Is this the answer to addiction?

 

The winds were wild that day. They whipped round the farmhouse and thrashed the lowland conifers this way and that, bending them to near breaking point. It was like some grim metaphor for what had been going on all week inside the building.

Lower Johnshill Farm stands up a farm track well back from the road in the dour countryside somewhere to the south of Glasgow. Nearby lies a golf course and an old people’s home as big as a small town. To the side huge pylons carrying thick electricity cables bisect the length of the small valley. Only a Glaswegian could have dubbed it “beautiful Lanarkshire countryside”.

This unlikely setting had more to commend it, however, than a dubious rural idyll. Inside the house, not far from the town of Lesmahagow, two trials have just been held into a revolutionary new treatment which claims, astonishingly, to be able to remove the cravings of heroin addicts in a matter of mere days.

If it works as billed, it could, at last, be a cure for the epidemic of drug addiction – cocaine addiction has tripled in the last ten years and heroin has quadrupled in the last fifteen – which is spreading with alarming speed throughout the developed world. And Scotland was the place to try it out because it now has more drug addicts per head of population than anywhere else in the world.

The farmhouse interior was unremarkable. Inside the living room were three large sofas, set  around an unlit open fire. “No admittance. Closed session,” said a note on the glass of the door to the room, inside which a group of women sat in animated conversation.

On the walls were stuck notes, in varying sizes, which gave a clue to what was going on. “The harder we suffer, the better we recover,” one said. “I will live through this day only and not tackle my whole life’s problems at once,” said another. “Life is 2 good to waste.” “If you’re going through hell, keep on going – Winston Churchill”. “Don’t feed into negative thoughts”. “The best is yet to come 🙂 .”

It looked like pretty standard rehab stuff. But the largest, by the fireplace, was more intriguing. “Methadone is a crutch to the vulnerable,” it said. For this pilot trial is turning upside down much of the conventional wisdom about the chemistry of addiction.

They broke for lunch and invited me in. I glanced surreptitiously around the group. It was clear enough who was being treated and who were the therapists. The women, most of whom had taken their final fix just five days before, were gaunt. They appeared tired and weak. Yet they were not the focus of attention. Their eyes, like the clinicians, nurses and drug rehab experts, were on a tall broad-shouldered 24-year-old young man with spiky hair and a broad grin who was serving the soup.

Barry Phillips underwent the same treatment that the six women were experiencing exactly a year ago to the day. After five years on heroin, and four previous attempts to kick the devil’s dandruff, as he called it, he is now free of the habit – and of all cravings to return to it.

His unsuccessful attempts included the standard detox treatments of methadone, dyhydracodeine, valium plus the “cold turkey” of stopping the drug without taking anything at all to cushion his withdrawal symptoms. His successful attempt involved the little black box which the six recovering addicts were wearing, from which two leads projected, running to two electrodes taped behind the women’s ears.  To the unsuspecting eye it looked only as if a they were using ipods.

In fact they were wearing the latest version of a device pioneered by a Scottish surgeon, Dr Meg Patterson. Working in a leading hospital in Hong Kong in the early Seventies, she discovered that low pulses of electricity used by Chinese surgeons, as a form of electro-acupuncture to control pain during surgery, had an extraordinary side-effect. They removed all cravings for drugs from the opium addicts who constituted around one in six of the hospital’s patients.

Over the 30 years that followed she, and later her family, worked on a succession of prototypes of the device which was now on trial in the sequestered Lanarkshire farmhouse. NeuroElectric Therapy, she hypothesised, stimulates the brain to resume production of the natural endorphins which drug-use kills off . In the early years she used it treat rock stars including Eric Clapton, Keith Richards, Pete Townshend and Boy George all of whom kicked their heroin habit with her help.

But the treatment has never met with the approval of the scientific establishment. The Lesmahagow trial, run by Dr Patterson’s children, and funded by a Scottish drugs charity, could change all that.

