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Police are blamed for drug deaths in custody

By Jason Bennetto, Crime Correspondent
28 October 2002
Police officers failed to notice in time that prisoners were critically ill in nine out of ten drug-related deaths in custody, a study has found.

In a significant number of cases involving fatal overdoses, prisoners were able to smuggle drugs past police and take them while in custody, the research also discovered.

The head of research at the independent Police Complaints Authority [PCA] blamed the "poor" and "inadequate" training of custody officers for the high number of deaths.

In the first study of its kind, researchers from the PCA examined 42 drug-related deaths in custody in 22 forces in England and Wales since March 1997. In 88 per cent of the deaths, the police did not call for a doctor or medical help before the prisoner became ill. In some deaths, the police believe the inmate was faking an overdose; others thought they had taken drugs but did not call an ambulance; and some thought the prisoner was drunk.

In a fifth of the cases of fatal overdoses, the custody officers failed to find the drugs which were later taken by the prisoner in a cell, police station or vehicle, researchers discovered.

Dr David Best, head of research at the PCA, said: "From the evidence we have gathered, the training of custody staff is inadequate. Our preliminary findings have huge implications for searches and the adequacies of searches."

Drug-related deaths account for about a quarter of all fatalities in police custody. There have been 233 deaths in custody in England and Wales in the past five years, but in the year to April 2002 there were 19 drug and alcohol-related deaths out of at total of 34.

The PCA is currently investigating deaths in custody, firearms incidents, and fatal police chases, in an attempt to identify where the police are going wrong and to encourage best practice among forces and bring down the death rate.

The unpublished preliminary report, "Analysis of drug related deaths in police care or custody 1997-2002", by Dr Best and Siobhan Havis, has identified a number of alarming trends.

In 12 per cent of the cases, medical help was called before the prisoner showed signs of distress and illness. In 10 per cent of cases, the officer mistakenly thought the prisoner was faking his illness.

Dr Best said the problem was particularly bad with civilian custody officers and police constables who receiving minimal or no training. In eight of the 42 deaths examined – 19 per cent – prisoners overdosed on drugs while in police custody. That means – in all those cases – the police failed to find drugs hidden on the suspect despite carrying out body searches.

In 15 deaths – about a third – the prisoners swallowed their drugs in an attempt to hide them from the police and overdosed or choked to death.

Surprisingly researchers found the drug that caused the most deaths was not heroin, as widely believed, but cocaine and crack-cocaine, which was found present in 60 per cent of the overdose cases. Traces of heroin and methadone, the chemical substitute, were found in 36 per cent of deaths.

The average age of the dead was 32, although they ranged from 15 to 65 and most were white men. Several police officers have been reprimanded after drug-related deaths. Three officers were disciplined over the death of a Gareth Brogden, 18, who choked on a condom filled with heroin in February 2000. The teenager, from Hartlepool, Cleveland, was nicknamed "Balaclava Boy" at the age of 11 after he wore a black mask on television and boasted about a series of crimes. As Brogden was arrested for a motoring offence he placed the drugs in his mouth. He was handcuffed and placed on his own in the back of van and taken to Hartlepool police station where he collapsed. An inquest said his death was an accident.

Three officers were disciplined in the case of Paul Harding, 48, who managed to conceal cocaine. He died in February 2001 of an overdose after taking the drug in his cell at Colindale police station in north London.

The PCA's full report, is due to be published in March.

Matthew Tempest, political correspondent, in Bournemouth
Wednesday October 9, 2002

Oliver Letwin today offered drug addicts a choice between rehabilitation or the courts as the Conservatives sought to show a more caring face on crime.
The shadow home secretary, speaking at the party conference in Bournemouth, insisted new drying-out clinics would not be an "easy option" - mindful that only two years ago delegates were thrilling to Ann Widdecombe's cannabis crackdown.

Instead of that hardline approach, Mr Letwin offered new measures to end what he called the "conveyer belt of crime".

And he dubbed the Home Office the "Office for Missing Targets", joking: "First the target is announced with a great fanfare. Then the target is missed. Finally the target itself goes missing."

And he attacked the government on four fronts: asylum, policing, drugs and crime. However, he only offered new policies on two of them: new drugs clincs for addicts, and new sentences for young offenders to include time spent in rehabilitation.

Mr Letwin told delegates it was a "radical new approach to dealing with the menace of hard drugs".

He said: "I propose we should actively identify those young people who are on heroin and cocaine, and that we should face them with a choice: treatment (including all the psychological and other hep required to beat the offence) or off to court.

"There should be no third way."

Young people caught using heroin and cocaine could avoid court by opting for treatment under the plans announced today.

Even those who refused it would see their record wiped clean at 18 under Mr Letwin's proposals. Drug treatment and testing orders are currently issued through the courts.

Mr Letwin's plans, shift the party's traditional emphasis on punishment to treatment.

However, those committing other offences would still face court.

He insisted treatment was no "easy option".

"This is about tough choices. We will say: 'we can help you find a way out but if you refuse to do that, we cannot let you go on harming society'".

Tories would build 10 times the current number of treatment places, which currently have waiting lists running into months, at a cost of almost £500m.

However, they would be run by community and voluntary groups.

The scheme would also rely on parents, friends and others coming into contact with young drug abusers to identify them.

"A Conservative government would will make the funding for such projects a priority within the health budget," Mr Letwin said.

"There is too much at stake for our young people and for society as a whole to allow this opportunity to pass us by.

"If we grasp that opportunity, and significantly diminish the number of teenage addicts, we will automatically reduce both the number of crimes and the number of persistent young criminals - because so many of our crimes are drug-related."

On his other proposal, Mr Letwin said re-offending rates could be cut by giving regular troublemakers "longer and more constructive" sentences.

Offenders should be taught self-discipline, personal responsibility and how to act like "a decent human being".

The aim was "not just a period of incarceration - but a long period, beyond, of active rehabilitation and reform".

He told delegates: "We need to lift young people off the conveyor belt to crime and we need to start now."

Some persistent offenders were moving through the criminal justice system "like hamsters caught in a wheel," going from one crime to another after periods in jail, in a "ghastly ceaseless round of self-destruction and social destruction".

A quarter of young people held within young offender institutions had already been convicted on seven or more occasions, often many more, he said.

"We need longer and more constructive sentences based on the reform of character." Mr Letwin said that a rehabilitation centre in Devon showed how such an approach could work.

