The bureaucracy of drug addiction needs drug addicts far more than drug addicts need the bureaucracy of drug addiction.

For the past 14 years, I have worked as a doctor in a large general hospital in a deprived area of Britain , and in the even larger prison next door. In that time, I have seen heroin addiction rise from an infrequently encountered problem to a mass phenomenon. It has now become so widespread that the city council has politely asked residents not to put used needles and syringes in the weekly rubbish collections. No stairwell in any housing estate is complete without the discarded paraphernalia of drug abuse.

If an increase in the number of heroin addicts such as Britain has experienced in the last few decades - up from a very few in the 1950s (there were only 62 known cases in Britain in 1958, 67 in 1968, and as late as 1978 there were only 859, when heroin addicts were still few enough to be registered individually by the Home Office, which no doubt underestimated the numbers, but not by orders of magnitude) to well over 100,000 by the year 2000 and up to 195,000 in 2007 - constitutes an epidemic, it is an epidemic of a very strange kind, one that is spread by the psychological contagion of bad ideas and bad desires rather than by the physical contagion of bad germs.

Drug-addiction services have also grown massively. In our society, every problem calls forth its equal and supposedly opposite bureaucracy, the ostensible purpose of which is to solve the problem. But the bureaucracy quickly develops a survival instinct, and so no more wishes the problem to disappear altogether than the lion wishes to kill all the gazelle in the bush and leave itself without food. In short, the bureaucracy of drug addiction needs drug addicts far more than drug addicts need the bureaucracy of drug addiction. The propaganda, assiduously spread for many years now, is that heroin addiction is an "illness". This view serves the interests both of the addicts who wish to continue their habit while placing the blame for their behaviour elsewhere, and the bureaucracy that wishes to continue in employment, preferably for ever and at higher rates of pay.

Viewing addiction as an illness automatically implies there is a medical solution to it. So, when all the proposed "cures" fail to work, addicts blame not themselves but those who have offered them ineffectual solutions. And for bureaucracies, nothing succeeds like failure. The Government spends £384m a year on drug treatment alone, despite there being little evidence of any reduction in the number of addicts and only achieving a 3% success rate, however the true cost is much more startling:

Since the bureaucratic solution to waste is to waste even more, you don't have to be Nostradamus to predict that funding in Britain will continue to rise. Before the expansion of heroin addiction in my city, I knew little about it. I'd known a few addicts in the higher echelons of society, but they had been peculiar even before their addiction. I had briefly run a drug-addiction clinic in a famous university town, at a time when I accepted what I now know to be myths about heroin addiction. But as more addicts came to my attention – I see up to 20 new cases a day in prison – I began to think about it more.

The medical perspective, that these people were ill and in need of treatment, seemed less and less convincing. I discovered that most addicted prisoners stopped taking heroin in jail, even when it was available. They came into the prison starving and miserable, and went out relatively healthy. But within a few months, many were back in their former condition, and when brought once more before the courts, some would beg to be imprisoned. When, soon after their return, I asked them whether they intended to give up taking heroin, some would reply: "I'll have to, I've got no choice." Asked why, they would offer replies such as: "Because my girlfriend's just had a baby and she won't let me see it unless I do."

This answer was a strange one if these addicts truly thought of themselves as ill and in need of treatment. Instead, they clearly believed a purpose in life was enough to enable them to abstain. This is not how pneumonia, for instance, is cured. No one would say: "I must stop having pleuritic pain each time I breathe deeply because I have just had a baby." Yet the medical services allow addicts to focus exclusively on the physiological aspects of addiction, which in practice means the prescription of a drug such as methadone.

It's very hard work to become an addict

Going cold turkey is quite easy

People choose to get hooked...

There is a strenuous, almost outraged, rejection of the idea that addiction is, at bottom, a moral problem, or even that it raises any moral questions at all. Of course, addiction to heroin and other opiates has serious medical consequences. I often saw addicts with deep vein thromboses or multiple abscesses; they would have TB; they would be malnourished and infected with Hepatitis B or C, or both, and HIV. It would be difficult to obtain blood from the veins in their arms or legs because they had injected so often. But medical consequences do not make a disease. Many mountaineers get frostbite, but mountaineering is not a disease. To conceive of heroin addiction as such seems to me to miss the fundamental point: it is a moral or spiritual condition that will never yield to medical treatment.

Having started with a vague supposition that the medical approach to addiction must be right, I came to a different conclusion: that such an approach, having started no doubt as an honest attempt to help addicts, now represented a combination of moral cowardice, displacement activity and employment opportunity. The therapeutic juggernaut rolls on. It is easier, after all, to give people a dose of medicine than a reason for living. That is something the patient must minister to himself. In coming to these conclusions, I felt I was living in a world in which the plainest of truths could neither be said out loud nor acknowledged.

Every day I saw addicts selling their prescription drugs or continuing to take heroin and any other drug they could get; addicts who, despite their "treatment", continued to commit crimes; addicts openly contemptuous of attempts to help them, who lied to and manipulated their helpers shamelessly; and addicts who had, without any assistance, given up heroin completely. Above all, I observed the true triviality of heroin withdrawal symptoms. Yet my observations did not seem to matter. It was almost impolite, and increasingly impolitic, to mention them to colleagues who dealt with addicts, though they must have observed the same things.

I felt like a heretic who had better keep his beliefs to himself. Had I not been lucky enough to work with three eminent physicians who had observed precisely what I had, and drawn the same conclusions, I might have broken down. The orthodox view of addiction is that a person is somehow exposed to heroin more or less by chance. It has a pleasurable effect, and he or she keeps taking it. Before long, the person is addicted and, to avoid the terrible suffering of withdrawal, must take more. Of course, to pay for this, addicts usually resort to crime, for their addiction precludes normal paid work but requires a large income. All powers of self-control are destroyed by heroin, and unless they take a substitute drug, such as methadone, or enter a lengthy rehabilitation programme, addicts cannot give up. They are hooked for life and need help – from the drug-addiction bureaucracy. There is only a tiny grain of truth in all this. That physiological addiction exists is indisputable. But in practically all other respects the standard view is wrong, a masterpiece of rhetorical tricks.

It is to heroin addicts what Marxism was to the Politburo of the former Soviet Union : a systematic pseudo-scientific justification for everything they do. The orthodox view is self-serving for addicts because it implies no possibility of self-control and so no blame. What, perhaps, is more surprising is that many doctors, therapists and social workers swallow such nonsense. The truth is people who are genuinely exposed to strong opiates by chance, such as after an operation, rarely become addicted to them. It might once have been the case, before awareness of the addictive properties of heroin was so general, that unsuspecting people were introduced to the habit by others and were thus "hooked". Whatever may have been the case in the past, this is not a plausible explanation now.

Children may no longer know the date of the Battle of Hastings, but they know heroin is addictive. Many addicts say they did not know what they were getting themselves into when first they took heroin, but this is not credible; they could not have failed to know. Again, the standard view is that the process of becoming addicted to heroin is swift. The future addict has to take the drug only a couple of times and then – hey presto – his willpower is gone. He is hooked forever. But actually, you have to work quite hard to become a heroin addict. It is not something that creeps up on you unnoticed. In fact, addicts are people intent on rebelling against received norms. They enjoy the feeling of swimmy calm that heroin produces and make a free choice to become an addict. Nor are the withdrawal symptoms from heroin anywhere as terrible as normally painted. In the popular conception, going "cold turkey" is dreadful beyond all description, involving cramps, insomnia, vomiting, shaking and sweating.

But not a single addict has ever caused me as a doctor to feel anxiety for his safety on account of his withdrawal. And all the genuine symptoms, which are never severe, such as muscular aching, diarrhoea, crying, sneezing and insomnia, have been relieved by simple, non-opiate medication. Certainly, most withdrawing addicts have portrayed themselves to me as being in the grip of dreadful suffering. They writhe in agony, claiming they have experienced nothing as bad in their lives, and they make all kinds of threats if I do not prescribe "something" – they mean an opiate – to alleviate their suffering. The threats range from damaging their cells to killing themselves, others or even me. (Withdrawing alcoholics never make such threats.) In fact, heroin addicts rarely carry out their threats. Those who say they are suicidal quickly admit they were merely trying to get methadone when I suggest they be put in a cell so bare that there is nowhere from which to suspend a noose.

My counter-threat produces in most cases the most miraculous improvement in their mood. Not all the addicts I see exaggerate in this fashion. Some admit with a laugh that anyone who says cold turkey is terrible is lying and more than likely trying to bluff his way to getting methadone.

As long ago as the Thirties, experiments showed that salt solution could be substituted for morphine without the addicts' knowledge, and they could be deceived out of their withdrawal symptoms. Yet the established fact that withdrawal from opiates is not a serious medical condition is a truth universally ignored by doctors. The great glory of withdrawal agony, from a career point of view, is that where suffering exists, it is necessary to employ more and more doctors, nurses, psychologists, social workers and counsellors to relieve it. Yet consider what happened in China after Mao took power in 1949. At the time, China had more opiate addicts than the rest of the world put together – about 20million.

But Mao gave them a strong motive to give up: he shot the dealers and any addicts who did not give up their habit. Within three years, Mao produced more cures than all the drug clinics in the world before or since, or indeed to come. He was, indeed, the greatest drug worker in history. The point of this story is not to advocate a repetition of Mao's methods. It is to demonstrate that, when a motive is sufficiently strong, many millions of addicted people can abandon their addiction without the paraphernalia of help considered necessary today.

It demonstrates that people take heroin out of choice, ultimately, and so can stop out of choice. Addicts are not blameless victims of some terrible illness they have no control over.

Almost everything you know about heroin addiction is wrong.

Based on his experience as a prison doctor and as a psychiatrist in a large general hospital in Birmingham, Dr. Dalrymple argues that addiction to heroin is not an illness at all, and that doctors only make it worse. They deceive both the addicts and themselves by pretending that they have something to offer.