What NET claims is that, by using the pocket-sized stimulator continuously for six to 10 days the acute pains suffered by addicts during cold turkey are drastically reduced. NET’s chief clinician, the inventor’s son Lorne Patterson, a psychiatric nurse, says it provides withdrawal relief of between 50-75 per cent for most patients. A minority experience between 75-95 per cent relief as the current passes through self-adhesive electrodes applied behind each ear and the brain heals itself.

More than that, he says, 95 per cent of patients finish the treatment with no craving for the drug.

“I was sceptical,” Barry told the six women, “but I knew that rock stars had tried it so I decided to give it a go. I wouldn’t say it was easy, but it was easier than any detox I’d tried before.” Barry signed up to try out the new treatment with every hour being chronicled for a fly-on-the-wall TV programme, Coming Clean, made by the BAFTA-winning director Norman Stone. “On cold turkey I’d lasted no more than 24 hours. In the first few days I could still see clearly in front of me a spoon, a needle and a bag of heroin and that’s all I wanted to do. But as the days went on, that picture faded. By the end the cravings had gone. And they have never returned.”

It was exactly a year to the day that he had had his last fix. The six women had baked him a cake to celebrate his re-birthday. “I’m strong now,” he said simply. “But without NET I’d be a member of the living dead.”

But would the Lesmahagow trial back his claims?

 

***

Things were already looking mixed. The week before six male addicts had been subjected to the programme. Two were kicked out for bringing drugs into the farmhouse and using them while on the NET machine. Two had walked out before the end of the trial, though there was to be an intriguing development with both of them. And two had completed the course and left saying that they were free of cravings and intended to stay clean.

The second week of the trial was already looking better. A tougher regime had been imposed upon the women. They were searched as they entered the house and their money, lighters and mobile phones were all confiscated. “This isn’t a pain-free-ticket out of addiction,” said Lorne Patterson , “though it does help cushion the more acute symptoms of cold turkey – the sweats, twitches and cramps; the restlessness, anxiety and mood swings; and the lack of sleep. Most people have tried other ways before they come to us. They have the yardstick of cold turkey.”

So it was with the six women. Margaret, 22, from Ayr, had been on heroin since she was 15 when she went to visit a friend and the girl’s mother – a dealer – gave her daughter and Margaret free heroin for a week, until they were hooked and became customers. She had been on the drug for seven years, and had tried various ways of coming off, in vain. She had even had two Notrexone implants – at £2,000 each – implanted by the doctor who treated the Babyshambles singer Pete Doherty. Five days earlier she had her last hit – 0.5gm of heroin – and the next day she had put on Lorne Patterson’s NET machine.

“The first day was quite easy,” she recalled, “but in the night vomiting and sweating set in along with shaking, twitching, runny nose and eyes and mind running wild. It was a pretty grim night. Every night has been grim until last night when I slept a bit.

“But it has got better day by day. On Day 2 the rattle [addicts slang for withdrawal symptoms] set in for one hour and then I was fine for two hours. Slowly things got better. Now I’ve had no cramps for two days.  I got unplugged from the machine yesterday. I felt fine. I’ve thought about heroin but not craved it. I’d say it’s worked for me.”

The others all, with varying degrees of conviction, agree. “I’ve had all the symptoms of cold turkey,” said Laura, 27, a law student, “ but it’s a lot quicker. I haven’t had any cravings for two days. I haven’t even thought about heroin.”

Not that it has been easy. “I got a bit of sleep the first night,” says Liz, also 27, a mother of three children, who had been on heroin for 10 years, “but on the second night I started hallucinating. I was so distressed that I packed my case to leave but there was no transport. They’d taken my mobile off me so I couldn’t get hold of my family. But by the next morning I felt better. I’ve had six previous detoxes and I knew that by that point cold turkey would have had me wrapped round in a ball on the floor. And I was feeling better. Jack McConnell saw me on my worst day. I’d like him to see me now.”

