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COLIN FREEMAN IN HERAT

QARIM Baluch’s decision to dabble in a spot of heroin smuggling was a disaster. Having led a team of donkeys over Afghanistan’s mountainous border into Iran, he delivered a two-tonne load to his paymaster, only to be arrested a day later.

He kept his mouth shut and was rewarded with two years in jail while his cargo carried safely on to the streets of Europe.

On this occasion, though, its addictive curse was not for export only. It waited outside the jail and followed him home. "During the smuggling trips over the mountains I started smoking the heroin to help me with the long walks," he said. "After I came back to Afghanistan from prison I carried on using it and got addicted. I thought it would be easy to give up. It’s not."

Baluch, 32, tells his tale from within the 15-foot high mud walls of a prison-like compound in the western Afghan city of Herat, near the Iranian border, that is the staging post for the multi-billion-dollar heroin trade.

Patrolled round the clock by Kalashnikov-wielding guards, it is one of only two full-time drug addiction centres in the country, offering a crude programme of medical treatment and gun-enforced abstinence that Baluch entered of his own accord.

Occasionally, one of the 250 shaven-headed addict-inmates is caught by the guards trying to escape, unable to face three months without a hit. Those who complete the course successfully are just a tiny fraction of the escalating numbers of Afghan heroin users in desperate need of treatment.

While vast amounts of Western money has been spent stemming Afghanistan’s massive heroin export trade, the fragile nation is facing widespread domestic addiction largely unaided. A new UN report this week will name Afghanistan as the world’s leading producer of narcotics, ousting Columbia.

Under the Taliban, who imposed a hardline Islamic rule after taking over most of Afghanistan in 1996, the cultivation of opium poppies was largely eliminated. Since the fall of the regime in 2001 to the US-led coalition, however, opium production has risen dramatically in lawless provinces, bringing in $2.3bn, more than half of the nation’s gross domestic product, last year alone. Afghanistan supplies more than 90% of the heroin that reaches Britain.

With some estimates putting addiction levels at anything up to one million - one in 25 of the population - Afghanistan’s fledgling new government is finally waking up to its massive home-grown smack habit.

Few countries could be deemed more vulnerable. A processed hit from the poppy plants that grow wild by the road sides costs less than $1 - easily within the reach of the poorest peasant and perfect for blotting out the miseries of 25 years of war and poverty.

With near total ignorance of its addictive effects, and little health or education infrastructure to teach otherwise, it is no surprise that the number of ‘poderi’ - addicts - is rocketing .

Dr Tariq Suliman, deputy director of the Nejat clinic in Kabul, which has just ten beds for full-time treatment, said: "The problem gets worse every day. We used to have hardly anybody addicted - but in the last three years that has risen to about 62,000 in Kabul alone. We desperately need more clinics for treating people and educating them about the dangers. In most provinces right now there is nothing at all."

Afghanistan has been world-famous for its opium and hashish ever since its days as a hippy paradise in the 1970s, but until recently drug use among locals was largely just as a substitute painkiller.

Problems began during the Taliban regime when large sections of the population fled to neighbouring Iran and Pakistan, both of which are already home to more than one million addicts each.

Rootless, jobless and often depressed, Afghans young and old found a warm welcome in Tehran and Peshawar’s many opium dens. They then took the habit into the vast and wretched refugee camps on the borders, where in some cases entire families became addicted.

The result is young boys like Naimat Ullah, who checked into the Herat clinic a month ago at the tender age of 13. Even now, his eyes are still glazed and his speech faltering.

"My family were refugees on the Iranian border, and both my father and my mother started using opium," he said. "I used to threaten to beat my mother to get her to stop it, but she just kept on and it affected her very badly. Eventually I too was using it twice a day."

While Afghan addicts traditionally smoked raw opium, around one in ten now use heroin instead, thanks partly to the growing number of locally based factories refining the product for export.

Those who inject, like 45-year-old Safir Mahmat, are also the most likely to turn to crime. "I have used for 35 years," he said, the veins on his legs hardened into rope-like thickness by constant needlework.

"I sold everything I ever had, smuggled, and eventually got six months in jail for mugging someone. I don’t even enjoy the effect anymore. I just want to give up."

Britain, which leads the international effort to stamp out poppy production, has pledged £70m to official efforts and part funds places like the Nejat clinic. The real challenge, though, is to change attitudes.

In the tight-knit, deeply conservative rural communities that make up 80% of the Afghan population, even talking about drug abuse - never mind admitting it - can be difficult.

A nationwide poster campaign is under way, some of it aimed at pricking the consciences of Afghanistan’s poppy farmers, for whom a crop of opium can earn $15,000 a year.

In one, a mother cries at a graveside while a neighbour points accusingly at a poppy field nearby. "The one who killed your son is in the field," he says.

But most experts believe the country’s drug problem is likely to get a lot worse before it gets better. In Afghanistan, as in many other places, drugs like heroin fill the yawning gaps created by a near-total lack of jobs, fulfilment and opportunity.

AP in Sydney
Tuesday October 26, 2004
The Guardian

Underworld criminals in Europe are making more money out of bodybuilding drugs than some narcotics, a senior anti-doping official said yesterday.
David Howman, director-general of the World Anti-Doping Agency (Wada), said the so-called gym culture among people wanting to look good had become a major health and policing issue.
"Trafficking in steroids is now seen as a more lucrative task for those who work in the underworld than trafficking in some of the more familiar social drugs," Howman said.
He went on to say that he was relying on information given to him by Interpol, the international police network.
Although Wada is primarily concerned with sports doping, it is working closely with Interpol to help prevent international trade in steroids and other muscle-building drugs such as peptides and human growth hormone (HGH).
"Steroids are getting to the stage of being too available, therefore the temptations and the risks that our athletes are taking become [greater]," he added.

Comment: In which case it is lucky that KFx are offering a one-day training course on Steroids and other PEDs for drugs workers!

Tuesday October 19, 2004
The Guardian

Passive smoking is a "substantial public health hazard," expert advisers have told the government in a boost to those seeking tobacco bans in restaurants, bars and other work and public places.
A report leaked yesterday is said to conclude that knowledge of the hazardous nature of second-hand smoking has consolidated in the past five years and "this evidence strengthens earlier estimates of the size of the health risk."

