needle injury in a playground

It was distressing to see on the Look East regional news magazine, then read in the Cambridge News yesterday, the news that a council worker had been jabbed in the leg by a used needle in a children's play area. But I found myself wishing that the former news outlet, part of the BBC, had researched their facts about the diseases that can be caught through contact with injecting equipment more thoroughly.

The needle had been wedged into the rope seat of a swing then, presumably, broken off, and had jabbed Jason Law, who works as a groundsman for Littleport Parish Council in East Cambridgeshire, through the trousers.

According to Look East, Mr Law would have "an agonising wait of 6-8 weeks" before he found out whether he would find if, God forbid, he had contracted anything from the needle.

This is tosh. The diseases most often caught from needles - Hepatitis B (against which any council should have workers like Mr Law vaccinated), Hepatitis C and HIV take a minimum of three months to show their ugly faces; in reality, negative test results are meaningless unless samples are taken six months after exposure. The Cambridge News got it right: "he has to have regular blood tests and injections over the next six months before, hopefully, being given the all-clear". The initial tests would have been at the behest of the behemoth which wants to stop schoolchildren play conkers, push gravestones over and now ban doormats: the insurance industry. Should Mr Law be found to already have an illness that might be caught through contact with needles or other injecting equipment - or indeed through something as innocent as a boyhood blood transfusion - any payout would be substantially reduced or indeed non-existent.

It's being presumed that the needle was put into the swing-seat maliciously, as well it may have been. On the other hand, there is a growing awareness among the various communities of injecting drug-users that they have a responsibility not to allow their equipment to be reused, which might risk transferring the very beasties that Mr Law has been put at risk of. In the absence of education otherwise, they often stick needles into trees and snap the attached syringes off (and the needles often later fall out and await a passing child in thin-soled sandals).

The correct procedure, of course, is to place the used injecting equipment into a burnbin/sharpsbin and take it to a needle-exchange, which is usually a pharmacist displaying one of the symbols to the right; or it may be within a drugs agency; from either the burnbins will be collected and incinerated, hence the unofficial name "sinbin" (incineration-bin).

What happened to Mr Law is of course the responsibility of the individual drug-user, and if this individual is found I hope they lock him away and throw away the key, both for what they are putting the groundsman through and the risk to which they exposed children at play. But, given that in the year to April 2009 hundreds of paedophiles and rapists were let off with cautions, I'm not hopeful.

What doesn't help as well is the refusal of some authorities to accept that a serious class A problem exists within their boundaries - perhaps a consequence of public bodies being allowed to rate their own performance?

Another stumbling-block can be groups of residents fearful for their house-prices putting pressure on the outlets where Methadone is dispensed to be closed, as they are unhappy at seeing what in reality is a minority of clients collect their heroin-substitute then sit around swallowing cheap strong lager or cider. They're looking at the wrong side of the equation: if off-licenses, including shops that sell alcohol from dawn till after dusk, were forced to raise the price of their Carlsberg Special Brew, White Lightning Cider and the rest - as the Conservative Party has pledged to make happen - the problem would much lessen.

The war on drugs, of course, must continue; but like any war, resources must be targeted on a pragmatic basis. For example, it would make more sense to decriminalise or even prescribe - under strictly controlled conditions - diamorphine (heroin) for the purposes of detoxification than to cede to the many attacks on the illegality of cannabis, because the problem of cannabis cultivation can largely be dealt with within our shores, whereas 95% of heroin comes from Afghanistan. Until a decision can be made as to whether to buy the products of the poppy fields at a higher rate than the Taliban offer and produce pharmaceutical opiates, or apply liberal helpings of Agent Orange (or some such herbicide) thereupon, all we can do is disconnect what supply from demand as we can and deal with the effects of what gets through.

But all this doesn't help Mr Law. I wish him as much peace as he can garner over the coming months, and hope he is given the support he so richly deserves for his devotion to his job.

so why was she in court?

"If you have a body...then it has to be tested in court."

That's what Anne Widdecombe said on TV earlier this week on another subject, but it provides a perfect answer to the question Caroline Gammell posed in the Telegraph: Why was Kay Gilderdale in court charged with attempted murder?