Jack McConnell is Scotland’s First Minister. Disturbed at the apparent failure of the nation’s anti-heroin strategy – which relied on replacing heroin with methadone, which can be taken orally, thus avoiding the problems associated with needle-use – Scotland’s premier visited the farmhouse pilot on its second day. He has asked his officials to review the methadone programme and investigate the electro therapy.

He is not the only one intrigued by the possibility that a cure has been found for heroin addiction. The Inspector of Prisons in Scotland, Andrew McLelland, visited the farmhouse in person and the Governor of Edinburgh Prison sent tow observers to the pilot. So did Phoenix Futures, the largest provider of rehab services in the UK.  So did a team from the Centre for Drug Misuse Research at Glasgow University led by Professor Neil McKeganey. NeuroElectric Therapy is beginning to look like an idea whose time has come.

 

***

 

It has been a long time arriving. It was in the 1970s that Meg Paterson and her anti-addiction machine was used to treat its first celebrity patient, Eric Clapton. Pete Townshend, Keith Richards and Boy George all followed. Given such high profile clients, several of whom publicly endorsed NET over the years, how was it that the world did not beat a path to Dr Patterson’s door?

A number of factors combined to keep NeuroElectric Therapy in relative obscurity. The first was medical suspicion of the exotic Chinese business of acupuncture, a practice which Western science has only relatively recently accepted as effective, struggling, as it does, to explain how it can work. The second was that NET’s inventor, though a distinguished surgeon, was not a psychiatrist; she was operating outside her accepted field of expertise.

Moreover, the work she was pioneering was enormously complex. In seven years of work with 186 patients she used the machine to successfully treat a wide range of addictive drugs: heroin, opium, amphetamines, benzodiazepines, cocaine, crack cocaine, methadone, nicotine and alcohol – all of them requiring the machine to operate on different frequencies and wave shapes.

And though the success rates she reported were phenomenal – with 95 per cent of patients claiming they were free of craving, 75 per cent that they were free of anxiety and a drop-out rate of just 1.6 per cent over a period of seven years – she was unable to explain exactly how the treatment worked. Her theory that the pulses stimulated the production of endorphins which repeated use of drugs had suppressed was only a hypothesis.

She was also battling against a scientific and medical culture whose paradigm is essentially pharmacological. Though physicians used aspirin for over a hundred years before they knew about prostaglandins, they were not to be that easily persuaded to allow electricity to be pulsed into a patient’s head – even if it was the barely-perceptible pulse from a 9 volt battery which is a thousand times more gentle than the current used in electro-convulsive shock therapy, which remains medically approved.

“Electro-therapy is voodoo,” says Lorne Patterson and drug companies, teaching hospitals, and universities all share that assumption. Suggestions from his mother’s initial studies that NET was considerably less effective if it was used in conjunction with heroin-substitutes like methadone doubly alarmed them – and the large pharmaceutical companies, in whose gift were so many research grants and who stood to lose billions of dollars a year if daily doses of methadone were to be replaced by a one-off treatment powered by a £3 battery.

When Dr Patterson applied for official funding she was refused it, though the medical research council told her it would be interested to see the results if she could finance proper clinical trials herself.

She did try. Celebrities like The Who guitarist Pete Townshend put up some cash for her to open a drug treatment clinic London.  But the amounts needed were too large. And things were not helped when Meg Paterson – no businesswoman – struck up partnerships with dubious characters whose shady  business practises and legal wranglings inflicted a substantial amount of damage to her work. Dr Patterson died in 2002 without seeing her discovery applied more widely to treat addicts, though her obituary in the British Medical Journal decided that her contribution to curative addiction treatments was so significant that she ought to have been awarded the Nobel Prize.

Her family persisted, raising $3m for yet another generation of prototypes.  They tried, too, to organise the kind of clinical trials the scientific community would find convincing. In 1992 they set up a randomised double blind trial at the University of Pennsylvania in Philadelphia, with two groups of patients, one receiving NET, the other receiving a dummy box, and with neither the individuals nor the researchers knowing who got which to rule out the possibility of NET’s efficacy being caused by a placebo effect.

