Professor John Henry is Britain’s foremost expert on the medical effects of illegal drug use. In this interview with MercatorNet he predicts that young drug users will have a tough time in their old age — if, of course, they live that long. Professor Henry, a toxicologist, is Professor of Accident and Emergency Medicine at St. Mary’s Medical School in London.
MercatorNet: You have said that London has become the drug capital of Europe, especially for cocaine. How could this have been prevented?
John Henry: Cocaine is now the drug of choice for dealers because the financial rewards are so high. Drug dealers are ruthless and tough; they aim for profits and target specific groups of individuals for their sales tactics. How could it have been prevented? By better education of the public, especially the young. Also, firmer Government policies, could have led to stronger policing and Customs activity in recent years. The result is that in Europe, we are now leaders for cocaine, leaders for heroin, and third for ecstasy after the Czech Republic and the Republic of Ireland.
The tide is already well advanced and it is correspondingly more difficult to turn it back now. But we can’t just give in at this stage, because then there would be worse to come. Decriminalisation or legalization may regulate sales, but will not get rid of the social or health problems.
MercatorNet: Is illegal drug use having an impact upon emergency department visits? Are Britons less healthy than they were 30 years ago because of drugs?
John Henry: Illegal drug use is having a marked impact on emergency departments. We frequently see people with cocaine induced chest pain, as well as cases of stroke and heart attacks – in the United States, around a quarter of all heart attacks in people under 45 are due to cocaine, and ten per cent of all babies die in the womb due to cocaine, and Britain is set to follow. Heroin users are brought in due to overdosing or else because of the infectious complications of intravenous drug use. Cannabis users develop collapsed lungs because they have been damaged through smoking; they can also attend with acute psychological disturbances.
Long term problems from drug use mainly affect the mental health services, though serious medical complications are also going to be more frequent. A large number of individuals are less healthy than they were 30 years ago because of drugs, but there is more to come.
MercatorNet: Do you think Britain’s “harm prevention” policies are mistaken?
John Henry: In Britain, the term “prevention” usually means harm reduction for users. It is clearly important to minimize harm in drug users, but this is simply secondary prevention – stopping further damage in those who use drugs already. You rarely hear mention of primary prevention of drug use, though we know that it works in the field of tobacco smoking. In the United States, the Government’s website has a three-pronged approach to tackling drug misuse – one is to prevent people from ever using substances in the first place, the second is to treat people who are addicted, and the third is to control the supply of drugs. We in Britain could learn from this.
MercatorNet: You have said that the permanent lifetime loss of mental ability among so many young people could match the current burden of Alzheimers. Isn’t that a bit extreme? If we fast-forward 30 years, what do you see?
John Henry: Thirty years from now, many people will have reduced memory abilities because they used ecstasy. These changes are permanent, and in these people the natural decline in memory that starts to occur in middle age is likely to be much more marked. Depression, which also becomes commoner with increasing age, is very likely to be more severe and less easy to treat in those who have used ecstasy. Cocaine also gradually reduces brain power because the surges in blood pressure lead to brain cells being starved of oxygen. Present and past cannabis users will have a higher incidence of schizophrenia and depression 30 years from now.
So we can only look forward to a range of different problems in a large number of people as drug use increases and time goes by. At present the numbers of regular and occasional users are rising year on year, though the money turned over is not, because drug prices are falling.
MercatorNet: You have claimed that Britons are in denial about their country’s drug problem. Why do you say that?
John Henry: Denial means saying there is no cause for concern and nothing to worry about – when all the time there is a real problem. In Britain, the image that very many people have of drug taking is that it is “cool” and fashionable. Most people consider that taking drugs is a matter of personal freedom, a lifestyle choice and that there is no down side because drugs are mild and relatively harmless. Denial also means thinking that problems from drug use always happen to other people – sometimes that illusion is sadly shattered.
Well, the truth is that drugs present a real problem – for individuals and for society. People and families suffer from the medical and social effects. Many people lose their livelihoods and their health and sometimes their lives; over half of all recorded crimes in the United Kingdom are drug related.
MercatorNet: Is there a sequence in drug use amongst young people?
John Henry: There is a definite sequence in drug use among young people, which may vary from place to place. In general, they start with alcohol and go on to smoking tobacco. Many children also try volatile substances for a while (inhaling butane or sniffing vapor from glues or aerosols). After this they may take cannabis, then ecstasy. And then one of the other fashionable substances such as ketamine or GHB or amphetamines, followed by cocaine or heroin.
There are two main problems about this sequence of use. The first is that the more substances that young people try, the more likely they are to take one of the more addictive substances and end up with the drug taking control of their life. And the second is the younger they are when they start, the more likely they are to end up as problem drug users.
MercatorNet: Do you think that a bit of experimentation with cannabis can be harmful? It seems that many politicians have done it, doesn’t it?
John Henry: Many people try drugs once or twice and come to no harm. It is also true that many people tried cannabis when it was a much milder substance than it is now, but they often have little idea of what it is like these days. The concentration of the active ingredient THC was probably tenfold lower in those days, and smoking cannabis was less likely to cause any harm. Nowadays, regular cannabis smokers have difficulty in focusing on their daily activities and getting on with their life precisely because they get a greater dose when they smoke. The chance of becoming addicted to cannabis is higher (about ten per cent of people who try it become addicted) and the risks of mental illness are also greater.
Another way of looking at this question is that in the past, cannabis was used as a mild relaxing substance, while nowadays it is used much more as a drug, with people taking cannabis in order to get stoned – rather like the change in attitudes to alcohol. In years gone by, people generally used alcohol as a means of socializing and relaxing, while now many younger people have taken to using alcohol as a drug, aiming to get very drunk within a short space of time – the so-called “binge drinking” culture, which has high risks for accidents, sexual encounters and health problems.
MercatorNet: You have often pointed out that there is evidence that so-called soft drugs like ecstasy and cannabis can cause long-term physical and mental damage. Why isn’t the message getting across to young people?
John Henry: Apart from occasional dramatic stories, the media say little about the harmful effects of drugs. Also this message is not getting across to young people because the effects produced are often not apparent to the user. The memory problems caused by ecstasy are mild and gradual and not immediately obvious.
Cannabis users tend to claim that they have no problems, while their friends and family notice their change in behaviour and attitudes. Families frequently phone me and ask what can they do about their son or daughter whose whole life has been changed since they started using cannabis. At that stage, it is up to the individual to admit they have a problem and recognize what is causing it, but often they simply do not want to stop, even though they know the answer.
Michael Cook is editor of MercatorNet. He writes from Melbourne.