It added: "This is a controllable and preventable form of indoor air pollution. It is evidence that no infant, child or adult should be exposed to second-hand smoke."

The conclusions of the scientific committee on tobacco and health (Scoth), reportedly reached in April, have yet to be officially published, and the leak to the Evening Standard in London comes at an embarrassing time as minis ters determine how hard they should stamp on smoking in the long-promised public health white paper next month.

The Scoth review of the evidence on passive smoking suggests there is about 25% increased risk of lung cancer and of heart disease in non-smokers if they are exposed to other people's smoke. New studies had also confirmed health damage in infancy and childhood.

The Department of Health tried to fend off suggestions it had sat on the report.

"The vast majority of the studies on second-hand smoke look at the effects of non-smokers living with smokers," said a spokeswoman. "Ministers have been looking for evidence around the impact of second-hand smoke in public places. not simply private homes."

She added the government had launched a campaign depicting the danger of smoking around babies and children.

However, Andrew Lansley, for the Conservatives, said there needed to be a consistent message about the dangers of smoking. "On the one hand, the report suggests a ban on smoking in public places, whereas on the other [health secretary] John Reid tells an audience that for some people smoking is one of life's small pleasures."

Paul Burstow, for the Liberal Democrats, said: "Ministers should introduce a ban on smoking in enclosed public places to protect people working in bars and restaurants from the effects of second-hand smoke. This was recommended by their own chief medical officer last year. A ban should be on a national basis and not a piecemeal ban which only takes in certain parts of the country."

Doctors weighed in, too. John Britton, chair of the Royal College of Physicians' tobacco advisory group, said there could now "be no excuse for not introducing a total ban on smoking in enclosed spaces as soon as possible."

Brendan Barber, general secretary of the TUC, said: "Workplaces will be safer when they are smoke-free. Half-measures will not save the 700 employers who die every year due to passive smoking at work."

Deborah Arnott, director of anti-smoking group Ash, said that it was "deeply worrying" that the government should have sat on the report when it should have been published in good time to inform debate on the white paper. "Remarkably, on TV yesterday, Mr Reid was still referring to the 'possible' health effects of second-hand smoke."

But Simon Clark, of the smokers' lobby group Forest, said that the report sounded "dubious". He added: "It is simply not true that the vast majority of research shows passive smoking is damaging health. There have been almost 150 studies on passive smoking and overall the resulted are inconclusive."

Tuesday October 19, 2004
The Guardian

Drinkers in Leeds and Blackpool are to test a simple 5p device to cut the risk of date rape in bars and clubs.
The plastic security device snaps over the bottle and guards unwatched drinks from being spiked with such drugs as benzodiazepines, GHB and ketamine.

More than 60,000 tops will be distributed over the next few weeks before full-scale production begins. At least 20,000 were handed out during freshers' week in Leeds.

If successful, the tops could go on sale across the UK, with bars urged to add 5p to drinks prices to cover costs.

The Drinksafe top is the brainchild of retired design engineer John Blundell from Dewsbury, West Yorkshire.

"The cap has a ring which is forced over the standard crown-cap bottle and is then very difficult to remove," he said. "The cap goes into the top of the bottle when you are not drinking ... It's very difficult to get the cap off. It's a one-off device. When you come back to your drink, you snap off the bottom half of the tamper-proof leg. You can then fit another cap if you wish.

"An extra 5p on a bottle is not a great deal of money. Let's say people have six bottles in a night: the extra protection will then cost them only 30p."

Comment: Look closely at this again; you need to close it when you leave the drink. You need to remove it (which is difficult to do) if you want to put a new one on. Presumably you'd have to buy a pocket full at the start of the night or queue for a new one each time. So you go to the loo, and put a new one on. Then you come back and start drinking again. You go for a dance; new sealer. So not 30p and evening. Rather a false sense of security and limited use.

Drug alert as Afghan opium crop soars by 35%

Evening Standard Political Correspondent
18 October 2004

Coalition troops are losing the battle against Afghan drug lords, causing more heroin to flood into Britain, a damning report will reveal this month.

A United Nations investigation will show opium production in Afghanistan rose 35 per cent last year. The findings are an embarrassment to Britain, which is the country charged by the UN with eradicating Afghanistan's poppy fields.

Opium from poppies is the raw material needed to produce heroin, and the figures have serious implications for the drugs trade in the United Kingdom.

Charities claim greater cultivation in Afghanistan is likely to lead to cheaper heroin here. The country provides 70 per cent of the world's opium production and is responsible for 95 per cent of the heroin sold in the UK.

The annual UN Afghanistan Opium Survey will show that while production rose eight per cent last year, this year it rocketed another 35 per cent. That means opium cultivation is now more widespread than it was before the Taliban regime was overthrown.

More than 100,000 hectares are now being used for opium cultivation in Afghanistan - higher than the peak figure of 91,000 hectares in 1999. The report was originally to have been released at the start of this month but was delayed because of last weekend's elections in Afghanistan. It is now not expected to be released until the end of this month at the earliest.

The failure to clamp down on the opium trade will prompt further questions about Britain and America's reconstruction efforts in Afghanistan and Iraq.

Tony Blair cited the campaign against drugs as a key justification for the war against the Taliban. Before the military invasion in 2001 he said: "We act because the al Qaeda and the Taliban regime are funded in large parts by the drugs trade."

Labour MP David Cairns, who has led calls for poppy fields to be eradicated, accused the Government of not having a strategy to deal with the problem. He said: "Nobody is going to be surprised there's been a big increase as we haven't done anything to stop it."

Mr Cairns said the current policy of encouraging farmers to grow alternative crops, such as saffron, "cannot provide them with anything like the same money". He added: "In the meantime poppy cultivation grows, which increases opium supplies, which increases sales of heroin, which leads to more addicts."

Drug information charity DrugsCope said bumper opium harvests in Afghanistan were a cause for concern.

A spokesman said: "There is a strong likelihood a big increase in opium production in Afghanistan will result in increased supply of heroin to the UK, and an attendant lowering of local prices." The charity wants to see more international investment in Afghanistan to encourage opium producers to take up other professions.

But the spokesman added that unless demand was reduced in Britain, it was unlikely enforcement agencies would be able to reverse the increase in supply.

