It starts with facts regarding World Heroin Production and how Britain relies on Afghanistan to provide our 30 tonnes+ annual heroin consumption and how arranging alternative supply-lines is easier said than done.
I then launch into a pro-Heroin-Assisted-Treatment, antimethadone critique of British prescribing practice to addicts one of (my favourite subjects to rant on).
I then apply the barely-existent treatment options mentioned to my own life and ask what else could I do, apart from what I'm already doing now...
IF ANYBODY HAS BETTER FACTS, NEWER IDEAS, FINE LINKS OR ANYTHING HELPFUL OR CRITICAL, DON'T HOLD BACK. PLEASE LEAVE A COMMENT. BE AS DETAILED AS YOU LIKE. ALL OPINIONS ARE WELCOME.
MANY THANKS AND HAPPY HOLIDAYS TO YOU ALL XXX
IN ANSWER to some of the drought comments I got, I've dug out some facts regarding world heroin and opium cultivation and consumption. You'll notice from the information up top that Europe consumes more than four times as much heroin as North America.
Several commenters have wondered why Colombia, upon which the Eastern United States rely almost exclusively for their supply, doesn't ship their lovely #4 white heroin to the drought-ridden UK I can give you an answer.
Of course it is quite possible that Colombian heroin might find its way here in small amounts. But Colombia produces only 5-10 tonnes of heroin per year, enough to suffice for America's Eastern seaboard, but nowhere near enough to satisfy the UK's pre-drought consumption of 30-35 tonnes of heroin per year. 35 tonnes would be the entire annual production of Burma. (Burma produced 345 tonnes opium in 2009, equivalent to just under 35 tonnes of China White heroin.)
Alternative sources of supply to the UK could easily take two years or more to arrange. Last week I was talking to a retired dealer to used to serve my local area when it was the norm for addicts to score from other addicts. This person knows a lot about how the heroin trade actually works. I was told categorically that the time lapse between harvest in Afghanistan and heroin bags on Britain's streets is at least a year to eighteen months.
The government know they could smash the heroin trade by prescribing pharmaceutical heroin to addicts. Switzerland is the only country to have implemented diamorphine therapy as a first-line treatment. Now Switzerland, once notorious for its "needle parks" and a centrepoint for drug tourism, has some of the lowest rates of heroin use in Europe.
Pharmaceutical heroin is widely used in the UK as pain relief. Many family doctors carry diamorphine amps in their medical bags. But contrary to certain reports, diamorphine is prescribed only rarely to addicts in the UK. Estimates state that only 400-800 addicts receive diamorphine therapy in this country. The latest experimental scheme, RIOTT, trialled injectable diamorphine against injectable methadone and oral methadone. Not surprisingly the success rate of oral methadone was dire. Injectable methadone did better. Injectable diamorphine did best of all, with an 80% reduction in illicit drug use among those prescribed this treatment.
It is easy to test for illicit opiates against pharmaceutical grade heroin, so cheating is not possible. Any use of street heroin on top of a diamorphine prescription is easily flagged up by a simple urine test.
Different countries have implemented diamorphine prescription in different ways. In Switzerland, the Diaphin diamorphine is premixed to a strength of 100mg/1ml, handed to the patient in a syringe and injected in the presence of a trained nurse. A similar system was trialled in Holland. In the UK, patients are eventually allowed to take home their diamorphine prescription (usually in 100mg and 30mg dry amps). They can then fit the prescribed drug into their lives as most convenient (e.g. directly before or after food, at bedtime, immediately on waking and so on: the times addicts most like to use). They can also mix the hit to the strength and dilution that suits them best.
Presciption-wise, the Netherlands have been the most forward-thinking, issuing not only injectable heroin hydrochloride to needle-wielding addicts, but pharmaceutical-grade smokeable heroin base to addicts who chased their dose from tinfoil. Caffeine was added to the white heroin base to make it run more easily over the foil.
Another treatment used in the Netherlands yet barely heard of elsewhere is an oral therapy that has been shown to help addicts with a needle-fixation (like I had/have). Detxtromoramide (better known as Palfium) was issued to addicts in Holland who were receiving oral methadone doses, but proved unable to give up injecting street heroin on top. Palfium syrup (or noninjectable pills) work quickly and effectively by mouth. Knocking back a dose has a similar effect to slamming back alcohol. Within minutes a "hit" is felt. A degree of willingness plus a prescription for Palfium could help thousands of addicts in Britain and elsewhere to make that final step of stopping using on top of methadone. If only our governments were a little more open-minded years and years of suffering could be brought to an end within months.
Of course the Government will not listen. The "experts" who have trawled medical papers, compared clinical trials and yet may never have popped an opiate in their lives, much less lived through years of addiction... these get a full hearing. While the true experts, the addicts on the street, who can vouch first hand how ineffectual at quashing drug-cravings oral methadone actually is ~ are dismissed as whingeing, deceptive junkies who'd say anything to get a free high.
Well drug addiction IS (among many other things) about getting high. Take an addict's high from them, and they'll use something else that WILL give that missing high. This "high" gets addicts out of the door and to appointments. It gets them to eat, to sleep. The high helps them engage with their children, spend quality time and play games they might not ordinarily want to play. So get out of your head the idea of selfish pleasure-seeking. The opiate high is what addicts need to function. Without that high you have a methadone-state. No physical withdrawal (provided the dose is right) but no energy, no enthusiasm either. A mood that's flat at best, severely depressed at worst. It's methadone's extreme unsuitability as a long-term treatment that leads addicts to the typical on-methadone pattern of behaviour where they give up raising heroin-money and reduce heroin sharply, yet in no way give it up. This is the best that methadone does. At its worst it merely exacerbates physical dependency. The addict drinks it, because they're forced to under legal duress, having been caught too many times shoplifting (or whatever). And they carry on precisely as before: piping, piping, piping crack (and methadone does nothing for crack addiction), drinking, popping downers and still using heroin ~ perhaps slightly less.
