Archive for the ‘opiates’ Tag

Smacktastic Britain

Monday, April 15th, 2013

A report today indicates a record opium crop in Afghanistan this year. The farming of poppies is seeing a resurgence, particularly in areas where violence is rife and agricultural aid is sparse. It seems that large-scale producers will not only provide all the necessary ingredients, but also pay in advance. This is in addition to reports that cannabis cultivation is also seeing a dramatic rise in the country.

And who can blame them. In a country where Western interventions have caused political instability and war, why would anyone, including the UN who are tasked to monitor and reduce drug production in the country, expect the Afghani people to give a toss about what rich white people on the other side of the world choose to spend their money on? I see no lack of morality in the trade myself – they are producing a crop to meet a demand, they are earning a decent living for them and their families, in circumstances most of us can’t even imagine. The fact that other people may then choose, under their own free will, to use that crop in way a manner which may be harmful to themselves, is no concern of the farmers.

Yet the War On Drugs prohibits it, and no doubt Afghanistan will come under further fire for failing to control its most lucrative exports.

Now this year’s bumper crop, partly due to poor weather for two previous years, partly due to more farmers choosing this crop above less well-paid alternatives, is coming at a time when, as a country, we probably need it most. Britian’s poorest are being targeted by benefit cuts and room taxes; budgets for social and health care are being reduced; politicians are diverting our eyes from their significant fuck-ups and self-serving financial scams by blaming the state of the country’s finances on the poor by likening them all to Mick Philpott; the impact of Margaret Thatcher’s policies still resonating across the country following her death, the anger no less fierce than the day she lost power. It does not surprise me that there were two incidents of football violence at prominent matches over the weekend – I think the current feelings of distrust and unfairness are rising in much the same as they did in the 80s.

And, in the 80s, at a time where everyone but those at the top of the social strata battled against the system and lost, and feelings of disempowerment and displacement engulfed the country, which market flourished? Here’s a clue – it blocks out physical and emotional pain, it provides a sense of social identity, and maintaining its demands is equivalent to a full-time job. That’s right guys, strap in – heroin’s sure to make a come-back!

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Breaking news – GPs to carry tasers

Thursday, February 14th, 2013

The official bodies representing GPs and psychiatrists have released a joint statement raising concerns about addiction to prescription drugs. I don’t really know who they are raising the issue with as it’s them who are prescribing the bloody things – it’s a bit like punching a child then telling it off for having a bruise.

Bodies representing pharmacists, social workers and drug workers have also jumped on board. The difference is – they mean it. While the GPs and psychiatrists spend 5 minutes every 3-6 months with these patients, it is the pharmacists who have to double-check dates and signatures on prescriptions every week to make sure they are dispensing legally and are not operating outside the law because they have been duped by some pitiful neurotic; it is the social worker who will be trying to monitor parenting skills through a legal, medical haze; it is the drug worker who faces abuse when the patient uses their medication illogically and unmathematically and comes begging for an early script. And the housing workers. And the Jobcentre staff. And Probation. And counselling services. And Women’s Aid. Basically any service that attempts to address the route cause of the ailment instead of smothering it with something sedative.

In exactly the same way that heroin dependence ruins people’s lives, addiction to prescribed medication can be, in many cases, as debilitating. And whilst it is more sociably acceptable, amongst the middle classes at least addiction is still embarrassing, and the lies resorted to in hiding it can be crippling and destructive.

In terms of the physical dependence, benzodiazepines (such as Valium, temazepam and nitrazepam, generally prescribed for anxiety, muscle spasms and insomnia) in particular are horrendous. Along with alcohol, they are one of the few groups of substances that can lead to death from withdrawal. They are so addictive that in heavy abusers, tolerance can eventually overtake capacity – meaning that the amount of the drug you need to stop your body going into withdrawal can be higher than the amount needed to induce overdose. That’s a pretty fine line to walk.

The withdrawals also create a desperation that supersedes even opiate addiction. Whereas a heroin user that has ‘dropped’ (read ‘sold’) his methadone dose will start to panic when he realises he is soon to start squitting out of both ends as the dreaded withdrawals set in, benzodiazepine users will go that extra mile in an attempt to procure what they need. We’re talking threats to kill, smashing stuff up, full-on tantrums and shameless sobbing. Now any but the most integrous GP will swat a script at that to get it out of their consulting room.

There are a fair few people now in drug treatment that have become opiate-dependent due to prescribed painkillers too. Generally prescribed in the first place for toothache or back pain, these clients are chilling reminders that this could happen to anyone. These people never thought they would end up in a drug clinic being treated in exactly the same way as a heroin user.

And the problem with both benzodiazepines and opiates is – they are amazing emotional blockers and make you feel great. Emotional pain – gone. Traumatic memories – vanished. Feelings of guilt – disappeared. And stopping taking them results in sky-high adrenaline production, so that these buried feelings are not only exposed, but anxieties around them go through the roof. So if you couple that with quickly-built tolerance, and the fact that these are being given to you, nay insisted on, by a revered specialist – and are free – it would take a strong person to resist. And the people going to their GP in pain or with depression or anxiety do not meet this criteria.

And while I’m levelling my criticisms at GPs, I want to uncategorically state that psychiatrists are a hundred times worse. In my experience, it is extremely rare to find a psychiatrist that doesn’t just dish out sedating meds. This is despite an ever-increasing evidence base for psychological therapies and social interventions to improve people’s quality of life. You only need to visit to psychiatric ward to see the scrap heap that people with enduring mental health problems get thrown on. There is no inkling that these people might get better, or any real effort made to increase their level of function – they are dosed up and kept quiet until they say little enough to be discharged. Then they are expected to be able to cope in the outside world, on reduced medication (as high levels are only safe to dispense in a controlled environment), and within a matter of time they are back in hospital and whacked up again. No wonder people become institutionalised. To anyone who likes to think that One Flew Over The Cuckoo’s nest is a thing of the past, I challenge you to visit a psychiatric ward and tell me how treatment has improved over the last fifty years.

And in my usual cynical manner, I can’t help but think – you’ve been dishing out tablets for years because it is the cheapest way to keep ‘problem patients’ quiet, so what’s changed? This has got to be laying the groundwork for some political announcement about austerity and impending cuts to prescription budgets, because many GPs and psychiatrists didn’t give a shit about the highly-strung benzo-dependent housewives and the antipsychotic-shuffling oddballs before, and I struggle to see why suddenly they would do now. I reckon it’s another one of those Tories’ ‘we’re doing it for your own good’ measures. Like benefit cuts. And paying bankers’ bonuses. And Care In The Community.

One thing’s for sure – it won’t be the whiskey-drinking doctors or the pill-popping politicians that have their doses reduced and their scripts stopped. And, to be honest, unless GPs start wearing stab vests as standard, I doubt anybody else’s will be either.

Postscript – catslondonmarathon you are a wonderful GP and human being and I do not refer to you or your practice here. There are many more like you – but we both know you are in a minority.

Also, here’s a link to (wait for it) The Daily Mail *gasp* – a scare-mongering set of photos relating to crystal meth, clearly an advert for private rehab programmes, but freakishly interesting all the same. Make you count your blessings it never really took off over here. We’ve got enough on our paste with Cocodamol and Mogadon.

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