Pubdate: Thu, 14 Oct 1999
Source: Belfast Telegraph (UK)
Copyright: 1999 Belfast Telegraph Newspapers Ltd.
Contact:  http://www.belfasttelegraph.co.uk/
Author: Darwin Templeton, Chief Reporter

HEROIN ADDICTS GIVE FRIGHTENING INSIGHT

American academic Dr Karen McElrath today offers a frightening glimpse
into the murky underworld of heroin use in Northern Ireland.

For the last two years, she has been slipping away from the
comfortable environs of Queen's University to interview addicts.

It was a difficult task, first in identifying potential subjects and
then persuading them to overcome their suspicion of authority and take
her into their confidence.

Controversially, Dr McElrath, who carried out previous research in
Miami, decided to offer payment of pounds 15 to pounds 20 per interview.

That decision will no doubt face criticism, but she is hoping that the
issue will not deflect the main focus of attention from her findings.

She said: "It represents a considerable risk for someone to come
forward and disclose information those people are taking a risk in
disclosing criminal activity.

"I was also taking two to three hours of their time. Yes, they might
be using the money to score heroin, but they might be paying the
electric bill or buying groceries."

In all, Dr McElrath managed to contact 35 people from all over the
province, mostly men between the ages of 18 and 45 from Belfast.

Interestingly, half were drawn from middle- and upper-middle income
backgrounds, exploding the stereotype of the down-and-out junkie.

And her interim report paints an alarming picture of inadequate
treatment facilities and heroin users putting themselves at risk from
diseases like HIV and Hepatitis C.

Overall, she is amazed at how drug policy in Northern Ireland differs
from the rest of the United Kingdom.

Dr McElrath points to the ban on methadone prescription, to the fact
that most treatment options are geared towards alcoholics and to the
absence of proper after-care facilities for addicts.

But she highlights the serious health risks among injecting heroin
users, which are heightened by the lack of needle exchange programmes.

During her interviews, she uncovered disturbing evidence of confusion
among users as to what was safe practice.

Addicts in Ballymena and Bangor complained that needles were hard to
get, perhaps because chemists in the tightly-knit communities were
less likely to believe the lie that they were diabetics.

As a result, in Ballymena users said they had resorted to buying
needles from dealers, but there could be no guarantee that they were
new or clean.

One user admitted to using a needle up to 30 times, while another
said: "When you are sick enough, you would use someone else's." Others
attempted to clean their needles using anything from boiling water to
vodka.

There was also an alarming ignorance about HIV and how it could be
passed.

Dr McElrath also encountered complaints about the role of health
professionals and GPs in particular.

She concluded: "GPs are in a position to help drug users, but they are
hindered by current drugs policy. "Users found themselves developing
their own strategies to kick heroin, which often involved switching to
other drugs".

Concluding, Dr McElrath calls for street outreach to educate heroin
users and to provide fresh needles, and an overhaul of treatment
provision, including the offer of methadone.

Dr McElrath questions suggestions that heroin use in Northern Ireland
dates from the mid-1990s.

"Heroin was discovered in 1898 and has been used legally and illegally
since then," she said.

"It's very likely that there have been heroin users in the North since
it was discovered." 
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