It did not succeed. If one group had had a box that made the skin tingle, and the other a box that produced no sensation, then it would have been apparent to everyone who was getting the placebo. So the dummy group was given a box set at the wrong frequency but whose low 0.2mA of current appeared to be enough to provide a degree of active treatment. In both groups 88 per cent of the detoxes were successful.

This latest pilot study at Lesmahagow was funded by a small Glasgow charity, The Third Step, in an attempt to break the scientific deadlock. There has been another key development. The new push is being masterminded not by Dr Patterson’s medic children – Lorne, the psychiatric nurse, Sean, a professor of neurophysiology, or Myrrh, a nursing student – but by Myrrh’s husband, Joe Winston, who is an American businessman.

Winston has digitised the old NET machine with its 40,000 possible combinations of currents, frequencies and wave patterns – which required six months supervised clinical training to use. The digitised box – the size of a pack of playing cards – has a computer coded key for each of the main drugs. It is far simpler to use clinically. Pilot projects like the one at Lesmahagow are now underway with the 50 prototype boxes now in existence in Australia, Romania, the Ukraine and the United States where a trial with 108 patients has just finished in Kentucky.

There are sceptics to be convinced. Dr Laurence Gruer is the director of public health

science for the NHS in Scotland. Until recently he was the drugs co-ordinator for Greater Glasgow and a member of the UK’s government’s key advisory body on drug misuse. Drug addiction works on two levels, he says. It affects the chemistry of the brain, influencing motivation, memory and the sense of well-being. But it also creates a mass of powerful memories and cues to learned behaviour.

“If we have got used to coping with stress by using a certain drug then stress will prompt us to reach for that drug again,” he says. “There’s a fairly profound programming of the brain in addition to the chemical process. Because the brain runs on electrical impulses it is possible, even plausible, that NET might be capable of operating at that level in the short term. (That would tie in with the whole idea of how acupuncture works, by stimulating the production and release of endorphins that overcome the pain, though it is still a bit vague exactly how that would work.) But can it help deal with the deeper alterations in brain chemistry and psychological conditioning?”

The experience of at least two of the women on the trial suggests that the answer to that question might be Yes.

 

***

There were two people missing from the group as lunch began.  They returned soon after, a woman with lank black hair, hollow cheeks and a drained air who looked a deal older than her 35 years, and a lithe man with a crew cut and an air of jaunty self-confidence. He was Joe Winston, Dr Meg Patterson’s son-in-law and the man responsible for the resurgence of NeuroElectric Therapy. They had spent the morning in court.

“Cecilia did it,” he announced cheerily. The woman smiled wanly. A hubbub of congratulation suddenly surrounded her.

Winston had that morning offered to accompany one of the six women on the NET trial to court where she was to fight a custody battle. Her opponent was her own father who had been caring for her five-year-old son for the latter part of the 15 years during which she had been enslaved by heroin. “I was going to tell the court that Cecilia was doing well on the treatment, that her cravings had disappeared, and that she was now on the way to recovery,” he said privately afterwards. “But it didn’t quite go as I’d anticipated.”

Before the hearing began Cecilia had approached her father outside the court and appealed for him to drop the case. Her father’s response set out the long strained history of failed parenting and broken promises of his daughter. “I got up to all kinds of dodges and dishonesty; you don’t want to know,” Cecilia later told me.

The encounter had made the buoyant American pause. “I told her: ‘Your Dad has a point. You have let him and your son down too many times before’,” Winston said. “ ‘Even if NET has removed your cravings you still have those relationships to rebuild, which is a much longer, slower business. You have to go round and cook tea every night and put your son to bed; you have to earn your way back into you Dad’s trust and your son’s. You have to show that you have become reliable’.

“And then I persuaded her Dad to postpone his custody application to give Cecilia chance to do that. He was reluctant at first, but I suggested that he just gave her a few weeks, knowing that if she relapsed he could go back to court then. And he agreed.”