Foreign Office Minister Bill Rammell said he was expecting an increase in opium production, adding: "We know from other countries which have managed to stamp it out that cultivation actually increases before reduction takes effect. Sizeable seizures are being made - 51 tonnes so far this year - and traffickers are being arrested."

He added: "There are no short cuts to success, but we and the Afghans are making progress towards a long-term solution. Development projects are underway to provide farmers with a viable alternative livelihood, and targeting for next year's poppy crop destruction is in hand.

"The real test of our efforts will be the next planting season."

A REPORT to Tony Blair has revealed a “lack of coherence” and “shortcomings” in the government’s crackdown on drink-fuelled crime and disorder on Britain’s streets.

The leaked document, sent to the prime minister last week, discloses that although the police and councils now have the necessary powers to deal with the culprits, they are not being used to the full.

The document was drawn up by Hazel Blears, the home office minister who chairs the ministerial working group on alcohol.

Although Blears says the legal framework is in place and the drinks industry is co-operating on efforts to tackle crime associated with binge drinking, more needs to be done.

She says that councils and the police need to adopt a “single approach” but that “there is often a lack of coherence in the approach taken across all aspects of local authority responsibilities”.

Blears also says that a government crackdown over the summer highlighted “shortcomings” in the legislative and administrative framework.

The issue of late night drink-related disorder on Britain’s streets is coming to the top of the political agenda.

Michael Howard, the Tory leader, has attacked government plans to extend the licensing laws so that bars and clubs can open 24 hours a day. He has said that binge drinking in Britain’s towns and cities was leading to a “yob culture”.

The Tories have proposed that councils be allowed to determine whether the number of pubs and bars has reached saturation point and adopt New York-style limits under which a new bar cannot open within 500 yards of an existing one.

Ministers responded with a crackdown on alcohol-related crime over the summer. But sting operations revealed that 35% of off-licences and 65% of bars and clubs tested were still selling to underage drinkers, according to the report by Blears. In it she lists 39 recommendations for improving the current regime, including:

• Doubling fines for drink- related offences from £40 to £80.
• Raising the maximum penalty for off-licences selling to minors from £1,000 to £5,000
• Introducing fixed penalty notices for bars and clubs where there is excessive noise.
• Imposing minimum prices in bars to clamp down on “happy hour” promotions which encourage binge drinking.
• Charging higher licence fees for “high volume vertical drinking establishments”.
• Ensuring bars and clubs have a “dispersal policy”, such as gradually raising the lights or reducing the volume of music.
• A report by Downing Street’s strategy unit found that up to 70% of accident and emergency admissions to hospitals at weekends were caused by alcohol.

Shadow Attorney General Dominic Grieve told BBC London he finds it "extraordinary" that shops and stalls in London are selling them openly.

They are sold legally if they are fresh but are a Class A drug if they are prepared, for example, by drying them.

Several test cases are in the process of being brought to court, and define what constitutes preparation.

The Home Office says it is concerned about their open sale.
A spokesman said: "The Home Office has been looking closely at the legal aspects of the situation, particularly in relation to freshly packaged magic mushrooms, and it is the Home Office's view that if they are packaged as a product and offered for sale, they are unlawful."

But Mr Grieve said: "Certainly the law is unclear. Magic mushrooms occur naturally in the environment, therefore attempting to ban them in that sense is impossible.

"But there is certainly a loophole because although the law says if you dry them you turn them into a product, and that can also be preparation, it doesn't make clear what will happen if you sell mushrooms in their natural state. "One way of dealing with this is to ban the sale of magic mushrooms. "I do find it fairly extraordinary that people should openly seek to make money from selling it when there are potentially extremely serious side affects from their use, and feel that the can do that in good conscience".

Tony Van owns the Amsterdam of London shop on Camden High Street in north London, which sells magic mushrooms. He told BBC London: "The problem is with the law is that it doesn't actually define anything. "It's either preparation or product, so as long as we maintain this freshness and sell it then we are going by the law and we don't have to worry about that."

Mr Van says his outlets offer safety advice to those they sell magic mushrooms to, for instance that they should not take other drugs at the same time, drink alcohol, drive, or use them when pregnant or if they suffer from depression.

He also says the authorities are sending out mixed messages about magic mushrooms. His shop in Birmingham has been forbidden from selling them by the police but he is still allowed to sell them openly in Camden. A Metropolitan Police spokesman said: "If we receive a complaint about the sale of the fresh mushrooms we would look into it. "We are currently aware of the test cases coming to court which will provide some clarification of the law."

Customs and Excise is also attempting to levy tax on the sale of magic mushrooms at 17.5%.

Wednesday October 6, 2004
Guardian

Addicts who turn to crime to feed their habit will face a choice of jail or rehabilitation under a 10-fold expansion of drug treatment programmes, the Conservatives will announce today. David Davis, the shadow home secretary, will unveil a "timetable for action" at the Tories' key law and order debate in Bournemouth today.

He is to pledge that the country "hasn't even begun" fighting the "war on drugs" yet. More controversially, he will announce a massive expansion of random drug testing for school pupils.

Crime and law and order are traditionally perceived as Tory trump cards in election campaigning, although David Blunkett's hardline stance as home secretary has seen the divide between the parties narrow.

Many delegates on the fringe this week have expressed doubts about the government's £3bn scheme to introduce ID cards, so any word on that in Mr Davis's speech will be eagerly awaited.

Since shadow chancellor Oliver Letwin's spending plans include no extra money for the Home Office, Mr Davis is expected to propose paying for an extra 5,000 police officers a year by diverting savings planned for the immigration and nationality departments.

Yesterday Michael Howard pledged a "war on crime" based on the zero-tolerance policies of former New York mayor Rudolph Giuliani and Middlesbrough "Robocop" Ray Mallon.

Today, Mr Davis is due to say: "Some people say that we've lost the war on drugs. I say we haven't begun to fight it. Fighting it will be my top priority."

Mr Davis will insist that offering addicts the choice of undergoing rehabilitation to escape prison was "no soft option".
"It will mean court supervision, and failure will mean prison. This has worked in America and with the right powers it can work here. "The public is protected. The addict is encouraged to go straight - and stay straight. "If nothing is done, we will face a drugs epidemic, with terrible effects on our whole society."

