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Pontifications on Poison

Being some ramblings on events associated with poisonous plants.

Thursday 21st July 2011

I said I’d be writing about an Al Jazeera English documentary today so I will; even though I haven’t seen it. I’m a long way from being the first person to write about something they haven’t seen but, generally, if it’s a theatre critic who couldn’t be bothered to go to the performance, you won’t find the admission being part of the report.

My problem is that, although, like a lot of modern broadcasts, this programme is being repeated about half a dozen times over a week, none of those times is when Al Jazeera is available on Freeview so I can’t see it. (They laughed when I said I wouldn’t have Sky because I didn’t like Rupert Murdoch but it’s looking like a better viewpoint, now.)

Fortunately, however, the Al Jazeera website has a reasonably detailed summary of the programme’s contents that should, I hope, provide enough of a basis for this blog entry. A few days ago, I wrote about how, when the UN declared that the alkaloids found in Catha edulis were to be added to the Convention on Psychotropic Substances, some countries took that to be an indication that they should bring the whole plant into the scope of their anti-drugs legislation. The same seems to have happened with morphine, the alkaloid extracted from Papaver somniferum, the opium poppy.

Papaver somniferum, opium poppy

Morphine is one of the most effective painkillers available and has been used, since its discovery early in the 19th century to treat the pain associated with injury and illness. But as the article on ‘Freedom from Pain’ says  ‘more than half the world's countries have little to no access to morphine’. Even before the isolation of morphine, the power of opium, the complex latex found in the seed capsule of the plant, to act as a narcotic and pain reliever was well known. The popular picture of Chinese opium ‘fiends’ is something of a misrepresentation. In 18th and 19th century China there was only about one qualified medical practitioner for every 100,000 people so for many people the only way to deal with pain was to self-medicate with opium.

The problem with opium and morphine, and for that matter diamorphine, the stronger substance produced from morphine and better known as heroin, is that uncontrolled use can lead to addiction. Even in the UK, before the increase in ‘recreational use’ from the 1960s on, the principal route to heroin addiction was via long-term use of morphine to control chronic pain.

The Al Jazeera programme looked at countries where fear of an inability to control morphine use or an over-zealous interpretation of the requirements of the various UN conventions has resulted in stories of people suffering great pain and hardship because they cannot access medication. It quotes a representative of Human Rights Watch who points out that some people are treated worse than the victims of torture because the pain of torture tends to come to an end once the torturer has the confession or information he wants. But, for people in chronic pain, their governments refuse to take action to help them.

Though the morphine used in hospitals is obtained from the same species of plant that provides street heroin, the actual plants used to produce the two are different. That is to say that Papaver somniferum, when grown as a crop, is intended either to produce morphine for legitimate purposes or to produce heroin. In the middle years of the last decade this created a bizarre situation. Because not enough farmers were growing opium poppies, there was a long-running shortage of morphine and, more particularly, diamorphine. This was happening at the same time as the UNODC was reporting that Afghanistan was producing around 30% more opium than that required to meet the estimated world demand for street heroin.

Papaver somniferum, opium poppy

At around this time, I heard a number of stories, from both medical professionals and patients and their families, about courses of cancer treatment being delayed because the supply of morphine or diamorphine could not be assured. But the most bizarre story was told to me by a hospital pharmacist. She said that doctors became so used to finding treatment plans based on painkillers other than diamorphine that, when she succeeded in obtaining some, there was no call for it and it had to be scrapped after going out of date.

Of course, because street heroin is produced in less than ideal conditions there can be no question of using seized drugs as a means of alleviating shortages in hospitals and, as I set out in one of the chapters of ‘Is That Cat Dead?’, there are compelling reasons why purchasing the opium crop from illegal farmers is not sensible. So, while the present UN policy on drugs remains unchanged, there is no way to ensure that those who need it can have access to morphine and diamorphine.

For the programme, UNODC Executive Director, Uri Fedotov, said that he accepts that the war on drugs is cutting people off from pain medication but had little to offer as a solution.  In wars there are always innocent bystanders who suffer. With the war on drugs, those innocents are people whose only ‘crime’ is to have become ill.