, suggesting the bill would lead to a widening in the health gap between rich and poor regions of England. A second exemption for 20,000 private members' clubs was seen as a sop to many such venues affiliated to the Labour party. Among the few pub groups to welcome yesterday's bill was Punch Taverns, which believes a significant number of its 8,000 pubs could operate as non-food pubs, catering to smokers. It said: "Although we acknowledge that the proposed non-food/food split will present some landlords with difficult decisions, none the less we feel that the distinction is relatively straightforward and workable as well as preserving some degree of choice."

Scotland will introduce an outright smoking ban next year while Northern Ireland will have a complete ban from 2007. The Welsh Assembly hopes to be granted powers allowing it to follow suit. Just days ago, advisers to Ms Hewitt are said to have described the exemption as "unworkable". Following cabinet talks, however, she backtracked, reverting to the partial ban as set out in the Labour manifesto.

The British Beer and Pub Association said: "This is groundhog day. We are back to square one, with a proposal that is unworkable and grossly unfair on Britain's pubs. I hope further consultation will make the government think again."

Most pub group's profits from cigarette machines are negligible, though the proportion of pub-goers who smoke is estimated to be 45% to 50% - about twice the national average.

DOH Press Release http://www.dh.gov.uk/PublicationsAndStatistics/PressReleases/PressReleasesNotices/fs/en?CONTENT_ID=4122137&chk=MXpacX

Health Bill: http://www.publications.parliament.uk/pa/cm200506/cmbills/069/2006069.htm

· Up to 10% of patients with chest pains took drug
· Greater acceptability and lower prices fuel growth

Ian Sample, science correspondent
Monday October 24, 2005
The Guardian

A surge in cocaine use is pushing Britain towards a "healthcare disaster" that will see a dramatic rise in heart attacks, strokes and neurological problems among young people, says a leading specialist. The warning follows a three-year investigation into cocaine use carried out at a London hospital emergency unit which indicates that the medical complications of the drug will become a significant burden on hospital resources.
The study looked at levels of cocaine in people who arrived at the accident and emergency unit of St Mary's hospital, Paddington, London, who were complaining of chest pains, a common side-effect of the drug. It found that on Friday or Saturday nights up to half the young people tested had cocaine in their system.

While fewer tested positive for the drug during the week, the numbers were still surprisingly high, said John Henry, a leading toxicologist and professor of accident and emergency medicine, who led the study. "Cocaine usage has peaked in the US but here it is still on the rise, which means the worst is yet to come. We're going to see more severe addiction, more strokes and heart attacks in young people, and more of the other complications linked to its usage," said Professor Henry, who is regarded as the UK's leading expert on illicit drug use. "It's a healthcare disaster and it's coming here."

Records taken during the study, to be published in an academic journal, show that between 7% and 10% of all those complaining of chest pains were found to have traces of cocaine in their urine. With the under-40s cocaine usage was markedly higher; a third of this group tested positive for the drug on weekdays, rising to 50% over the weekend. Tests on a control group admitted to A&E without chest pains showed only 3% had taken cocaine.

The study confirms the fears of other healthcare professionals that cocaine use in Britain has reached an unprecedented level. In an audit of drug tests carried out by the City Hospital NHS teaching trust in Birmingham cocaine use was found to be increasing by about 50% every three years, a trend showing no sign of slowing. "The arrival of the cocaine epidemic has now started to become a reality in the UK," said Stephen George, the doctor who did the survey.

The rise of cocaine has been boosted by greater acceptability of the drug and better supply, bringing more drugs to UK streets and lower prices. A gram wrap of cocaine now costs as little as £45. Experts fear cocaine use will continue to soar until it reaches a peak, as it did in the 1990s in the US where there are now 25 million users and two million addicts.

The increased availability of the drug has been picked up by coroners' offices which have found that most heroin addicts dying of an overdose now have cocaine in their systems. "Even 10 years ago we didn't see cocaine in those cases," said Susan Paterson, a toxicologist at Imperial College, London, who works with coroners on more than half of the capital's heroin deaths.

Cocaine tightens up blood vessels, making the heart work harder and raising blood pressure. While long-term heart problems can build up in cocaine users, as little as two 100mg lines (a fraction of an ounce) is enough to cause chest pains. US studies found that 5% of cocaine users attending A&E departments with chest pains had heart attacks because of their drug usage. Hospitals are already reporting patients in their early 30s suffering strokes and severe coronary heart disease brought on by cocaine use. Many do not smoke, are not overweight and do not have naturally high blood pressure.