In this brilliant, entertaining and provocative book, Theodore Dalrymple explains how and why a literary tradition dating back to De Quincey and Coleridge, and continuing up to the deeply sociopathic William Burroughs and beyond, has misled all Western societies for generations about the nature of heroin addiction. These writers' self-dramatizing and dishonest accounts of their own addiction have been accepted uncritically, and have been more influential by far in forming public attitudes than the whole of pharmacological science. As a result, a self-serving, self-perpetuating and completely useless medical bureaucracy has been set up to deal with the problem.

With scathing wit, implacable logic and savage denunciation, Dr. Dalrymple exposes the mythology surrounding heroin addiction. Moving seamlessly between literature, pharmacology, history and philosophy, he demonstrates what happens when the nature of a social problem is so thoroughly misunderstood, and when human beings are regarded as inanimate objects rather than as agents of their own destiny. His scintillating, iconoclastic little book has an importance far beyond its immediate subject matter.

Junk Medicine: Doctors, Lies And The Addiction Bureaucracy, by Dr Theodore Dalrymple, is published by Harriman House Publishing on August 27, 2007 , priced £14.99. Click here to order . 18th August 2007

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Perpetuating the Addiction Myth

The book, The Truth about Addiction and Recovery makes a very compelling argument that the "disease theory" of addiction, especially for alcohol and drugs, is completely wrong. Common dogma says that "Addiction is a disease." Researchers explain addictions are caused by endorphins, chemicals the brain secretes in pleasurable moments. Addicts chase the high from endorphins, as the theory goes. There's just one problem: It's never been proven.

"Addicts can't stop themselves." "They'll be addicted for the rest of their lives." "They must never smoke or drink again!" Again, all are myths. Smokers, drinkers and even drug users have stopped on their own or with effective treatment.

As for drug users, there have been several studies affirming that people do quit drugs and don't give into temptations to use them; one study followed Vietnam vets: Many used heroin while in combat, but few continued using it after they came home. Consider how many people experimented with drugs during the '60's, yet this did not lead to mass addiction in the 70's.

Addicts are "cured" by treating them in hospital-based programs. Yet, there's no evidence that they don't get people off drugs or alcohol any faster or more effectively. In fact, they may even hinder recovery. The typical hospital-treatment program for drug and alcohol addicts imposes these premises on the patient: "You have a disease", "You are an addict", "You will be addicted for the rest of your life", "You are in denial", "You must turn to other addicts for guidance". Many of these programs impose a coercive environment so that addicts can "come to terms" with their addiction. Many of these programs are physically abusive, but the worst part of treatment, though, is the way that clients have their identities forced upon them. No longer are they housewives, teachers, executives or writers–they are addicts! Forever.

People need treatment in the context of their lives, and encouraged to overcome their addictions among family and friends. Well-balanced people, rather than addicts, are their models. Most importantly, people under treatment develop an identity of their own, without coercion.

Claims that the 12-Step/Disease Concept of recovery is the most successful treatment ever devised are what we hear. The reality is that these treatment paradigms have consistently demonstrated outcomes ranked lowest among the various options studied. The Ditman Study provided evidence that AA is no more effective than no treatment at all. The AA itself conducts surveys. The AA Monograph, Comments on AA's Triennial Surveys, revealed this surprising result regarding new member dropout rates:

At one month, the percentage of those that have remained is 19%, at 3 months 10%, and at 12 months 5%. This is a 5% success rate at the one-year point if success is simply defined as continuing AA membership. Because AA considers addiction a chronic, progressive disease, these findings make it ironic that the 12-Step model is described as a “program for life”.

There is an opposing viewpoint to that of Alcoholics Anonymous (AA), Narcotics Anonymous (NA), and all other twelve-step mutual-help support groups, that these groups, unfortunately, are part of the problem, not the solution. They only serve to perpetuate myths that have clearly been proven false based upon the vast amount of research that has been done in the field of substance abuse.

All twelve-step support groups teach the disease model of addiction, which was popularized by AA and adopted by professional organizations and government agencies. The disease model of addiction is intellectually sloppy and unscientific. This model does much more harm than good because it undermines peoples' feelings of self-control. Here are its basic premises: Addicts inherit the disease of addiction. They are born with this disease and are therefore already addicts long before they ever use drugs/alcohol.

Their disease is characterized by loss of control and progression. In other words, addicts can never control their drug/alcohol use and their disease inevitably gets worse and worse. Their only hope is to remain completely abstinent from all drugs and become a lifelong member of a twelve-step support group. This definition of the 'disease concept' is from the book of Narcotics Anonymous.

Counsellors, AA members, and other disease proponents often talk about inheriting "the gene for alcoholism." These genes have never been found (although a lot of time and money has been spent looking for them). Most researchers, in fact, agree that it is highly unlikely that any such genes exist. A study was published in the Journal of the American Medical Association (JAMA) on April 18, 1990, linking alcoholism to a specific gene. The study was accompanied by press releases, news conferences, and interviews with the researchers. Eight months later another study was published in JAMA that reported a lack of association between alcoholism and this gene (the dopamine D2 receptor gene). Of course this study was not publicized like the original study and most people never heard of it. They still believe that the alcoholism gene has been found.

All scientific attempts to define an addict have failed because the concept itself is fundamentally flawed. Addicts exist in our minds but not in the objective world around us. The DSM-III-R, which is the authority on psychiatric disorders, contains two categories of pathological patterns of substance use: abuse and dependence.

It's important to note, that the criteria used to diagnose alcohol problems is exactly the same as those for all other substances. The American Psychiatric Association (APA), therefore, doesn't appear to believe that alcohol abuse is any different from that of other substances. Once the person stops using the substance, he no longer meets the criteria for abuse or dependence. In other words, he is no longer an addict or an alcoholic. This is what is known as all-or-nothing thinking, either you are or aren't an alcoholic or a drug addict.

Experts claim the trouble with the drug and alcohol treatment industry and twelve-step support groups is, they take those people with the worst success in controlling their own behaviour and allow them to tell the rest of us what our attitudes should be. If you tell people enough times that they have no hope of controlling themselves, they will eventually start to believe you and prove you right.

Loss of control over drugs and alcohol is much more a cultural phenomenon than it is a symptom of a disease. Take for example the Italians. They respect their alcohol. They drink beer or wine at every meal but only drink one or two glasses. They think of alcoholism as a problem over which people can exert control and they object to those who become intoxicated. The Italians have the lowest alcoholism rates.

Another reason that the disease concept is so popular is that it gives people an easy way out. They believe that they inherited their addiction, therefore they're not responsible for their own behaviour. At first glance this practice may seem helpful. The argument is that it absolves substance abusers of blame and therefore makes them more likely to enter treatment to get help. But keep in mind two things about calling addiction a disease:

1. It's not true.
2. It doesn't help and keeps the individual from doing things that really would help.

People believe that alcoholism and drug addiction are diseases because they want to believe it. It makes them feel better to think that their problems are beyond their control. Most people desperately search for something outside of themselves to blame things on. Real solutions to real problems, however, will never result from ignorance and misinformation.

The truth is most drug and alcohol 'treatments' is ineffective, and therefore a waste of money. Substance abuse is a problem that is never going to be completely prevented and it's never going to be solved using current ineffective treatment methods.

What goes on in treatment anyway? Patients in treatment centres are coerced by the counsellors and other patients to "discover" that they have the disease of addiction. They are shown a list of symptoms (blackouts, loss of control, progression of the disease, etc), and told to admit that they have them. If they claim that they never experienced one or more of these symptoms they are harassed in an effort to combat their denial.

The concept of denial is a dangerous one because as soon as people claim they don't have a problem, it means they really do have it. Denial is viewed as a symptom of the disease. People who have the worst substance abuse problems, on the other hand, are often those who cannot gain a foothold in life. They more often come from deprived environments or from seriously disrupted homes, or have severe personal or emotional problems. Drugs do not make people indolent, antisocial, or delinquent. Rather, people choose to use drugs because drugs allow them to feel and act in ways they need or want to.

New statistics suggest that while more money is being thrown at drug treatment programmes, the number of people leaving them free of their dependency on drugs has barely increased. According to figures from the National Treatment Agency (NTA), spending on drugs services reached £384m last year, up from £253m in 2004-05.

In 2004, 5,759 people left drug treatment free from their addiction, compared with 5,829 in 2006, that's an extra 70 people for the extra £131m spent. The proportion of people who are completely drug-free after treatment is actually falling, down to a lowly 3 per cent. However the rate of 3% is nothing more than the natural rate of remission, meaning that, at least 3% a year will quit using drugs because they have simply had enough and want to be drug free, with this in mind the actual success rate and the sum total of all spending on drug treatment services equals a 0% success rate.

A source said, 'the only way to change the present system is to change their pay structure, if the drug bureaucrats were paid for results and a bonus system for each person who 'recovered' then all manner of treatment would be used to try and achieve this goal, instead the current pay structure offers no incentives for recovery, in fact, it's just the opposite, for example the restructuring of pay scales in dentistry has seen a dramatic fall in unnecessary dental work'. 15.10.07

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Drink and drugs 'key' to suicide

Alcohol and drug misuse means Scots are almost twice as likely as people south of the border to take their own life or kill, a new report has said.

Research from Manchester University also showed the number of mental health patients killing themselves or others was proportionately higher in Scotland. The report found that the north-south divide was highest among teenagers. It said alcohol and drugs were the "most pressing mental health problems in Scotland". The Lessons for Mental Health Care in Scotland report was commissioned by the Scottish Government. Researchers found there were 500 killings north of the border over five years and 5,000 suicides over six years. Suicide rates in Scotland were 18.7 per 100,000 of the population, compared with 10.2 per 100,000 in England and Wales.

Of the 1,373 patient suicides in the report, there was a history of alcohol misuse in 785 cases, an average of 131 deaths per year. There was a history of drug misuse witnessed in 522 cases, or 87 deaths per year. About 28% of people who took their own life and 12% of killers had recently been mental health patients, the report said.

Louis Appleby, professor of psychiatry at Manchester University, said the findings suggested that alcohol and drugs lay behind Scotland's high rates of suicide and homicide. He called the frequency with which they occurred as antecedents as "striking". Professor Appleby added: "Alcohol and drug misuse runs through these findings and it appears to be a major contributor to risk in mental health care and broader society.