"Their education is intensive, 14 hours a day, seven days a week."

Following this three-month period of custody, the offenders were not just "dumped on society" but given months of intense mentoring instead.

"It is tough, but it isn't uncivilised. It is caring, but it isn't a pushover. And it works. The reconviction rate is hugely reduced.

"A future Conservative government will base sentences for persistent young offenders on that model."

Mr Letwin said a Tory government would also extend, nationwide, a programme to help the parents of "messed up" four and five-year-olds become better parents - in a bid to stop them becoming criminals later on.

He called for smaller accommodation centres for asylum seekers with six-week processing of applications to clear the backlog.

And he urged more "New York-style policing" in Britain with more officers on the streets and less red tape.

"We need police officers visible and present, and being seen to be present, on the streets, in every neighbourhood."

Comment:

Letwin has consistently impressed as Shadow Home Secretary and while there is a great deal that he says that I have reservations about, there is also much here to welcome. Especially welcome is the acknowledgement that there needs to be a substantial increase in spending on treatment, and the proposal that young drug offenders shold have a "clean slate" at 18. Less palatable are the proposals to oblige parents and others to report people who use drugs, but nonethless, a startlingly good set of observations and ones that should give Blunkett some food for thought...

Sarah Boseley, health editor
Saturday October 12, 2002
The Guardian

The British drug company GlaxoSmithKline has been found to be in breach of the industry's code of marketing practice by playing down the side effects of the bestselling antidepressant, Seroxat.
Thousands of people have complained of severe withdrawal symptoms including nausea, dizziness and agitation after trying to give up the drug, which is a selective serotonin reuptake inhibitor (SSRI) like Prozac.

Glaxo says that Seroxat does not cause dependence because patients do not crave the drug or need increasing doses to feel good as they would if they were addicted to heroin. But a court in the US recently banned television adverts for the drug, which claimed it was "non habit forming".

The appeal board of the industry's self-regulatory body, the Prescription Medicines Code of Practice Authority, ruled yesterday that Glaxo had committed three breaches of the code of practice that says information and claims about a drug must be based on evidence, "must not mislead directly or by implication", must be substantiated by clinical experience and should be presented in a balanced way.

The complaint was brought by the consumer group, Social Audit, which won a previous case against Glaxo over the marketing of Seroxat (the generic name is paroxetine) a year ago. Both cases were rejected but won on appeal.

"This is an important ruling which casts doubt on GSK's claims that paroxetine is not addictive," said Charles Medawar, of Social Audit, "and by extension applies to all manufacturers of antidepressant drugs of this kind."

Mr Medawar said that the ruling cast discredit on the drug regulatory authorities in the UK, which had not paid enough attention to the problems suffered by patients on Seroxat.

"This ruling should cause the UK committee on safety of medicines, the medicines control agency and the US food and drug administration to fundamentally rethink their warning policies - which to date have been lamentable," he said.

He said that the patient information leaflet supplied with the drug and approved by the MCA said that "these tablets are not addictive" and that withdrawal problems "are not common and are not a sign of addiction".

Glaxo said that it was disappointed with the result of the case and that it strives for the highest standards of accuracy. "We have taken steps to learn from this," it said. It pointed out the MCA approved the patient information leaflet.

The problems with the SSRIs had been known for some years, said Ralph Edwards, director of the World Health Organisation's adverse drug reaction monitoring centre in Sweden. In 1997, his centre reported that the rate of withdrawal reactions with paroxetine was higher than with other SSRIs.

Comment:

Now, I don't suppose that anyone from Glaxo will be sent to prison for this, will they? Or even go to court. Not that we would want to draw a comparison between what big businesses can get away with selling dangerous drugs to the masses and what those supplying cannabis get...

The vindication of Ruth Wyner

Nick Cohen, Observer: 6th October 2002

The war on drugs has many victims. Few in my opinion were as undeserving as Ruth Wyner. She ran a hostel for the homeless in Cambridge and was jailed along with a colleague for failing to prevent heroin dealing on her premises.

No one said that she sold drugs or encouraged the sale of drugs or stood by as drugs were sold. Nevertheless, when her back was turned, the homeless sought the oblivion drugs brought for obvious reasons. Wyner and her colleagues refused to shop them. They protected confidentiality because they feared their clients would take to the streets and sleep rough if word got out that she was shopping them to the police.

The constabulary responded by disguising two officers as down-and-outs. They infiltrated the hostel and collected 300 hours of secretly shot film to prove a woman who had devoted her life to helping the wretched was a criminal.

Wyner's prison sentence showed how the courts did not begin to understand the lives of the dirt poor. Many charities feared with some justice that their workers could end up in the slammer if the law said they must stop the homeless shooting up. How, they asked, were they meant to do this? And why should volunteers help them with the threat of jail hanging over their heads?

Wyner lost her job and her family nearly lost its home. Although the Court of Appeal got her out of prison, it upheld a conviction which would allow the prosecution of parents who didn't turn in their dope-smoking teenagers. Imbecilic newspapers were delighted. The Government did nothing to address the worries of the managers of hostels. Until now, that is.

The Home Office is quietly consulting about reform. It is considering making it harder to prosecute parents, those working with rough sleepers and drug treatment workers if a conviction would do more harm than good. Civil servants have told Wyner that her 'case has highlighted the need for assessing a change in the law. A lot of our paperwork relates to your case.'

There's a long way to go before before the law is changed (you should never underestimate effect of a critical headline in a tabloid on the Home Office). Still, David Blunkett is a braver Home Secretary than his predecessor, and Wyner is already enjoying a small, happy glow as she contemplates the possibility that she will be vindicated.

Comment:

Tricky one this. Much as I respect Nick Cohen's vocal stance on Wintercomfort, this is sloppy and ill-informed journalism and I've emailed Mr. Cohen with a few concerns. The primary concern is that it suggest that the revised Section 8 will provide more, rather than less protection to workers. As we argue elsewhere in the Drug News section, this is not true, and there is precious little that should make anyone feel vindicated. I will post Nick Cohen's reply, if one is forthcoming.

Paddick Escapes Drugs Charges

Controversial police Commander Brian Paddick is not to face criminal charges over drugs allegations.

The Crown Prosecution Service said there was "insufficient evidence" to prosecute him for the possession of cannabis.

It also said it would not be in the public interest to prosecute him for allowing cannabis to be smoked at his home.