In the US a condition called aortic dissection has become common among cocaine users. Caused by blood being forced into the lining of big vessels, it essentially creates a new channel for blood to flow down. The rupture itself causes crushing chest pains but also reduces blood flow to vital organs, leading to brain and kidney damage in many cases. A third of the cases of aortic dissection in the US are attributed to cocaine use.

The drug has also lead to a rise in foetal deaths in the US. It is believed that one in 10 babies dying in the womb do so because their mother took cocaine - a factor that leads to a rupture of the placenta, making it shear away from the womb.

Groups that deal with cocaine addicts say users are often oblivious to the harm cocaine can cause. And low prices, a poor understanding of the drug's medical effects and wide acceptability of cocaine, mean there is little to put the brakes on its soaring popularity. "There's no measure of an increase in heart problems yet, but I foresee it happening. We're attacking the other risk factors for heart disease, such as smoking ... but the rise in cocaine usage is the introduction of another serious risk factor. It's already impacting on emergency services," said Prof Henry.

The fullest survey yet into the UK's crack and heroin trade shows it is fuelled by children and teenagers in search of a quick fortune. Denis Campbell reports

Sunday October 16, 2005
The Observer

Joe had just celebrated his 15th birthday when his father asked him to join the family business: selling heroin and crack cocaine. With time on his hands after being excluded from school, and keen to please his dad - a veteran drug dealer - Joe agreed.
'I was bored and thought it was cool to help my dad out [selling drugs]. He's always bought us quite a lot, so I wanted to help,' says Joe, now aged 17.

He has been acting as a 'runner' for two years, carrying small bags of heroin or rocks of crack from his father to 30-40 buyers every day and returning with pocketfuls of £10 and £20 notes.

With a grim inevitability his father also recruited Joe's younger brother Daniel once he turned 15. Daniel said: 'I had nothing to do. My dad asked me. It's easy money. I like it. I can buy things now and I get girls.'

The brothers are now entrenched in the £6.5 billion-a-year UK illicit drugs trade, carrying out dozens of daily drop-offs to addicts. It has been a lucrative decision for both boys: they are each paid £150 a week for selling and distributing 200 bags of heroin and 200 rocks of crack between them. Their father pays them from his £3,000-£4,000 weekly proceeds.

For Joe and Daniel, brought up in a bleak, deprived part of a major British city, with little formal education and few career prospects, running drugs is now their life.

'It's people like me and my brother. We've got nothing else, so why not?' says Joe. 'I know it's wrong, but what else is there for me?'

But they are not the only child foot-soldiers in Britain's flourishing black market in illegal substances - and they are not the youngest. The number of children and teenagers working in Britain's drugs industry is growing, according to a shocking new study of drug dealing.

An in-depth, 20-month investigation by a team of criminologists and drugs experts from King's College London - including, for the first time, testimony from scores of dealers themselves - has found that:

· Children aged 12 are selling drugs.

· More young people are becoming runners or spotters for dealers.

· Many truant from school in order to keep their clients supplied.

· Many are drawn into the trade by a close relative.

· Teenagers in areas rife with drugs often admire dealers, envy their income and aspire to emulate them.

· Adult dealers increasingly enlist them as runners and lookouts because they believe their age makes them less likely to be caught.

Indeed, teenagers in some rundown parts of British cities are so desperate to get into the drugs trade that they offer to work for free in order to gain a foothold, according to research by the four academics led by Professor Mike Hough, director of the Institute for Criminal Policy Research at King's College.

Their forthcoming report, commissioned by the Joseph Rowntree Foundation, carries extra weight because, uniquely, drug dealers themselves - 68 in total - have revealed who gets involved, why they do it, how they spend their proceeds and how they avoid getting arrested.

The report concludes that: 'From our interviews we found that young people's involvement in all our drug markets was on the increase.' Initiatives to keep teenagers from becoming sellers were not working, they found.

Evidence from more than 100 police officers, probation officers, drug treatment specialists and community workers in the four urban areas of England studied, as well as 200 local residents in each place, bore out the dealers' testimony - including the shocking revelation that 12-year-olds were involved. In each place, heroin and crack cocaine were the most commonly consumed drugs.

