Britain's first drug 'shooting galleries' hailed a success

Health Editor,Jeremy Laurance
Monday 19 November 2007 20:00 EST
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A trial scheme which set up "shooting galleries" in three cities, enabling heroin users to obtain drugs and inject them under supervision, has dramatically cut crime rates and stopped addicts buying their supplies on the streets.

Yesterday's preliminary results from the £2.5m pilot project sent a ripple of excitement through the treatment community, because long-term heroin users are among the hardest addicts to treat. They lead chaotic lives, often robbing and stealing to fund their habits. According to official figures, 10 per cent of drug addicts commit 75 per cent of the acquisitive crimes in the Britain. But the number of offences committed by the heroin addicts taking part in the shooting gallery scheme fell from an average of 40 each per month before they were admitted to "about half a dozen a month" after six months of intensive therapy, according to Professor John Strang, the head of the National Addiction Centre at the Maudsley Hospital, who is leading the study.

Instead of buying street heroin every day, the 150 volunteers are now buying it only four or five times a month on average – while a third of them have completely stopped "scoring" the drug on the streets.

Professor Strang said: "This is genuinely exciting news. These are people with a juggernaut-sized heroin problem and I really didn't know whether we could turn it around. We have succeeded with people who looked as if their problem was unturnable, and we have done it in six months."

The scheme is modelled on one in Switzerland, where the introduction of injecting clinics "medicalised" heroin use and transformed it from an act of rebellion to a treatable illness. Similar clinics operate in France, Germany and Canada.

The first British injecting clinic opened in south London two years ago, funded by the Home Office and the Department of Health. Two more were opened, in Darlington last year and in Brighton two months ago. During the trial, a third of the volunteer addicts take the heroin substitute methadone orally, while a third inject it under supervision. The remaining third, observed by nurses, attend twice a day to inject themselves with diamorphine – or pure heroin – which is imported from Switzerland and provided by the clinic. Professor Strang said: "The rules are incredibly strict. There is no 'take-away' at all [to avoid the users selling their drugs on the streets]. All injections are witnessed at the clinic.

"The approach introduces routine and drudgery by forcing the users to attend for their fix twice a day. The nurses have become quite involved, telling users off about their bad practice or lack of hygiene. I was quite surprised how, after decades of injecting, some users were still so bad at it."

There are an estimated 280,000 users of hard drugs in Britain, most taking heroin and crack cocaine, and about 2,500 deaths a year. The shooting gallery scheme, targeted at long-term heroin users, operates seven days a week, 365 days a year and costs £15,000 per year for each addict – three times the cost of providing oral methadone treatment.

Jamie, 39, heroin addict: 'I have got no warrants hanging over my head'

Since the age of 16, Jamie has been to jail 28 times. She has lost her children, her possessions and very nearly her life when she was hospitalised for six weeks in 2004. All because of heroin.

"It started when I was 14. I kept running away from home and got involved with some older kids who were using 'skag'. I wanted to know what it was like. By 16 I was addicted."

Much of her life since then has been spent on the run from police and in treatment programmes, none of which succeeded in weaning her off the drugs.

In 2005 she was one of the first addicts to be taken on by the injecting clinic in south London. It has transformed her life. "I am no longer out shoplifting. I have got no fines or arrest warrants hanging over my head and I am not in prison. I have a better relationship with my family and I feel great."

Now 39, she injects diamorphine every morning and afternoon and wants to start reducing her dose soon. "My plan is to go to college and get a job. Heroin addiction is an illness – it has been my illness since I was a teenager."

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