A recent survey suggested that as many as 100,000 children aged 13 to 15 in the UK had used cocaine, Mr Davis will say, adding: "That's why we will support, encourage and accelerate the implementation of random drug-testing of pupils."

He will add: "Children need to know that it is not cool to use drugs - it's stupid, it's dangerous, it's illegal.
"And parents should know that the law will be enforced. "I make no apology for taking a hard line on drugs. They destroy lives, destroy society and render all our efforts to reduce crime worthless."

Mr Davis will also confirm plans to scrap Labour's early release scheme for prisoners and slim down form-filling by police officers. Mr Davis told BBC1's Breakfast programme: "The policing budget in the first four years primarily comes from the savings we are going to make on the immigration and nationality department. "What has happened since this government has been in power is that the cost of that department has gone from £280m in the first year up to £1,820m - six times up. We are not going to get it right back to £280m, but we will get it back roughly to half over a couple of years. "The prison-building will come as a result of the major savings programme that Oliver has been talking about across Whitehall. The drugs funding will come in the health budget."

Mr Davis acknowledged that it would take time to create extra prison places. But he said that the additional pressure on space created by his immediate abolition of the early release scheme would be eased by the diversion of young drug offenders from prison to rehabilitation programmes.

He also pledged a future Tory government would end the "target culture" and free up "bottlenecks" in the criminal justice system. He denied this contradicted Mr Howard's "timetable for action", stressing that Tories would free police from the "paperwork mountain". "The problem that we have at the moment is the whole system is under pressure because you have got bottlenecks all along it, from the police right through to the prisons," he told Today.

Mr Davis also attacked the early release scheme, stressing that electronic tagging must be used in conjunction with prison sentences. "Roughly half the crime in the country is carried out by about 100,000 persistent criminals. At any point in time only 15,000 of them are in jail, which means you've got 85,000 on the streets robbing you, robbing me, carrying on putting the crime rate up.

"That's why you need more prison cells," he said.

Drug users fear clinic that saved them will close

Nick Davies
Monday October 4, 2004
The Guardian

In a case that may prove a turning point in the treatment of black-market drug addicts, the General Medical Council is due today to resume its hearing into charges of serious professional misconduct against doctors writing prescriptions at a leading private drug clinic.

The hearing is the biggest in the history of the GMC. It pits officials of the NHS and the Home Office against seven private doctors at the Stapleford centre, including its founder, Colin Brewer, his recently retired deputy, four full-time doctors, and one who no longer works there.

The clinic, based in London and Essex, cares for more than 200 addicts. If the charges are found proven it is likely to close. The hearing opened in February but was stalled when Dr Brewer, aged 62, fell ill.

The Guardian has obtained letters from scores of Stapleford patients, written earlier this year as the threat to their clinic became clear. Some are middle-class professionals - company directors, shop owners, a chartered accountant, several journalists; others were born and remain in poverty. All are long-term addicts. In the noisy debate about drugs these are the silent voices.

A letter from a man aged 49 in Essex captures the outline of the story. He had been addicted to opiates for 20 years, and describes how the NHS denied him effective treatment. "Then I found Dr Brewer. I've been attending his centre for eight years approx. I now own my own house, in a quiet small town. I have two cars, am married with two children, who are doing well at school, I haven't missed a day's work except for minor illness for eight years. I don't know any drug people any more. My hair tests have always been negative. And all this I owe to the Stapleford doctors."

Addressing himself to the GMC and the government, he added: "I was once irresponsible. Must I and my peers pay for the rest of our lives for this? Must these caring doctors suffer punishment? .... please, please, I implore you, drop the charges and let them carry on doing what they do best - helping."

The letters describe how the Stapleford doctors prescribed patients either the heroin, amphetamine or codeine they were addicted to, or an approved substitute, such as methadone for heroin or dexedrine for crack. This regular "script" became the key to a new life.

By contrast, the most common and the most passionate theme of the letters is the failure of NHS drug clinics to offer this long-term "maintenance prescribing" in a form that allows users to leave the black market and build new lives.
They describe how NHS clinics impose a ceiling on the amount of methadone which they will prescribe, thus pushing users back on to the black market; how the clinics generally expect the user to rapidly reduce their dose even if they are not ready; will cut off the prescription if the patient is caught using other drugs or breaking any clinic rule; and frequently will supply only 24-hour prescriptions, so forcing users to visit the clinic every day, preventing them from working and compelling them to stay in touch with other users.

The letters speak of repeated NHS failure: "I am 40 this year, and over the decades have seen many friends fail or die due to inadequate maintenance from NHS clinics ... most of the doctors who scripted me would only give me 150mg of methadone for fear of being struck off. I was using far more than this ... I was being reduced, which I couldn't cope with. This led me to buy ampoules of methadone on the black market. This put me at risk of arrest, which soon followed ... they will not be flexible with their drug policies, hence they cannot, or will not, treat me."

They speak too of humiliation in the NHS: "I was made to feel like the backside of society ... I'm not really sure why the counsellors at this clinic were there. Perhaps being able to bully and belittle people in some way gave them some sense of power ... not even alcoholics are treated with the same disdain, even though their illness is essentially the same."

A woman addicted to codeine describes how she queried the treatment which an NHS doctor was suggesting for her. "He said: 'Well, piss off and don't waste my time then.'"

Drug clinic 'cast aside duty of care'

Hearing billed as showdown for treatment methods

Steven Morris
Tuesday October 5, 2004
The Guardian

Seven doctors from a world-renowned clinic specialising in the treatment of heroin addicts "cast aside" their duty of care to patients by prescribing drugs inappropriately, a disciplinary hearing was told yesterday.

The type, quantity and combination of drugs doctors at the Stapleford Centre gave the addicts was flawed, the General Medical Council's professional misconduct committee heard.

In one case a man treated by the founder of the centre, Colin Brewer, who is acknowledged as a worldwide expert on heroin addiction, choked to death on his vomit after undergoing a "DIY home detox" in which he was prescribed 16 drugs, it was claimed.

The hearing was told that another man was prescribed a cocktail of so many drugs over 13 years that he became a "truly remarkable" drug user.

The hearing, the biggest in the history of the GMC, is being billed as a clash between two schools of thought on how drug addicts should be treated.

One group, including the Stapleford, champions a liberal approach, giving users of heroin and other drugs "maintenance prescriptions" of the substances they are addicted to, or substitutes, intended to take them out of the illegal drugs market.