The authors agreed to keep the exact locations secret and persuade the dealers to talk in detail about the realities, rather than mythologies, of their trade. But they say that most cities in Britain contain areas very similar to the four they examined.

'They are as young as 12. The early to mid-teens are involved as runners. There's a quick turnaround of runners if some are arrested,' one police officer told the researchers. Explaining their motivation, a community group worker said: 'A lot of them see the money. If you come from a single-parent background and can't afford very much because you have six brothers and sisters, and you can get an extra £150 a week, you wouldn't say no. They are the runners.' Or, as one dealer put it: 'Dealers ask them to run, young people want to run, and they get money - everyone's happy.'

The researchers were repeatedly told that teenagers craved the fast cars and designer clothes lifestyle associated with drug dealers. 'The young men we spoke to wanted to be successful and free from money worries, but they also thought that the chances of success in the legitimate economy were non-existent, but that in the illegitimate economy they had everything to play for,' they concluded.

Of the 68 drug sellers, 52 were male and 16 female; the youngest was a boy aged 12, the oldest a 53-year-old man. Twenty had begun selling drugs before turning 18. Thirty-six had left school before the official age of 16; 28 had spent time in a young offenders' institution for 15 to 21-year-olds; and over half had spent part of their childhood at a children's home, with a foster family or in secure accommodation.

'Given such troubled backgrounds, it is easy to see why some teenagers start selling drugs - as a more exciting and rewarding alternative to slogging away for hours in a fastfood restaurant or supermarket, and a way of earning two or three times more money,' the report reveals. Some are young men aged 17 or 18 who have at least one child.

As one 17-year-old said: 'I can't sign on, can't get a job and I need to raise money. I asked a dealer if I could do it and he said yes, so I just started doing it. I have a daughter.'

Drug experts said that the report's findings were stark. 'These findings about young people's growing role in the drugs trade reminds me of when crack hit New York in the Eighties. It was estimated that it created jobs for 100,000-150,000 young people, working as runners, lookouts and gofers,' said Harry Shapiro of Drugscope, the UK's leading drug information charity.

'The stark economics of life in the sort of deprived urban areas where drug dealing is endemic, that are found in most of the UK's larger conurbations, is that 12 to 15-year-olds with limited employment opportunities, apart from perhaps a paper round, have the opportunity to earn sums which would be impossible for them in other circumstances.'

The 60-page report is grim reading. It reveals how council flats are taken over and turned into dealing dens; tenants are bullied and bribed into allowing drugs to be sold from their homes; up to 200 addicts a day visit these places, and spend up to £1,000 a week on their habit; and how the price of crack and heroin has fallen. Dealers also feel they have little to fear from the police.

Its findings raise a whole series of difficult questions about the effectiveness of current anti-drugs strategies, especially police efforts to stem the apparently free flow of Class A drugs. Revealingly, many of the 68 drug sellers said they viewed dealing as less risky than other crimes.

'The sellers in our study were largely unaffected by the police,' the authors note. While dealers 'took measures to avoid being arrested, the threat of imprisonment was not real enough for them to desist from selling'. The police's job in catching dealers has become even harder because mobile phones mean most sellers now operate from flats and send runners to deliver the gear and collect payment, rather than on the street, they note. Crackdowns only displace, not remove, the problem. Supply lines are only briefly interrupted.

Given that a Cabinet Office strategy unit report on crack, heroin and cocaine this summer estimated that users spend about £4 billion on them, it is easy to see why some of the dealers in this new study were earning as much as £20,000 a week, though the average was a more modest £7,500. Runners are making an average of £450 weekly, though some rake in as much as £4,000.

This study also challenges many of the popular notions about drug dealing. For example, rather than being loathed as parasites the researchers found that drug dealers sometimes 'command at least tacit support' from local residents and are 'tolerated to some degree'.

The authors conclude that this is partly because these communities have an 'ambiguous relationship' with the local police and, controversially, partly because some people in areas where dealers come from and operate themselves 'benefit' directly or indirectly from their activities.

Hough and his colleagues identify several such advantages. First, drug dealing gives local people opportunities to earn money working as runners, drivers, lookouts, door watchers at dealing houses and guards looking after dealers' drug supplies. Second, the easy availability of stolen goods, which around half the dealers interviewed accepted in lieu of cash, lets people in poverty buy items cheaply that they could otherwise not afford. Third, some residents receive cash handouts from relatives involved in drugs, enabling them to pay for their rent, weekly shopping, buy Christmas presents or pay for car repairs.

