Dear Dr Puff n’Stuff
A friend told me that Father Christmas was originally invented by
someone high on magic mushrooms. Is that true, or was he having me
on?
No, he’s almost right. The Father Christmas legend developed
in Victorian times from a very long tradition in various societies
of wizard-like creatures, who would appear at Christmas to reward
good children and punish bad ones. The man who first described somebody
like our modern Father Christmas was an American written who was familiar
with customs in Lapland and Siberia. It is likely that he based his
creation on the shamans or witch doctors who practiced their craft
in these icy northern regions. The regions are home to reindeers and
sledges, and also to an hallucinogenic mushroom called Amanita Muscaria,
or Fly Agaric. These mushrooms are white and red, the colour of Santa’s
uniform. When shamans eat them, they imagine themselves soaring up
through the chimneys of their huts and flying through the skies. They
bring back presents of wisdom to their people. All this is very like
Santa’s annual journey, and it appears that the shamans have
passed on to him the colour of his uniform, his reindeer and sledge,
his love of chimneys and his ability to fly.
The Father Christmas legend developed during the nineteenth century,
but it was a Coca Cola advertisement at the beginning of the twentieth
century, which first showed him in the exact garments with which we
are familiar nowadays. And you all know that Coca Cola started off
life as a throat medicine containing cocaine. Which all goes to show
that drugs are at the root of much more than you realise.
HAPPY CHRISTMAS!!.
Dear Dr Puff n’Stuff
How long do you think it will be before a THC spray is available for
personal and private use (not specifically for a medical condition)
i.e. for the non-smoker?
THC (tetrahydrocannibol) is
the active ingredient of cannabis. Taking cannabis by means of smoking
is an important cause of lung disease, both bronchitis and cancer,
although of course it is hard to work out how much is due to tobacco
and how much to cannabis. In George Harrison’s case, both probably
played a large role in his premature and uncomfortable death. It would
therefore make a lot of sense if cannabis users could take it by aerosol
spray rather than by smoking. The technology is already available,
but it is illegal to use cannabis for personal pleasure and so of
course the spray cannot be marketed.
Recently the government has permitted the development of cannabis
based medicines for use in medical trials. GW Pharmaceuticals are
currently conducting a trial of cannabis for multiple sclerosis sufferers,
using a device that sprays the drug under the tongue. Apparently this
works very well, and patients are making good progress. However, even
if the trials are successful it will be two years at lease before
cannabis is prescribed routinely by GPs. It takes that long for new
medicines to go through all the licensing procedures. There are no
plans to authorize prescription of THC for treatment of cannabis dependence.
As for when sprays become available to the general public, this depends
on when cannabis is fully legalised (if ever). Your guess is as good
as mine, but my prediction is in about ten to fifteen years. Perhaps
Father Christmas could help.
Dear Dr Puff n’Stuff
If someone is on a 100mg per day prescription of IV methadone, what
would be the ratio used to calculate the same dose of diamorphine,
bearing in mind that it could be prescribed as an alternative regime?
What are the different cost implications involved and why is it policy
to distribute diamorphine in glass ampoules as these take up most
of the cost?
Diamorphine lasts about eight hours in the body, while methadone is
effective for twenty-four hours. As they are both of similar potency,
this means you have to prescribe about three times as much diamorphine
per day as methadone. However, I usually find that someone on 100mg
IV methadone is likely to require about 400mg diamorphine to be comfortable.
This much diamorphine costs about £18 per day, or about £6,500
per year. Two 50mg methadone amps cost £4 per day, or about
£1,500 per year. In both cases dispensing charges have to be
added, which comes to about £500 a year (for daily dispensing).
In other words, the diamorphine would cost the NHS £5000 per
year more than the methadone amps. This kind of figure is not calculated
to cause delight in our finance departments.
You are right that diamorphine is much cheaper if it is dispensed
in the form of powder. 400mg costs £2.60 per day, or £950
a year; not much difference from methadone mixture. We cannot prescribe
it in this form for two reasons. Firstly, it is not guaranteed to
be sterile. Therefore if you injected it and acquired an infection,
you could rightly complain of poor medical practice. Secondly, the
Home Office does not allow it. They argue that powder is more easily
sold on than ampoules, because it can be readily cut down with other
substances. I’m not sure they are right about this, because there
is a ready market for diamorphine ampoules. Nonetheless, they are
the ones who are in charge.
If a lot of people were prescribed diamorphine, I’m sure the
government could negotiate a more reasonable price from the manufacturers.
The whole issue of diamorphine prescription is currently being reviewed
by the new National Treatment Agency, so watch this space. This could
be another request to send up the chimney to Father Christmas (he
does look quite like David Blunkett, after all).
Dr P's letters were aimed at our pre-Xmas deadline, but we thought
we'd keep his jokes in anyway.
Do you have any questions for Dr Puffn'Stuff?
is there anything about drugs or problems related to drugs that you
have always wanted to know? Well here's your chance. The good doctor
(we are keeping his real identity under wraps for reasons of confidentiality)
is waiting for your questions. Write to:
Monkey users mag
PO Box 108, Stretford M32 8FT
