Thursday, 14th December 2017

Heroin Opiates

UK Opiate Usage

 

Consumption, Attitudes and Prices

There are many different estimates of the amount of opiates consumed by dependent users. Few of these can be regarded as entirely reliable, as the amounts and purities of the drug seized can vary considerably. Most of the research into opiate consumption in the UK was conducted in the mid-1980s.

Heroin

Consumption - The Literature

In 1987, Parker et al [1] reported that users consumed between 2 "bags" of heroin per day (about £10) and one gram (£60), with the majority consuming between one quarter and one half gram. Caplin & Woodward [2] in a survey of problem drug users conducted by the BBC, found that 39% of the heroin users they surveyed reported spending over £250 per week on the drug. This would have been the rough equivalent of 0.6g of heroin per day (@£60 per gram). The Institute for the study of Drug Dependence (ISDD) [3] suggested that a dependent user is likely to take one quarter gram per day, although they did not state the source from which this estimate is derived.

In 1988, Gossop et al [4] found that, for users of heroin by injection 70% used less than 0.5g per day, 19% used 0.5g-0.75g, and 11% used over 0.75g per day. Two thirds (66%) of chasers (inhalers) used under 0.5g per day, 12% used 0.5g to 0.75g, and 22% used over 0.75g per day. The same team reported in 1992 [5] that current heroin users would consume between 0.06g and 5g per day, with 23% using 1g per day or more. Parry [6] , in criticising maintenance prescribing at levels of 100mg (pharmaceutical diamorphine), suggested that daily prescription of 300-400mg would normally be needed to prevent an addict "topping up" from illicit sources, and that few users would consume more than 500-600mg per day even if free access were allowed. These quantities would be the equivalent of 0.6g-1.8g of street heroin, at 30-50% purity [7] . In an autobiographical account, Stewart [8] stated that addicts will use 'at least £20 to £60 per day (1/4g for £20)', and that some 'users can smoke 2-3 grams a day costing up to £70 each.'

Assessing the actual level of opiate dependence is fraught with difficulties, primarily concerning the perceived reliability of self-report accounts of usage, and the unknown purity levels of street drugs. Higgins et al [9] proposed that testing pupillary response to a challenge dose of methadone would provide an objective marker, as response was lowest in heroin addicts claiming the heaviest and most prolonged levels of dependent use.

Case Histories

I have examined medical reports of a number of registered heroin addicts in the course of court cases, and have noted individuals being prescribed in excess of 300mg of pharmaceutical (injectable) diamorphine per day, equivalent to the amount contained in around a gram of street heroin. Many registered addicts supplement their prescriptions with street heroin, indicating yet higher levels of use.

 

A recent case involved detailed accounts of an alleged heroin supply conspiracy in the North of England [10] . A total of 782 transactions were recorded, involving a nominal 477.45g and £17,554, over 90 regular customers plus a number of individuals whose name appeared once. The average (mean) deal size was 0.6g, with an average price paid of £22.15. Some customers would purchase small amounts on a regular basis, other customers would buy amounts varying from 0.1g to 1/8oz (3.5g) at different times, presumably according to the funds available. Presuming these records were complete, and represented the only source of heroin for the individuals concerned, the accounts provided a unique insight into the consumption and purchasing patterns of 92 heroin addicts. When all the named individuals and their total purchases were ranked in order, the results were as follows (table 1):

Table 1 - Heroin Use Percentiles

Percentile

10-day Use (g)

Daily Use (mg)

Pure Drug (mg)

Lower 5%

0.2

20

4

Lower 10%

0.3

30

6

Lower 25%

1.2

120

25

Median (50%)

2.8

280

59

Upper 25%

5.15

515

108

Upper 10%

8.95

895

188

Upper 5%

12.25

1225

257

Top 1%

26.7

2670

561