"Our findings support the view that alcohol and drugs are the most pressing mental health problems in Scotland and mental health services can play their part."

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£1.85m to get each person off drugs - Drug services make slow progress

Treatment services in England have made slow progress in increasing the numbers of people they get off drugs, despite a £130m rise in their budget. Spending on drugs services rose from £253m in 2004-05 to £384m last year, National Treatment Agency figures show. Yet the numbers emerging from treatment free of addiction has barely changed. Three years ago, 5,759 left drug-free compared with 5,829 last year. The Department of Health said the figures "distort the true picture".

BBC home editor Mark Easton said fewer than 3% were drug-free after treatment. The government had always maintained treatment was not just about getting people off drugs - it also cut crime, improved health and helped users get their lives straight, our correspondent added. The government is committed to getting people into "effective treatment" which can do something to make their lives better which has "benefits for wider society".

However, he said analysis of the recently published figures showed the proportion of people getting off drugs after treatment had fallen from 3.5% three years ago to less than 3% now. And the figures meant that the cost of getting each person off drugs over this three-year period worked out as £1.85m.

Mr Easton also said that the government's ten-year strategy, due to be launched next April and about which a statement is due soon, is "about getting more people off drugs". Earlier this month, it emerged that heroin and cocaine addicts on the same government treatment programme were being given drugs as a reward for clean urine samples.

The National Treatment Agency's own survey of almost 200 clinics in England found users were being offered extra methadone, a heroin substitute, or anti-depressants for good behaviour. It admitted the practice was "unethical" and offering drugs for anything other than clinical need was wrong. Health minister Dawn Primarolo asked for a report into the survey.

A spokesperson for the Department of Health said: "In the last few years, there has been a massive expansion in the numbers entering drug treatment. "It generally takes between five and seven years for an addict to successfully complete their treatment, and therefore it would be unrealistic to expect to see the results of this expansion in treatment immediately.

"Getting users into treatment and keeping them there is the best way to save their lives and reduce the harm they cause to people around them and to society. "We have made important progress in recent years. There are now over 195,000 people accessing drug treatment every year, 130% more than in 1998." 30.10.07

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Drug success rate of 3% is nothing more than the natural rate of remission

Drug Treatment services in England have made little to no progress with 5,829 addicts leaving treatment drug-free last year. There are now over 195,000 people accessing drug treatment every year which equates to just a 3% success rate.

Paul Hayes of the NTA says “ the £400m the Government invested in drug treatment last year has to be judged against 195,000 individuals whose treatment has protected them from early death, reduced the criminality and provided opportunity to rebuild their lives. To judge treatment solely on the small numbers that finally leave the treatment system in a given year is misleading and dangerous to the drug users, their families and society”.

But critics argue Mr Hayes is missing the point, treatment is all about getting people off drugs and back into society and this figure of 3% is nothing more than the natural rate of remission, meaning that, at least 3% a year will quit using drugs because they have simply had enough and want to be drug free, with this in mind the actual success rate and the sum total of all spending on drug treatment services equals a 0% success rate, which is simply not good enough.

A source said "Newer and more effective forms of treatment are required than the ones presently used which are clearly not working and those in charge of providing treatment need to be held more accountable for their poor results". 2.11.07

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Are Government drug treatment programmes a waste of taxpayers' money?

Why are we asking this now?
Because new statistics suggest that while more money is being thrown at drug treatment programmes, the number of people leaving them free of their dependency on drugs has barely increased. According to figures from the National Treatment Agency (NTA), spending on drugs services reached £384m last year, up from £253m in 2004-05. In 2004, 5,759 people left drug treatment free from their addiction, compared with 5,829 in 2006, thats an extra 70 people for the extra £131m spent. The proportion of people who are completely drug-free after treatment is actually falling, down to a lowly 3 per cent. That has led some to suggest that the Government's current policy on treating those with drug addictions is flawed, and that public money is being mis-spent.

How has the Government reacted?
The Department of Health has defended its increased investment in drug treatment services by saying that the effects of the heightened spending have not been felt yet. It says that it can take as much as seven years for an addict to complete their treatment successfully, meaning that it is too early to make any judgements about the effects of the extra money.

It also points out that the number of drug users receiving treatment is at a record high, meaning that the Government's target on treatment has been achieved two years early. There are now more than 195,000 people accessing drug treatment, which is 130 per cent more than in 1998. Health minister, Dawn Primarolo, said that achievement was "remarkable". She said: "Many thought that the targets set in 1998 were aspirational and unrealistic. We have made massive strides in tackling the harm that drugs cause to both individuals and society as a whole. Through the drug strategy we will continue to ensure that effective drug treatment is available to those who need it."

Who should we believe?
It probably is too early to make any definite judgement on the Government's drug treatment strategy, as there are interesting statistics about the number of people now staying in their drug-treatment programmes. The NTA figures showed that the number of drug users completing early treatment or being retained on treatment increased from 76 per cent in 2005-06 to 80 per cent in 2006-07. This could be a sign that the increased investment is beginning to have an impact.

Does drug treatment serve any purpose?
For some, it is life-changing. There are more than 5,000 people each year who are given the opportunity of a drug-free life due to the drug-addiction programmes. The economy and society also benefit, as addicts can again become productive members of their community. But with the cost of getting each one off drugs reportedly reaching £1.85m over the past three years, questions are bound to be asked about whether it is worth the burden on the taxpayer.

Others argue that drug treatment should not just be measured by the number of people who leave it drug-free. "You cannot get heavy drug users off drugs over night," said the chair of the all-party Parliamentary Drugs Misuse Group, Labour MP, Brian Iddon. "A lot of drug treatment is about stabilising users, so they can function normally, get a job and sort themselves out. It is a complicated issue, but it is not all about abstinence."

Is the UK's drugs policy failing?
When seen in terms of the number of people now accessing drug treatment, there has been a vast improvement over the past decade. That suggests that drug addicts are much more aware of the help that is available to them. And anti-drugs messages might be having a greater effect more generally. According to the British Crime Survey, the number of people reporting to have used drugs in the past year is falling. Now, 8 per cent of 16- to 24-year-olds say that they have taken a Class A drug, down from 8.6 per cent in 1998. And 24.1 per cent say that they have taken any illegal drug in the past 12 months, down from 31.8 per cent in 1998. But as the new figures have confirmed, trying to get people off drugs permanently is a lengthy and costly process – and one on which there does not seem to be much progress.

So what's going wrong?
Part of the problem is the nature of drug addiction itself. While it takes years to kick the habit, a relapse can happen in a second. For many drug users and former drug users, it is an on-going battle, rather than a clean break from their drug habit. According to some, too much attention has been paid to getting people into treatment, rather than focusing on the quality of treatment given to each patient. "The Government has gone for targets – on the quantity of people receiving treatment rather than the quality of treatment," said Brian Iddon. "We are now beginning to see the quality of treatments improve as well, including wider use of psychological treatments for cocaine addicts."

What are the policy alternatives?
Some say that a radical change is needed in the form of an end to the policy of prohibition. That is the opinion of drugs policy think-tank, Transform. It believes that drug prohibition itself is the prime cause of drug-related harm to both the individual users and society as a whole. It believes that proper government regulation would cut out criminal involvement in drugs, as well as decriminalising thousands of users.

"The Government has created a rod for its own back by over-hyping the usefulness of drug treatment," said Danny Kushlick, the director of Transform. "Becoming totally drug-free is only possible for a tiny minority of drug users of any type. Only around 5 per cent will be able to totally stop taking drugs.

"The reason that the Government gives so much money to the issue is because it wants to be seen to be tackling drug-related crime. If it really wants to tackle that, it needs to get rid of prohibition, which is the greatest cause of drug-related crime. Drug treatment should not be about making people drug-free. It should be about public health."

Will anything change?
Any movement away from the prohibition of drugs is unlikely, as it is an extremely politically sensitive issue. If anything, the Government is moving in the other direction. Gordon Brown has already said he is opposed to the legalisation of drugs, and has hinted he wants to reclassify cannabis.

Early next year, the Government will launch a new 10-year drug strategy, which could see a slight change in philosophy. It is already thought that a greater focus will be placed on getting people off drugs, rather than focusing on improving access to drug treatment services. 31.10.07

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The new 2008 drugs strategy explained

The problem
There are an estimated 332,000 problem drug users in England.
Class A drug uses costs the country £15.4bn a year in crime and health costs.
Between a third and a half of theft and burglary is estimated to be drug-related.
24% of people aged 16 to 24 have used an illegal drug in the past year.
10% of people aged 16 to 59 have used an illegal drug in the past year.
The UK illegal drug market is estimated to be worth between £4bn and £6.6bn a year.

Crime measures
Police to have the power to seize cash and assets belonging to suspected drug dealers on arrest, rather than on conviction. "Those who buy 'bling', plasma screens and other household goods, to avoid circulating cash, will have their assets seized before they have a chance to disperse them."

A greater range of goods will be subject to the asset recovery programme, which enables convicted drug dealers to have their assets seized. The 12-year time limit governing asset recovery will also be abandoned. Asset seizure agreements to be negotiated with other countries, starting with the United Arab Emirates in April 2008, "so dealers can't channel proceeds abroad".

Antisocial behaviour orders to be imposed on drug dealers after conviction. These could ban them from entering certain areas, or engaging in certain behaviour linked to drug dealing. Further drug screening at airports. Police to be encouraged to make greater use of the powers they have to close crack houses. Wider use of drug intervention programmes, which involves offenders having to take treatment programmes.

Benefit measures
Drug users to be threatened with benefit cuts if they do not participate in drug treatment programmes. "We do not think it is right for the taxpayer to help sustain drug habits when individuals could be getting treatment to overcome barriers to employment." Increasing support available to drug users to help them get housing and work. Trial projects to "explore the potential of a more flexible use of funding to address individual needs".

Drug treatment services
Programmes involving prescription of injectable heroin and methadone to addicts who do not respond to other forms of treatment to be rolled out, "subject to the findings, due in 2009, of pilots exploring the use of this type of treatment". "New and innovative treatment approaches" to be investigated. Programmes using "positive reinforcement techniques" to be piloted. Addicts to be encouraged to make wider use of mutual aid support networks. Prison drug treatment programmes to be improved.

