The Sunday Herald (UK) du 20 mai 2000.



Auteur : Stephen Naysmith



The man in charge of Scotland's leading charity tackling drug misuse has warned that prescribing heroin to addicts might be the only way to stop the growing number of mystery deaths.

"We need to stop people taking the drug, but we can't remove the heroin from the market. If the deaths continue we may have to prescribe extensively across the city and kill the market," said Andrew Horne, regional manager of Turning Point.

Health boards, drug agencies and police are still baffled by the spate of unexplained deaths from multiple organ failure among Scottish drug users.

The illness, which has affected 25 people and killed 11 since the beginning of the month, has spread panic throughout the drug-using community and dismayed those working to help addicts.

However, warnings from health boards in Glasgow, and also Grampian, Lanarkshire and Stirling, where suspected cases are also under investigation, that users should smoke rather than inject the drug is ignored because addicts crave the "rush" of injection.

What is now being discussed is not the sustaining of drug users on heroin substitute methadone, common practice for addressing addiction, but the prescribing of diamorphine, heroin in pharmaceutical form and "the next step up", according to Horne.

Dr Laurence Gruer, senior consultant in public health medicine with the Greater Glasgow Health Board, said the idea merited serious consideration.

"We know, particularly from controlled trials in Switzerland, that prescribing heroin can work where other means of treatment have failed," he said.

However, British doctors must be specially licensed to prescribe controlled drugs to addicts.

Dr Gruer also admitted there would be enormous practical problems in addressing the current crisis with diamorphine prescriptions. "The size of the drug problem is so big that to make a real dent on the market you would have to set up a huge number of clinics," he said.

Such drastic tactics may be warranted, according to Horne, because the current situation is putting drug agencies in a quandary. Turning Point's Glasgow Drug Crisis Centre has been seeing hundreds of addicts a day since the crisis began. Most say they will not give up injecting the drug, and are still "skin-popping"-injecting directly into muscle or tissue.

"It is creating some serious dilemmas for us. We are managing the busiest needle exchange in Scotland and if people tell us they are injecting, what can we do? If you don't give people needles then they are at risk of hepatitis and HIV," Horne said.

Scottish Socialist MSP Tommy Sheridan, whose party backed the provision of legalised heroin for addicts in their manifesto for election to the Scottish parliament, said: "People are now realising that it is the safest way of approaching a chaotic drug problem."


© 2000 Sunday Herald