Weights and Measures

Drug users confuse us with many things, but I particularly struggle with their weights and measures, because they insist on using both metric and imperial measures, and dress it all up in confusing jargon as well. So I am indebted to friends who have given me a Tutorial, and I pass this on to you. When dealing in heroin, cocaine and Crack cocaine, the following measures apply:

28g = 1 oz , 7g = ¼ oz , 3.5g=1/8 oz, and a “teenth” (ie. 1/16 oz) should contain 1.75g, but is usually more like 1.5g {NOTE for dealers: a “Nine Bar” is 9oz (250g), and there are 4 Nine Bars to 1 kilogram (36oz)}

So, a typical £10 deal, bag, or wrap of “product” will contain 0.15-0.4g of drug (note the wide range of purity). (Also note that you cannot equate ANY amount of heroin with an “equivalent” dose of methadone for reasons of purity and the variability of individual physiology). So a typical heroin habit that costs, say, £30- £70 per day will involve doses ranging from 0.5g to 1.5g a day, which is…. errrr…. a teenth.

Cocaine and Crack: A dealer will begin with a large amount of powder cocaine, say 1 kilo, or a Nine Bar. Nine Bars of good powder cocaine cost £8000 wholesale. This can then be “re-pressed” (cut or diluted) with a pharmaceutical inert powder called Mannitol, costing £50 for 1kg. An ounce of good powder cocaine might cost £1100, but re-pressed powder cocaine might be £800. Most cocaine sold in ounces or less will have been re-pressed.

Crack cocaine is the free base of (powder) cocaine hydrochloride. “Freebase” Coke is essentially Crack that has been “washed up” (the manufacturing process) using ammonia and ends up weighing less than the original powder weight. Traditional street Crack however is a gain in weight due to the addition of bi-carb, hence the high profit for dealers. The purer the gram of coke, the more weight is returned. 1oz of powder (cost £800) can be turned into £1400 of Rocks if sold in £10 amounts. This can be injected, broken down using frightening amounts of citric, but really its designed to be smoked

Cannabis: The best value in dealing comes from buying Grass in kilos I am told – apparently you can double your money.

The Treatment Outcomes Profile

Have you heard of this? do you care? well as a GP it wont affect you much yet - but I have a sneaking suspicion that it may in the future. The "TOP" (the unfortunate clash of acronyms has clearly not bothered the NTA whose knowledge of gynaecology I would imagine is scant) is a simple new scoring tool to assess patient progress in treatment. Like the NDTMS data set, it is (at the moment) the job of your Shared Care worker to complete. So why would a GP need to know about this? well I can imagine some PCTs making the completion of these three monthly forms part of your LES, particulalrly if you are a more advanced GP who might start a patient on treatment before the Shared Care worker is involved - or you might be required to fill them in if you are supporting a patient's abstinence and the Shared Care worker has withdrawn.

But fear not, the form is easy and quick to fill in - and should provide some pragmatic and useful data on the value of treatment....Well MOST of the data is useful - but one question asks "How many "Spliffs" does the patient smoke a day!!! for Heaven's sake! are we talking Fat Ones? Four Skinners? A Camberwell Carrot??!!

I don't think that any GPs yet need to be involved in this new bureaucracy - but if you happen to be the sort of proactive, anally retentive sort who wants to know everything that is going on, then click here and you will be beamed over to the NTA documentation and you can read all about it.