UK addicts may be given free foil for 'safer' heroin smoking'

[bp]

UK addicts may be given free foil for 'safer' heroin smoking'

    * Denis Campbell, health correspondent
    * The Observer, Sunday 20 September 2009
   

Heroin addicts could be given free aluminium foil to encourage them to smoke rather than inject the class A drug under plans being considered by government advisers.

Drug treatment experts say that inhaling heroin instead of injecting reduces a user's risk of contracting HIV and Hepatitis C. An addict heats a blob of heroin on the foil in a process known as "chasing the dragon".

The Advisory Council on the Misuse of Drugs (ACMD) is examining whether the law should be changed to allow Britain's 300,000 problem drug users to receive foil as a way of protecting their health. Since last year, the ACMD's 31 members, who advise the Home Office, have been considering whether section 9A of the Misuse of Drugs act, governing "paraphernalia" or equipment used in the consumption of illicit substances, should be amended to allow the UK's network of needle exchanges to supply foil. At present, it prohibits the supply of "articles to be used for the preparation or consumption of illicit drugs".

Critics say the ban endangers users' health because most drug workers are too afraid of being prosecuted to risk giving out something that many see as a sensible harm-reduction measure. An estimated 100 of England's 1,300 needle exchanges already defy the law by providing foil. Some have even had tacit support in the form of "letters of comfort" from their local police force, such as Avon and Somerset, which emphasises that it does not see the pursuit of section 9A as a priority.

The ACMD's technical committee has held two private evidence-gathering sessions on the subject with with Jamie Bridge of the International Harm Reduction Association, which backs legalisation, and drugs treatment researchers Neil Hunt and Rachael Pizzey. It is due to hear on 29 October from veteran Dutch drugs worker John-Peter Kools, who has issued foil in the Netherlands. Both Holland and Spain issue foil through needle exchanges without any major problems.

The full ACMD is to debate the issue in November and is expected to suggest setting up a pilot study on the effects of foil provision. It hopes to advise ministers of its views soon – possibly before the end of the year – on whether the law should be changed. Bridge said: "Smoking drugs is by no means safe, but is a great deal safer than injecting drugs – which is particularly associated with overdose, blood-borne viruses, drug-related litter, greater dependency, abscesses and vein damage.

"The law has unintentionally put us in a strange position whereby we can give someone clean needles to inject with, but we face arrest for giving them aluminium foil to smoke with. Providing foil in this way is such a common-sense approach – with huge potential benefits and little opposition or potential costs – that we hope the law will change soon." Significantly, the Association of Chief Police Officers, which represents the country's most senior officers, is neutral on whether the law should be amended. But it would support a change if the ACMD recommended such a move on public health grounds, sources told the Observer.

Harry Shapiro of Drugscope, which represents 800 drug projects, said: "It's important to do everything possible to discourage Britain's 300,000 problem drug users from injecting their drugs, and we should allow injecting heroin users to be provided with foil as part of a harm-reduction programme. As the law now stands users' health is being compromised and it would be better if section 9A was repealed."

But James Brokenshire, the Conservative shadow home affairs minister, said: "I'm cautious about these sort of moves, which progress harm reduction rather than focus on getting people drug-free. In recent years there has been insufficient focus on getting people off drugs and too much on just maintaining people on drugs through methadone and other measures.

"I would need to be swayed that there are clear and compelling public health arguments to make such a change [in the law]. I want to promote abstinence-based rehabilitation. There needs to be a greater emphasis in getting people off their drug habit rather than maintaining their addiction."

Paul Hayes, the chief executive of the NHS's National Treatment Agency, which funds drug treatment, said: "Any way of using heroin is dangerous and likely to lead to addiction. However, injecting the drug is far more dangerous than other means of ingestion, such as smoking. Currently, the provision of foil is not legal. The NTA cannot advise drug treatment services to follow a course of action which is illegal and could have adverse consequences for provider services."

   

[flashman]

 the foil from X change supplies is excellent, I hope more areas get letters of tolerance from the old bill. However what we we really need is that dutch prescribed smokeable diamorphine!

To be realistic however its hard to see it moving a significant amount of injectors to smoking but it might protect a few smokers from the perils of 'best in' foil and the like. Lets face it if people are reluctant to try up the bum, a far more cost effective method that mirrors the experience of an IM injection without all the risks, then moving people to chasing is a more uphill struggle[albeit one worth trying]

R

[bp]

One of the reasons it's difficult to move people from injecting to smoking is simply because people don't know how to actually smoke gear and frequently end up with a lump of charred gear on the foil; people need to be taught how to smoke.

Beryl

[wastedyouth]

I know this was ages ago but it had been the first time i had seen it.  I smoked heroin for 9 years and most of the time if being truthfull unless i was doing alright i never burned my foil, to eager i knew it was dangerous but at that time i didn't care, and i was using the cheepest of the cheepest foil.  I also know i wasn't the only one doing this so this would be a great idea just for smokers.  Sometimes i feel like they forget about smokers as if were not that bad and i know it's prob harder to overdose,none of the problems of IV, but the same withdrawls though.  I went to my doctor to get methadone and because i was only smoking he knocked me back, that was about 8yrs ago and im sure things have moved on, but if they would try and catch people before they move to the needle if possible not the other way about.  The foil would be a great idea but since this was october 2009 it doesn't look like it's on it's way(not in scotland anyway)
Great idea though!!

[Flip]

The really worrying thing is that the Tories now in government are so fired up about "abstinence based treatments".to most of these people its a moral question; you can tell by the way they phrase things . They've bought into the bogus "cure" rates claimed by groups using this form of treatment because its politically expedient. What many of them would like to do is jack sentences through the roof and cease drug treatment altogether they just don't think the electorate would buy it at the present time, but I expect this kind of thing to get a lot worse before it gets better ( if it ever does).

Flip

[wastedyouth]

I'd love to know what the forms of treatment they are.  Iv'e not heard of any treatments that have a high  success rate, rehab has a really low success rate, methadone detoxs have low success rates what are we talking about here, something like the Priory,great if you can afford it.  I have never heard of anything that has been successful for a high number of addicts.  The only way i see me ever getting completely clean and free from methadone is doing it slowly with my own time limit and with guidence from my doctor complete freedom to go up, down or stoping still for a while depending on how im coping, put pressure on us or start handing out time limits to be off methadone will just not work, it will backfire in there faces, crime rates will go up, more children in care, more work for the NHS etc the place would go wild.  Maybe more money could be put into helping us realise when is a good time, with coucelling, building confidence that we can decrease with a little guidence.  I have been on 50mls for 4 yrs now(with all clean urines) and my doctor has not once asked me if/when i intend to start to detox and when i have asked, the next script hasn't been changed it ends up getting left you lose your bottle and im still here in the same place 4yrs later.  Every month i am in my doctors for 5mins "how are you, have you used" thats it then i get my script and go home, surely there is room for improvement there.

[OP8S]

Quite often it's not the fault of the person smoking it that it ends up frazzled up on the foil, I certainly did know how to smoke gear & also was an iv user. When at times I was tring to come of the needle because of an infection or something, so I was really trying(!) & there was some dodgy gear about, if it frazzled on the foil I would always end up with the rest of it in the works to get the best hit. It sounds crazy that foil shouldn't be handed out when pins are, I think it should be but a lot of the time the problem is the quality of the gear that tempts people down the iv route in my opinion.