A month after the Director of Public Prosecutions issued guidelines on assisted suicide that SPUC said "legally downgrade the right to life of disabled or terminally-ill people", Kay Gilderdale's daughter Lynn - who had chronic myalgic encepalopathy (ME or chronic fatigue syndrome - took an overdose of her prescribed morphine, at which point Gilderdale mater then fed her sleeping-pills and antidepressants and injected air into her veins. She was cleared by a jury on Monday 25 January.

My first reaction to the headline was to wonder why the woman might not be in court for attempted murder at least, but it was interesting to read on and find out that a spokesman for another mother who had killed her child shortly beforehand commented: "Frances’s conviction and sentence were wrong and for this lady it seems they have got it right".

The lady in question is Frances Inglis, who is also referenced in the Guardian's treatment of the Mrs Gilderdale, where we learn that Mrs Inglis bought two grams of heroin from dealers and injected her son with it.

The Disability Matters blog, however, fleshes out some details about what happened after Inglis' son, became brain-damaged after either falling out of or jumping from the ambulance that had come for him after he'd been in a fight:

Frances Inglis...immediately became obsessed with ending his life, repeatedly making the case to anyone who would listen that she did not think any treatment was in her son's best interest. She visited her son almost constantly and was described by Thomas’ brother, Alexander, as "obsessive and negative."

Only 10 days after the accident, Inglis decided that she had to “put her son out of his misery.” So she injected him with a lethal dose of morphine. While Thomas was successfully resuscitated, he had been without oxygen long enough that his brain damage was much worse...Out on bail, a condition of which was that she go nowhere near Thomas, she disguised herself as Thomas' aunt, fooled the nurses, and injected Thomas with a fatal dose of heroin.

Two grams of heroin is a prodigious amount but, even if only a quarter-pure, it would be a massive overdose. One only hopes that the material with which the heroin was "cut" - and cut it certainly was, as she bought it from dealers - wasn't medically active and didn't cause any seizures as the boy passed away.


Pro-euthanasia campaigners would reply that if physician-assisted suicide were legal, Thomas would have been given pharmaceutical diamorphine (heroin), but, given the material above, it's by no means certain that a doctor would have considered Thomas eligible - although in a chilling caveat, Richard Normington quotes Dr Regina Dwyer's conclusion to a New York Times article on doctors who kill:

In the end, we doctors are no different than the rest of you. We probably turn killer less often than most other occupations. But our ranks have and will always include the deeply flawed, the greedy, the delusional, bunglers, rationalizers and just plain sociopaths - like every other population.

But the issue isn't doctor-assisted suicide, as opposed as I am to that. It's how we prevent, in some cases, abuse of the effective power that members of the above categories have to kill the sick relative of their choice, and in others - given assisted-suicide supporter Jamie Dettmer's assertion that Mrs. Gilderdale had sought to dissuade her bedridden daughter, Lynn, from wanting to end [her] life - people wracked by pain and despair and in crisis from unintentionally applying emotional blackmail upon their loved ones to act with lethal effect upon them.

I'm sure Kay Gilderdale and Frances Inglis are, possibly in different ways, occupying somewhere resembling hell right now. Cecil B De Mille, for example, in his 1952 The Greatest Show on Earth, presented a visual interpretation of a self-assumed mark of Cain in Buttons the Clown's smiley face perpetually masking the lugubrious demeanour of somebody who has "killed the thing he loved".

That's why killing sick or disabled people, although it has always happened, has always been fenced in by a taboo which the Establishment is dismantling to all of our peril.

And, for all the guidelines revolving around assisted suicide and living wills, that's why Kay Gilderdale was in court charged with attempted murder.

Akmal Shaikh - one among many victims of heroin

It's started already. Have a read:

Where is the medical research that says that being bi-polar impairs your judgement as to what is right and what is wrong? Do you think that if I decided to go out now on the streets and start dealing drugs when I end up in court I could say to the judge; "Oh please your honour, I didn't know what I was doing- as I have bi-polar!" It is a pathetic excuse and can never be used in a court of law to excuse a crime.