Support for families
Family members such as grandparents who take on caring responsibilities in the place of drug-using parents to get additional support through a programme in which councils can pay those caring for children classified as "in need". More support for parents with drug problems so that children do not fall into "excessive or inappropriate caring roles". More family-based treatment services to protect young people.

Drugs education
Improved information and guidance to be available to all parents. Schools and colleges to be encouraged to see what they can do to identify and support. Further action to be taken to reduce underage sales of alcohol and cigarettes. 27.2.08

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Warning cocaine will be bigger problem than heroin

COCAINE will soon become a bigger problem than heroin in Edinburgh , according to Edinburgh 's outgoing drugs and alcohol tsar. Tom Wood said the falling cost of the drug – now around the price of a glass of wine – means it is no longer the preserve of professionals, but is already being used together with heroin in some parts of Edinburgh. He said this would lead to the same antisocial problems associated with heroin, such as crime and prostitution.

Mr Wood is handing over to the council's director of health and social care, Peter Gabbitas, at the end of the month. He told councillors: "In this city, we are living with the legacy of heavy heroin use in the 1980s.

"Drug-taking and heavy alcohol use is normal in many parts of society in our city. We are not at the top of the bell curve yet, and there will be a huge increase in child protection referrals and drug deaths for the next five or six years. It's a long road ahead.

"Cocaine is here, and in some parts of the city it is already a bigger problem than heroin. In five years time, it will be the major problem in Edinburgh and east Scotland . It won't be restricted to the wine bars – it will permeate throughout and it is really difficult to treat."

Mr Wood said a heavy cocaine habit is just as addictive as heroin. But he also said that a "reality check" is needed, because the level of heavy alcohol abuse is 20 times higher than drug use. 14.5.08

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Cocaine overdose hospital admissions rise 400 per cent in just four years

The number of drug users being admitted to hospital with cocaine overdoses is four times higher than it was eight years ago, new figures reveal. Just 161 people were admitted to hospital in England for cocaine-related emergencies in 1999. But 740 users needed treatment in 2007, most of them men and with an average age of 29 years, according to the magazine Druglink.

Among hospitals that have seen a huge rise in cocaine poisonings is St Thomas's Hospital in Lambeth, South London. It dealt with 138 cocaine-related cases between April 2006 and March 2007. In the second half of last year alone, the hospital treated 121 patients in its Accident and Emergency department in connection with cocaine use. Drug use in the UK is at an 11-year low but cocaine abuse has been on the increase since 1998.

While use of most drugs has remained stable, the proportion of adults who admitted using cocaine has risen from 1.2 per cent ten years ago to 2.6 per cent last year. Campaigners said last night that celebrity figures such as Amy Winehouse made the drug look 'cool' among wealthy young professionals but the health dangers include heart attacks and strokes. Almost 200 Britons a year are killed by the class A drug.

Models Nina Campbell and Kate Moss, along with former Eastenders actress Danniella Westbrook - who had to have her nose rebuilt - are among those who have been treated for addiction. A survey found one in three young men attending A&E at a London hospital with suspected heart attacks were cocaine users. However, experts believe it causes more deaths than appear in official statistics because it may not be acknowledged as being involved in a heart attack or a stroke.

Druglink editor Max Daly said 'Cocaine use constricts blood vessels and can result in a rise in body temperature, burst blood vessels and, in extreme cases, death from brain seizures, heart failure and respiratory problems.' Tony D'Agostino, a leading expert on cocaine use, said 'This provides yet another warning to the government that it must spend money on an awareness campaign and on special health services if it is serious about tackling the dangers of cocaine use.'

As cocaine poisonings have risen, cannabis poisonings dipped from 171 in 1999 to 96 last year and heroin overdoses also slumped from 1,962 in 1999 to 1,530 in 2007. Mary Brett, spokesman for Europe Against Drugs, said celebrity users of cocaine sent out the wrong message. She said 'We were supposed to see cocaine use being targeted as a class A drug, instead it's going through the roof.

'Young people think it's cool to use cocaine, that it's a safe recreational drug but it can have dramatic effects on the body and cause psychosis. We need more health campaigns and some way of getting the message through that celebrities are not role models, they can afford the rehab unlike some of those who get addicted.' Norman Lamb MP, Lib Dem shadow health secretary, said 'These  figures highlight an epidemic in hard drug use, which will  have grave consequences for the NHS.

'Years of casual celebrity endorsement has led to cocaine being seen as a fun thing to do on a Saturday night when in reality it puts users at severe  risk of overdose, which can lead to death. 'A and E wards are having to cope with the increasing strain and are not able to offer the immediate support services which many hard drug users need.' 16.7.08

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Current drug policy has 'limited impact'

The UK has an unusually severe drugs problem and the government's strategy has had a very limited impact on drug use, a new watchdog body has been told. The report for the independent UK Drug Policy Commission said more addicts were being treated. But it added that the benefits were limited, and there was little evidence education schemes had had an impact.

The Home Office insisted the strategy was working - with a 16% decline in drug use since 1998. BBC home affairs correspondent Danny Shaw said the report was part of the debate about the government's 10-year drug strategy, which is due to be updated next year. Attempts to restrict the availability of drugs by arresting dealers and seizing supplies were failing and drugs prices on the street were falling, the report argued. And the benefits of drugs treatment programmes were limited because some users relapsed and many went untreated, it added.

The UK Drug Policy Commission (UKDPC) - chaired by Dame Ruth Runciman - has been set up to analyse drug policy in the country and is being funded with a three-year grant from a charity, the Esmee Fairbairn Foundation. Twelve experts have been recruited from the drug treatment and medical research sectors, as well as some from policing, public policy research and the media. They include homeless charity Shelter's chief executive Adam Sampson and the head of the Medical Research Council, Professor Colin Blakemore.

The report says that as well as having the highest level of problem drug use in Europe, the UK has the second highest number of drug-related deaths. The study found about a quarter of people in the 26-to-30 age group had tried a Class A drug on at least one occasion.

The value of the illegal drugs market in the UK is put at £5bn a year, and the cost of drug-related crime in England and Wales is estimated at more than £13bn. About one in five people arrested is a heroin addict, the report adds. Drug addiction rates in the UK are double those in France, Sweden, Germany and the Netherlands.

There has been a 111% rise in the number of people jailed for all drug-related offences between 1994 and 2005. However, street prices have dropped - with heroin falling from £70 a gram in 2000 to £54 in 2005. The report said: "Tougher enforcement should theoretically make illegal drugs more expensive and harder to get.

"The prices of the principal drugs in Britain have declined for most of the last 10 years and there is no indication that tougher enforcement has succeeded in making drugs less accessible." But the report's authors, Professor Peter Reuter and Dr Alex Stevens, say policies are succeeding in tackling certain illnesses and some aspects of criminal behaviour linked to drug use.

Dame Ruth said: "The commission does not start from the position that all UK drug policy has failed, but rather that we do not know enough about which elements of policy work, why they work and where they work well." The debate on drugs was often "sensationalised and polarised", she added. 18.4.07

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UK drug crime strategy criticised

The government strategy for cutting drug-related crime has been severely criticised in a report by the influential UK Drug Policy Commission. The independent panel said evidence to show what worked in drug treatment was "seriously weak or absent". More than £330m is spent in England and Wales on treating offenders annually.

The panel said some treatment services risked doing more harm than good. It criticised the Carat service, which took on 78,000 new prisoners last year. In a report seen by BBC home editor Mark Easton, the commission said the treatment service cost £31m to run but "there are no evaluations of its effectiveness".

It found for the 40,000 prisoners who go through detox while in jail, a lack of proper aftercare meant many went straight back to using hard drugs when they left prison. And that one in 200 injecting heroin users would be dead from an overdose within a fortnight of being released.

There was also a lack of evidence for the effectiveness of drug-free wings in prisons, it said. "Given the considerable ongoing investment in criminal justice system drug interventions, it is striking that we still know so little about the effectiveness of many of them, especially those in prisons and crucially whether they represent value for money", it added.

While community programmes appeared to work better, they were no magic bullet. In February, the government launched its 10-year drugs strategy, which saw more money focused on drug-dependent offenders. But the commission said: "We simply do not know enough about which programmes work best for whom. "Answers to even basic questions are not freely available and the weakness of the evidence base severely hampers good practice."

The report was highly critical of the quality of treatment in jails, where "provision often falls short of even minimum standards... a major concern for the health and well-being of prisoners and the subsequent impact on crime". But the government said there was a growing body of evidence treating offenders could reduce drug-related crime. Its new drugs strategy made "proactively targeting and managing drug-misusing offenders" a key element.

An additional £25m a year will be spent on treating offenders by 2011. Justice Minister David Hanson welcomed the commission's report. He said it recognised the challenges, difficulties and recent improvements in drug treatment. He said 53 prisons would benefit from health funding for enhanced clinical drug services by April.

The £175m Drugs Intervention Programme treated 40,000 offenders in the community last year. Six months later, 47% had reduced their offending. But 28% had increased. The report said plans to widen treatment to drug users whose habit was not directly related to their offending was "likely to be inefficient and could be harmful".

The risk was that younger recreational drug users would fail to complete some treatment programme and would end up being further criminalised. The law of diminishing returns could kick in, making the scheme less effective and more expensive, it warned. Chairman of the British Medical Association's forensic medicine committee, George Fernie, said the prison system lacked a "comprehensive care package" from when someone entered the custodial chain to when they were released.

"Technically, it is not that difficult to get somebody off drugs," he said. "It is the follow-through that we have to have, with stable housing, employment and family support." He backed community treatment, saying: "Prisons are perhaps not awash with drugs, but illegal substances are readily available. "We would like people treated effectively in the community if the alternative is a short prison sentence." 17.3.08

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Anti-Depressants taken by thousands of Brits 'do NOT work', major new study reveals

Anti-depressant tablets taken by millions of Britons may be a waste of time and money, research shows. An analysis of dozens of studies involving thousands of patients revealed that some of the most widely-prescribed anti-depressants work little better than dummy pills. The drugs studied - including Prozac, Seroxat and Efexor - were little more effective than placebos in improving the mental health in the majority of cases, the University of Hull research showed.

