‘IfI’m going to die. which I am. I’d like to see the death rather than die in my sleep perhaps in a crash. or be cut in two by a chainsaw.‘ Ex-newspaper publisher Eddy Shah dwells on a demise that would fill the headlines.

‘I didn‘t quite know what to do last November when one day the Prime Minister was older than my mum, and the next day younger than Mick Jaggerf

Billy Bragg is confused by the swinging nature of British politics.

‘His copulation behaviour was normal, mating four times in six daysf

Dr Robin Lovell-Badge reveals why the world 's firstsex-change mouse is called Randy.

‘It’s just a matter ofgetting over the fact that my mother is the Queen.‘ Prince Andrew finds parents a problem in the Royal Navy.

‘1 used to drive my father up the wall because he would find all his football coupons arranged in psychedelic patterns.‘

Scottish clothes designer Pam H ogg on a possible precursor to the new international away strip.

‘Sometimes I say ‘Which day is it‘." I never said that at No l().‘

Poor Mrs Thatcher discovers the joys of being ‘unemployed '.

‘Once you get him on his own. he’s quite sensible.‘

Jane Sutherland-Earl. Tory councillor in Devon. finds the worst possible insult for Stuart Hughes, her recently elected Raving Loony Green

G iant colleague.


4The List 17—30 May 1991

The link between two epidemics in Scotland drug-taking and HIV infection has been clear for several years. But how much is really being done to stop matters getting worse? Alan Morrison looks at

the work of Edinburgh’s Community Drugs Problem Service and its

attempts to stop addicts injecting.

igures released last week by the Home Office have revealed an alarming 50 per cent rise in the number ofdeaths among drug users in Scotland. It is not yet clear whether this is due to an increase in

I deaths from AIDS, although the

association between HIV infection and

. intravenous drug abuse has for several years been a medical and statistical fact. Regardless of

society’s prejudices, AIDS has for some time not

, been the exclusive property ofthe homosexual

: community, and now a second wave of

AIDS-related deaths seems likely to hit Scotland I particularly hard.

The roots of this latest epidemic can be found in

= the unemployment-hit housing estates ofthe

' early 19805. A new drug culture sprang up among Z disaffected teenagers who were looking for kicks, : but were inexperienced when it came to sterilising 1 equipment. Government action to outlaw drugs

and dealers had the short term effect of forcing this culture further underground rather than

eradicating it. The police in Edinburgh decided to

concentrate on clamping down on sources of

., syringes which led to the supply ofclean needles = drying up. ‘Shooting galleries’ groups of young

people sharing needles and syringes— then became common just at the time when HIV appeared on the scene at its most infectious and the virus spread quickly.

‘When you‘re experimenting and you don’t care

3 much about yourself,’ says Dr Judy Greenwood of Lothian’s Community Drug Problem Service, ‘you become more extreme to get a buzz. People

get a feeling ofcalm or well-being from the drug,

and there aren‘t all that many ways these young

people can get that feeling.’

Dr Greenwood. a consultant psychiatrist, is the driving force behind the CDPS. which was set up by Lothian Health Board at the Royal Edinburgh Hospital in 1988. The year before, she had begun

' a needle exchange scheme in Leith. and the

sudden influx of young people covered in injecting marks ‘half of them HIV positive’ had convinced her that more was needed in terms of specialist counselling and advice.

Working closely with local GPs. the CDPS has dealt with over 900 referrals (regardless of HIV status) in its three year existence. Its policy of providing support and counselling for drug users who are being prescribed substitute non—injectable drugs by their family doctors has attracted a certain amount ofcontroversy. Opponents claim that this approach and that of needle exchange schemes condones drug-taking, but Dr Greenwood argues that both are important stages in stopping addicts injecting and weaning them off drugs in the long term.

‘I would rather people didn’t inject, because it’s so dangerous. but ifthey refuse to stop. then obviously it‘s sensible to give them clean needles and syringes. The proof of the pudding is that injecting has dramatically dropped in Lothian.’

The shim and of the drug'problem

Lothian Health Board claims a 70 per cent return rate through its needle exchange centres and participating chemists. In Glasgow the figure is even more encouraging, with a recent ‘spring clean’ bringing in used needles at a rate of 114 per cent, indicating that conscientious addicts are now returning needles obtained from sources other than Greater Glasgow Health Board’s five exchange centres around the city. Injecting does remain high in Glasgow, however, as the city has no policy of prescribing alternative drugs. On the other hand, the decline in number of usedneedles found discarded in open streets and parks of either city is proof of the schemes’ success.

Despite the recent addition of a competitive edge to health funding. the Scottish Office has set aside separate money for drugs and HIV services in all of Scotland’s cities. It is to be hoped that other cities recognise the positive effects of the Community Drug Problem Service. and that similar projects will be set up to expand upon the advice services currently offered at exchange centres. This would ensure that chemists and family GPs across Scotland had the professional. specialist back-up that exists in Lothian.

While the drug users themselves regularly praise the CDPS, Dr Greenwood notes that public understanding ofthe problem still lags behind. ‘It’s important that people get away from the beliefthat drug users are creatures with horns. We all have different ways of handling our worries, and the fact that these people are using drugs rather than over-eating or over-drinking shouldn’t make us treat them like aliens different to the rest ofthe world. Ifthe public can start to be more sympathetic towards them rather than rejecting them. then that’s the first step towards actually helping them. And these kids need help— they don’t need punishment.’

Further information on the CDPS is available from the Royal Edinburgh Hospital, Morningside Terrace (031 4472011 ext. 4570).

The next issue of The List will look at how HIV infection is spreading into the heterosexual community.