Cecilia’s case was doubly interesting. She and one of the other women, Sharon – who, at 39, was also one of the older addicts in the trial – had been off heroin for some weeks already. Both had come off cold turkey and had been heroin free for two months. But in that time the cravings had continued.

“I came off in August. But I’ve been struggling with the cravings.  So much so that I’ve had a couple of slips – I last used before Christmas. I came back off it but the cravings are always there at the back of your mind,” Cecilia said. “But I put this NET box on and within 3 days the cravings went. They have gone so completely that I took the box off yesterday and got them to reprogramme it to a frequency aimed at cannabis, because I have cravings for that too.”

Sharon told a similar story. A mother with three children she only started using heroin five years ago. “I took two drags and I was hooked,” she says. “I’ve been trying to get off it ever since. I’ve had 12 cold turkeys. I remember them all: hospital detox, home detox, methadone. I’ve had no heroin since December but I’ve been on Valium since then. The cravings have been chronic.”

But then she was put on the NET machine. “Now I’m not having any cravings at all. It’s remarkable.”

Such a result was routinely claimed by NET’s inventor, Dr Meg Paterson, who in 1984 published a study suggesting that 80 per cent of addicts (and 78 per cent of alcoholics) were completely free of cravings drug-free up to eight years after treatment. Her explanation was that once NET stimulates the normal production of endorphins, and the brain achieves a normal healthy balance, the cravings also disappear. And because the sleep pattern returns to normal far more rapidly with NET than is usual in the withdrawal of narcotics – 4 to 6 days compared with 40 to 60 days – the consequent risk of addiction to sedatives is reduced. There is also a consistent increase in optimism, in contrast to the depression which normally characterises those struggling to stay off opiates.

Many scientists are sceptical of the idea that NET reduces cravings permanently. “It sounds a bit unlikely,” says  Dr Laurence Gruer is the director of public health science for the NHS in Scotland.

“There’s been a fair amount of progress in recent years,” he adds, “in examining what goes on inside the brain through the use of new imaging techniques which allow us to see what kind of activity is going on in particular parts of the brain and how that responds to certain drugs or treatments. It shows, for example, that the brains of people addicted to cocaine are not back to normal even several months later. So it’s fairly implausible that, just by applying a low electrical current, NET could have a long-term impact. That’s not to say that it couldn’t conceivably happen. But at present the evidence seems fairly anecdotal.”

At the Centre for Drug Misuse Research in Glasgow a broader response is given by Professor Neil McKeganey who is widely acknowledged as Scotland’s foremost authority on drug abuse. “We don’t fully understand the nature of cravings, or the process by which they may be reduced,” he says.

“Psychologically, heroin addicts frequently describe their separation from the drug as resembling, but being more agonizing than, losing a husband or wife. But physiologically craving is like the feeling that you get when you need to urinate. It builds to become so strong that you focus almost entirely on the need to release the pressure. Your whole body focuses on it. It becomes a deep physical urge. For addicts the only was to resolve that is to use. Addiction is a huge magnet locking these individuals to use drugs in the face of their own witness to the damage that drugs are doing to them and to those around them.”

Prof McKeganey is already convinced of one huge advantage which NET has over drug-substitution strategies, like replacing heroin with methadone. “What the Lesmahagow pilot studies have done is bring to the forefront of many people’s minds the business of recovery.” That is a significant shift.

Over the past two decades the dangers of HIV/Aids shifted the emphasis of drug strategies away from getting users off drugs and towards minimising the risks they pose to public health more widely. “Fears of an Aids epidemic gave way to a rising concern about drug-related criminality,” says Prof McKeganey. “Both led to an approach which moved away from an emphasis on recovery to one of minimising drug users risk behaviour.”

So methadone was offered as an alternative to heroin because it removes the risks associated with needle use. Today around 20,000 of the 51,000 heroin addicts in Scotland are on methadone. But Prof McKeganey’s research – he has contact with more than 1,000 heroin addicts across Scotland whom he regularly surveys – has prompted increasing disillusion with the methadone-substitution programme which has been the backbone of the UK’s anti-heroin strategy.

