THE DRUG THAT COULD BRING A NEW 'ICE AGE' TO SCOTLAND

Experts are set to warn that the dangerous illegal drug crystal meth
could rapidly make inroads in Scotland, with devastating effects on
the physical, mental and sexual health of those who abuse it.

The drug, methamphetamine in its crystalline form, also known as ice'
is usually smoked in a similar way to crack cocaine. As yet its use
has been relatively confined to the gay club scene in London, but
evidence from other countries has shown how rapidly an epidemic' of
the drug can take hold.

This week a conference hosted by NHS Grampian in Aberdeen: Sex and
Drugs and Crystal Meth, will assess the likely impact and how public
sector agencies should respond now to reduce the danger. Backed by
Grampian Police, the two day event is also supported by Aberdeen and
Aberdeenshire councils.

Leaders in the field of harm reduction, public health and psychiatry
from London and Manchester will describe their experiences of dealing
with crystal meth.

The conference on Thursday and Friday will also examine the impact on
sexual and mental health of other substances including cannabis and
alcohol, and thorny issues such as how best to support women drug
users who become pregnant.

Colin Tyrie, senior Public Health Development Advisor with
Manchester's public health development service argues that the
rapidity of the spread of Crystal Meth in the USA and Australia
illustrates why the NHS and drug agencies need to be ready. "In
Manchester, like London, it is more in pockets, particularly around
the gay club scene, but there is a sense that this is a coming
storm," he told the Herald.

Crack was around in other countries for a long time before making
rapid inroads in the UK, he points out. At present, it may only be
the relatively cheap cost of established drugs such as heroin and
cocaine that is keeping crystal meth at bay. "If cocaine became less
available, we may see an increase in crystal meth use. We would be
worried if we got caught off our guard, particularly with the sexual
health issue."

Crack brought with it a rise in HIV transmission in some areas and
the fear is that if drugs like heroin, which suppress libido and
fertility are replaced by crystal meth, sexual health problems could spiral.

Tyrie's main contribution to the conference will be to describe a
ground-breaking, but controversial research project in Manchester
which will involve profiling young people, predicting the likelihood
that they will take drugs or take part in other risky behaviour, and
exploring whether it is possible to intervene.

A pilot scheme will target children already known to be at greater
risk, primarily children in care and children who have been excluded
from school and intervene to improve their life skills' such as how
they weigh the consequences of their actions and how they negotiate.

"We know that drug users don't tend to come into contact with
services until a year after they have begun risky behaviour," Tyrie
says. "If we are really serious about preventing infections and other
consequences, should we be profiling people to see who is likely to
engage in those risks?"

The scheme will target 11-15s with a DVD and other materials in an
attempt at prevention rather than attempting harm reduction at a
later stage. However, while the project - a UK first - has attracted
European interest, Tyrie acknowledges there are ethical issues to be
considered. Some find the idea of profiling alarming. "Schools find
it very politically sensitive and people feel anxious about the
stigma. It taps into the concerns people have about the amount of
information collected about them. But the real danger is people can't
break away from their early experiences, and we don't make it
possible for people to to change."

Dr Mary Hepburn, consultant obstetrician at Glasgow's Princess Royal
Maternity hospital is known for ground-breaking work to improve the
outcomes of disadvantaged women who become pregnant. She argues that
crystal meth is a significant threat, although uncommon as yet in Scotland.

"We don't have huge amounts coming through the maternity service,"
she said. "But crystal meth is an issue and we need to know about it."

But she will tell the conference that the biggest concern is the lack
of dedicated services for disadvantaged parents.

Hepburn blames the widening gap between rich and poor and calls the
results tragic'.

"We are seeing more poverty-related ill health. It is more
entrenched. Twenty years ago when drugs first came into this country
the majority of drug using young women were 17-24. They tended to be
fairly healthy but for their drug use.

"Now women are older and the social factors that cause ill health are
more entrenched."

The results are "awful", she says, with indigenious Glaswegian
mothers increasingly having worse outcomes to their pregnancies even
than asylum seeking mothers, who also attend Hepburn's clinic for
socially disadvantaged families.

"Glaswegians who are disadvantaged have worse outcomes than
disadvantaged incomers, including higher rates of prematurity and
mortality, more babies born preterm, and lower birthweights."

Hepburn is also calling for earlier intervention - in this case,
getting information to drug-using women about planning their pregnancies.

However this doesn't go down well in some quarters against a
background where some would back removing babies from drug users or
even pay them to use contraception.

This is unrealistic and immoral, Hepburn argues: "Putting in extra
support applies for women who have for example mental health problems
or a learning disability or a condition like diabetes, but women who
use drugs are seen as responsible for their own problems."

This is simplistic, she says. "Problem drug use is overwhelmingily
linked to poverty and social disadvantage."

However the Princess Royal's specialist maternity ward for
disadvantaged mums has been closed and they are now managed in
mainstream wards, which has meant a step backwards, according to Hepburn.

"One thing we could do to improve babies' chances of being healthy
was persuade women to breastfeed. We were delighted that we were able
to get the rate up to 20% but we haven't been able to maintain those
rates on mainstream wards."

Some of those attending the conference are not keen to talk up the
dangers of crystal meth. Tim Bottomley, a senior practitioner with
Salford Drug and Alcohol Service, is to give a talk entitled The New
Ice' Age. However he said there was a danger of fuelling hysteria
about the drug. "It has the potential undoubtedly to be problematic
and you can see that where it has taken hold in the US, the far east,
the Czech republic and Australia.

"We need to look at what we might do if and when it becomes an issue,
but we need to be wary. When heroin users started using crack in the
1990s some of their curiosity was undoubtedly fuelled by headlines
and politicians talking it up."

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METHAMPHETAMINE FACTS

Methamphetamine is a psycho-stimulant drug which can be snorted,
injected, ingested or inhaled.

t has gained popularity in some countries such as Australia, where a
2001 heroin shortage led users to switch and 73,000 Australians are
now addicted - double the number using heroin.

Small quantities of crystal meth have been reported in Shetland,
Grampian, Ayrshire and Glasgow.a.. Effects can include euphoria,
agitation and increased libido.