Observations on addiction

Experts on addiction, including senior police officers, are warning that we could be on the verge of an epidemic of a particularly grim drug, one that is highly addictive and can lead to psychosis, loss of teeth and an increased risk of heart disease and strokes.

You've seen the drug education posters showing the progressive decline of a pretty 20-year-old girl into a skull-faced fiend? This dramatic descent is typical of the effects of methamphetamine - or "crystal meth", "crank", or "ice", to give it three of its street names.

Methamphetamine is an extraordinarily powerful stimulant that has had a devastating impact in North America, South Africa, Australia and south-east Asia. Often, it emerges in one social group, such as the gay community or biker gangs, but then its use spreads with bewildering pace.

Hamid Ghodse, president of the United Nations International Narcotics Control Board, is unequivocal on the subject. "If I want to pick on one major drug problem pandemic today," he says, "it is methamphetamine."

In Britain, only about 20 laboratories have been uncovered so far. However, the police think we may be on the cusp of an explosion in use. Detective Sergeant Andy Waite recently told Radio 5 Live: "We are effectively at the point Australia was in 1998 . . . in four years it could be as big a problem here as crack cocaine."

Meth is made from a cocktail of nasty, often toxic, chemicals (red phosphorus, iodine, ephedrine). It is "cooked up" in kitchens and outhouses, often in poor, rural areas, forming into "crystals" that are usually smoked in a pipe, although it can be injected or taken in pill form. Despite its grim origins, the "high" appears to be like no other, a tremendous sense of superiority combined with an immense rush of euphoria.

Lee, a 42-year-old composer from New York, describes the effects. "It gave me a sense of power. It made me feel sexual. It was like all the switches in my body and my brain felt like they finally got turned on."

Unlike crack, the high does not diminish rapidly but is maintained for seven to ten hours. Users often stay awake for five days at a stretch, barely eating or drinking. It costs £50 a gram, about the same as heroin. Where methamphetamine use is rife, there is substantial addiction-related crime.

John Marsden, of the Institute of Psychiatry, wrote the report on methamphetamine for the government's Advisory Council on the Misuse of Drugs. "Meth has a very high dependence liability," he says. "After prolonged use, the euphoria disappears - there are many cases of stimulant psychosis revealed by anxiety, extreme paranoia and violence."

Dr Marsden feels that the police are containing the problem but that the labs in Holland which supply much of Britain's Ecstasy could switch to methamphetamine production easily. If they did, Britain could be "very vulnerable".

The US has the biggest problem of any country. In 2006, there were an estimated 731,000 users, all prey to the serious social costs of methamphetamine use, including risky sexual behaviour. A recent rise in HIV/Aids among gay men in the US has been attributed to its use.

Unlike heroin, there is no effective substitute treatment for the drug. Relapse is common. Longer-term users often develop "meth mouth" where their lips are covered in sores and their teeth fall out. "Meth kids" are easily spotted - they show the usual signs of parental neglect but also have burns on their feet because of corrosive chemicals left around by their addicted parents.

About half the users are women (only 30 per cent of heroin and cocaine users are female), many attracted by its weight-loss properties.

But Sebastian Saville, director of the drugs helpline Release, believes there is no reason yet to be too worried: "Release has had very few calls from meth users. Ecstasy is still very cheap here so there isn't a gap in the market. Often meth use in other countries takes off in rural areas where there is limited access to Ecstasy, heroin or coke. In Britain, people can get most drugs anywhere."

So, should we be worried? The chemicals and instructions for manufacturing crystal meth are easily obtained from the internet. Drug problems in the US have in the past always crossed the Atlantic. In the mid-1980s, there was a huge increase in crack in the US, whose police authorities warned Britain to be ready for the same. For a while, it didn't happen. The government now estimates we have nearly 60,000 crack users.

John Reid, when home secretary, reclassified crystal meth from B to A in January 2007, and regulations controlling the precursors used to make the drug have been strengthened. But there is no government programme warning of the dangers of meth, although the Home Office drug advice website gives some information.

A Home Office spokesperson says: "The latest evidence from the Association of Chief Police Officers [Acpo] shows that the current prevalence of methamphetamine remains low, but we take this issue seriously and are not complacent.

"Acpo continues to monitor the extent of methamphetamine in the UK and we are working with them to ensure that we have an appropriate response as the intelligence and evidence develops. In addition, we are already taking a number of preventative steps as part of our efforts to tackle drug use and associated crime."

But even if the government appears alive to the issues, it risks finding itself largely helpless in the face of a huge increase in the use of this deadly drug.

A report at the end of last month from the drug dependency charity Addaction calculated that Britain's Class A drug addiction problem costs the nation around £16.4bn a year, more than one and a half times the cost of holding the Olympic Games in 2012.

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