This was, curiously, posted on a football website, about the execution on 29 December of Akmal Shaikh in China for bringing 4kg of heroin into the country, having been allegedly "duped" by a chap in Poland. I don't personally have a problem with believing that: a friend's son was offered a wad of money to take a package from A to B and, having been stopped by the police, found that the "easy money" had been payment for his being stupid enough to transport a class-A drug. So he served his time in prison: paid the price, you might say, according to the law of the land he was arrested in.

What the fellow says in the quote at the top of the page isn't all that far off-target, but where I take issue is with the phrase "pathetic excuse" as part of a description of a serious mental illness, one that I have myself. I prefer the more measured reasoning of the Telegraph's Richard Edwards:

The episodes [of extreme mood swings] can last several weeks or months and at worst can include psychotic symptoms such as hallucinations and delusions that one has special powers or abilities...There is debate in legal circles as to whether those affected can claim it as a defence to their actions because bipolar [disorder] affects mood rather than cognition, and therefore does not necessarily affect a person’s ability to know right from wrong.

Shaikh's supporters pointed to the lyrics of a song for world peace inviting a rabbit to pray with him as proof of his mental illness, and even Reprieve, the prisoners' human rights charity, called the song "bizarre" and "terrible". But if insipid songs voiced by grandiose personalities indicated serious mental illness, there'd be still more pop stars on medication than there presently are - even among the hubris-scarred Live Aid veterans, whose pomposity was outdone only by the scale of the hair and shoulderpads. (Actually, Syd Barrett produced some rather brilliant stuff in the florid phase of his illness.)

While I was in hospital and in the grip of a delusion that was urging me to break the law, a psychiatrist advised me that should I do so then my treatment would continue in prison, and that was enough to keep me on the right side of the law. The same principle has applied here in reverse: Shaikh broke the law not just in China but in its Xinjian Uyghur Autonomous Region, where the treatment of Christians such as Alimujiang Yimiti, bravely exposed by ChinaAid, show that compassion there is especially a stranger in a strange land.

But there we may be hitting the nub of the problem - the Establishment's pavlovian response to selected shibboleths of diversity. Had he been called, say, Joe Bloggs and not Akmal Shaikh, and been born in Penzance instead of Pakistan, would Prime Minister Gordon Brown, Foreign Secretary David Milliband and Foreign Office Minister Ivan Lewis (who professed himself "sick to the stomach") have joined the howls of protest from Amnesty and Reprieve?

Another villain in this tragedy is British drugs policy, especially as relates to celebrities who use drugs. We've seen supermodel Kate Moss cut lines of cocaine and not be arrested; Amy Winehouse hospitalised after a multi-substance overdose and Billy Joel describe the routine nature of rehab for substance abuse disorders as "mental floss". (And sacked chair of the Advisory Board on the Misuse of Drugs, David Nutt - who seems to be trying to break into the celebrity circuit in his own right - admits to experimenting with highly-addictive benzodiazepines before giving lectures.)

All of this is no comfort to the Shaikh family who, presumably through no fault of their own, have lost their loved one. It might be worth noting, though, that in the UK, the 4kg of heroin he was carrying would be worth £40,000 ($63,700) at current prices before it was cut with potentially lethal contaminants to make it go further and earn up to ten times as much.

So should China have executed Akmal Shaikh? You could say that what he was carrying in his suitcase, knowingly or not, was as life-destroying as a bus ploughing through a crowd; like a suicide-bomb in slow motion. I cannot find myself condemning China for the move, but that doesn't mean we can become less suspicious towards the murderous tiger, whose colonial claws are already gripping swathes of Africa, nor can we pretend not to see the abuses towards its own citizens who may be members of house-churches that don't officially exist, or perhaps aren't even born yet. SPUC director John Smeaton highlights our own complicity in this:

The UNFPA's participation in China's forced abortion one-child policy is well-documented. Furthermore, when Colin Powell (a supporter of abortion) was US Secretary of State, the State Department verified the pro-life Population Research Institute’s allegations that the UNFPA was cooperating with China's coercive abortion programme...The UK government gave over 40 million US dollars to the "regular funds contributions" of UNFPA in 2007 (the latest report available), about 10% of the total income China received in regular donations from over 180 countries worldwide.