The 43-year-old, who is the UK's highest-ranked openly gay officer, was moved from his post after a former lover made the cannabis claims.

Reviewed

A CPS spokeswoman said: "The decision took account of recent decisions in similar cases.

"The file was reviewed by a senior and experienced Crown prosecutor who took the view that on balance the factors against such a prosecution clearly outweighed the factors in favour."

A file was sent to the CPS a month ago following a four-month inquiry by Deputy Chief Constable Gordon Clark of Humberside Police.

Mr Clark looked into claims by Cdr Paddick's former partner, ex-male model James Renolleau.

Switched

Cdr Paddick was not suspended from his £93,000-a-year job as the high profile head of policing in Lambeth but was switched to desk duties.

He came to prominence last year for introducing a more lenient police approach to cannabis in Lambeth.

People caught with small amounts of the drug were given a formal warning rather than arrested and the cannabis confiscated.

Comment:

An interesting lesson in how to twist the facts to make a story: Brian Paddick doesn't "escape charges," rather there was not enough evidence to say he had actually done anything wrong. A big difference. But more interesting was the CPS decision that it would not be "in the public interest" to prosecute him for allowing the smoking of cannabis at home. While we wholly welcome this decision in Commander Paddick's case, we hope and trust that a similar approach will be taken in other less high profile cases as this would effectively mean that the CPS did not consider section 8(d) of he MDA, in domestic settings worth enforcing, at least as far as cannabis went.

We are pleased that Commander Paddick's ordeal by media should now be coming to an end, look forward to abject apologies from the more rabidly rightwing end of the press, and wish him well in his future career. We share the dismay voiced aware that he will not be resuming duties in Brixton.

In considering the decriminalisation of marijuana, Canada's outgoing prime minister may make a hash of US relations, writes Anne McIlroy

Monday October 7, 2002

Prime Minister Jean Chrétien seems prepared to risk the ire of the United States and decriminalise the use of marijuana.
Last week, the Liberal government laid out its agenda for this session of parliament and included plans to decriminalize cannabis.

Mr Chrétien, who has announced he will retire in 2004, is sniffing the wind for a legacy. Decriminalising marijuana has the sweet smell of something Canadians might remember him for, so the normally cautious Mr Chrétien appears to be prepared to move ahead. Not that he has ever smoked any himself.

"When I was young the word marijuana did not exist. I didn't know. I learned about the world long after that. It was too late to try it, " Mr Chrétien, 67, recently told reporters.

But his 39-year-old justice minister confesses to having inhaled. "Of course I tried it before. Obviously," said Martin Cauchon. He is keen to decriminalise marijuana, which would mean that people caught smoking the drug would get tickets instead of heavy jail sentences, punitive fines or a criminal record.

The UK took a similar step earlier this year. But Britain isn't next door to the United States, where the government of President Bush continues to push an aggressive zero tolerance drug policy, for both itself and its neighbours.

John Walters, the Bush administration's drug tsar, has publicly stated that if Canada decriminalises marijuana it could face serious disruptions to border trade, which is crucial to the Canadian economy. Other US politicians have warned of dire consequences if Canada becomes the pot patch of the north.

Fear of angering the US is one reason why Mr Chrétien has left himself room to back away from decriminalising marijuana. He has said his government will look at decriminalising pot, but has stopped short of actually promising to do so.

But momentum is clearly building. Last month a Canadian senate committee made headlines, recommending that anyone over the age of 16 be able to smoke marijuana freely.

If it is ever implemented, the recommendation would mean joints would be legally available to teenagers long before a pint of beer. The report, which filled four volumes, was extensively researched. It also urged amnesty for the 600,000 Canadians convicted of possessing marijuana.

The senate committee argued that the recreational use of pot is no more harmful that smoking cigarettes or drinking alcohol, both legal vices that provide healthy annual tax revenues. There is no reason marijuana shouldn't be legal and sold at the local store, the committee said.

Canada is also moving ahead with plans to allow the use of medical marijuana, for people undergoing chemotherapy or suffering from HIV/Aids.

In November, a special committee of Canada's House of Commons is due to report on the non-medical use of drugs. If it recommends decriminalisation, it will give Mr Chrétien the green light to move ahead.

There is no chance he will follow the advice of the senate committee and legalise marijuana, but decriminalisation looks increasingly like safe middle ground. Pot wouldn't be legal, but getting caught smoking it wouldn't mean a jail term and restricted job possibilities.

Yes, the US government would be upset, but a retired Mr Chrétien won't be around to face the consequences. His heir apparent, former finance minister Paul Martin, would be in charge. He might not mind standing up to Mr Bush on the issue. His aides have let it be known that he ate a hash brownie when he was a much younger man.

Medicinal cannabis may be available within two years

Pharmaceutical companies invest millions to develop new painkillers as Medical Research Council tests enter their final phase

By Jeremy Laurance, Health Editor

07 October 2002
The world's oldest euphoric drug is poised to make a return to the medicine cabinet. Cannabis, reputedly taken by Queen Victoria to quell her period pains but banished from Britain's schedule of medicinal drugs in 1971, is on the point of winning scientific backing for its role in easing the symptoms of chronic disease.

This week the Medical Research Council is due to announce that it has recruited the last of 660 patients to a £1.2m trial of cannabis-based medicines in the treatment of multiple sclerosis, the largest in the world. Most of the patients recruited over the past two years have already completed the 15-week trial, in 30 centres round the UK.

Although final results will not be available until next summer, researchers are optimistic. Dr John Zajicek, consultant neurologist at Derriford Hospital, Plymouth, who is leading the research, said: "I'm fairly confident we are going to find an effect in reducing spasticity, or muscle spasms, and it is also going to have an effect on bladder control.

"Anecdotally some patients have had tremendous benefit from it. One or two who couldn't walk or go to the loo found they were able to when they were on the drug. There have been some whose lives have changed dramatically."

Next month, a venture capital firm, GW Pharmaceuticals, is due to report preliminary results from its own Phase III trials of cannabis-based medicines in patients with multiple sclerosis, spinal cord injury and other conditions. Phase III trials are the largest and most rigorous, and must show positive results before a drug can be licensed.

Last week the company published results from an earlier, smaller Phase II trial which showed that 28 out of 34 patients suffering severe pain benefited from the medicines and had elected to continue on the trial. Geoffrey Guy, GW's executive chairman, said: "One can be confident the Phase III trials are going to yield results reflective of Phase II."

