| Joergen
Kjaer
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UKHRA
wrote to the Danish Authorities in support of Joergen Kjaer a leading
drug user activist who was arrested and charged with possession of heroin
that he was holding for friends and fellow activists when setting off
for an annual gathering/holiday.
Unfortunately
the letter only had limited impact and Joergen was sentenced to 14months
in prison - with a probable release date of June 2005.
I am writing on behalf
of the UK Harm Reduction Alliance, an organisation that is concerned with
the provision of public health-based drug policy.
It is our understanding that Joergen Kjaer has been charged with an offence
connected with the possession of 170 grammes of heroin.
We believe that regulations
to control the use of drugs are a necessary requirement for any national
government. Drugs such as heroin have the potential to cause harm and
their unregulated availability is likely to result in harm to public health
and can contribute to public disorder. Conversely, many drugs that are
prohibited within the international conventions of 1961, 1971 and 1988
and corresponding national legislation also have some role to play within
medical treatment and care.
Diamorphine (heroin) is no exception. Beyond its widely accepted medical
use as an analgesic for pain control and within palliative treatment of
the terminally ill, it is also used within the treatment of heroin dependence
(for a detailed review see Stimson and Metrebian 2003[1]
).
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People with heroin dependence who are reliant on 'street' heroin are exposed
to risk in several ways: impurities and contaminants can be injurious
to health (for example the series of deaths from Clostridium Novyii in
a contaminated batch of street heroin in Scotland during 2000[2]
), variations in supply increase the risk of overdose due to the unpredictability
of its strength, the dependent heroin user's reliance on irregular supplies
can contribute to public disorder and generate street drug dealing scenes
that are widely regarded as undesirable and, the lack of a regular supply
can hinder the social reintegration of a proportion of people with dependence
- typically those with more entrenched addiction problems.
There is an international body of medical and other evidence (see Stimson
and Metrebian) to show that in some circumstances, alongside other treatment
such as methadone prescribing, diamorphine prescribing can reduce these
problems, with medical prescribing programmes now operating in the UK,
Switzerland and the Netherlands and further programmes proposed or taking
place in Germany, France, Belgium, Spain, and Canada. Increasingly, governmental
bodies such as the National Treatment Agency for England advocate the
targeted use of injectable heroin prescribing treatment[3]
.
Without questioning the essential legal basis of any charges, we have
strong reason to believe that those against Joergen Kjaer should be interpreted
in the context of a quasi-medical supply programme that aims to reduce
harm among a group of long-term dependent heroin users. We believe that
this is a qualitatively different situation to that of people who supply
heroin for gain and that this should be taken into account in any consideration
of his case.
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Joergen Kjaer is known to us as an international public health and drug
user activist. In his role as President of the Danish Drug Users' Union
we are familiar with his work, undertaken since at least 1993, which promotes
the availability and use of drug treatment programmes and harm reduction
work to prevent life-threatening blood-borne infections such as HIV/AIDS
and hepatitis C. These are not the activities of a stereotypical drug
dealer and mark Joergen out from many other people who might ordinarily
appear before the judiciary.
It is our belief that Joergen's activity can reasonably be understood
as those of someone who is providing a quasi-medical supply, with the
primary aim of reducing harm, rather than personal, material gain. In
the absence of readily-available, government-sanctioned diamorphine prescribing,
someone who attempts to provide a consistent supply of pharmaceutical
quality diamorphine at (or near to) cost, to a selected group of chronically
dependent heroin users may reasonably be seen in this light. Our view
is reinforced by evidence and direct knowledge we have of efforts that
Joergen has made to assist English dependent heroin users to obtain appropriate,
corresponding medically prescribed diamorphine treatment here in the UK.
In this respect, we believe that Joergen's activities can be interpreted
as paralleling those of medical marijuana charities that seek to enable
people with chronic illnesses such as multiple sclerosis to obtain proscribed
treatments that nevertheless benefit their health and well-being; even
though these activities may appear paradoxical to many observers.
Without contesting whether a crime has been committed, we urge you to
consider our submission within your deliberations over this case and in
determining what should be a just outcome.
Neil Hunt - Director, UK Harm Reduction Alliance; Senior Research Associate,
University of Kent; Honorary Research Fellow, Imperial College, London
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[1]Stimson G and Metrebian M (2003) Prescribing heroin what is the
evidence? Joseph Rowntree Foundation.
[2] McGuigan CC, Penrice
GM, Black M et al. (2002) Outbreak of infection
with Clostridium novyi and other sporulating bacteria in Scottish injecting
drug users. J Med Microbiol ; 51: 971977.
[3] National Treatment
Agency for Substance Misuse (2003) Injectable heroin
(and injectable methadone): potential roles in treatment. London: NTA.
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