Lastly, the authors also found that an area with high levels of drug dealing may well also have less 'ordinary' crime - car theft and burglary especially - because dealers use their influence to ensure they don't happen, so the police have less reason to visit the estate. Shapiro confirms: 'Drug dealers want to protect their own turf and wish as far as possible not to attract the police's attention, so they may have their own enforcement procedures to keep other sorts of crime down.'

The King's College team believe the authorities need to accept that enforcement tactics alone will never halt the drugs trade. Instead they should hire ex-dealers to educate young people about the less glamorous realities of their former trade and run a drug-specific equivalent of the prison 'buddy' scheme for dealers returning to the outside world, to help them avoid returning to the drug trade.

Best of all, they say, would be preventing teenagers from getting involved in the first place by investing in youth outreach workers to identify and help the sort of vulnerable young people who do start selling drugs, stop relying on shock tactics to deter youngsters, and give them an alternative to the dead-end existences that let them see drug dealing as more rewarding.

As the report reveals, it is not an easy task. 'I spend my money on everything: clothes, cars and women. I swear to God, I try to live like [rap star] Diddy,' explains one young dealer. 'I just love it, I just love it. I'm still young. My cousins are all settled down, but I go out from the Wednesday night to the Saturday and just kill it with eveything, drink, the lot.'

Until the alternatives to drug selling are more appealing than £200-a-week menial jobs in Tesco, McDonald's and the like, the number of teenagers ready and eager to play their part in Britain's biggest, murkiest and most damaging underground trade is unlikely to fall.

*The names of some dealers have been changed

Drugs in Britain: The facts

11m people in England and Wales have used illegal drugs.

4m people a year take a banned substance. 500,000 use Class A substances such as cocaine and heroin.

35.6 per cent of 16 to 59-year-olds have taken illicit drugs.

£10 bn is the annual economic cost of drug misuse, including treatment and drug-related crime

500,000 Britons are thought to be drug addicts.

141,000 people receive treatment from drug misuse agencies and GPs.

18 is the average age at which people start using drugs.

6,406 drug-related deaths were recorded between 1997 and 2001 in England and Wales: 369 from cocaine, 145 from ecstasy and 5,188 from opiates. In the same period alcohol killed 25,000 to 200,000 and tobacco was involved in about 500,000 fatalities.

Matt Weaver
Monday October 3, 2005

Thames Reach Bondway super-strength alcohol advert

A homelessness charity has today called for a ban on super-strength lagers and ciders, known as "tramp juice", to help save the lives of street drinkers.
Thames Reach Bondway claims that the cheap availability of brands such as Tennents Super, Carlsberg Special Brew and the cider White Lighting, is leading to severe health problems for many rough sleepers.

It has launched a poster campaign in support of its call for a 6% limit on the alcohol content of bottled and canned lagers.

Thames Reach Bondway pointed out that currently a single 500ml can of 9% strength lager exceeds the government's daily recommended alcohol limit of four units a day.
Jeremy Swain, the charity's chief executive, said: "Our campaign is not a moralistic one. Our intention is simply to highlight the impact of the super-strength lager phenomenon that has developed over the past 20 years and the entirely unacceptable cull of people whose deaths are hastened through consuming these products."

Thames Reach Bondway will be urging the government to impose a 6% alcohol limit or sharply increase taxes on larger and cider that exceeds that level. In addition it wants to see cigarette-style health warnings printed on cans and bottles of the products.

Mr Swain added: "We need support and help from the breweries and government to end the easy availability of 9% lagers, and to accept that the cost of cheap, super strength is, in human terms, simply too high."

The charity said that the easy availability of extra strength brews is the main cause of alcohol-related problems for 800 of the homeless people that it is currently supporting. At least six of these people die each year from alcohol problems, it said.

The super-strength lager market is currently worth around £159m a year alone. Mr Swain said: "Everyone knows that these products are used by street drinkers. Nobody buys them for the taste."

A spokeswoman for Carlsberg UK said that a ban on extra strong lager would be a "nanny state" measure. She said: "We are keen to promote responsible drinking. We give information about the alcohol content on all our products, it's up to individuals to take responsibility for what they consume."

“Police stations are no substitutes for psychiatric hospital places and should not be treated as places of safety,” Independent Police Complaints Commission deputy chair John Wadham said today.