If such hopes are fulfilled, cannabis-based medicines could be on the market in two to three years. The National Institute for Clinical Excellence, the government watchdog on new medicines, has been alerted by its horizon scanning unit in Birmingham, whose job is to spot drugs in development before they hit the NHS.

The medicinal benefits of cannabis have been known for at least 2,000 years. Its analgesic properties were described by the British herbalist Nicholas Culpepper in 1653. Two drugs based on the active constituent tetrahydrocannabinol (THC) have been used in the UK for over 30 years to treat nausea in cancer patients undergoing chemotherapy, although their use has declined as better anti-emetics have been developed.

Medicines derived from the cannabis plant are being tested by drug companies around the world as treatments for pain, stiffness, tremor, weak bladder, loss of appetite and high blood pressure. It is being tested in people with behavioural disturbance caused by Alzheimer's and in sufferers from Parkinson's disease.

Research is also going on into its role in stimulating appetite in cancer and Aids patients ­ cannabis has long been known to give users the "munchies".

But one hurdle remains to be overcome. Scientists have not so far succeeded in isolating cannabis's medicinal properties from its euphoria-inducing ones. Although patients in both trials have not got high, that is believed to be because they were taking low doses.

"Most of the active ingredients of cannabis can give a high. What the Government wants is a drug that can be used without being abused," Dr Zajicek said.

In the 1970s, researchers discovered morphine-like opioid receptors in the spinal cord that led to the development of epidural painkillers, which did not have the psychoactive effects of morphine. They are now widely used in childbirth, after surgery, and increasingly for intractable pain such as that caused by cancer.

Similar receptors for cannabinoids have been identified in the spinal cord, and the hope is that cannabis-based drugs can be developed to target them which would have a painkilling effect without a psychoactive one.

With scientists confident that they can harness some of the 60 active constituents of cannabis to alleviate a range of symptoms, millions of pounds are being invested by drug companies in developing unique combinations of the constituents or finding a unique means of delivering them to the body, which would be patentable. As cannabis is a natural plant, neither it nor the oil produced from it can be patented.

In the MRC trial, patients were given either THC ­ cannabis oil derived from the whole plant ­ or a placebo in a capsule to be swallowed. The THC was manufactured in California and the cannabis oil was derived from plants grown in Switzerland and processed in Germany.

One drawback of using an oral drug is that there is great variation between patients in the dose needed to produce an effect. Patients in the MRC trial were started on a target dose based on their weight, which was adjusted over the first five weeks, depending on side effects.

GW Pharmaceuticals have developed an under-the-tongue spray which they claim is absorbed more quickly, making dose adjustment simpler. Their patients received THC or cannabidiol, either alone or in combination, manufactured from cannabis plants grown in a secret location under tight security in southern England.

The Multiple Sclerosis Society has taken a close interest in the research, but has declined to fund patients who wished to continue on the drug after the end of the MRC trial ­ to the anger of some of its members.

A spokesman said: "There is a tremendous amount of anecdotal evidence that cannabis in various forms can be helpful in alleviating some of the most unpleasant symptoms of MS.

"But we also know that there have been people with MS who have had very bad experiences. So the main concern is whether the substance is safe in the long term, because people with MS have a condition that is going to last the rest of their life."

'It was brilliant just to be able to stand'

The pills Hazel Walker swallowed as part of the Medical Research Council's (MRC) cannabis trial helped her get out of her wheelchair and walk. She took them for 15 weeks last year and the effect was dramatic.

"I could walk a couple of lengths of the hallway and do simple things that other people take for granted. It was brilliant, really brilliant," she said.

She still doesn't know what was in the pills because the trial was "double blind" to prevent both the patients and their doctors knowing who was taking the active ingredient and who was taking the placebo.

But the improvement in her condition was so striking that after a fortnight's break at the end of the trial she elected to go back on the pills for another year and continued to reap the benefits.

"The first week after I came off the pills I really went downhill. I tried to do things I had got used to and I found I couldn't. When I went back on them I noticed a change again – more mobility and fewer spasms. It is very hard to stand at the sink and wash the dishes if you have got spasms in your legs."

Her love life improved, too. "It was brilliant to be able to stand up. It is difficult to get passionate stuck in a wheelchair."

Aged 47, she has had multiple sclerosis for seven years. She is confined to a wheelchair and when her husband, a fisherman, is away, she needs two carers to get her up and dressed in the morning and put her to bed at night at their home in Plymouth.

The only drugs that have helped during those seven years have been steroids, but they have damaging effects if taken long-term. Medicines based on cannabis are her only hope but now they, too, have been taken away.

Funding was only available to provide one year's supply of pills. For Hazel, they ran out this summer. The MRC's researchers applied to the Multiple Sclerosis Society for financial help to continue supplying the drugs, but the society declined.

Hazel said: "I was left in limbo. I was annoyed, to be honest. The MS Society says it won't fund the drug, yet it gives benefits to people with MS. It's frustrating."

She experimented with herbal cannabis for a while: "I tried it for a fortnight. I sat watching telly and started laughing. I don't know whether it helped because I was giggling all the time."

"I didn't fancy going out if I was going to be in the street giggling. People already think if you are in a wheelchair you are practically braindead and if they saw me giggling they would probably think I had lost it altogether. You need your wits about you. My hope now is that the trial is successful, the drug is licensed and I can start taking it again."

Comment:

So finally, science acknowledges that cannabis has medicinal benefits, and that means that wisdom more than 2000 years old has been accepted in the new Millenium. It also means that all those people who have used cannabis medicinally have been vindicated and should have their convictions overturned and their criminal records wiped clean. The state owes these people a colossal apology and compensation for denying them a substance that now has proven health benefits for certain conditions.

Similarly, those who have been criminalised for making the drug available should be pardoned, and those in prison be released.

Actually, what will happen is that nothing will change except that big pharmaceutical companies will reap collosal profits from the supply of cannabis derivatives. In turn they will lobby for the drug to remain a Controlled Drug, thus ensuring that they have a monopoly on its supply and ensuring that noone produces their own.

So next time a GP speaks out on the dangers of Cannabis, it will be worth checking which of the pharmaceutical companies is bunging them a few quid. For ironic comparisons see the stories relating to Colin Davies and Seroxat.

Cocaine use is rising faster in the UK than anywhere else in the European Union.

A new report warns the drug's use may be so widespread because the UK is among the cheapest places to buy it.