Only in the most extreme depression did the tablets, which are taken by around two million Britons and have been linked to a host of sideeffects including suicide, prove substantially superior in improving mental health.

Dr Tim Kendall, of the Royal College of Psychiatrists, described the results as "fantastically important". He added that one of the study's strengths lay in the inclusion of data which drug companies had chosen not to publicise - perhaps because it was less favourable than they would like. The study, published in the respected journal PLoS Medicine, suggests hundreds of thousands of Britons are needlessly taking powerful - and potentially dangerous - drugs.

As well as suicide and suicidal thoughts, side-effects associated with the drugs studied and other SSRI (Selective Serotonin Reuptake Inhibitor) anti-depressants range from self harm to anxiety, insomnia, nausea, headaches and vomiting. Seroxat alone has been linked to at least 50 suicides - both adult and child - in the UK since 1990.

The research comes as prescriptionsfor anti-depressants are at record levels, with 31million written in 2006 at a cost to the NHS of almost £300million. Around half of these were for Prozac, Seroxat, Efexor and other SSRIs. Research which showed the most widely prescribed anti-depressant pills are ineffective was gathered by combining the results of 35 clinical trials involving 5,000 patients

Researcher Professor Irving Kirsch said: "Given these data, there seems little evidence to support the prescription of anti-depressant medication to any but the most severely depressed patients, unless alternative treatments have failed to provide benefit." Professor Kirsch, a psychologist, reached his conclusion after combining the results of 35 clinical trials involving more than 5,000 patients with depression. The data on Prozac, Seroxat, Efexor and a fourth drug not used in the UK had been submitted to the U.S. drug watchdog ahead of the antidepressants being licensed for sale.

Two-thirds of those taking part in the studies were prescribed the SSRIs, while the remainder took placebo tablets. Comparison of the two groups showed that in the majority of cases the mental health of those taking anti-depressants improved little more than those on dummy pills. Only those who were extremely depressed - a very small proportion of those studied - fared substantially better when on medication.

The results suggest that those taking the tablets mainly benefit from the "placebo effect" - in which symptoms are eased not by medication but by relief in diagnosis and the simple expectation a treatment will work. Professor Kirsch emphasised that patients should not change their treatment without speaking to their doctor, but said other approaches include physical exercise, psychoanalysis and self-help books.

Richard Ley, the Association of the British Pharmaceutical Industry, the drug industry's trade body, said all medicines have to be proven to be more effective than a placebo before they are put on sale. A spokesman for the National Institute for Health and Clinical Excellence, which draws up guidelines on the treatment of illnesses, said routine use of anti-depressants is not recommended for mild depression. He added that Professor Kirsch's results would be taken into consideration when the existing guidelines are reviewed later this year.

Hailed as a miracle cure for depression when they were first prescribed in the late 1980s, the "happy pills" known as SSRIs work by keeping the moodboosting chemical serotonin in the brain for longer. Kate Charles spent seven years on anti-depressant drugs after suffering severe depression as a teenager. It was only when she took up running that she was able to stop taking the pills after finding that exercise was better at lifting her mood.

Speaking about her experiences three years ago, the 35-year-old writer from Dorset, said: "I have always felt quite low but my depression really hit when I was a teenager. "By the time I was 15, my GP was prescribing betablockers to relax my nerve impulses, slow my heartbeat down and make me feel calmer. Then, before my A-levels, I was put on anti-depressants. "In my final year at Sussex University, my GP moved me on to Prozac, which was the wonder drug at the time.

"Although it improved the depression, I felt detached and numb. I had other terrible side-effects -painful, aching joints, sleeplessness and anxiety. "Somehow, I managed to get a job in a finance company and struggled on but Prozac was my constant companion." Things changed when she set herself the challenge of training for a marathon.

She said: "Running was so much more effective at lifting my mood than Prozac that I consulted the doctor and spent eight months weaning myself off the drugs. "The withdrawal was painful but I was determined. I have no doubt that running took me out of my depression." 26.2.08

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More than 200 heroin addict prisoners forced to go 'cold turkey' win £4,000 damages each for human rights breach

MPs condemned the Government after it was revealed that nearly 200 prisoners received £3,807 each in compensation - because they were forced to give up heroin in jail. The convicted criminals claimed their human rights were infringed when they were deprived of the heroin substitute methadone and had to go "cold turkey".

A High Court test case involving six prisoners was given the go-ahead but the Government agreed to settle out of court and pay £750,000 to 197 inmates. When lawyers' fees are taken into consideration, the total cost to the taxpayer is well over £1million. The payouts were branded "disgusting" today as full details of the settlement emerged for the first time.

Andrew Rosindell, Tory MP for Romford, said: "This is astonishing. It's an outrageous waste of public money. "You go to prison to receive punishment and drug addicts are supposed to be taken off drugs."

Matthew Elliott, chief executive of the TaxPayers' Alliance , said: "It's disgusting that law-abiding taxpayers are being forced to pay money to these drug-addled criminals. "If you are in jail of course you should be forced to be clean. The prison system is failing precisely because meddling bureaucrats and foolish legislation stops prison guards doing their job." The former heroin addicts claimed the cash from prisons around the country.

The prisoners had all been using methadone - paid for the the Government - to combat their addictions. They claimed their human rights were breached when this approach was ditched in favour of a cold turkey detox. The group claimed breaches under Articles 3 and 14 of the European Convention on Human Rights - which ban discrimination, torture or inhuman or degrading treatment or punishment - and Article 8, which enshrines the right to respect for private life. They also claimed they were the victims of trespass in the form of unwanted treatment and accused the Prison Service of "clinical negligence".

A test case involving six of the 197 prisoners was given the go-ahead after a preliminary hearing at the High Court in May 2006. The prisoner's barrister Richard Hermer, a human rights lawyer specialising in group actions against the Government, told the court: "Many of the prisoners were receiving methadone treatment before they entered prison and were upset at the short period of treatment using opiates they encountered in jail.

"Imposing the short, sharp detoxification is the issue." Inmates claimed their drug treatment was "handled inappropriately" so they suffered "injuries and had difficulties with their withdrawal". The full month-long hearing was due to take place in November 2006 but the Government settled out of court shortly before it was due to begin.

The money was then paid out through a set up called the "opiate dependent prisoner litigation scheme". Among those to receive payouts are six inmates at HMP Altcourse in Fazakerley, near Liverpool , seven at Blakenhurst, near Redditch , Worcestershire, nine at Exeter , Devon , and 11 in Hull .

A Prison Service spokeswoman yesterday said the payments made were a minority of the claims made against the Government by lags but refused to give out details. She said: "We successfully defend the majority of contested claims. "We make payments only when we are instructed to do so by the courts or where strong legal advice suggests that a settlement will save public money.

"Each compensation claim received by the Prison Service is treated on its individual merits. "Legal advice is sought and, on the basis of that advice, a decision is made on whether or not the claim should be defended. "We cannot therefore comment on individual cases or the reasons that they were settled, as the terms of each settlement vary and may be subject to confidentiality clauses."

There are legal precedents to the settlement. In 2004, Lord Bonomy awarded armed robber Robert Napier awarded £2,400 for enduring the same treatment at Barlinnie prison in Glasgow. During the same year, gunman George Knights, 46, given nine life sentences for shooting three police officers, repeatedly sought compensation after being refused extra luxuries for his cell.

The Government has paid out £9million in compensation to convicted offenders for a huge range of claims over the last few years. Pay-outs were made for incidents including assaults by fellow lags, medical negligence and even sporting injuries while exercising in jail. 15.4.08

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Crystal meth could become middle Britain's crack cocaine within four years

Crystal meth could become a problem on the same scale as crack cocaine within the next four years, according to a new police report. The investigation carried out by the Association of Chief Police Officers (ACPO) has predicted the drug has grown in popularity and could become a major problem. Use of the drug, which is a form of crystallised amphetamine, has reached epidemic levels in parts of America and Australia.

The report compares UK growth and patterns of use to that in each of these countries. ACPO expert on the drug, Detective Sergeant Andy Waite, told the Today programme on BBC Radio 4 "in the last two or three years" police had seen "a gradual rise in the reporting of the use and manufacturing of the drug" in the UK. He also warned UK production of the drug is "something we are alarmed about" and is being monitored by police but pointed out the problem is "still relatively minor" in this country.

Regarded as a class A drug since January 2007, crystal meth is highly addictive and can cause paranoia, kidney failure and internal bleeding. It also ages the skin and rots gums. If prosecuted, users can face up to seven years in jail. Also known as Tina and Ice, meth can be snorted, smoked, eaten or melted and injected depending on whether it is bought as a powder or crystal "rocks".

The price varies from region to region but half a gram costs approximately £25 on the street. Dr Rebecca McKetin, from the National Drug and Alcohol Research Centre at the University of New South Wales (UNSW), in Australia, said to the BBC: "People are thinking, 'it's OK to go out and smoke it with my friends on a Friday night when I go to the club'. But it kind of creeps up on them and quite a lot of those people are starting to experience problems with their methamphetamine use. "And I think people here are starting to learn that this is not typical of a recreational kind of drug. It is actually a very addictive and potentially very dangerous drug." This is not the first time fears of the drug's growth have been voiced. In January 2007, a barrister based in a prosperous East Anglian town told the Mail: "Crystal meth? I've seen more addicts through the courts here in the past few months than heroin users. This time last year, I had never heard of the stuff. Now suddenly it's taking over." A detective who was part of a team that exposed an Isle of Wight factory producing the drug last year also highlighted how destructive it can be. He said: "It has had devastating effects on rural communities and can completely wipe people out because it is extremely addictive - ten times more than other amphetamines - and only six per cent of those who take the drug ever manage to come off it."

Meth makeover: US mugshots show the physical effects the drug can have.

Last month, a man was jailed for four years for causing a car crash while high on crystal meth that left a mother and daughter needing leg amputations. Alberto Ramos, 32, snorted a gram of the drug the night before the crash, and then drove home the following day through London rush hour traffic. He lost control of the vehicle on Regents Street and Victoria Reeve and daughter Kayleigh were on the pavement when the car hit them. On a shopping trip to celebrate the latter's 21st birthday, Mrs Reeve saw her foot being wrenched from her leg as she was hit by the car and lying 3ft away. Her daughter could not remember the crash.