“The received wisdom is that you get them off heroin and onto methadone, on which they can stay more safely for the rest of their lives. Methadone will be a lifelong response, like prescribing insulin for a diabetic,” he says. Studies from the United States suggest that Generation Grey is still on methadone they were prescribed in their 20s. We could end up with old people’s homes handing out methadone as happens in the Netherlands.

Since individuals on methadone cannot drive, operate machinery and will not be given a job by most employers this is a demoralising life sentence. Drug companies, naturally, do not object. Nor do the police who think that methadone – or legalised heroin on prescription – will reduce addicts’ need to commit crime.

“The problem is that after three years of methadone use only 3 per cent of addicts had given up drugs,” Prof McKeganey says. Worse still almost all of those on methadone also use heroin, because though methadone may reduce cravings it doesn’t provide the high that heroin does.

The cost of all this, in Scotland alone, is £100m a year. “For that we should expect more than stabilising the existing addict population,” he says. Worse than that, between 10,000 and 20,000 new addicts are becoming hooked each year. So the population of users could double or even treble within a decade. “The idea of condemning people to stay on methadone for the rest of their lives is as indefensible as it is reprehensible.”

What NeuroElectric Therapy has already done is challenge that orthodoxy. “Even the small pilot studies have crystallised the idea that there may be ways to get them off drug use entirely,” says Prof McKeganey. “Just as we see that containment is failing, here is something that can start an addict on the road to recovery.”

 

***

The atmosphere in the farmhouse had become intense and claustrophobic.  The women needed an outing, Joe Winston decided. We piled into cars and headed for New Lanark, a model village on the upper reaches of the River Clyde where the 19th century philanthropist textile mill-owner Robert Owen had, in a previous age, tried to combine a successful business with a social utopia.

With the six women, half of whom were still wearing their NET machines, was a formidable phalanx of people determined to offer them support in their first re-encounter with the outside world.

The quietest, but it emerged perhaps the most formidable, was a diminutive white haired lady named Maxie Richards. This retired primary school teacher became involved with drug addiction by making tea in a rehab centre 20 years ago. Since then she has become one of Scotland’s most experienced drug counsellors who has taken more than 1,000 addicts to live in her own home.

Next came a burly recovering alcoholic, John Mullen, whose Third Step charity had raised the £40,000 for the Lesmahagow pilots. Then there was Scott Walker, one of two workers from Phoenix Futures, the largest provider of rehab services in the UK. With them came NET’s most high-profile guinea pig, Barry Phillips, and its current driving force, the New Jersey businessman Joe Winston.

As the group toured the New Lanark village, which includes the world’s first nursery school, the talk was all of coping strategies. Barry and Scott were offering tips on how to re-establish normal sleeping patterns and how addicts needed help out of chaotic lifestyles with skills most people take for granted, such as how to keep control of a household budget.

It was not hard to see why sceptics like Dr Laurence Gruer wonder whether it is such intensive support systems that really lie behind the success of NeuroElectric Therapy rather than any physiological changes produced by electro-stimulation. “Relationships are important,” he says. Recovering addicts need a fair degree of psychological support to help them understand what their addiction has been about. “It is interesting that those better able to recover are those who, before they got addicted, had a job, were educated or had a strong relationship.”

It might be that those for whom NET works are those who were ready to come off heroin anyway – and that any alternative strategy – hypnosis, meditation, yoga, prayer or whatever – might be effective if  combined with strong support from others. “It would be pretty unusual for the person to come off if they didn’t have a high degree of motivation or were still in love with the drugs.”

Prof Neil McKeganey is open to that possibility. “If you surround someone with concerned professionals, giving affirmation, in an emotionally rich and supportive environment, that might be enough to wean them off anyway,” he says. “You can’t get answers to questions like that from this pilot. But what is impressive is how hardened addicts have become more reflective on their drug use and on where their life is going.” NET practitioners suggest that the therapy also makes addicts significantly more receptive to the  counselling or psychotherapy they need.