A third of the nine tonnes of heroin intercepted in the EU in 2000 were seized in the UK.

The report, compiled by the EU drugs agency in Lisbon, puts Britain with Italy, Luxembourg and Portugal as having the highest estimated levels of "problem" drug use.

It shows the number who have tried amphetamines in the UK is about double the rate anywhere else in Europe.

The report confirms cannabis is still the most commonly used illegal drug in Europe - with those having taken it ranging from about 10% of adults in Finland to up to 30% in Denmark and the UK.

In most other member states the rate is about 20% of the adult population, with cannabis use levelling off or even falling in Ireland, the Netherlands and Finland.

By comparison, cannabis is used by 34% of the adult population in America.

Use of all other illicit drugs in the EU is far lower: Amphetamines have been tried by 1%-6% of the population depending on member states - but by 11% in Britain.

The overall number of people recorded as being treated for drugs problems is on the rise - but that is partly because improved data is giving a more comprehensive picture of the situations, says the drugs agency.

A man who opened what was claimed to be Britain's first Amsterdam-style coffee shop under the smokescreen of being a cannabis "healer" has been jailed for three years.

Colin Davies "persistently flouted the law" by being involved with cannabis even while he was on bail for other drug-related offences, a court heard.

The 44-year-old hung his head as he was sentenced on a total of eight charges relating to the activities of the Dutch Experience cafe he opened in Stockport, Manchester's Minshull Street Crown Court heard.

He was given two years for the supply of a class B drug, 18 months for being involved in the importation of cannabis, 24 months, 15 months and 12 months for possessing a class B drug with intent to supply, 12 months for permitting premises to be used for smoking of the drug.

All of these sentences are to run concurrently, making a total of two years. Davies had pleaded not guilty to all of those charges but was convicted of them by a jury of seven men and five women.

He was given two lengthier terms for possessing with intent because he committed those offences while he was on bail, the court heard.

Davies also pleaded guilty to another charge of possessing a class B drug with intent to supply and perjury for which he was given 12 months for each offence to run concurrently.

The prison sentences for the two latter offences are to run consecutively with his sentences for the other six counts, making a total of three years.

His father Colin Davies Senior, 72, of Stockport, also appeared with his son in the dock charged with perjury and perverting the course of justice. He had described, his son as a "healer not a dealer".

He pleaded not guilty to both allegations and the court ordered that the charges should remain on file and that Mr Davies Senior was free to go.

After his son, who has already served nine months in jail since his arrest last year, was taken by security from the courtroom, Mr Davies senior looked on shaking his head. He said of the sentencing outside the courtroom: "We'd think it's pretty hard really for what the lad has done. It's really hard."

Commentary:

If anyone still thinks that we are entering a period of elightened, liberal drug policy, this sentencing should disabuse them of that notion for a while. Please also note the size of the sentence for the premises (section 8) part of the offence - 12 months. This would suggest that the courts would consider this an appropriate sentence for such offences, and organisations tolerating use of cannabis should take heed.

Rather than condemning the sentence, though, condemnation should be directed at the legislation that underpins it.

Police plan heroin 'injecting rooms'

The Guardian

Sara Gaines and agencies
Monday September 30, 2002

A police force is considering a pilot scheme to allow drug users to take prescribed heroin in a controlled environment, it was confirmed today.

Kent police and local health workers are looking at setting up a clinic that would offer diamorphine to some addicts, as part of its drive to tackle crime.

The Kent drug action team - a partnership between health workers, police and the probation service - is expected to offer the clinic only to addicts who fail to respond to other treatments.

But a police spokesman denied that the proposals amounted to a heroin "shooting gallery".

"A shooting gallery is what you get on the south side of Chicago in a derelict house where addicts go to take crack cocaine and heroin," he said. "To describe what is being looked at as being like a shooting gallery is completely and fundamentally wrong.

"We know from experience that a high percentage of people that we arrest in connection with vehicle crime and burglary have drug addiction issues.

"What we are looking at is removing the link that exists between addiction and the committing of crime.

"It is still very early days. We still need to look at who would be eligible, and under what circumstances it would be carried out."

No area of Kent has yet been earmarked, but any such scheme would likely be set up in the Medway towns of Rochester, Chatham and Gillingham.

The talks have the blessing of the chief constable of Kent, Sir David Phillips, who is also president of the Association of Chief Police Officers.

"He is not afraid to do things just because they have not been done before by other forces. He believes that there is some potential in doing something like this," the police spokesman added.

It comes four months after a home affairs select committee report recommended that such clinics - which already exist in Germany, Holland and Australia - should be set up in the UK.

The chief executive of DrugScope, Roger Howard, welcomed the Kent police plans but said safe injecting rooms should be set up countrywide and offered to all heroin users, not just the handful that are prescribed pure heroin.

He said: "It is certainly an excellent first step in the right direction but we need to go further and responsibility to go further must lie with the government.

"Safe injecting rooms have the capability to save hundreds of lives and reduce nuisance to the public by decreasing injecting in public places."

A DrugScope spokesman added that some addicts might be wary of getting involved in a scheme run by the police, even if, having been prescribed heroin, they were not acting illegally.

"We would question whether the police are the best agency to deal with this," he said. "It is a health problem first and foremost not a criminal problem - though that is how the government have chosen to view it."

Research suggests injecting rooms have many benefits: in Sydney, Australia, 30% of the 600 registered users who used the safe injecting room had taken up advice regarding treatment. There have been no fatal overdoses in the injecting facilities in Germany and Switzerland.

In Berne, the Swiss capital, around 70% of the injecting drug user population use the injecting rooms, with two-thirds doing so regularly.

Commentary:

Now this is getting silly! In the same few days that that the Government proposes it's Section 8 amendment, police forces are simultaneously exploring "safer injecting rooms." But just safer injecting rooms for prescribed heroin users, not street users? This article is frankly bizarre.

Injecting rooms in Holland and Germany allow people to inject non-prescribed drugs. Provision for people with injectable scripts is not new; nor will it decrease public nuisance or oversdoses unless a lot of people are moved on to injectable opiate scripts.

UK Braced For Heroin Flood


Heroin production in Afghanistan has soared by 1,400% since the war on terror and the fall of the Taliban, experts have said.

The total yield of this year's opium poppy crop will be between 1,900 and 2,700 metric tons, compared with 185 tons last year.

Afghanistan's vast opium poppy harvest is said to account for 90% of the highly-addictive drug sold in Britain.