Presumably the diplomatic and political row over the execution of Akmal Shaikh will lumber on as China saves face while Gordon Brown searches for a figleaf to cover the intellectual, moral and political paucity of his position; and meanwhile, the products of the Afghan opium fields alone kill 100,000 people a year - the equivalent of over 1900 executions daily. Where are the wailing politicians?

in praise of betrayal

I'm not proposing that betrayal in general be praised, merely that some instances of betrayal can have a decidedly therapeutic effect in a manner that I can only describe as praiseworthy.

Take Billie Holiday, for example. Various motives have been forwarded for her agent, Joe Glaser, turning her over to the police in 1947 because of her heroin habit, including a suggestion that she was a "trade" and the return was blind eyes dutifully turned to the cannabis habit of Louis Armstrong, another of Glaser's acts. But Holiday got clean in prison, and almost certainly lived a little longer to enrich our lives with her music - until liver-disease took her in 1959.

Winston Churchill entered Parliament as a Consrvative Party MP in 1900, and crossed the floor of the House of Commons to join the Liberals in 1904 in protest, partly, at lack of rights for trade unionists; twenty years later, with experience as Home Secretary and First Lord of the Admiralty under his belt, he rejoined the Conservatives His comment?Anyone can rat, but it takes a certain amount of ingenuity to re-rat".


You can't get far in a discussion about betrayal without mentioning the Big One. Dante has Judas being eternally chewed in one of Lucifer's three mouths (between Brutus and Cassius) in a circle of Hell named for him with the anti-Semitism that besmirched much of the times: Judecca. In his 1910 article for the Catholic Encyclopedia, William Knight shows how thinking had become more subtly nuanced over the centuries by mitigating the condemnation somewhat with the assertion that the whole episode is a mystery. However, although The Passion of the Christ treats Judas' betrayal and death in the manner of reportage, most film-makers attempting a life of Jesus can't resist exploring Judas' psychological motivation - from wanting the Sanhedrin to listen to him in Jesus of Nazareth to wishing to force his hand but ultimately being used almost as a patsy in the Time-Life film simply called Jesus. Whatever, Judas' course of action had a decidedly beneficial effect.

What I'm getting to is that, in the age of "compliance" that ensures boxes are ticked to assure managers that rules are adhered to, perhaps a little more betrayal of the therapeutic sort is called for.

For example, earlier this year, former SAS officer John Wick found himself in the possession of evidence that some MPs were misleading the public as to their use of expenses - which, of course, comes from taxpayers' money. Even though he knew some of the casualties would be Conservatives (he is a fundraiser for the party), he put his country first and chose to pass the documents to the Daily Telegraph, finishing an article he wrote for the paper with "As a man who served Queen and country in the Armed Forces, I feel proud to have played my part in what the Telegraph rightly describes as 'a very British revolution'".


Not all whistleblowers are so fortunate, or perhaps as robust as a former Special Forces officer. For example, Liberal Democrat MP Norman Baker has sugested that the 2003 death of Dr David Kelly, who criticised the Government's "sexed-up" dossier on Iraq's nuclear capabilities, may have been murder; Greg Ocytko, former risk analyst for Halifax Bank of Sotland (HBOS), which collapsed spectacularly in 2008 in an implosion mirroring that of Lehman brothers, claims to have been forced from his job for making his disquiet known when he found fatal flaws in the bank's systems; and Nevres Kemal, who warned former head for Haringey Social Services Sharon Shoesmith that there was going to be another Victoria Climbié prior to the death of Peter Connelly (Baby P), suffered the fate of thorns in the side of authority since Socrates when she was investigated for abusing her daughter.

Last Thursday, the Patients' Association released a report called Patients...not numbers, people...not statistics about the "dreadful, neglectful, demeaning, painful and sometimes downright cruel treatment" that has been visited by nursing staff upon older people in NHS hospitals, including a report on Bella Bailey, whose daughter kept a diary of the neglect with which her mother was tortured to her death in plain sight of the nursing station, and founded the pressure-group Cure the NHS to campaign for better care in the NHS.