I've seen pensioners ~ on methadone for years ~ for whom Money Day is the highlight of the week. The Dealer comes round and hands out bags of magic B* that really does work, and does make them OK for the one or two days of the week they can afford it. The rest of the week they live a morose half-life. Heroin days are the only days anything gets done. A life on methadone is no life. I cannot see myself ever being OK on methadone, hence my reliance on temazepam and drink to be OK. On methadone alone I have all the symptoms of depression: excessive sleep, low mood, lack of interest in anything much, low self-esteem, fatigue, slowed thought process and a generalized misery unrelated to any particular issue or event.
The sooner I can get off this syrupy rubbish the better. My experience with antidepressants has been disastrous. My last reaction to mirtazapine was so extreme ~ involving not sleeping for days on end, pinging about everywhere for a week all disinhibited so people assumed I was drunk and on crack when it was just this antidepressant... then I crashed BADLY and got so low I felt my life was over. On one of my lowest days I scored heroin, not because I wanted it but only because I didn't know what else to do. I opened it and stared at it forlornly for hours, not wanting it, not wanting not to take it either. When I did eventually take it, heroin was no help.
This is why I feel I need psychiatric help. I'm not claiming to suffer any more than any other addict. All addicts suffer. I have a sense that something is going on with me that is undiagnosed and untreated. When I'm asked to name my problem on Government forms I don't know what to put any more. No psychiatrist is ever going to be my saviour, I know that. But I would appreciate the insight of someone who recognizes a constellation of experience and might say to me "this is the issue, this is what you can do about it".
So for me, it's no drugs. That's my prescribed therapy. No drugs, no drink. I'm not exactly flourishing on the no drink. Life hurts me too much not to be in a haze, so I don't know how I'm going to do it.
My current plan is to physically tidy myself and my house up. Then I'll pull the plug on alcohol and all these pills. And if life is so very unbearable that I just want to die, I'm going in the nuthouse. That's the only place left for me to go.
I'm fine today because I've had an extra special Xmas methadone dose, an extra special Xmas temazepam dose and a half-bottle of Caramel Baileys. So I'm in a pleasant fog of indifference. Without this pharmaceutical mist, I don't know how I will survive. But I'm determined to do it, no matter how much it hurts. I don't even care about losing my sanity. When I lost it three weeks ago it wasn't as frightening as you'd imagine. Your terror of insanity is the terror of a sane person. I was insane and hence not scared. When I first began to hear voices I found them hilariously funny. In fact I spent most of my time in the manic whirlwind laughing, singing and writing crap online. You can make the best of any situation. And that's what I've endeavoured to do my entire life through. Turn sour old lemons into refreshing lemonade. To make the best of a bad lot.
One day I hope to look back on this extended period of time-wasting and see no more than a bad memory from a past life. A life that's barely worth remembering, except as a cautionary tale for others. For if I can turn into a raving smackhead, literally anybody can. Heroin does not respect so-called boundaries of class or race, intelligence or social background. I'm by no means posh, but I did not come from a deprived housing estate. None of my friends or neighbours or family ever used heroin. I came to heroin through a mixture of fascination with a fair measure of death-wish thrown in. I came to it late (only got addicted at 28). But once it did get me, I knew I was well and truly got. Hook, line and sinker, it had me. No escape. And no way out. Heroin was the only thing that made life worthwhile. The only thing that made life made sense.
Every day without heroin or my substitution drink and pills on top of methadone is a day out in the cold, where life is fractured and senseless. And it hurts. I know I've said this before. I'm writing not to convince you of anything, but to convince myself that I can Do It. There is no Easy Way, I know that. If anybody has an Answer they think might help, I'd love to hear it. As things stand I'm plodding on as planned. And I will not be shaken or moved. I'll keep on trudging no matter how tired I get. I know life isn't meant to be fun. Life is a struggle. At least by struggling I'll know I'm Living.
My one Dream is that one day I might wake up somewhere sunny and safe and realize at last that I'm now a thousand miles away from where I used to be. That I finally have broken free. And that I'm never ever going back There. Where I never belonged, but nearly drowned.
I want Freedom.
*B is short for Brown. "Brown Sugar" base heroin from Afghanistan and other countries in the so-called Golden Crescent
**Re the UN's 2007 Opium Cultivation table, bear in mind that judging opium production per hectare without specialist knowledge can be deceptive. Specialists say Afghanistan's richer soil and superior irrigation infrastructure produce per-hectare opium yields more than double those of Burma ...
PS: I'm on Gabbly now (from about 5pm London time; that is about 9am Pacific, midday Eastern, 6pm Central European and about 3am most of Australia). Gabbly is my live chat box, towards the top of the sidebar, between the Double UO Globe symbol and the rotating molecule. Every new visitor here sets off a doorbell chime. Anyone who's up for a chat say Hi. If you don't get a response keep Dmmmm-Dmmm-Dmmming that thing and WAKE ME UP!
HM the Queen's Xmas Message 2010
The Queen's speech comes on BBC1 and ITV (the 2 major channels) at 3pm Xmas day.
This year she talks about the King James ("Authorized") translation of the Bible which is now four centuries old.
Plus the benefits of sport.
The Queen's Speech isn't exactly the most exciting broadcast of the year, but I, among millions of others, watch it, as much for the novelty of the Queen talking to me as anything else ...
It's 02:27 and I've just woken up having dreamed I was posting. See I'm in a chair with the computer in front of me, dreaming about posting and commenting on my blog. Got blogs on the brain, me!