Sentencing him, Judge Rivlin warned of the dangers of crystal meth - which at the time of the incident had just been reclassified from a Class B to a Class A drug. He said: "This drug is similar to amphetamines, but the effects are much stronger. "It is a potent, dangerous stimulant which causes drivers to drift off the road and out of their lane. It also causes excessive sleeping and depressive symptoms." 15.2.08

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

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." (What utter rubbish) 20.11.07

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£2.5m to treat drug addicts - with heroin

Drug addicts have received £2.5million of free heroin and nursing care in NHS 'shooting galleries', it was revealed yesterday. They are allowed to inject themselves with a pure form of the Class A drug under the supervision of round-theclock nursing staff. Despite the cost, and the fact that many of the addicts are still committing crimes, leaders of the project say the results are encouraging and three pilot schemes may be extended nationwide.

But critics questioned the decision to plough so much NHS money into treating criminals when law-abiding citizens are denied vital treatments. Matthew Elliott, chief executive of the Taxpayers' Alliance , said: 'It shows a pretty warped sense of priorities.' The joint Home Office and Health Department project began two years ago in London, Brighton and Darlington. Trial leader Professor John Strang said it had cut crime and kept users away from drug dealers.

About 40 per cent of users in London had 'quit their involvement with the street scene completely', he said, and others had reduced it dramatically. Professor Strang, of the National Addiction Centre at the Institute of Psychiatry in London, added: 'Their crimes have gone from 40 a month each to perhaps four a month. The reduction is not perfect but it is a great deal better for them and, crucially, a great deal better for society.'

The cost of the treatment, including providing the speciallyimported heroin, is between £9,000 and £15,000 per patient - three times as much as a year's course of methadone. It is restricted to hardcore addicts, who experts say cannot be helped in other ways.

But critics contrasted the spending to the decisions not to fund some Alzheimer's drugs, which cost just £2.50 each day, and restrict treatments for some types of cancer, arthritis, bone disease and the prevention of blindness in older people. Mr Elliott said: 'Free healthcare shouldn't be about getting high at taxpayers' expense. Drug users should be given help to kick their habit and lead an honest life. We shouldn't aid and abet their personal failings.'

Shadow Home Secretary David Davis said: 'This is a white flag approach. The Government are effectively conceding that the war on drugs is not winnable and instead spending millions trying to "manage" addiction. 'We believe they should spend the drugs budget on ending addiction. We would do this by expanding abstinence-based rehabilitation programmes, which have proved far more successful than the Government's approach. 'By simply giving addicts drugs the Government is betraying the people in our society who so desperately need our help.'

The Victims of Crime Trust said: 'We need to get criminals off drugs and stop them reoffending, but it should not be at the expense of people whose only crime is to be gravely ill. We are allowing Class A drug addicts to hold us to ransom.' Dr Nicola Metrebian, who manages the clinical trials, said: 'It is more expensive than standard treatment, but standard treatment is not effective for this group of people.' 20.11.07

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MPs demand reform of drug rationing body NICE - Call for quicker drug decisions

A faster, more streamlined system of assessing treatments for the NHS in England , Wales and Northern Ireland should be introduced, MPs say.

The National Institute for Health and Clinical Excellence should adopt a "rough and ready" approach, similar to Scotland , a Commons committee said. The health committee said an in-depth review of new drugs and technologies could be done later if needed. It is now up to ministers to consider the findings.

NICE was set up in 1999 to make recommendations to the NHS about which treatments should be made available by assessing their cost effectiveness. The directives apply to the whole of the UK , except Scotland which has its own advisory body, the Scottish Medicines Consortium.

The Scottish system has often been compared favourably to NICE as it carries out much more simple appraisals and as a result decisions are often made within a few months.By comparison, the fastest appraisals NICE carries out take between nine months and a year on average.

The MPs also called on NICE to carry out appraisals on all new treatments - at the moment it just tends to focus on the most expensive, such as cancer drugs used in hospitals. The report said this meant NHS trusts were overly focused on these expensive treatments often at the expense of the cheaper, but highly effective, drugs that could be prescribed by GPs.

MPs also questioned the method used by NICE to assess treatments. New treatments are generally only used if they cost under £30,000 for each year of good health they provide, a measurement known as a Quality Adjusted Life Year (QALY). They said there was no scientific basis to the threshold, which had not changed since NICE was set up. They said this needed to be reviewed and a two-stage assessment process introduced.

The initial "rough and ready" assessment could use tougher criteria meaning only the most effective treatments were recommended. The idea would be to do this as soon as a treatment received a licence so that any recommendations would be in place by the time the drug was put on the market - normally four months after licensing. Another assessment could then be carried out if evidence suggested it needed to be, but this would use a higher QALY threshold decreasing the risk a treatment would be taken out of NHS use once it had been recommended.

Health Committee chairman Kevin Barron said NICE had a vital role to play in the future with the prospect of expensive new treatments coming on to the market at a time when the rises in the NHS budget were falling. But he added: "We have concerns about how NICE does its job. No healthcare system can deliver everything... but more cost effective treatment means more treatment."

Joyce Robins, of Patient Concern, said: "We would welcome faster assessments. "But we would be concerned if the two-stage assessment process meant treatments were taken out of use when patients were on them."

NICE chief executive Andrew Dillon said the organisation would consider the report along with the government, but described the criticisms as "constructive". He added: "The committee has identified some of the key challenges we face as we move into our 10th year of operation."

The Department of Health said it would be considering the findings in the coming months. 10.01.08

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Patients get poor deal from slow NHS, say MPs

Patients in England, Wales and Northern Ireland are getting a poor deal from the NHS because the system of assessing drugs and other treatments is too slow and inefficient, MPs said today. The health select committee said the National Institute for Health and Clinical Excellence (Nice), which decides what treatments the NHS should be provided, should introduce a faster and more streamlined system for assessing treatments.

The highly critical report identified several other flaws in Nice's appraisals, warning that its guidance was often not based on empirical evidence nor took into account the pressures on the NHS budget. But most criticism was reserved for the time taken to assess new medicines and treatments, which has led to repeated protests by patients, drug companies and MPs.

The report advised Nice to adopt a similar approach to its Scottish counterpart, which carries out more simple appraisals that allow it to issue guidance within a few months. In contrast to the speed of the Scottish Medicines Consortium, the fastest appraisals carried out by Nice take around 9-12 months. The committee recommended that Nice assess all medicines when they were launched, so doctors could prescribe useful and cost-effective drugs as soon as they became available.

The chief executive of Nice, Andrew Dillon, said it would be possible to speed up assessments as long as the Department of Health promptly decided which drugs it wanted appraising. "I think we are too slow at starting our evaluations of some of the things that are referred to us," he told the BBC Radio 4 Today programme. "We have to move more quickly to make sure that we get the requests from the Department of Health to start work on the treatments we look at."

It said Nice's current approach was to prioritise the assessment of the most expensive new treatments, such as cancer drugs, over cheaper but highly effective drugs that could be prescribed by GPs. The MPs said that as a result many NHS trusts felt forced to fund Nice-appraised drugs at the expense of other treatments.

The study said: "The affordability of Nice guidance and the threshold it uses to decide whether a treatment is cost-effective is of serious concern. "The threshold is not based on empirical research and is not directly related to the NHS budget." The study noted that some NHS trusts struggled to balance the need to provide drugs approved by Nice with the need to treat many patients.

The NHS Confederation, which represents 90% of NHS organisations, told the committee that many of the treatments examined by Nice were only just within the defined limits of cost-effectiveness. It said: "As a result, the paradox arises that NHS funding is mandated for a marginally cost-effective drug and local NHS organisations may have to achieve this by not spending on treatments which may be very much more effective and could benefit more people."

Nice should also review the use of older medicines that may no longer be cost effective, said the committee of MPs. The report also stressed the importance of Nice's work remaining free from political interference by ministers. It highlighted the intervention of former health secretary, Patricia Hewitt, who in 2005 said trusts should not refuse to provide breast cancer drug Herceptin on cost grounds alone, even though Nice had not finished its appraisal of the drug.

The report said: "We note that it is not the role for ministers to directly or indirectly seek to influence the Nice decision-making process." 10.1.08

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Cocaine: The Hidden Epidemic

COCAINE use in Greater Manchester reaches far beyond bars and clubs and into the area's police HQ, hospitals and a Manchester crown court, an M.E.N. investigation can reveal. A team of M.E.N. reporters used the same testing kits employed by police to spot check toilets - the place where users most commonly prepare and snort cocaine - across the area.

Positive results were produced in the women's toilets in the reception area of Chester House, the headquarters of Greater Manchester Police.
And traces were found in four sets of hospital toilets and at Manchester's Minshull Street Crown Court . As part of the testing, a random sweep was also done of the toilets in the M.E.N. Media building in Scott Place. This, too, produced a positive test.

The test swabs used by our reporters turn blue due to a chemical reaction produced by the presence of cocaine. The areas tested were always flat surfaces within toilet cubicles, where people might prepare and sniff cocaine. These ranged from toilet seats and cistern lids to toilet roll holders and window sills. Drug experts say that lower prices and greater availability mean that cocaine powder use is on the up.

Former cocaine addict Tom Kirkwood said use of the drug has spread across all levels of society. He said: "People's general view of alcoholics and drug addicts are the guy on the park bench with his trousers held up with string or the guy with the needle hanging out of his arm. "In fact we are doctors, we are lawyers, we are policemen, we are factory workers and we are also the guys on the street. We represent every class and creed."

Mark Gilman, north-west regional manager of the national treatment agency for substance misuse, said: "It is spreading like wild fire. The problem is getting these people into treatment. "The findings confirm what I thought. Cocaine use is now not restricted to those on nights out looking for a quick high. It has infiltrated society and has spread across all environments. In some cases people are using it regularly just to get through the daily nine to five and to cope with stress in the workplace.