Addressing a London conference on the police service and civil actions, John Wadham said: “Police are often called to deal with people in public places, who are in need of help and who turn out to be suffering from a mental illness. They can use section 136 of the Mental Health Act to detain them to protect them or others. The aim is laudable, to ensure that the person concerned is taken to a place of safety.

“A survey among doctors, nurses and police on Humberside showed that four in 10 consultants and half of specialist registrars recognise that hospital accident and emergency departments are not a place of safety. Many hospitals will not accept such patients because they do not have secure facilities.

“If we accept that A and E departments in a large hospital are not a place of safety for somebody who may be mentally ill, then how can a cell block, staffed entirely by police officers be designated a place of safety?

“Cell blocks can keep somebody safe in the sense of ‘under lock and key’ but they cannot provide the skilled, medical care that a mentally ill person needs.

“It is also of concern that only one in 10 of A&E staff and just over one in five of police had received any formal training about Section 136 powers.

“The IPCC would like to see more places made available in secure psychiatric units for people who have been detained by police.

“There are some possible solutions but at first we need to know the full extent of the problem that the police service faces and with their cooperation and encouragement we are planning to start a research project on the use of police cells as a place of safety,” said John Wadham.

· Experts say 500,000 people are carrying virus
· NHS accused of giving disease low priority

James Meikle, health correspondent
Friday September 30, 2005
The Guardian

Up to 200,000 people will die from hepatitis C infection in Britain over the next 20 to 30 years unless diagnosis and treatment of the disease improves dramatically, doctors predicted yesterday. They warned that the government was underestimating the looming public health disaster, comparing its record in tackling the problems unfavourably with administrations in France, Germany, Italy and Spain.
Experts led by William Rosenberg, a consultant at Southampton general hospital, for a study commissioned by the Hepatitis C Trust, suggest that at least 500,000 people carry the virus, and that that "conservative" estimate is double the government figures. Nine in 10 people are unaware of their infection and the numbers will rise steadily unless public awareness campaigns encourage people who might be infected to offer themselves for screening via a blood test.

Over 30 years, about 30% of people infected will not develop liver disease, but 40% might suffer relatively minor damage to their liver, and 30% will face serious damage to their organs, many of whom will need transplants, for which there will be long waiting lists.
The cost to the NHS could rise over the same period to £8bn.

Professor Rosenberg accused the NHS of regarding hepatitis C as "a low-life disease" because many diagnosed are drug injectors. Yet others included those who only "dabbled" in drugs and decades ago. Hepatitis C can spread through blood on needles or other surfaces, and cocaine can cause localised bleeding in the nose.

"My clinic is packed full of lawyers and bankers. They are what we would call respectable, middle-class, people who dabbled when at university or in their teens. It might be a person who took a little bit of [injected] speed in the 60s. You could have been a very infrequent injector in the past. It could be you snorted cocaine in the 80s for a couple of years."

Other patients developed disease from infected blood products and transfusions. Heat treatment for products for people with haemophilia was only introduced in 1986 and a blood test to protect traditional blood transfusions came five years later.

People who come to Britain from abroad may have been infected through transfusions or medical equipment, and other less common infection routes include poor hygiene at tattoo parlours, shared toothbrushes and razors, mother to baby transmission, and, rarely, sex.

Only about one in 20 people who undergo blood tests which then indicate infection receive drugs that might cure them, say campaigners, and that figure represents only 1-2% of those who might be infected.

Courses, involving weekly intravenous treatments and twice daily tablets, can last six or 12 months depending on the strain of hepatitis C. But these drugs, costing £12,000 for the year, cure about 60% of those prescribed them.

Researchers say many people fall out of the system between first warnings through blood tests and the eventual treatment. Some hospitals never receive GP referrals, patients are often highly mobile and do not receive the results of tests, and some either do not believe how serious the virus can be, or worry that there is a stigma linked to the disease.

In France, 13% of people infected with the disease are treated, which is a level six to 12 times better than that occurring in Britain. Critics compare the £2.5m being spent on an awareness campaign in England with the £50m being spent in the battle against sexually transmittted diseases.

The Department of Health said the Health Protection Agency believed about 200,000 people in England might be infected, of whom just under one in five had been diagnosed through tests.