Although members of the Patients' Association are not whistleblowers, bullying of such is so engrained within the NHS (and governmental departments generally) that the Association has been threatened with legal action by one hospital trust for revealing information about the 1-2% of patients (possibly up to a million nationally) who, for example, are left in their own excrement, have to have their toilets cleaned by relatives or are left to slake their thirst from vases.

Libby Purves reports that the reaction of Dame Christine Beasley, England's Chief Nursing Officer since 2004, has been to opine that nurses who refuse to report abusive colleagues are "as culpable as the person who did it". Although she recognises that reporting senior colleagues can be more dificult ("but that's no excuse"), she doesn't deal with a fact related to Bella Bailey: that on Dame Christine's shift Cynthia Bower, who failed to spot the massacre at Stafford General Hospital when she was chief executive of the West Midlands Strategic Health Authority, charged with checking standards are maintained, was promoted to the head post in the Care Quality Commission in April of this year - in charge of maintaining standards throughout the NHS. In a piece of staggering hypocrisy that she may come to have cause to regret quite soon, Bower told the Guardian upon her appointment that

It was not until the final months before her mother died that she understood how powerless people can feel when confronted by inadequate care.

I believe there's only one strategy through which Dame Christine can hold on to her integrity: to call for an amnesty for NHS staff who wish to report negligently poor care concomitantly with an investigation with the powers to interview staff at absolutely any level of authority, held by a body independent of the NHS and with safeguards in place to weed out vexatious complaints.

Or, on the other hand, she could let her reputation and those of the individuals below her and above her be eroded by the steady drip of therapeutic betrayals as the disgust becomes unbearable and the Great British Revolution rolls on.

cocaine: heartless, soulless waste

The UK has just achieved an unattractive prominence: according to the Telegraph's Tom Whitehead, Great Britain is now the world's capital for cocaine use, says a UN report (which I haven't been able to locate on the organisation's byzantine site).


Ironically, we've just seen the publication of a report by Nottingham Trent University, in conjunction with the Nottingham Crime and Disorder Partnership, which focussed on an aspect of occaine-use that's often overlooked: the marriage of cocaine and alcohol to form a substance called coca-ethylene, which is toxic to the heart and the liver.

The research, I think, hits the nail on the head with its title - Heart and soul of the Party? Unfortunately, I think many of us will have had the displeasure of seeing somebody emerge from the WC at a party or in a pub far more cheerful than when they went in, talking twelve to the dozen and on the edge of starting fights because they have lost any conception of personal space.

The worst thing is - I heard again and again from users trying to recover when I was a drugs worker - it feels that one can drink the place half dry and not feel that one is drunk. Not feel is the operative phrase: co-ordination might be less affected than if one had not had cocaine, but judgement goes right out the window, leading to more consumption of alcohol/cocaine and impulsive behaviour like fighting, or sex that is often unsafe and may lead to an unwanted present being transmitted to one's partner. (And that's assuming that the sex is consensual.)

The reason I mention sex more than once is that cocaine affects the brain by piggybacking on the reward system in the midbrain that makes sex, for one thing, feel enjoyable. The desire to take cocaine very soon inserts itself, cuckoo-like, as a drive. That's why the damn thing's so addictive that the brain doesn't really settle down until after about six months of abstinence.

That's the reason I spit feathers when I read articles by liberal-minded journalists who chide society - whatever they think they mean by this - for criminalising black people who take crack (the smokeable form of the drug) while turning a blind eye to white people who use cocaine. (I speak as somebody who met one black crack user in many years in the job.) The reason for my reaction is that if we see the council estates raided, then shouldn't we see the same happen to the Stock Exchange and the bankers' parties (like the one which saw the birth of derivatives)?

I can't disagree with the vice-president of Colombia, Francisco Santos Calderón (left), that "Every user that snorts a gram of cocaine kills 4.4 square meters of rain forest"; so I wonder why Minora comes back from school reciting the relative prices Colombian farmers can make for cocaine and traditional crops.