And experts fear the the upsurge in production could lead to a flood of cut-price heroin on Britain's streets.

Concern

They say the collapse of the Taliban triggered the massive rise because poppy growing was banned by the regime in July 2000, leading to a fall of 95% in the size of last year's crop.

The figures will be discussed by experts from the United Nations Drug Control Programme at a conference on Thursday.

DrugScope, the drugs charity which is staging the conference, said the new figure demonstrated opium cultivation was back to "a very significant level".

Chief executive of DrugScope, Roger Howard, said: "The expected large rise in Afghan opium production is a major concern."

Massive post-war rise in production of Afghan opium
By Jason Bennetto Crime Correspondent
26 September 2002
Internal links

Massive post-war rise in production of Afghan opium

First Afghan war criminal is jailed
Britain is expected to be hit by a flood of heroin after a gigantic increase in the production of opium in Afghanistan, the United Nations will warn today. A UN survey estimates the farmers will grow 2,700 tons of opium this year compared with 185 tons in 2001, a 1,400 per cent jump.

In July 2000, the Taliban government banned farmers from growing the opium poppies, but since the regime was toppled, production of the lucrative crop has resumed.

Afghanistan is the source of 75 per cent of the world's heroin and 90 per cent of Britain's supply. Evidence suggests heroin supplies to western Europe had been running low, an international drugs conference in Paris will be told.

Brian Taylor, head of the supply, reduction and law enforcement section of the UN drug control programme, will say that the Afghan authorities lack the equipment and training to tackle the problem.

Customs and Excise, and MI5, have been warning ministers for months about the growing drugs threat from Afghanistan. Mr Taylor will tell a conference on trafficking and law enforcement, organised by the research organisation DrugScope, that the total amount of opium expected to be produced this year is between 1,900 and 2,700 tons. In 2000 3,300 tons were cultivated, and 4,600 tons produced in 1999.

The UN will also report that the price of opium from Afghanistan has doubled to $350 (£225) a kilo. Ten kilos of opium make one kilo of heroin.

Drugs specialists from the UN made a survey in February in the growing regions of the south and east of Afghanistan, which account for 84 per cent of the poppy cultivation in the country. They found between 45,000 and 65,000 hectares (one hectare is 2.4 acres) were under poppy cultivation. In May a second survey in the northern region found opium cultivation had increased from 6,640 hectares in 2001 to 9,750.

Mr Taylor will say that despite the slump in heroin production last year the war in Afghanistan lead to "panic sales of reserves" of the drug to western Europe, which kept the prices stable.

There have been encouraging signs that purity levels of heroin seized in the UK had started to drop, indicating that supplies may be running out, he will add.

Britain has a growing heroin problem, with the drug being used by an estimated 300,000 people in a trade worth £2.3bn a year. In April, the Foreign Office said the amount of heroin on the streets would be cut by a scheme offering Afghan farmers £1,250 (£800) for each hectare of opium destroyed.

Afghan authorities are beset with problems in trying to counter the cultivation of drugs. These include poorly trained and equipped staff, no operational police equipment, a lack of transport, and no scientific equipment to test suspected drugs.

Commentary:

The concern that this will see more heroin hitting the street is more speculative. Past experience would suggest than rather than this glut hitting the market, it will be refined and stockpiled rather than forcing the already low prices lower still. Some of the prices that we have seen variously quoted in the press for heroin prices (e.g. £80/gramme) are at odds with Release's ongoing mapping of prices, which are routinely producing figures of half this, although fraction-of-a-gramme purchases are more expensive.

Monday, 23 September, 2002,

UK BBC UK

GP sold banned slimming pills - Dr Sabbuba admitted selling phentermine

A doctor accused of selling slimming pills to patients without properly warning of the side-effects or checking medical histories has appeared before a General Medical Council tribunal. Dr Mohammad Sabbuba, from Caerphilly, admitted selling phentermine, a drug whose licence was withdrawn after fears about its safety, but he denies serious professional misconduct. The GMC tribunal, meeting in Manchester, viewed secretly filmed footage of Dr Sabbuba selling the drug to three undercover BBC Wales journalists. Dr Sabbuba faces a General Medical Council hearing

Dr Sabbuba, faces further allegations that his prescribing of the drug was inappropriate, irresponsible, not in the patients' best interests and contrary to accepted medical practice. The GP retired from his practice at Lansbury Park, Caerphilly in 2000 and was running a private slimming clinic from his home in the Energlyn area of the town. Researchers from the current affairs programme Week In Week Out went undercover to show him prescribing unlicensed drugs without sticking to guidelines.

At the hearing in Manchester, Dr Sabbuba admitted prescribing phentermine, an appetite suppressant, in May 2001. The drugs manufacturers claim the drug is safe and are appealing against its licence withdrawal. Dr Sabbuba also admitted that he failed to find out the identity of the patients' GPs and to advise them to consult their GP about the use of the drugs. The film footage showed him prescribing phentermine after a short consultation. Staff who worked on the BBC programme gave evidence about their appointments. All the journalists said Dr Sabbuba was very affable and came across very well during their meeting.

But an expert witness, Graham Smith, a professor of clinical pharmacology, said Dr Sabbuba was going against the advice of the Medicines Control Agency by providing the drug which is only to be used when all other options have failed. Professor Smith said he was concerned about the would-be patients being prescribed the drug without the doctor delving into their medical history. The hearing is expected to end on Wednesday.

MONDAY 16/09/2002 15:58:56
UK cannabis row

A split emerged among senior police officers today over plans to introduce a ''three strikes and you're out'' policy on cannabis.

The Police Superintendents` Association (PSA) said the proposal announced by the Association of Chief Police Officers earlier this month was an ``unworkable fudge`` which would confuse the public.

Home Secretary David Blunkett plans to reclassify cannabis from a Class B drug to Class C, removing the police`s power to arrest someone found with small amounts of the drug and putting it alongside steroids and prescription anti-depressants.

Chairman of ACPO`s drugs committee, the Metropolitan Police`s Deputy Assistant Commissioner Andy Hayman, said officers should be able to arrest cannabis users when they are caught with up to three grams on three occasions.