“But getting off drugs is not the same as staying off drugs. The hard part for any addict is re-engineering their life after detox to change the environment – maybe going out in the day and staying in at night, instead of the other way round – that is part of the magnet  effect. They need to build a non-addictive framework to their lives.”

That much became clear from a private conversation between the youngest two of the women, Rona and Margaret, as they sat down to rest while the others in the party toured the Victorian nursery school. Rona  is a middle class addict with a private school background who was first offered cocaine at an ice rink at the age of 15. When her husband left her she became a heavy user and then, ironically, was taught how to “jag” (inject) the drug by someone she met at a meeting of Cocaine Addicts Anonymous. She moved onto heroin two years ago.

“I keep trying to come off. I’ve had 20 attempts at Cold Turkey and been off it for 3 weeks, 8 weeks, 20 weeks,” the 20-year-old said. “I’ve been clean more than I’ve been dirty but the cravings don’t go away.  Being on the box has speeded up my detox.”

Two days earlier, during the trial, she had been hospitalised suddenly with liver problems. “While I was in,” she said, “I was lying in bed and I saw two canulars on a tray. As I looked at them I suddenly realized that I wasn’t thinking of stealing them. Heroin wasn’t at the front of my mind any more.

“But the craving is still a wee bit in my head. The prospect of being completely drug-free frightens me. I just want to go back to the person I was five years ago. I’d like to go back to having a few drinks and a few spliffs and just using drugs recreationally.”

Margaret nodded in agreement. “A wee bit of cannabis or drink won’t hurt you. It’s just a wee giggle. I’m pretty confident I can keep to that and stay off the heroin. I know people who have been clean for five years and yet smoke a joint and drink a pint. At our age [she’s 22] we need to have a wee bit of partying.”

Rona was pleased at the affirmation. “I want to go out deejaying again and have a couple of drinks and get back to how I was instead being a stay-at-home junkie.”

Scott Walker of Phoenix Futures listened, and kept his counsel.

 

***

It was the last day of the trial. But before their “graduation” ceremony there was one final session, chaired by Myrrh Winston.

“You six are going to be your own core support group,” she began. “You’ll be here for each other when we have gone back to the States. But there is one issue I want to get out right at the start. Two of you,” she said, nodding at Rona and Margaret, “are talking about going out partying. It’s important to get this out in the open so the group knows, so the group can hold you both up.

“Because you need to know: Pot is a drug, Eckie (ecstasy) is a drug, alcohol is a drug. And all drugs are dangerous for you, even Valium – if a doctor tries to prescribe it for you it’s up to you to tell the doctor.

“Rona, you are the least strong of the ladies here.” Rona tossed her long blonde hair and shrugged. “Your commitment isn’t as strong. You have a sick liver – you cannot drink. Margaret, if you take Rona partying you need to know that you’re going to bear some responsibility for her downfall. You’ll help her hurt herself.”

“It’s just a wee spliff,” riposted Margaret.

“Drum that idea right out of your head,” Liz told the others. “I started on cannabis. You can’t go back to it.

“The first joint will change your mindset,” said Cecilia. “It’s a slippery slope.”

“I used to smoke a joint on my way to work,” shrugged Rona. Margaret pursed her lips and stayed silent.

 

“You think I’m picking on you,” Myrrh told her. “Well, I am. Because I see danger signs. If in this group you’re not picking on each other you’re not doing the best for each other

“If people are giving you yak yak yak,” said Rona, a touch petulantly, “you’ll just stop coming. My mum doesn’t want me totally abstinent. Don’t be saying to her: ‘she canna have a joint or she’ll turn back in to a smackhead’.”

“Don’t smoke a joint,” said Myrrh. “You’re making excuses. That’s bad. You are drug-free now. You have a choice. It is your choice.”

