Belfast Telegraph

Wednesday 23 July 2014

Doctors propose using Afghan opium as NHS pain-killer

Afghan heroin available on the NHS? It may sound far-fetched but that is what two leading doctors from the British Medical Association have put forward as a way of dealing with a shortage of the drug.

Heroin is used by doctors under its medical name diamorphine as a pain-killer for the terminally ill and after serious operations. But there is currently a severe shortage of legal diamorphine in the UK.



At the same time, British soldiers in Afghanistan are in the midst of efforts to wipe out the cultivation of opium, from which heroin is refined. Doctors have suggested a solution to both problems: use the opium to produce heroin for medicinal use.



"If we were harvesting this drug from Afghanistan rather than destroying it, we'd be benefiting the population of Afghanistan as well as helping patients," Dr Vivienne Nathanson, the BMA's head of science and ethics, told the BBC.



But the suggestion has been rejected by both the Department of Health in Britain and the Afghan government. The idea of using Afghan opium for legal medicines has been touted before by a French think-tank. But it is the first time that the proposal has been given the weight of an internationally respected medical association.



Britain is the leading Western donor to Afghanistan's efforts to wipe out opium production, which accounts for 90 per cent of the world's illegal opium. Kabul does not have a major domestic problem with opium abuse, with most being exported to Europe.



To satisfy Western demands that this supply chain is broken, Afghan farmers have had their entire crops destroyed. Other farmers who voluntarily gave up growing poppies on the promise of financial help to grow other crops say the help never materialised. Reports have emerged of farmers made destitute by the West's anti-poppy campaign, who have resorted to selling their children in order to stay financially afloat.



The targeting of the poppy fields is widely believed to be a major factor in the popularity of the Taliban insurgency in the south and east. British troops facing some of the most intense fighting are in Helmand, a major centre of poppy cultivation.



"There must be ways of harvesting it and making sure that the harvest safely reaches the drug industry which would then refine it into diamorphine," Dr Nathanson said.



Her remarks were supported by Dr Jonathan Fielden, a consultant in anaesthesia and intensive care. He said: "Over the past year the availability of diamorphine has dramatically reduced. It has got to the stage where it is almost impossible in some hospitals to get hold of this drug for use outside very specific circumstances."



But the Department of Health said the shortage of diamorphine was due to limited production capacity, not a shortage of raw opium. Western anti-narcotics agencies have rejected the suggestion of cultivating Afghan opium for medicinal use in the past, saying it is too difficult to put safeguards in place and ensure the opium conforms to international standards.



Leading NGOs still contend the best solution is long-term investment in alternative crops. The problem is little else will grow in many barren parts of Afghanistan.

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