A more conservative approach, which tends to be favoured in the public sector, prescribes only small quantities of drugs such as the heroin substitute methadone to try to wean users off drugs.

On the first day of the hearing, which is expected to last 12 weeks, Andrew Collender QC, for the GMC, acknowledged there were "serious discussions and debates" about the best way to treat users.

But he said: "Responsible debate about the treatment of drug users does not permit a doctor to cast aside his general duty of care for his patient."

The hearing will focus on 16 patients of the clinic, which has bases in London and Essex.

Mr Collender said the first of the 16, RF, arrived at the centre in 1990 aged 23. He was injecting up to 750mg of heroin a day, not an unusual amount. He was prescribed a daily dose of 70mg of methadone, but by the end of his treatment in 2003 this had increased to a 400mg cocktail of methadone and heroin.

Mr Collender said there was "no evidence of a legitimate reason" for this increase.

RF was prescribed 17 different drugs in all. Mr Collender also said RF, who was treated by five of the doctors, including Dr Brewer, was prescribed large quantities of drugs at a time.

The barrister also suggested that the rules had been bent when RF was prescribed injectable heroin. Home Office rules mean such a treatment has to be carried out under a special licence, but the drug had ostensibly been given to RF as a painkiller - for a road accident which had happened nine years before.

Mr Collender concluded that RF arrived at the centre with an "unremarkable habit".

"Thirteen years later he was truly remarkable for the number of different drugs he was prescribed."

Dr Brewer, 63, who set up the clinic in 1986 and remained clinical director until January 2003, is accused of serious professional misconduct in relation to 13 patients.

The other six doctors are Ronald Tovey, 47, the current clinical director, who is accused in relation to six patients, Anthony Haines, 75 (two), Hugh Kindness, 66 (four), Timothy Willocks, 47 (two) Martin O'Rawe, 46 (one), and Nicolette Mervitz, 37 (one). In several cases more than one doctor treated the same patient.

Guardian
Wednesday September 22, 2004

Women were warned about a new date-rape threat today after a Swansea nightclubber was apparently attacked after smoking a spiked cigarette.

The 30-year-old woman is believed to be the first British victim of "fry" cigarettes - tobacco dipped in embalming fluid - a practice which first came to attention in the US state of North Carolina in the late 1990s.

Graham Rhodes, chief executive of the Roofie Foundation, which campaigns on behalf of sex crime victims, warned women not to "accept a casual cigarette from anyone". He said taking cigarettes offered on a night out should be considered as dangerous as accepting a drink from a stranger.

The Swansea woman was given the cigarette at a club last week and told police she began to feel "giddy and disorientated". One of the two men she was talking to offered to take her home in a taxi but the next thing she remembered was waking up alone in a guest house, having been raped.

A 39-year-old man from Ebbw Vale, 50 miles from Swansea, was later arrested.

Dr Jim Campbell, a former Home Office forensic scientist who carries out work for the Roofie Foundation, said that on its own, a drugged cigarette was unlikely to be enough to allow a sex attack. However, a woman who was normally unlikely to accept a drink from a stranger would be more ready to take one while under the temporary influence of embalming fluid. The liquid is a mixture of formaldehyde and alcohol which has an almost instantaneous effect.

"You will feel giddy and may go into a stupor, but it will not last very long and will not incapacitate anyone," Dr Campbell said. "It will not affect the memory either so it does not have many of the effects of a date-rape drug."
But Rape Crisis Online http://www.rapecrisisonline.com/DateRapeDrugs.htm - a North Carolina website - suggests the dangers could be far greater. "Sometimes, the compound used in the fry cigarettes is PCP," it says. "This drug adds an incredible level of danger to the user - it can kill."

The website adds: "According to a 1998 study by the Texas Commission on Alcohol and Drug Abuse, those who smoke fry cigarettes experience toxic psychosis, hallucinations, delusions, and sometimes, unconsciousness. Some men who were interviewed for the study said that "you can control a girl more than you can with Rohypnol". Others stated that the drug heightens a woman's sexual appetite. "

Comment: An old story dressed up in a new guise as a "date rape" story. The presence of embalming fluid will have a distinctive taste and the cigarette is likely to be discoloured. The sense of intoxication is likely to be rapid and disorientating. PCP is not widely used in the UK, though ketamine is. For a great overview of the subject visit: http://www.inch.com/~jholland/julie/illie.htm

Thursday September 23, 2004
The Guardian

The illicit image of the opium poppy has withered. Scientists have discovered a naturally-occurring form of the plant that does not produce addictive drugs.
Normal poppies produce codeine and morphine, addictive chemicals used as painkillers - and also the raw ingredients for heroin.
Philip J Larkin, of Australia's Commonwealth Scientific and Industrial Research Organisation, and colleagues describe today in Nature a mutant poppy that does not produce morphine or codeine.
Biochemical pathways that would normally produce them are blocked, leading to an accumulation in the plant of the precursors, thebaine and oripavine. These can be extracted and made into non-addictive painkillers. It is impossible to make heroin from the mutant poppy, known as top1. In Tasmania, the source of more than 40% of the world's legal opiates, the mutant is already being used to re-engineer the native poppy crop.

Government plans to let more doctors prescribe drug were 'abandoned'

Martin Bright, home affairs editor
Sunday September 19, 2004
The Observer

Drugs charities have accused the government of abandoning plans to set up a network of doctors prescribing pure heroin to addicts.

Two years ago, the Home Secretary, David Blunkett, announced that the number of licences issued to GPs entitled to prescribe heroin should be increased from less than 50 to 1,500 in an attempt to take the supply of the drug out of the hands of criminals.

The move was applauded by drugs organisations, which said the use of medical heroin - known as diamorphine - would help addicts control their chaotic lifestyle and stop them being sucked into crime to support their habit.
But new Home Office figures show that the number of prescribing doctors has barely doubled. The National Treatment Agency, the government body responsible for dealing with addiction, confirmed that, by March of this year, only 123 doctors were licenced to prescribe medical heroin.

The majority of Britain's GPs see at least one addict a month and a quarter treat heroin or cocaine addicts, but only a tiny minority are able to use heroin itself during treatment and most use the heroin substitute methadone.