I think that Cambridgeshire Constabulary is going down the right road by squeezing pubs with a name for cocaine use with an amalgamation of new technology and old-fashioned policing. As Operation Ortolan, mounted some years ago, showed, big fish and small fish are relative: in the end, there are only fish, some bigger than others, most aspiring to become bigger than they are. The Force's drugs lead, Chief Inspector Gary Goose, said:

"The dealing of heroin and cocaine is an appalling trade. It destroys people's lives and can also make life a misery for those who become a victim of associated crime such as burglary, robbery and anti-social behaviour. We do not want our communities to suffer the effects of drug misuse and we will do all we can to make the city a safer place to live and work.

The lesson of all this can be found, I believe, in Genesis 3. I've heard users say many times that they wished they'd never tried cocaine: there's such a thing as forbidden fruit.

And well done to the Nottingham Trent University students who have worked with Nottingham Crime Disorder Partnership to bring out this timely report. You can read a summary of it at Drink and Drug News.

silly season for addled idiots

So here we go again, some eejit with nothing better to do thinks it's time to legalise all drugs, because Welsh chief constable Richard Brunstrom has called for legalisation and regulation of all drugs, describing the Misuse of Drugs Act 1971 as 'not fit for purpose' and 'immoral', urging its repeal."

There is a very good case to be made for decriminalising heroin under some conditions and prescribing it to people who are already addicted. It would vastly reduce the misery suffered by the victims of burglary and dealing, and moreover would make great inroads into reducing street-prostitution, as well as taking the most vulnerable (predominantly) women and girls out of situations where they might fall prey to the sort of scum who profit from their abuse at the hands of scum who use street prostitutes.

But what about stimulants?

This is the point at which pedants jump up and protest that caffeine's a stimulant. So it is, but caffeine never dissolved a nasal septum, bled calcium from bones, nails and teeth, induced impulsive crime and aggression or was to blame for unintended or even non-consensual sex. Cocaine does the first, amphetamines the second, both of them (and also methamphetamine) the third, and all three plus ecstasy the last - although a skinful can do the last two for less layout. Ecstasy, moreover, carries the perverse risk of death by drinking too much water due to its well-known effect of dehydration. Nobody in their right mind drinks a lethal amount of water, but if you have a roomful of people who have dropped E's then you will find nobody in their right mind.

Steroids turn the level playing field that sport should be played upon into a quagmire, lead to aggression and baldness (ever wondered why slapheads are moody buggers?), but on the upside, M&S will give any man brave enough to enter the lingerie section a free bra-fitting. And they shrink testicles to the dimensions of peanuts. Talking of which, as they are illicit and therefore not regulated, the carrier-oil can be anything...like peanut oil. Ouch.

And then there's the last refuge of the warm fuzzy liberal, cannabis. You know, the stuff that Bill Clinton put in the reefer that he tried to play the flute with. Trendy politicians push each other out of the way to offload that they did inhale once upon a time, and do not take it into account that cannabis has been selectively bred in the last two decades to maximise the amount of THC, the main one of the 60 or so psychoactive ingredients. Kids are ending up in psychiatric wards because they never had a chance in the face of huge amounts of psychosis-causing chemicals and of the collusion of their elders.

If the 1971 Act is not fit for purpose, it is precisely because it has been chipped away at by the cool, if unintended, products of middle-class upbringings stirring up sub-working-class sentiments to satisfy their need for publicity and controversy. Nothing wrong with being middle-class, of course (some of my best friends have fondue sets!), but when somebody with the means to spread their articulate attention-seeking propaganda among the fuddled masses pulls strings, we get the sort of Greek tragedies that have been inflicted upon the world by Marx, Lenin, Franco, Mosely, and not to forget St Clayre-Rayner, patron of professional victims.

In the draughty old fen, our hard-working sergeant is at pains to point out that recent drugs seizures don't mean we have an entrenched drug problem. Which is a good thing, as the tender mercies of John Barleycorn Esq upon some of our young folk keep the police busy. Mr Brunstrom should listen to his police officers and PCSO's on the ground before he gives the green light for the nation to get high.