Antisocial offenders face interim Asbos, stiffer bans and fines

Alan Travis, home affairs editor
Friday September 30, 2005
The Guardian

Tony Blair's willingness to embrace the law and order agenda became clear last night as Whitehall prepares to draw up powers for the police to dispense summary justice to combat antisocial behaviour and binge drinking. The new police powers are expected to include:
· Instant Asbos: much greater use of injunction-style "interim Asbos" granted to the police without evidence or witnesses having to be heard or the defendant informed. Bans and restrictions remain in place until a full court hearing.

· New police powers to cancel late-night extensions for rowdy pubs and clubs without having to bother the courts.
· Fixed penalty fines of £80 for drunk and disorderly behaviour. Three tickets and persistent binge drinkers will face a "drinking banning order" barring them from pubs and clubs in a specified area for a specified time, possibly a month. Underage drinkers and those who serve them will face similar fines.

· Extending £80 and £40 fixed penalty fines handed out by police officers for rowdy behaviour to 10- to 15-year-olds. schemes are under way in seven police forces. Those who do not pay or go to court will face fines of £120 and £60.

· Extending existing powers implemented in January 2004 to close down crack dens by giving the police wider powers to evict drug dealers first and insist they can only challenge the police action in the courts later.

The prime minister confirmed yesterday that this "radical extension of summary police powers" will be hammered out in the next few weeks and published before the end of the year. It will put the rights of law-abiding people to live in safety before the need to protect the innocent from wrongful conviction if necessary.

"I don't think that the traditional law can give law-abiding people adequate protection. We are trying to fight 21st-century crime - antisocial behaviour, drug-dealing, binge drinking, organised crime - with 19th-century methods as if we still lived in the time of Dickens," Mr Blair said in his Labour conference speech.

He spelled out yesterday what is going to be involved: "I want to go further," he said in a round of end-of-conference interviews. "I will have meetings in the next few weeks on this issue. Whatever powers the police need to crack down on this, I will give them," he said.

In the coming weeks ministers will also consider whether to adopt the measures outlined by the Metropolitan police commissioner, Sir Ian Blair, to give the police the power to suspend driving licences and seize cars, as well as his call for the wider use of "interim antisocial behaviour orders".

Judges have already warned the Home Office that they are not happy with the idea of imposing restrictions on people's liberty without a proper hearing. One district judge told Home Office researchers last year: "It would come under the human rights situation, wouldn't it? Making orders without there being any evidence considered?"

Shami Chakrabarti, director of Liberty, said the prime minister wanted the police to dispense summary justice: "They are no longer investigating crime but dishing out the punishments themselves. If he goes any further than he has already gone, he will be modifying policing in this country for all time."

Responding to reports of addiction counselors being barred from working in Red Cross shelters in the aftermath of Hurricane Katrina, Red Cross officials issued a letter saying that shelter managers "must allow substance-abuse counselors to enter the shelters in order for people with substance-abuse problems to receive appropriate counseling."

Susan Hamilton, who directs the Red Cross' post-disaster mental-health team, wrote to Brenda Bruun at the Substance Abuse and Mental Health Services Administration's (SAMHSA) Emergency Response Center on Sept. 11 to outline the Red Cross' policy on addiction counseling. Hamilton said that counselors and social workers who show proper identification must be allowed in shelters "in order to track cases and to reconnect their clients with available local resources."

"To not do so could impede the recovery of clients affected by Hurricane Katrina," wrote Hamilton.

She also said that shelters must allow the formation of 12-step programs, and that local mental-health officials should be welcomed to work alongside Red Cross relief workers.

Samantha-Hope Atkins, head of Baton Rouge, La.-based Hope Networks, said that some Red Cross shelters had barred Alcoholism Anonymous and Narcotics Anonymous from entering, citing security risks. Some churches that housed storm refugees also have been less-than-welcoming to volunteers distributing copies of the Big Book of Alcoholics Anonymous and other addiction-related literature, she said.

By John Simpson
BBC world affairs editor

Twenty years before the war on terror, we had a war on drugs.

The Reagan administration came up with the idea, the Thatcher government backed it. It was, for a time, one of the most important initiatives the US and UK were involved in. By the 1990s, when I spent a lot of time in Colombia and Peru, the main centres for growing coca for cocaine, it was clear the war on drugs had been comprehensively lost.

At first, if you suggested that to officials in Washington or London, they would question your motives: you must be anti-American, or biased against the prime minister of the day. Yet by the end of the 1990s, although no government officials on either side of the Atlantic wanted to be quoted as saying so, they would privately agree that, yes, they had failed to stop the exponential growth in cocaine and heroin. Now, the very phrase "war on drugs" has fallen out of use. The drugs have been allowed to win.