But PSA president, Chief Superintendent Kevin Morris said: ``We cannot understand how the power of arrest suddenly becomes available when it wasn`t available on the first two occasions.``If that`s not clear we are in danger of making our officers make mistakes.``How is a bobby on the streets going to know if it is three grams or not - are they going to carry scales with them?``I understand ACPO`s desire to show they are not going to let anybody take the mickey. But if it is not a serious offence the first time around, how can it be a serious offence on the third?``

Chairman of the PSA`s crime committee, Chief Superintendent Phil Carter added: ``No thought has gone into how this would operate on the streets.``It`s a total, unworkable fudge.``The officer, from Lincolnshire, continued: ``We need to get some clarity on how we are going to deal with cannabis and the sooner we get that clarity the better for the public and the police.``Mr Carter questioned the need for ACPO to introduce new complications to Mr Blunkett`s plan, which police officers widely agreed would allow them to focus resources on tackling hard drugs like heroin and cocaine.``I cannot see the need for it,`` he said.``Three strikes and you`re out is a halfway house that leaves us nowhere.``There was already confusion among some members of the public who have wrongly assumed that Mr Blunkett`s proposal - first announced last October - meant cannabis was being legalised, he said.

Mr Morris also questioned how ACPO`s proposal would work if a cannabis user was caught in one area of the country and later challenged by officers in another region.``If it will require another database, who will collect the data and who will pay for it?`` he asked.``The Police National Computer isn`t noted for being up to date so why would another database be up to date?``UTV (Ulster) 16.9.02

Commentary:

It would seem that some of the very concerns raised in the "Smokescreen" document are being raised by the PSA. One does need to question how a process of consultation and guidance writing by ACPO can have failed to take account of the PSA. As this, and the analysis below of the cannabis proposals by Tiggey May at South Bank university highlight, the current proposals on cannabis appear ill thought out and unworkable. It would be a brave (or foolhardy) Home Secretary that pressed on with these frankly daft proposals in the face of growing and rational objections.

Date rape drug test breakthrough

Sep 22 2002

Sex attackers who prey on young women by spiking their drinks with near-untraceable drugs are to finally face justice after a major breakthrough by Midland scientists. They have developed a new do-it-yourself evidence collection kit for victims - which can detect the substances up to FOUR days after an attack.

Developed by Birmingham's Forensic Science Service, the kits will soon be kept at all West Midland Police stations and possibly in patrol cars.Victims will be able to use them to collect vital evidence of date-rape drugs at the station or even at their home - avoiding the often lengthy wait for a police doctor.

The move comes after a staggering rise in alleged drug rape cases in the last two years.More than 2,000 women have come forward claiming to be victims but despite the increase in reported cases only seven convictions have ever been secured.The discrepancy arises mainly because of the delay in taking and preserving bodily fluid samples from victims.In some cases it can be hours before a complainant is medically examined by a police doctor - with the offending drugs often having already passed through the body.

But the introduction of the K106 Early Evidence Detection Kit means victims will be able to take their own samples if required.It was a delay in collecting forensic evidence which led to a Midland mother last year criticising police after her daughter killed herself after claiming to have been drug raped.Carol Marsden told the Sunday Mercury how 19-year-old Emma, from Studley, Warwickshire, was kept waiting at a police station for "hours on end" before being examined.She had been on a night out in Birmingham and met a clubber who bought her a drink.Carol said: "The next thing she could remember was being at a police station the next morning."Officers had picked her up after she started banging hysterically on someone's door in the early hours."

A man was eventually arrested on suspicion of rape but later released without charge through lack of evidence.The new K106 kit, which took 18 months to develop and costs £5.50, is only available to law enforcement agencies and involves taking a urine sample and mouth swab.It can detect traces of nearly 20 drugs in the body up to four days after they were taken.Narcotics administered in drug rape cases like GHB and Rohypnol leave the body within two to eight hours - making detection virtually impossible.Mrs Mary Newton, of the FSS, said: "Time is always an issue when trying to detect drugs in the body because it metabolises different drugs at different rates."This kit will ensure that firm forensic evidence admissible in court can be collected at an early stage and so hopefully help secure a conviction."

Cindy Sturman of the Drug Rape Trust, welcomed the new kit which she said demonstrated the authorities were taking the issue seriously.A recent report by the charity claimed 70% of drug rape victims knew their attackers and 42% were in their 30s. Pubs and clubs accounted for 40% of the venues where druggings took place with 11% of the victims being men.She said: "Alcohol still accounts for the vast majority of all assisted rapes but we have pinpointed up to 67 different drugs that have been used in rape cases in this country and the USA."Drug rape is not a new phenomenon and was around in the 1960s and 70s but it is only through modern technology that we have been able to actually identify the drugs being used and tell when they were administered."The fact that this kit is quite unobtrusive and can be administered by a constable will hopefully mean more women will come forward."Last year we had 2,000 women contact us claiming to be drug rape victims. But we feel that is only the tip of the iceberg considering only about seven per cent of rapes are reported to police."She added: "It is the simplicity of the new kit which makes it so effective. It can be administered anywhere the victim feels comfortable."

A spokeswoman for West Midlands Police said the force was hoping to have the kits at all its stations."We may even extend it so that all patrol cars will keep one as they are often first on the scene."

IC Coventry 22.9.02

800 hooked on drug seek legal action

Patients say warning on side effects inadequate

Sarah Boseley, health editor
Monday September 16, 2002
The Guardian

More than 800 men and women who have found themselves hooked on the antidepressant Seroxat are seeking legal action against the British manufacturers, increasing the pressure for tougher warnings about the drug's side effects.
The potential litigants want to force Glaxo SmithKline to change the information it puts out to doctors and patients. They want the company to warn that significant numbers of people can become dependent on the drug - an SSRI (selective serotonin reuptake inhibitor) like Prozac - which GPs often prescribe for relatively minor depression.
As the numbers of those seeking action in the UK continue to rise, a row is under way in the United States where a federal court judge has ordered Glaxo to pull television advertisements which state the drug is "non-habit forming".
Mark Harvey, of the solicitors Hugh James in Cardiff, who has most of the UK cases, said his clients were most anxious to get an adequate warning on the drug and research into the dependency problems and aggression they say they have experienced. Compensation for their distress, which in some cases is said to have lasted years and wrecked lives, was a lesser priority.
Mr Harvey said the cases were still coming in at the rate of around a dozen a day. The scale of the problem was so great that he believed the medicines control agency (MCA), which regulates pharmaceutical drugs, should take action.
"I have written to the MCA who have continued to say there isn't a problem here because we accept what the companies tell us," he said.
"The system for reporting adverse drug reactions has never been satisfactory. I have got 800. I suggested they might listen to the stories my clients tell and accept those as reports."
Only doctors, and, more recently, pharmacists and some nurses, can send reports of problems with drugs to the MCA through what is known as the yellow card scheme - not the patient who is experiencing the side effects.
Only a few doctors ever send in reports, however, and most experts believe the scale of drug-induced illness is under-estimated.
Seroxat has topped the league for yellow card reports of withdrawal problems by some distance, with 1,281 reports to date.
"They can't continue to say there isn't a problem when I have 800 people," said Mr Harvey. "The World Health Organisation has said there is a problem. This is like a living clinical trial."
The MCA has recently said that it may be willing to consider some way of accepting reports of side effects from patients themselves.