The charity Drugscope said that the move towards prescribing heroin was derailed by the publicity surrounding Harold Shipman, the GP who murdered at least 215 of his patients using diamorphine. Shipman was jailed for life in 2000, but the inquiry into the case, led by Dame Janet Smith, has had a lasting impact on the medical profession.
Smith's fourth report, published in July, called for stricter controls to avoid the kind of stockpiling that allowed Shipman to build up his supply.

The debate over prescribing will be severely tested later this year by the investigation by the General Medical Council into seven doctors at the Stapleford clinic, a private treatment centre for addicts. The six men and one woman worked in centres in Belgravia, London and Stapleford Tawney, Essex and are charged with 'excessive and improper' prescribing.

The centre is alleged to have kept patients on lengthy courses of methadone, rather than cutting the supply sharply as recommended by NHS guide lines. The defendants include Dr Colin Brewer, the founder of the centre, who is recognised as an international expert in the field.

The plans to set up the network of prescribing GPs came after a Home Affairs Select Committee report found that drug misuse by Britain's 250,000 heroin addicts was fuelling drug crime worth £20 billion a year. The committee also recommended establishing safe 'shooting galleries' for addicts. But these have also failed to take off after councils failed to persuade residents that they would encourage addicts off the streets.

Drugscope spokeswoman Natasha Vromen said: 'These figures are disappointing. There were great hopes that the government and doctors were developing a drugs policy where the health aspects were brought to the fore. Unfortunately, it is now dominated by the crime agenda.'

The Times 18.9.04DAVID BLUNKETT is writing to more than 650 bars, shops and off-licences after they were caught repeatedly selling alcohol to under-18s. The Home Secretary is also calling on magistrates to increase fines for any licensees who break the law, after a three-month summer blitz in 92 city and town centres aimed at ending binge-drinking and drunken violence by young people.

Police and licensing authorities mounted sting operations on 1,825 premises and 51 per cent were found selling drink to under-18s in at least two tests. They included 191 bars or pubs and 466, or 32 per cent, of off-licence outlets tested.

Officers also arrested 5,764 people, gave on-the-spot £40 fines to more than 4,000 rowdy drinkers and confiscated alcohol from more than 9,500 adults and juveniles.

Mr Blunkett said: “I recognise that good work is being done by many in the industry but there is no point for policies to be in place to deal with sales of alcohol to minors if they are not implemented. “That is why I will be writing to the chief executives of the off-licences and drinking establishments that have repeatedly sold alcohol illegally to find out what positive action will be taken to address this.”

Mr Blunkett said that he would ask the Sentencing Guidelines Council to look at whether “being drunk” should be changed to an aggravating rather than a mitigating factor in antisocial offences.

The panel, which advises the courts on sentencing, will also look at whether the full range of fines are being used against establishments prosecuted for selling alcohol illegally. The Home Secretary said that it was difficult to persuade communities that alcohol problems were being addressed when “fine levels for alcohol-related prosecutions within the industry are often very low and when people committing antisocial offences can use the excuse of ‘drunkenness’ to get a shorter sentence”.

He said that fixed-penalty notices to target people involved in selling or buying alcohol for under-18s will come into force in November and that the summer campaign will be continued at regular intervals.

Hazel Blears, a Home Office minister, said that cheap drink promotions remained a “recipe for disaster” which fuelled street violence. She said that the industry had to prove quickly that it could deal with the situation itself or face further action. She said that drinkers should also be more responsible.

Jean Coussins, chief executive of the Portman Group, an industry body which promotes responsible drinking, said: “We’re pleased to see tough action being taken by police against drunks who commit public order offences, and against unscrupulous adults who buy alcohol for under-18s on the streets. And we have always argued for tough action to be taken against any retailers who knowingly and persistently serve underage drinkers.”

David Davis, the Shadow Home Secretary, said: “It is going to take more than an eight-week summer blitz to reverse the growing trend of our major towns and cities becoming no-go areas at the weekend. This Government has tried to tackle problems surrounding alcohol and crime and failed every time.” He accused the Government of being hypocritical, saying: “While they talk tough about a summer blitz on binge drinking, David Blunkett is planning to let pubs open 24 hours a day.”

All-party group calls for warning labels on alcohol bottles as EU considers use of shock images to deter smokers

Gaby Hinsliff and Jo Revill
Sunday September 12, 2004
The Observer

Young women who binge drink will be told this week that they risk a sharp rise in the number of children born with birth defects.

As the 'lager loutette' generation begins to settle down and have families, campaigners are urging more draconian health warnings against drinking during pregnancy.

By the end of the year the French government will follow the example of America by demanding that warning labels are put on all bottles, spelling out that alcohol may cause birth defects.

Ross Cranston, the former minister and chairman of the all-party parliamentary group on alcohol misuse, will host a House of Commons meeting this week to highlight foetal alcohol syndrome (FAS), where heavy drinking during pregnancy can lead to serious developmental disorders in the baby.

He said the rise in women drinking heavily had alarming potential consequences,: 'If they don't yet know they are pregnant and so carry on binge drinking, it's a worry. We have not taken this problem seriously in this country.'
The all-party group has campaigned for labelling.

In the US pregnant women are advised not to drink at all: the French public health minister has also signalled plans to put warning labels on alcohol bottles and cans.

It follows legal action taken against the state by three mothers from Lille whose children have congenital deformities. They say that they were not told enough about the consequences of drinking when pregnant.

Benoit Titran, the lawyer who runs the group representing the mothers, argues that Britain should start to give women far more information about what drink can do to the foetus.

The official advice to mothers-to-be in the UK is that they can drink one or two units a week. While it is universally accepted that heavy drinking in pregnancy can cause a recognised syndrome - FAS children typically have distinctively shaped skulls, eyes and upper lips, along with low IQs and behavioural problems - there is debate over whether 'social' drinking is harmful.

The National Organisation for Foetal Alcohol Syndrome, a charity set up in the UK last year, argues that there is growing evidence that milder problems such as hyperactivity could be linked to relatively low levels of drinking during pregnancy.

However, Dr Moira Plant, director of the Alcohol and Health Research Trust at the University of the West of England and an adviser to the World Health Organisation, said there was little evidence.

She added: 'If you don't drink, you are guaranteed to have no harm to your baby, of course. But if one glass of wine harmed your baby, you would have an amazing number of damaged babies around.