"Most powder cocaine users don't think they've got a problem. They don't see themselves as addicts because they don't identify with Big Issue sellers, it's more Kate Moss and Amy Winehouse to them. "There's a lot of reference to two grades of cocaine - the premium stuff at around £50 per gram and a cheaper lower-quality type for £25 to £30 a gram.

"The fact that two markets can be sustained shows something about how much use there is." Of eight city-centre bars and hotels tested by the M.E.N. only one - Panacea - revealed traces of the drug.

The toilets in three hospital A&E departments - Manchester Royal Infirmary, Stepping Hill in Stockport and Fairfield hospital in Bury - and the ones in the MRI's main reception area did prove positive.

Mike Linnell, from the Manchester drug charity Lifeline, said he wasn't surprised. "A number of the people who end up in A&E are drunk or off their faces on drugs," he said. "They've got five hours to wait and some cocaine in their pocket - they're going to take it."

GMP uses the swabs to test for drug use when assessing licence applications. They are also used by forces across the country, by customs staff and in prisons. Dave Rigg of Crackdown Drug Testing Ltd produces the kits and was a policeman in Oldham for 18 years. He said: "The swabs are very reliable, they'll detect milligram levels.

"This means if there were traces of cocaine on somebody's clothes or fingers and they touched the tested surface it wouldn't pick it up unless there was a substantial amount. "The levels they detect means that it is the presence of the drug on that surface they are showing."

Although it is impossible to say whether employees or visitors are responsible for the drug use in the places tested, experts said employers must be aware they have a legal obligation to keep premises drug free.

Gary Beeny, drugs advice worker for Lifeline, said: "Under Section Eight of the Misuse of Drugs Act, it is illegal for people who own, manage or control a building to knowingly allow drug use. But in terms of support, if people are using drugs at work then you would have to say they have more of a problem than those people using it on Friday and Saturday nights.

"Employers should encourage people to seek advice. They can do that in confidence. If people come to Lifeline then they don't even need to give their name." 5.11.07

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Quarter of young adults take cocaine or cannabis

Nearly one in four young adults took drugs last year in spite of an overall fall in the amount of misuse, Home Office figures revealed today. Cannabis was the most common substance taken with more than 1.3 million 16-to 24-year-olds smoking it.

Cocaine was taken by 375,000 young adults — slightly up on the previous year's total and equivalent to more than six per cent of the under-24 age group. The figures, drawn from the Home Office's British Crime Survey, cover the year ending in March.

They also show that the percentage of those aged between 16 and 59 who took at least one illegal substance fell from 10.5 per cent the year before to 10 per cent. Prime Minister Gordon Brown recently ordered a review of the classification of cannabis, which is expected to revert to class B status. A separate Home Office report also published today shows that drug seizures have risen sharply.

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Cocaine Dieters: Women who turn to illegal drugs in their struggle to lose weight

One in seven women is using drugs such as cocaine or speed in a desperate attempt to lose weight, according to a survey. Many others take slimming pills or laxatives to try to shed the pounds. Yet both drug-taking and drastic dieting are largely ineffectual, with the great majority regaining any weight they may have lost within weeks or even days.

Nearly three out of ten women who took part in an internet survey by the celebrity magazine Now admitted they had made themselves sick after eating. One in ten said they would have an operation to fit a gastric band to control their eating. Now, which has a young readership, also said that one in seven of those responding to the survey claimed they had taken Class A drugs to lose weight. Fewer than one in ten who lose weight by dieting manage to keep it off, according to the survey of 2,000 women with an average age of 35.

Experts said last night that women were playing a dangerous game by using drugs to get thin. They warned the glamorous image of cocaine masked health risks such as heart attacks and strokes. Several dozen deaths are attributed to the use of cocaine and amphetamines every year. The survey, carried out by online analysts Demographix, found more than eight out of ten of those questioned had dieted.

Thirty seven per cent had taken slimming pills, 15 per cent had taken speed or cocaine and 26 per cent had used laxatives as slimming aids. Almost a third counted calories all the time. Three-quarters opted for 'faddy' crash diets - with many feeling unwell because of them - and two-thirds feared they had lost the ability to eat normally. More than a third raided the fridge in secret, almost half lied about the amount they ate and a quarter hid food in 'secret places'.

Three out of four said they spend their lives 'snacking' while two thirds starved themselves before a big night out. Fewer than one in five never tried to diet and only 2 per cent claimed to be happy with their body. Women would spend on average £11,000 for a better one. A third of women said they would give up sex to be slim for ever while 86 per cent said they would rather drop a dress size than sleep with David Beckham.

Dr Ian Campbell, medical director of Weight Concern, said it was alarming that women were using illicit drugs in ill-fated slimming attempts. "There is no evidence that they have any long-term effect on weight but a great deal of evidence that they are harmful to health," he added. "The only long-term solution to weight control is lifestyle changes, including dietary modification and more exercise. There is no substitute for effort."

David Raynes of the National Drug Prevention Alliance said cocaine-use could kill and cause facial disfigurement. "I fear that women are using drugs as an excuse for attempts at slimming, much like women say they smoke in an effort to keep their weight down," said Mr Raynes. "But its a cop- out and women should be aware of the very real dangers."

Now's editor Helen Johnston said: "Women today have a shocking relationship with food and are living a binge/purge lifestyle. "Sadly this survey shows once a woman starts on the path of fast faddy diets they become her companion until the day she dies. "Body image is the female curse of the 21st century. Whatever a woman's achievements in life, her whole self-image is totally bound up in her body shape." 16.10.07

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Drug addicts to be given i-Pods if they beat their habits

Drug addicts could be offered food vouchers and the chance to win prizes such as i-Pod music players by the Government body refusing treatment to Alzheimer's sufferers. The National Institute for Clinical Excellence (Nice) wants to offer heroin and crack addicts 'incentives' to quit their habit.

The users - many of whom commit crime to feed their habit - will be offered vouchers if they test clean for the illegal substances. The size of the taxpayer-funded gift will - on offer to as many as 50,000 addicts - increase with each successful test...starting at £1.50 and rising to £10 a week. Under draft plans, they could also be offered tickets for a prize draw each time they return a 'clean' test at their local clinic.

Increasing numbers of tickets would be awarded, raising the chance of winning the prizes. There could be a one-in-two chance of winning a small prize but a one-in-200 chance of winning a main prize - worth up to £100. Nice has not specified what types of prizes would be on offer - but clinics could decide they should include MP3 players, such as an i-Pod, or other electrical items.

The quango, which is in charge of rationing the treatment available on the NHS, believes that offering incentives to drug addicts will provide the taxpayer with value-for-money. By getting a user clean, society saves large sums of money in treatment costs and crime. But campaigners last night questioned the wisdom of lavishing funds on heroin users - whose condition is self-inflicted - while denying drugs to Alzheimer's sufferers, and those with other conditions

Alzheimer's sufferers are currently awaiting the verdict of a High Court challenge to Nice's decision to halt the prescription of £2.50-a-day tablets which alleviate the devastating symptoms of the disease. Katherine Murphy, of the Patients Association, said: "Why should these people with self-inflicted problems be given priority over people who have a genuine illness? Some people with genuine disease are being forced to sell their homes for the medicines they need."

Matthew Elliott, chief executive of the TaxPayers' Alliance, said: 'When women are going without life-saving drugs for breast cancer thanks NICE, the decision to give drug users lavish freebies clearly can't be justified. 'This programme will waste vital resources which could be better used for people with genuine illnesses rather than self-inflicted problems. It is a complete waste of money.'

Norman Brennan, director of the Victims of Crime Trust, said: 'Many of these drug addicts will have stolen to pay for their drug habit. It sends out completely the wrong message to then offer them a reward. People on the verge of taking drugs need to be discouraged - this does the complete opposite.'

The 'incentives' will be on offer until doctors are satisfied the addict's condition is 'stabilised'. People who returned to their habit would have to start again, at the bottom of the scale for the vouchers. Typically, they will undergo three tests each week, so the value could increase rapidly. Nice has said international trials have shown modest financial incentives could help hardened addicts stay off drugs.

Research by the University of Connecticut found cocaine and methamphetamine users stayed drug free for longer when they had the chance to win prizes such as telephones, stereos, DVD players and televisions. Every time addicts gave a negative drugs test they were given tickets for the draw. They "earned" an increasing number of tickets for every week that they remained drug free. A Nice spokesman declined to comment on the final version of the guidelines, ahead of their expected publication later this week. 23.7.07

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Britain is now cocaine capital of Europe

Britain is now the cocaine capital of Europe with soaring numbers of young people taking the drug, a United Nations report has revealed. It revealed more than 900,000 Britons buy cocaine, which means the country has overtaken Spain as the biggest user in the continent. In addition, Britain's 350,000 heroin users are the largest number in any country in Europe.

The annual survey from the UN's Office on Drugs and Crime said that across most of the world drug abuse is holding steady or is in decline because of successful law and order campaigns to prevent their distribution, sale and consumption.

But the falling tide in many countries is leaving Britain exposed as a thriving drugs market where millions remain addicted to or repeat users of illegal substances.

The report found cocaine use had gone up in Britain and added: "In absolute numbers estimates suggest that the UK's cocaine market, some 910,000 people, is even marginally larger than the market in Spain, some 890,000 people." It added "cocaine is now the second most widely used illegal drug in the UK after cannabis".

But it noted that cannabis use in this country had diminished since the reclassification of the drug - from Class B to less serious Class C - in 2004. The change made it rare for police to arrest anyone for possessing the drug.

The UN said the fall was "probably because extensive discussion about rescheduling cannabis brought new scientific findings on the potential harm of cannabis into the limelight". "Growing awareness of the dangers of cannabis use among young people went in parallel with declining cannabis use," it added.

The growth in cocaine use came alongside evidence that the drug is now available more cheaply than ever before. Drugscope said after a survey last year that prices have dropped to £44 a gram, nearly a third down on £65 a gram in 2000. Tory home affairs spokesman David Davis said: "This is yet more evidence that Labour continues to fail on drugs." But Home Office minister Vernon Coaker claimed success in cutting drug abuse.