There are all sorts of reasons why this had happened, many of them connected with the nature of Western society. If a famous model, earning millions a year, wants to snort coke, she will easily find someone to supply it to her, at a healthy price. The drugs business offers one of the best returns on investment of any commodity on earth. It operates according to the pure, undistorted laws of the market. And its greatest, though unconscious, supporters have been the governments of the European Union and the United States.

A few years ago I went with a camera crew to a frightening little drugs town in north-eastern Peru, where the farmers mostly grew coca. I assumed they would be violent and aggressive. Not at all: they were the ones who were scared. Every week or so gangs of armed, drugged-out tracateros, or buyers, would erupt into the town, forcing the growers to sell their coca paste to them at rock-bottom prices. So," I asked, "Why don't you simply grow something that won't get you into trouble? Maize, or wheat, or something?" As it happened, we were close to a little shop. The chief spokesmen of the coca growers took me by the arm and led me inside.

There were all sorts of foods and vegetables for sale, mostly imported from the United States or the EU. He told me how much each item cost; it was clear that every one of them had been dumped on the market at a fraction of its real value. "We're just poor peasants," he said. "We can't compete. We can't afford to grow these things so cheaply." The only commodity they could grow which wasn't fiercely undercut by the artificially cheap produce of Europe and America was coca.

Americans and Europeans have got themselves into the ludicrous position where they pay their farmers huge amounts to dump their surplus produce on the rest of the world. They then spend even larger amounts trying to deal with the social problems which are created by drugs - the only thing the deprived farmers of the developing world can grow without competition from the north. So what are we to do?

Something about agricultural subsidies would be nice, but that certainly isn't going to happen, either in the US or Europe. Yet there are other possibilities, and here is one of them.

This week, in Kabul, a French think-tank called the Senlis Council, which specialises in drug policy, is holding an international conference about the trade in opium and heroin. Afghanistan now produces something like 85% of the world's opium poppies, and most Afghan heroin ends up in Europe and the US. Since the overthrow of the Taleban the position has grown much worse.

The Senlis Council is making a proposal which is receiving guarded but positive responses from many different governments and organisations. It springs from a bit of lateral thinking by the Council's boss, earlier this year. Someone pointed out that there was a worldwide shortage of opiate-derived painkillers, chiefly morphine and codeine. Suppose, it was suggested, the opiates which cause such trouble in the form of heroin were diverted to medical use instead?

The Senlis Council carried out a feasibility study with the help of several universities, and the idea stood up. The plan would be to buy the produce of the poppy-growers, instead of allowing it to go to the big drugs middle-men who operate in Pakistan and Afghanistan itself.

What tends to happen when an idea like this comes along is that people start to point out how far short of perfection it falls, instead of accepting that it might present, say, a 60% improvement on what exists already. Because it isn't a 100% solution, it gets discarded.

The Senlis Council certainly doesn't expect that its big new idea will solve the problem of the heroin trade, but it might do some good. And it will certainly redress the absurd position whereby the world has more heroin, proportionately, than it has morphine. Not an awful lot of logic has been applied to the drugs trade over the years. It could do with some now.

· Increased risk of accident, arrest and unplanned sex
· More likely than men to get into fight, says survey

James Meikle, health correspondent
Tuesday September 27, 2005
The Guardian

More than one in three young women say they have been sexually assaulted after getting drunk, according to a survey which also suggests that excess alcohol makes them more likely than men to be involved in fights, be arrested or be cautioned by the police.

More women also say they have been injured in an accident, ended up in hospital, got into an argument, or been robbed or lost property after excessive drinking.

More than a third also report having unplanned or unprotected sex, according to a survey of 1,000 18- to 30-year-olds commissioned by the Portman Group, an industry-funded body devoted to promoting "responsible drinking".
The picture that emerges will reinforce concerns that young people are increasingly putting their health and safety at risk, and possibly stoke demands on politicians to counter problems of noise and disorder near pubs, including those seeking extended opening hours.

Jean Coussins, the chief executive of the Portman Group, said: "These findings are disturbing. Alcohol affects your judgment and the fact that so many young women are being sexually assaulted after getting drunk is shocking.

"What is most alarming of all is the fact that young women seem to be risking more than young men."

The questionnaire used by LM Rese