'If someone is pregnant and has been for 10 weeks before realising it, I would think the stress of saying "one drink is going to damage your baby" is more damaging than that one drink.'

The number of cases of FAS diagnosed in the NHS is small but it has risen from 95 in 2000-01 to 128 in 2002-3.
However, Jane Ellis - not her real name - argues that young women should be told not to drink at all if they are pregnant or thinking of conceiving. Her six-year-old adopted daughter has FAS. It was only when she started school that the extent of her problems became apparent. After two years, while she has no problems with maths, she can read only a few words.

She said: 'The important thing is to stop drinking as soon as you know you're pregnant. Life with an FAS child is very hard; it affects the whole family. It's not worth the risk.'

Call for further drug research on multiple sclerosis

Tim Radford, science editor
Saturday September 11, 2004
The Guardian

Research could soon show that cannabis could be a helpful long-term treatment for multiple sclerosis sufferers.
Patients who took part in a 15-week study - published in the Lancet last year - went on to try the effectiveness of the banned drug for a 52-week course, John Zajicek of the Peninsula medical school told the British Association science festival which ended in Exeter yesterday.

"Initial results of the longer-term study are positive and will be published in the near future. In the short-term study, there was some evidence of cannabinoids alleviating symptoms of multiple sclerosis; in the longer term there is a suggestion of a more useful beneficial effect, which was not clear at the initial stage," he said in a statement.
"I hope these results will encourage support of further studies of cannabinoids in multiple sclerosis and, potentially, other diseases."

Cannabis has been used as a medical treatment for at least as long as it has been a recreational drug. Queen Victoria is supposed to have used it for period pains. It was sometimes used in childbirth and a poignant archaeological discovery in the Middle East revealed cannabis remnants near the body of a young woman who probably died in childbirth 5,000 years ago.

Cancer patients have claimed that cannabis could help suppress nausea after chemotherapy. Glaucoma sufferers have claimed it relieves pressure on the eyeball and delays the onset of blindness.

Animal experiments have suggested the drug slows nerve cell death. And many multiple sclerosis sufferers have been using it, illegally, to relieve the pain and stiffness of their slow progression towards helplessness.
Once it became clear that cannabis-like chemicals were produced naturally in the human nervous system to control appetite and facilitate nerve cell communication, researchers began to understand why a folk remedy could be medically effective.

But clinical evidence in randomised double-blind trials has been rare. "We set out to establish whether there was any scientific truth behind that," Dr Zajicek said.

A total of 667 patients took part in a short-term study. More than 500 agreed to go on to longer trials. The patients were given either capsules containing cannabis extract, an active component of the drug called THC, or sugar pills. The chief aim had been relief of muscle stiffness.

"But we also wanted to look at the other symptoms, including pain, bladder disturbance and measures of disability," he said. "From the patient's symptomatic point of view there was beneficial effect but we couldn't prove that from an independent assessment by a physiotherapist of muscle stiffness."

So they continued the trials: the results could be published in a few weeks' time.

Researchers are notoriously unwilling to discuss results before they have been reviewed by their peers and published formally in a scientific journal. "What I can say at the moment is that there does seem to be evidence of some beneficial effect in the longer term that we didn't anticipate in the short term study."

A new drug craze sweeping Britain's nightclubs is proving so dangerous that paramedics are being hired to staff recovery rooms at major venues.

The drug - known as GBL - is being blamed for an increase in the numbers of clubbers collapsing into a comatose state on the dance floor. The drug, more commonly used as a cleaning fluid or industrial solvent to produce plastics and pesticides, is currently legal despite calls to ban it. It is increasingly replacing the better-known GHB as the drug of choice for clubbers - not least because GHB was made illegal last year and given a class C drug rating, putting it on a par with cannabis and amphetamines.

Like GHB, the drug brings on a state of euphoria. But it is now clear it is easy to overdose on the drug.

One company, which provides paramedic backup to six leading clubs in London, has told The Independent on Sunday the situation is now so worrying it is investing in cardiac defibrillators, which stimulate and monitor heart beats. Adam Cooper, who co-owns Knightlife Medical Services, said nine clubbers collapsed in the six venues his company attended last weekend. He said: "I have never sent anyone to hospital who has taken ecstasy, cocaine or amphetamines. The only people I have ever sent to hospital have been users of GHB and GBL or who mixed alcohol with those drugs."

GBL is effectively a stronger, more concentrated version of the body-building substance GHB, also known as Liquid X - a "date rape" drug that was outlawed last year by the Home Office. Possession carries a maximum sentence of two years, while possession of GBL is legal.

"We keep the classification of all drugs under constant review. GBL is very new and it is one of many we are looking at," a Home Office spokesman said.

The use of GBL is also causing concern in the gay community. The Gay Times has warned of the dangers of GBL and is campaigning to keep it and GHB out of clubs. According to the paper, one well-known gay event called Trade was barred from its normal London venue, Turnmills, earlier this year owing to the increasing incidence of GBL and GHB abuse. "If you have two or three ambulances coming to your venue every night you don't get your licence when it comes up for renewal," said Liam O'Hare, a manager of a central London club, The End, and a leading figure in the clubbing circuit's campaign to combat drugs.

'Last time I tried it I ended up in hospital'

"John" almost died after overdosing on GBL. He stopped breathing and his heart rate slowed to 40 beats per minute after taking just one millilitre too much.

John, aged 23, said: "I tried GBL two or three times, but the last time I ended up in hospital. My breathing was slowing and my wife called an ambulance. I was taken to hospital because my heart rate was down to 40 beats per minute [about half the normal resting rate].

"I felt very rough the next day and haven't touched it since. The overdose potential with GBL is monstrous. The dosage curve is exceedingly steep. One millilitre is generally all you need, but one-and-a-half millilitres or two and you pass out."

He bought the chemical - £50 for one litre - from a chemical supplier. It's freely available and legal to do so.

"If it's used in a club it comes diluted in a bottle of water," he said, "You shake it and drink it from a shot glass. It's cheap and it's legal and the effects are like being drunk."

John turned to GBL after its derivative GHB was made illegal last year. Friends told him GBL was a legal alternative.