He said: "I welcome the report which shows that tough enforcement is having an effect on cutting drug use. "We have achieved a great deal through our strategy of enforcement, early intervention, education and treatment: in England and Wales drug use has fallen by 16 per cent since 1998 while drug-related crime and the harm caused by illegal drugs have fallen." 27.06.07

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I vowed not to date men who use cocaine 18 months ago - I've been single ever since

The evening had been great. The wine had flowed, the conversation was effortless, and the man sitting opposite me in a London pub extremely handsome. As a first date, it could hardly have been better. But at the back of my mind was a nagging question. Steeling myself, I brought up the subject of drugs, and how I'd sworn never to date a cocaine user again.

His face fell. With just one look, I knew it was over before it began. But this wasn't any rock star, a model or even someone in the media - the stereotypical cocaine users. No, he was just a goodlooking builder. Hardly the glamorous type. But I wasn't surprised to discover he had a habit. Over the past few years, I've come to realise cocaine is not just a problem in the well-documented 'showbiz' circles of the capital, but across every class and occupation in Britain.

It was really brought home to me at a 30th birthday bash last month in Essex when one guest, a schoolteacher from York, told me about a dinner party she'd gone to where food wasn't on the menu. "If I'm invited to dinner," she said, "I prefer mine to be with a little nutritional value off a plate, not a powder off a mirror. I made my excuses and went home." At the same table around me that night were 20 or so people from all areas of Britain, with social backgrounds as varied as their addresses, their careers ranging from solicitor to ski rep, marketing rep to mother. In short, a selection of Middle England's finest. And out of all those people, I joined my teacher friend in being the only two who have never taken the illegal Class A drug cocaine.

Another guest at the party, a no-nonsense estate agent from the North-West, had recently returned to see her family one weekend and arranged to meet up with some old acquaintances in a bar. While she was out, she bumped into several of her stepmother's girlfriends. These fortysomething women are all outwardly respectable and vibrantly healthy - the type who do not eat red meat, but drink wheatgrass juice and eat only organic food. In the queue for the ladies - now longer than ever in nightspots throughout the country because of the number of women going to the loos in twos to powder their noses - my friend realised that her parents' pals had exchanged one type of vacuuming for another.

While a toilet attendant rushed to wipe down seat covers (employed by any place remotely trendy in case of spot checks by council officials), these super-mums were maintaining their super-high while their 11-year-olds slept at home in the hands of teenage babysitters. Bear in mind, too, that those babysitters themselves may well be familiar with cocaine.

While I was in Edinburgh last year catching up with a friend, she told me how her supposedly straight-laced teenage stepsister had been snorting the drug. "She told me if she didn't, she would be a social pariah. She hadn't been included in nights out with her friends before because they knew she'd fade late at night if she didn't use cocaine." Harry Shapiro, spokesman of the charity Drugscope, confirms the trend: "The celebrities on the front pages mask the reality that it's not just them taking cocaine." And he emphasises that abuse of the drug is far from the sole preserve of London's champagne and canapÈs set.

Thanks to its free-falling price over the past five years - National Criminal Intelligence Service figures show the price of a gram of cocaine fell from £80 in 1995 to as little as £40 today - the cost of a "line" can be less than a cocktail. Britain has the fastest-growing cocaine consumption in the world, and Shapiro says: "It used to be like heroin, but that taboo has gone now. Cocaine has become a fairly unremarkable aspect of a night out for a lot of people."

Meanwhile, a Southampton-based girlfriend of mine, who is a sales rep, told me: "If someone asked if they could take heroin in front of me, I'd be horrified. "But I'd be left with precious few friends if I complained every time someone did a line of coke." Certainly, statistics bear out the fact that the young are using cocaine more than ever. Its use has more than doubled among 16 to 24-year-olds over the past seven years.

Twenty-four hour drinking has contributed, too, because revellers are using drugs to keep the party going long into the night. For them cocaine, which keeps you alert and awake, is the perfect solution. Paul Broadbent, Chief Superintendent of South Yorkshire Police, has warned that the open-all-hours culture has led to a rise in cocaine and amphetamine use. His officers have noted the trend in Sheffield, a city that has encouraged a round-the-clock drinking culture. So more people are doing it, you might say, but surely they're not people you come into contact with? Well, don't be so sure.

The latest figures show that cocaine is now the fastest-growing drug problem among the middle classes. A UK Drugs Unlimited survey published last year found that nearly half the young professionals questioned had used the drug, a fourfold increase from a decade ago. The frightening truth is that these days, it's not just the Pete Doherty types who are using the drug, it's your dentist and that nice man who does your tax returns. Look closely enough and someone you know is almost inevitably more than familiar with cocaine.

A 36-year-old female GP I know - whom I'll call Clare - privately admits that until recently she was a regular user. Such behaviour is surprising for a medic, especially when you consider that cocaine is the cause of 50 per cent of weekend emergency hospital visits for heart and chest problems: it tightens up blood vessels, making the heart work harder and raising blood pressure.

As little as two 100mg lines (a fraction of an ounce) is enough to cause chest pain. Professor John Henry, a leading drugs expert, says: "People need to know not only that they can die from first use of cocaine, but that they're also going to end up with arteries like a 60-year-old and have brain damage." Then there are the other side effects of collapsing nostrils, suffered by the likes of EastEnders actress Danniella Westbrook and Tara Palmer-Tomkinson, kidney and respiratory failure, strokes, gastrointestinal complications and mental disorders.

So why on earth would my GP friend join the ranks of coke users, inanely repeating themselves and looking like warped versions of AA Milne's Tigger, bouncing around jerkily with runny noses, bulging eyes and sweaty skin? If you look carefully when you're out in a bar or pub - or even at your office - they're easy to spot. Users are the people who think they're the life and soul, sprinkling their conversation with sparkling wit, when actually they are unable to focus on anyone or converse with any sense.

They will also be making regular trips to the bathroom, and if they're not, they will suddenly get so paranoid-that they are even more of a nightmare to be around. That was certainly true of Clare's lover, Trevor, a fiftysomething who thought he was still a bit of a rocker. Trevor was an eerily thin, cheating, flaky liar who, when he wasn't high, was tired and depressed - classic cocaine side effects. While the drug gives women the libido of a nymphomaniac, too much of it can have the opposite effect on men, so Trevor was also a failure in the bedroom and could not give her the baby she desired. She finally ditched him after he turned violent thanks to the drug and broke her arm - and her heart.

Such bitter experiences have convinced me it's impossible for a non-user of cocaine to date a user. The world of the "cheeky line" has all the unfortunate aspects of a secret society, a destructive third person in any relationship. My New Year's resolution of 2006 was giving up men who use cocaine and, yes, I have been single ever since. But this is not because I never leave the smart enclave of clubs in Chelsea where one might assume you'd find scores of stereotypical cocaine users. On the contrary, my standard nights out are in pubs visiting my school friends in north and east London, and my weekends are spent with my university pals in towns around the country. As well as the handsome handyman-I also recently had to turn down the advances of a cute trainee chef because of his hideous drug habit.

Today, at 30, I find it easier to bring it up in conversation on the first date - always in a jovial way but so they know I'm serious. It's rare when I've made my stance clear that a man will bother to call me again, although I once almost wavered with a beautiful boy who got persistent and with whom I felt a massive spark of attraction. However, the memory of being let down on a number of occasions, including a birthday not so long ago, by an amour who was off doing cocaine instead, remains too fresh in my mind, and for self-preservation's sake, I know I must keep it that way. Cocaine use is so widespread that I have been unable to find a remotely attractive, decent male who doesn't snort the stuff.

The very fabric of UK society is in serious straits, thanks to this snowstorm. On a wider scale, as the film Traffic shows, the cocaine trade is handing over money, power and legitimisation to the most violent and corrupt forces in Latin America. UK users, no doubt a significant number of whom are card-carrying Amnesty International children's charity supporters, are also causing the death of children.

It is not Cambodia or Afghanistan that has the world's highest rate of injuries due to landmines, but Colombia, where insurgents from the Revolutionary Armed Forces of Colombia plant them to protect the coca fields and processing labs that produce the drug. It is time for an anti-cocaine crusade led by a politician or a personality with all the evangelical fervour associated with the ecological or world poverty cause. But can you see Bono or Bob Geldof campaigning to cut off the import of cocaine. Not very cool, is it? And as for government: David Cameron has notoriously kept his mouth shut on drugs, and in the wider political sphere, well, just remember that a couple of years ago, the toilets at all three party conferences all tested positive for cocaine.

So no, I won't be holding my breath waiting for the day when cocaine is neither cool nor ubiquitous. I fear I may be single for some time to come. 15.7.07

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Growing numbers of housewives and professionals are becoming addicted to over-the- counter drugs, doctors have warned.

Tens of thousands of "ordinary people" are thought to be dependent on tablets such as Solpadeine and Nurofen Plus, which contain the painkiller codeine.It is a narcotic, which makes users feel relaxed - so even after their pain has gone, some will keep taking it for the calming effect. As the body becomes accustomed to the codeine, addicts must start taking more and more. Some of those hooked are taking more than 70 pills a day, placing themselves at risk of liver dysfunction, gastrointestinal disorders, gall stones, chronic constipation, depression and constant headaches.

Writing in the British Medical Journal, a GP has called for more research into the problem and for larger labels to be placed on packets to warn of the dangers. London-based Dr Christine Ford said her warning was inspired by the rising numbers coming to her for help. In the past three months she has seen three patients with addictions to Nurofen Plus. They all started using it as a painkiller but became addicted to the codeine.

She said: "I think addiction to over-the-counter medicines has been going on for a long time but many doctors do not pick up on it, partly because their patients do not mention it. It is a bit like having an alcohol problem -you tend to keep that a secret. You are not going to tell someone that you are taking 13 Nurofen Plus a night." In 1999, comedian Mel Smith was rushed to hospital with a burst stomach ulcer after becoming addicted to Nurofen Plus. He had taken more than 50 pills in one go. Yesterday the largest organisation helping over-the-counter addicts, Overcount, said the numbers it was helping had almost doubled in three years to 15,000.

Project director Davie Grieve said: "The worst affected classes in order are married housewives, single mums and then people in professional jobs, because their type of lifestyle causes