Opiates for the Masses?

By Peter Carty, 10 March 2002

Calls for legal heroin shooting galleries in the UK, writes Peter Carty, are the latest episode in a history of misguided attempts to stamp out global recreational opiate use The world of drug users is often chaotic and confused. As is drug regulation and law enforcement. Long-term historical patterns, however, are clear. Facing failure in the war against drugs, the UK Association of Chief Police Officers (ACPO) is supporting the setting up of injecting rooms for legally prescribed heroin, similar to those operating in Germany, Netherlands, Switzerland and Sydney, Australia.

Unfortunately – and inevitably – ACPO lacks the backing of a government fearful of voter antagonism towards drug reform. A timid Home Secretary has so far merely announced the reclassification of cannabis from a class B to a class C drug, attracting lower penalties. In fairness, he is said to be in favour of increasing the amount of heroin available on prescription to addicts in the UK – currently tiny – by boosting the number of doctors authorised to dispense it. But he remains extremely wary of electoral prejudices – so forget legal shooting galleries.

ACPO’s call is not rooted in a desire to help addicts. UK crime statistics have deteriorated over the past two decades and senior police officers want a straightforward strategy for improvement. Prescribing heroin would stop the massive amounts of property theft which funds black market purchases, they reason.

A safe conclusion, given the results of trials elsewhere, most notably in Switzerland. But do not assume that the outcome of a similar project in the UK would be judged successful. A long term trial by Dr John Marks on Merseyside, from 1985 to 1995, was stopped by the authorities. Marks and his followers asserted that this was due to US pressure and that the exercise was a stunning success in reducing addiction and crime in the area. Then debate ensued on whether data was collated in a statistically rigorous fashion. Another trial in a large west London clinic, from 1995 to 1998, was also deemed inconclusive; addicts said that the amounts of heroin prescribed were inadequate. Generally, many doctors assert that prescribing sufficient opiates – whether heroin or methadone – to alleviate withdrawal symptoms is the extent of their responsibility. But addicts say that when symptoms abate cravings remain and that they are forced to augment legal supplies from the black market.

Meanwhile as a result of US dictat, over in South-East Asia traditional use of opium is being driven underground in countries in which it is deeply embedded in indigenous cultures. Most recently, in 1996 opium cultivation became illegal in Laos. There are now just three opium dens left in Vientiane, historically famous for such establishments. Opium is a cocktail of naturally occurring opiates and a much softer drug than heroin. It is addictive, but withdrawal symptoms are relatively mild. Recreational use in northern countries was widespread up to the early twentieth century, when it was banned.

Police raids, prompted by the desire for bribes, are now driving Laotian dens out of business. A socially disastrous scenario familiar from neighbouring Thailand – and with strong parallels to events in the US and the UK back in the early twentieth century – is now being played out in Laos. The Laotian opium ban is fuelling demand for a drug which is far easier to smuggle and deal on the black market: heroin. Perhaps, in a few years time, the Laotian ACPO will also be calling for shooting galleries.

Peter Carty <peter.carty AT> is a writer and journalist