He used to buy GHB in powder form from a chemist in South Africa over the internet. He would dissolve it in water and take it at home to help with his insomnia. He described the drug as a "relaxant" that releases dopamine in the brain. Because it is also naturally produced by the body it is very "gentle", he says, with no adverse after-effects.

He said: "The effect of GHB is a bit like a cross between alcohol and cannabis. It relaxes you and relieves stress.

"As it sedates you it is not an ideal club drug. Some people do it in clubs though, because it's like a long, better drunkenness.

"I did enjoy it. There was no hangover. It dissolves in the body into carbon dioxide and water, so it is not toxic.

"The difference between GBL and GHB is like the difference between hooch and malt whisky. GBL is a lot rougher."

Andrew Johnson

COMA IN A BOTTLE

GBL - gamma butyrolactone - is a colourless, odourless, virtually tasteless liquid. Once ingested, it causes a euphoric, hallucinogenic state as well as drowsiness. When mixed with alcohol or taken in too large a dose its depressant effect is enhanced. This can lead to respiratory problems, unconsciousness, even coma. GBL can become addictive with sustained use. It has been singled out by the US National Drug Intelligence Centre as a contributor to car accidents, sexual assaults and deaths. GBL is available legally as an industrial solvent.

Comment: Oh, could it be...that much loved item for all newspapers, the NEW DEADLY DRUG story. Oh how they love it and oh, how they get excited...must be the holidays...

Cannabis extract shrinks brain tumours

05:00 15 August 04

NewScientist.com news service

Cannabis extracts may shrink brain tumours and other cancers by blocking the growth of the blood vessels which feed them, suggests a new study.

An active component of the street drug has previously been shown to improve brain tumours in rats. But now Manuel Guzmán at Complutense University, Spain, and colleagues have demonstrated how the cannabis extracts block a key chemical needed for tumours to sprout blood vessels – a process called angiogenesis.

And for the first time, the team has shown the cannabinoids impede this chemical in people with the most aggressive form of brain cancer - glioblastoma multiforme.

Cristina Blázquez at Complutense University, and one of the team, stresses the results are preliminary. “But it’s a good point to start and continue,” she told New Scientist. “The cannabinoid inhibits the angiogenesis response - if a tumour doesn’t do angiogenesis, it doesn’t grow,” she explains. “So if you can improve angiogenesis on one side and kill the tumour cells on the other side, you can try for a therapy for cancer.” "This research provides an important new lead compound for anti-cancer drugs targeting cancer's blood supply,” says Richard Sullivan, head of clinical programmes, at Cancer Research UK.

Fat molecule

The team tested the effects of delta-9-tetrahydrocannabinol in 30 mice. They found the marijuana extract inhibited the expression of several genes related to the production of a chemical called vascular endothelial growth factor (VEGF). VEGF is critical for angiogenesis, which allows tumours to grow a network of blood vessels to supply their growth. The cannabinoid significantly lowered the activity of VEGF in the mice and two human brain cancer patients, the study showed.

The drug did this by increasing the activity of a fat molecule called ceramide, suggests the study, as adding a ceramide inhibitor stifled the ability of the cannabinoid to block VEGF.

Small and pallid

“We saw that the tumours [in mice] were smaller and a bit pallid,” adds Blázquez. The paleness of the cancer reflected its lack of blood supply as a result of the treatment. In the human patients, she says: "It seems that it works, but it's very early." Sullivan points out: “Although this work is at an early stage of development other research has already demonstrated that VEGF is an important drug target for a range of cancers.”

He emphasises the need for further work on cannabinoid combinations. “Cannabinoids would need to generate very strong data in the future as there are already a number of VEGF inhibitors in clinical development,” he says.

The two patients in the ongoing study are among 14 in a clinical trial of the drug. The patients are given one cycle of treatment, lasting a few days, and their survival and general health are being studied.

Journal reference: Cancer Research (vol 64, p 5617)


Shaoni Bhattacharya

How our brains fend off madness, we produce a cannabis like substance
New Scientist issue: 28 August 2004

A cannabis like substance produced by the brain may dampen delusional or psychotic experiences, rather than trigger them.

Heavy cannabis use has been linked to psychosis in the past, leading researchers to look for a connection between the brain's natural cannabinoid system and schizophrenia. Sure enough, when Markus Leweke of the University of Cologne, Germany, and Andrea Giuffrida and Danielle Piomelli of the University of California, Irvine, looked at levels of the natural cannabis-like substance anandamide, they were higher in people with schizophrenia than in healthy controls.

The team measured levels of anandamide in the cerebrospinal fluid (CSF) of 47 people suffering their first bout of schizophrenia, but who had not yet taken any drugs for it, and 26 people who had symptoms of psychosis and have a high risk of schizophrenia. Compared with 84 healthy volunteers, levels were six times as high in people with symptoms of psychosis and eight times as high in those with schizophrenia.

"This is a massive increase in anandamide levels," Leweke told the National Cannabis and Mental Illness Conference in Melbourne, Australia, last week. And that is just in the CSF. Levels could be a hundred times higher in the synapses, where nerve signalling is taking place, he says.

But were the high anandamide levels triggering the psychotic symptoms or a response to them? Leweke and his colleagues found, to their surprise, that the more severe people's schizophrenia was the lower their anandamide levels. The team's theory is that rather than triggering psychosis, the substance is released in response to psychotic symptoms to help control them. People with the worst symptoms might be unable to produce sufficient anandamide to prevent them.

At some point in their lives, between 5 and 30 per cent of healthy people have had symptoms such as delusions or hallucinations, which can be triggered by something as simple as sleep deprivation. "All of us are potentially psychotic," says David Castle of the University of Melbourne.

So for the body to have a system that prevents these experiences getting out of hand makes sense, he says. The new findings suggest antipsychotic drugs could be developed that target the anandamide system, but it will not be simple. The active ingredient in cannabis, THC, binds to anandamide receptors. But people with schizophrenia who use cannabis actually have more severe and frequent psychotic episodes than those who do not.

This may be because THC makes anandamide receptors less sensitive. Leweke's team also found anandamide levels lowest in people with schizophrenia who used cannabis more frequently, suggesting it may disrupt the system in other ways too.

Up to 60 per cent of people with schizophrenia use cannabis. A study by Castle, also reported at the Melbourne meeting, has found that people use the drug to get rid of unpleasant emotions associated with the disease such as anxiety and depression. This article appears in

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