Legalise all drugs worldwide, says Mowlam

Patrick Wintour, chief political correspondent
Thursday September 19, 2002
The Guardian

Mo Mowlam, the former cabinet minister responsible for drugs policy, is calling for the international legalisation of the drugs trade as part of a more effective drive to combat terrorism.
Writing in the Guardian today, Ms Mowlam says: "Rather than bombing civilians in various Muslim countries, the United States and Britain should begin to take a more intelligent approach to the international drugs trade, namely to legalise it internationally."
Ms Mowlam, already an advocate of the legalisation of cannabis in Britain, is unlikely to find her latest proposal embraced by Downing Street but she will find support from some drugs specialists, who believe the battle to stop trafficking, with its inextricable links with terrorism, cannot succeed through mere suppression.
In her article she joins another ex-cabinet minister, Chris Smith, in questioning the need to topple Saddam Hussein, arguing instead that an effort to neutralise the illgal trade will do more to win the war against terrorism.
She points out that the international drugs trade is estimated to be worth around $400bn a year, representing about 8% of world trade. She suggests that legalisation and regulation of the trade, requiring international action, will isolate the terrorists.
She also cites Republican s within the US administration, some of them in the state department, who admit that terrorist groups are increasingly using drug trafficking as a source of revenue.
She writes: "Drugs and terrorism are linked and are set to become more so. Legalisation of drugs would stop this connection: it would begin to solve many of the problems caused by drugs today and would isolate the terrorists".
Ms Mowlam stood down as MP for Redcar last year, partly due to her frustration at the government's slowness in moving to a softer line on drugs issues.

A lost war

David Blunkett has said that more addicts should have legal access to heroin. A key Whitehall adviser on drugs policy for over 30 years has argued that GPs should never have been stopped from prescribing

Alan Travis
Wednesday September 11, 2002
The Guardian

It is a rare civil servant who gets out from behind his desk to discover for himself the extent of a problem. But then HB "Bing" Spear, who rose to the rank of chief inspector of the drugs branch of the Home Office, was a most unusual Whitehall policy-maker.
The Rev Ken Leech, founder of homelessness charity Centrepoint and a man with a lifetime's experience of work with hardcore heroin users, says that in the 1960s and 1970s, Spear was a familiar figure to those who queued at midnight outside the Boots all-night chemist in Piccadilly Circus, central London, with their prescriptions, dated for the next day. The same addicts would, says Leech, "often invite themselves to tea" with Spear at the Home Office. There were no private security guards on the door in those days and he would provide not only friendly advice, but even the name of a doctor who might legally prescribe them injectable drugs.
When the "street addicts", many of them young, made their first appearance living rough in the West End, Spear made it his business to get to know them. His Cornish independence of mind, combined with a mild manner, ensured they remained in close touch - some even turned up at his funeral in 1995.
These extraordinary contacts meant that, for more than three decades, the senior policy official behind much of Britain's drugs policy was a man who not only knew police drugs squad officers and pharmacists, but was also on first-name terms with many drug addicts in London and the doctors who prescribed for them. There were, of course, far fewer heroin addicts in London in those days. Only 1,053 heroin addicts were "known to the Home Office" in 1967, compared to the estimated 250,000 problem drug users to be found in Britain today.
Spear joined the Home Office drugs branch in 1952 and was its chief inspector from 1977 to 1986. In his retirement, he brought all the unique experience he gained "keeping my bureaucratic nose clean for 34 years", as he put it, to writing the authoritative insider's history of Britain's drug policies, using the Home Office papers to which he himself had made such a substantial contribution.
The result, Heroin Addiction Care and Control: the British System 1916-1984, is belatedly published tomorrow, after the task of editing Spear's manuscript was taken on by his former colleague, Joy Mott. The book provides ample evidence to confirm that the traditional British approach to tackling hard drug abuse is not to employ American-style policies of crime and punishment, but to regard heroin addiction as a mental health problem and a suitable case for medical treatment.
The book's appearance is particularly timely now that the home secretary, David Blunkett, has sparked consternation in some corners of the medical world by suggesting it is time, once again, to expand NHS prescription of heroin to hardcore addicts partly as a way of undercutting the illegal market.
Spear has provided an authoritative and much-needed account of how and why British GPs lost the right to prescribe heroin unless they were specially licensed. The crunch came in 1967 - in many ways, a watershed year in British drug culture - when a handful of notorious doctors, including Lady Isabella Frankau and John Petro, were responsible for overprescribing and so creating Britain's first illegal market in pharmaceutical heroin. Several famous international jazz musicians and officials at the US embassy in London were among Frankau's patients.
The book argues that these maverick doctors could have been dealt with by a proper tribunal system. Instead, the loss of the GPs' right to prescribe and the creation of a handful of treatment clinics as an alternative, proved what Spear calls "an unmitigated disaster" that eventually left Britain defenceless when the mid-1980s' heroin boom arrived. "The moral high ground was seized by a small group within the medical establishment, and by psychiatrists in particular, who, over the years, succeeded in imposing their own ethical and judgmental values on treatment policy," he concludes.
Those psychiatrists knew almost nothing about treating heroin addiction. Yet, in the absence of any government policy on the question, they dictated what could be delivered as legitimate treatment and exerted enormous pressure on any colleague who had other ideas. Their strongly US-influenced moral approach to the treatment of addiction proved decisive in ensuring that oral methadone - not injectable heroin - was recommended when the Department of Health finally produced clinical guidelines to cope with the 1980s' heroin epidemic.
Spear writes that this group of psychiatrists ensured that the treatment centres were as uninviting as possible, with the result that there is now very little prescribing of heroin - or any injectable drug. In fact, only around 500 - fewer th