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  • Article

Guerrilla public health

From safe-use guides to needle exchange schemes, Harry Shapiro reflects on 40 years of drug harm reduction in the UK.

  • Article

The unearthly children of science fiction’s Cold War

In the 1950s a new figure emerged in British novels, film and television: a disturbing young alien that revealed postwar society’s fear of the unruly power of teenagers.

  • Article

A story of death, trauma and austerity

Marienna Pope-Weidemann, whose teenage cousin Gaia died after going missing, advocates a rethink of our systems, which currently fail many in mental distress.

  • Article

Inhaling happiness and gasping for a high

The rapid, short-lived high we get from whippets, reefers and vapes can be accompanied by long-term health consequences. The search is on for safer ways to get stoned.

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  • Veratrum nigrum L. Melanthiaceae Distribution: Europe. Cows do not eat Veratrum species in the meadows, and human poisoning with it caused vomiting and fainting. In the 1850s it was found to reduce the heart's action and slow the pulse (Bentley, 1861, called it an 'arterial sedative'), and in 1859 it was used orally in a woman who was having convulsions due to eclampsia. Dr Paul DeLacy Baker in Alabama treated her with drops of a tincture of V. viride. She recovered. It was used thereafter, as the first choice of treatment, and, when blood pressure monitoring became possible, it was discovered that it worked by reducing the high blood pressure that occurs in eclampsia. By 1947 death rates were reduced from 30% to 5% by its use at the Boston Lying-in Hospital. It works by dilating the arteries in muscles and in the gastrointestinal circulation. A further use of Veratrum species came to light when it was noted that V. californicum - and other species - if eaten by sheep resulted in foetal malformations, in particular only having one eye. The chemical in the plant that was responsible, cyclopamine, was found to act on certain genetic pathways responsible for stem cell division in the regulation of the development of bilateral symmetry in the embryo/foetus. Synthetic analogues have been developed which act on what have come to be called the 'hedgehog signalling pathways' in stem cell division, and these 'Hedgehog inhibitors' are being introduced into medicine for the treatment of various cancers like chondrosarcoma, myelofibrosis, and advanced basal cell carcinoma. The drugs are saridegib, erismodegib and vismodegib. All the early herbals report on its ability to cause vomiting. As a herbal medicine it is Prescription Only, via a registered dentist or physician (UK Medicines and Healthcare Products Regulatory Agency (MHRA)). Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Illicium verum Hook.f. Illiciaceae Chinese Star Anise Distribution: China. Illicium anisatum Japanese Star Anise. Distribution Japan. Illicium verum is used as a spice in Asian cooking and for Star Anise tea. The distilled oil is added to cough mixture used by children. Introduced to Europe in 1588 (Pharmacographia Indica, 1890). Illicium anisatum syn. religiosum, has been confused with it (Lindley, 1838, Bentley 1861) but is poisonous and was used to make incense in Japanese and Chinese temples. It was called Skimi by Kaempfer. The seed pods of both species contain shikimic acid (the name being derived from the Japanese word for the plant - shi-kimi) from which Tamiflu, the antiviral drug was synthesised. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Veratrum album L. Melanthiaceae Distribution: Europe. Cows do not eat Veratrum species in the meadows, and human poisoning with it caused vomiting and fainting. In the 1850s it was found to reduce the heart's action and slow the pulse (Bentley, 1861, called it an 'arterial sedative'), and in 1859 it was used orally in a woman who was having convulsions due to eclampsia. Dr Paul DeLacy Baker in Alabama treated her with drops of a tincture of V. viride. She recovered. It was used thereafter, as the first choice of treatment, and when blood pressure monitoring became possible, it was discovered that it worked by reducing the high blood pressure that occurs in eclampsia. By 1947 death rates were reduced from 30% to 5% by its use at the Boston Lying in Hospital. It works by dilating the arteries in muscles and in the gastrointestinal circulation. A further use of Veratrum species came to light when it was noted that V. californicum -and other species - if eaten by sheep resulted in foetal malformations, in particular only having one eye. The chemical in the plant that was responsible, cyclopamine, was found to act on certain genetic pathways responsible for stem cell division in the regulation of the development of bilateral symmetry in the embryo/foetus. Synthetic analogues have been developed which act on what have come to be called the 'hedgehog signalling pathways' in stem cell division, and these 'Hedgehog inhibitors' are being introduced into medicine for the treatment of various cancers like chondrosarcoma, myelofibrosis, and advanced basal cell carcinoma. The drugs are saridegib, erismodegib and vismodegib. All the early herbals report on its ability to cause vomiting. As a herbal medicine it is Prescription Only, via a registered dentist or physician (UK Medicines and Healthcare Products Regulatory Agency (MHRA)). Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • Taxus baccata L. Taxaceae European Yew. Trees are feminine in Latin, so while Taxus has a masculine ending (-us), its specific name, baccata (meaning 'having fleshy berries' (Stearn, 1994)), agrees with it in gender by having a female ending ( -a). Distribution: Europe. Although regarded as poisonous since Theophrastus, Gerard and his school friends used to eat the red berries (they are technically called 'arils') without harm. Johnson clearly ate the fleshy arils and spat out the seed, which is as poisonous as the leaves. It is a source of taxol, an important chemotherapeutic agent for breast and other cancers. It was first extracted from the bark of T. brevifolia, the Pacific yew tree, in 1966. About 1,100 kg of bark produces 10 g of taxol, and 360,000 trees a year would have been required for the needs of the USA – an unsustainable amount. In 1990 a precursor of taxol was extracted from the needles of the European yew so saving the Pacific trees. It is now produced in fermentation tanks from cell cultures of Taxus. Curiously, there is a fungus, Nodulisporium sylviforme, which lives on the yew tree, that also produces taxol. Because taxol stops cell division, it is also used in the stents that are inserted to keep coronary arteries open. Here it inhibits – in a different way, but like anti-fouling paint on the bottom of ships – the overgrowth of endothelial cells that would otherwise eventually block the tube. The economic costs of anticancer drugs are significant. Paclitaxel ‘Taxol’ for breast cancer costs (2012) £246 every 3 weeks
  • Catharanthus roseus (L.)G.Don Apocynaceae. Madagascar Periwinkle Distribution: Madagascar. It is the source of vincristine and vinblastine, which impair cell multiplication by interfering with microtubule assembly, causing metaphase arrest and are effective medications for leukaemias, lymphomas and some solid tumours. The mortality from childhood leukaemia fell from 100% to 30% once it was introduced - not a drug that could ethically be tested by double-blind trials. These chemicals were initially discovered by investigators in 1958 who were looking for cures for diabetes so tested this plant which was being used in the West Indies to reduce blood sugar levels. There are 70 different alkaloids present in this plant, and some - catharanthine, leurosine sulphate, lochnerine, tetrahydroalstonine, vindoline and vindolinine - lower blood sugar levels. However, the toxicity of this plant is such that this is not a plant to try at home for diabetic management. The vincristine content of the plant is 0.0003%, so two kilograms of leaf are required to produce sufficient vincristine for a single course of treatment for a child (6gm). Fortunately it is a vigorous weed and easy to grow in the tropics. Artificial synthesis has now been achieved. Photographed in the Medicinal Garden of the Royal College of Physicians, London.
  • A father with an axe breaking through the door of a teenager's bedroom; representing a parent to whom it is difficult to talk about drugs, but who is not typical of all parents. Colour lithograph for the Drugs Infolijn, 200-.
  • A father with a chainsaw running amok in a teenage boy's bedroom; representing a parent to whom it is difficult to talk about drugs, but who is not typical of all parents. Colour lithograph for the Drugs Infolijn and the Trimbos-instituut, 200-.
  • Usage de drogues : be gay : bien être / Crips Île-de-France.
  • Usage de drogues : be gay : bien être / Crips Île-de-France.
  • Usage de drogues : be gay : bien être / Crips Île-de-France.
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