BITTER PILL OF PRESCRIBING HEROIN

Doctors Attempting To Treat Problem Drug Users Face Police
Investigations And The Threat Of Being Struck Off

The government may have signalled its support for prescribing heroin
but doctors continue to be punished by the police and the medical
establishment for trying to help problem drug users.

The plight of GPs who prescribe heroin was raised in a Commons drugs
debate today.

Labour MP Brian Iddon, chairman of the all-party, parliamentary misuse
of drugs group, highlighted the case of London GP Dr Adrian Garfoot,
struck off by the General Medical Council (GMC) in September after
more than 25 years treating hundreds of long-term users, both in the
NHS and at his private clinic in Hackney.

Dr Iddon says Dr Garfoot's case is not unique. He knows of 15 other
doctors who have been struck off or are under investigation.

"These doctors fall into a group of people who believe drug addicts
are victims and need specially tailored treatment and counselling
rather than criminals who should be punished," he said.

"They are something of a rare breed since the majority of GPs, some
94%, are unwilling to treat drug users. This leaves the addicts with
no alternative other than to continue to use street drugs. This
situation ensures drug addicts are offered no support or incentive to
wean themselves away from the harmful substances that are destroying
their lives."

Dr Garfoot fell foul of the GMC because his treatment methods involved
prescribing pure substances to allow users with high tolerance levels
move away from impure and costly street drugs.

The GMC accepted Dr Garfoot had acted on what he believed were the
best interests of his patients, but concluded his prescribing was
irresponsible.

The GP had already endured a police raid on his clinic and a five-year
Home Office inquiry that finally cleared him of wrongdoing and
recorded a verdict of "abuse of process".

Dr Garfoot plans to appeal against the GMC decision. Meanwhile, one of
his former patients has since died from an overdose of street heroin,
another has committed suicide.

In Febrary last year, Dr John Gordon was arrested at his surgery by
Carlisle police on suspicion of involuntary manslaughter over the
methadone-related deaths of five of his patients over a year. He was
cleared three months later.

Dr Gordon said he could only assume the police clamped down on him
because they regarded him as the "drug addicts" friend. He had the
biggest list of drug using patients of any GP in Carlisle.

"My arrest was like something off The Bill. I turned up to work on a
Monday morning to be met by CID officers who took me into a side room,
read me my rights and marched me through the reception area in front
of patients," he said.

Dr Gordon is still suspended from treating his drug using patients
because the GMC is looking into his case, but he does not know whether
the police passed details of the arrest onto the disciplinary body, or
whether it has received a complaint from someone else. Meanwhile he
remains in limbo. The GMC refused to comment.

Essex GP Dr Zaid Kawa was also arrested last year at his surgery
following the death of a patient from a methadone overdose. A trial
jury cleared him of involuntary manslaughter this summer, but the GMC
struck him off last month for serious professional misconduct over his
prescribing practices.

Last week former drugs tsar Keith Hellawell admitted government
targets to reduce hard drug use are set to fail.

Napo, the probation officers' union, says virtually all the 150 to
200,000 chronic drug misusers nationwide are known to the probation
service. It is calling for an increase in the availability of drugs on
prescription as one way of cutting crime that takes place to pay for
street drugs.

Half of all property crime is believed to be drug related and the
government spends 75% of its ?2bn drugs budget on policing and
enforcement, while only 6% of problem users are thought to be in
contact with treatment services.

The home secretary, David Blunkett, signalled plans for wider heroin
prescribing when he announced his proposal to relax cannabis laws last
month. This move has been applauded by those who say the way to get
users off street drugs, away from crime and living stable and healthy
lives is to offer them a wider range of treatment options.

But doctors say the fear of disciplinary action or arrest will do
little to encourage them to help take on drug using patients.

Dr Chris Ford, a London GP and chairman of the Methadone Alliance,
said: "There is a problem here and it needs looking at. GPs can take
on very stable patients as long as they stick to the rules and offer
restricted methadone treatment, but anyone trying to provide a
slightly different service has to be fairly brave in the current climate."