And so it went. At the end of the meeting Maxie dished out a 2007 diary to everyone. “Let’s get the first meeting in your diaries,” she said.

 

***

Down the road, at the local hotel, Joe Winston was addressing the families of the  six women before bringing the six women into the room to be re-united with their parents, partners and children. He had discarded the casual clothes he had been wearing all week and put on a suit.

“After cold turkey it takes 4 to 6 months for the body to adapt and that gives families the time to adjust, too, to the fact that the person they love is changing. We’ve accelerated that to 4 to 6 days. You haven’t had time to adjust.

“Many of you have been put through the wringer; heroin has an amazingly destructive impact on relatives. But I need to tell you that the woman who will walk in here in a few minutes is not an addict. She is drug-free now. All six of them are. Many of you will be afraid to hope that this can be true; you have had so many hopes dashed in the past. But unless you hope and trust them they won’t be able to hope and trust in their new selves.

“It is a new person we’re going to hand to you. Of course, there are going to be issues.

Physical ailments are masked by heroin, so are emotional and psychological ones. It will be as if they had a broken arm which is now set, but still not strong. Trust them. One more time. Lift them up. Greet them eye to eye. So please welcome, drug-free, clean, Liz Wilson . . .”

It was an immensely emotionally-charged moment. Each of the six entered the room to music they had chosen. (Cecelia’s was Stayin’ Alive.)  As they were presented with a certificate and hugged each therapist and fellow former-user in turn, their families stood and applauded with tear-stained ferocity.

“I feel quite emotional,” said Laura’s mother. “When I brought her last week I hoped it was going to work but I had my doubts. The transformation is amazing. She looks much happier and healthier. She’s interacting, she’s more confident. It’s amazing, in a week.”

Behind her Cecilia’s father was hugging Joe Winston, the man with whom he had had the showdown outside court just a few days before.

“I have hope. I didn’t have any when I came here,” said Liz’s aunt. “This is the first day of the rest of their lives.”

“It’s quite remarkable how quickly it has happened. There should now be properly clinically controlled trials,” said Laura’s father, a microbiologist. “It seems very successful.”

They could now come.  Initial reports suggested that all six women were cleaned by the process, as were two of the men, and that – amazingly – the two men who had quit the trial early had made contact to say that even the incomplete treatment had curbed their cravings. All of that will be taken with a pinch of salt by the scientists. Heroin addicts are notorious liars. (“There is something about opiate addiction, more than any other, which seems to turn lying into a game,” says Joe Winston). And relapse rates are always high with heroin. But even allowing for all that the initial Lesmahagow results were impressive.

Even the sceptic Dr Laurence Gruer seemed upbeat. “The next step is that we need to see the data from the Lesmahagow trials, with at least three months follow-up, to see what the relapse rate has been.  If it suggests that the results are better than you would expect from doing nothing you could then move to a bigger trial with a statistically valid sample. If such a well-designed study was put together then one would be unwise to reject it out of hand. We shouldn’t discount it at this point in time and I hope that something positive will come out of it.”

The Scottish Prison Service has now asked the Centre for Drug Misuse Research at Glasgow University to come up with a proposal for a study involving the entire population of one Scottish prison.

“The prison system is the appropriate location to try this out,” said Professor Neil McKeganey. “At least 70 per cent of prisoners in Scottish jails are drug dependent; in one women’s prison the figure was recently 100 per cent of inmates. People become addicts in prison, or low-level uses find their use escalates there. It is a real crisis.”

His plan is to take a prison of 700 inmates in Scotland, monitor the drug use of individuals, along with their current treatments, and rates of improvement they bring over, say a six month period. He will then introduce NeuroElectric Therapy to the whole prison population and monitor the outcomes over a similar period.

“Politicians must now provide the resources necessary for such a trial,” he said. “The Royal College of Psychiatrists estimate that only a quarter of one per cent of the budget to fight drugs misuse is spent on research. We spend £12m a year on methadone. This study could be done for £200,000. Not to do it would be a scandal.”

End