Shane Levene is a writer, artist, musician, poet. He is, some might argue, a better poet than a musician, a better artist than a poet and a better writer than an artist. However, the role that Shane Levene inhabits most fully is, undoubtedly, that of a semi-functional heroin addict.

The entries in Levene’s blog, “Memoires of a Heroinhead,” are not all about the drug. To be sure, the author often evokes a typical, if uncompromisingly realistic “Trainspotting”-esque literary snapshot– a low-rent French apartment, whitewashed walls decorated with grotesque patterns of dried blood, a man-sized receptacle for used syringes and burnt papers– but he writes about other things too: a future and a past without heroin.

The loosely organized memories, such as they may be, brings forth the most haunting pictures of the author’s life as it is, as it was and, occasionally, as it might be. The son of working class, northern English addicts– one of whom was butchered by notorious serial killer Dennis Nilsen– Levene’s childhood appears to have been almost entirely misspent. Stories of teenage youths dressing up in drag to visit Glam clubs in Soho pepper the blog’s homepage, living side by side with recounted memories of domestic abuse, murder and soul-crushing poverty.

A consummate story teller, Levene is at times brutal and jarring, at others wistful and romantic. The kind of autobiographical self-reflection, typical to the memoir genre, that usually adulterates the graphic immediacy of the narrator’s experiences, is noticeably lacking in these vignettes. Granted, some posts are significantly better than others; Levene’s writing is inconsistent and occasionally contrived. But, particularly in the case of Levene’s most recent offerings, oftentimes they are vividly beautiful and utterly beguiling. Not to mention very, very sad.

In one particularly upsetting post, the raconteur relates how some of his closest friends deliberately attempted to infect him with HIV through shared needles. In another account, Levene poignantly describes an incident in which he overhears a young girl being beaten to death in the apartment above his, but is unable to call the police for fear of them discovering his drug paraphernalia.

The rest of the blog, the parts that aren’t directly about the drugs, is filtered through the creative lens of someone who, honestly and truly, has come to terms with the fact that they are going to die– not in 30 years, but maybe next year, next month, next week, today.

Levene’s portrait of his life as an addict is bleak, his experiences routinely horrific and far removed from the world of the non-junky. Just like Christiane F. before him, Levene faithfully chronicles some of the most harrowing physical and mental consequences of his addiction.

Levene writes, “I choose the needle. We must live and die by our swords. We cannot blame our enemy for us taking up arms. That is a bitter and all consuming road to take.”

It is this stark perspective that defines Levene’s literary persona in his memoirs. Essentially, on the page, a heroin addict is who Levene is, and, as things stand, it appears that Levene’s addiction is also inherent to all he can be. Indeed, as another literary heroinhead, William S. Burroughs once wrote: “Junk is not a kick. It is a way of life.”

Image Courtesy of  Stuart Monk / Shutterstock.com

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At The Scribbs Research Institute in La Jolla, California, a team of researchers have created a vaccine that can block heroin’s effects and could provide a potential therapy for heroin addiction.

This research was carried out on animal models that responded successfully to the vaccine, demonstrating how this could have effective results also in humans.

Kim D. Janda, Jr. Chaired Professor of Chemistry and Immunology at The Scripps Research Institute, member of The Skaggs Institute for Chemical Biology, and main researcher of the study said: “In my 25 years of making drug-of-abuse vaccines, I haven’t seen such a strong immune response as I have with what we term a dynamic anti-heroin vaccine.” “It is just extremely effective. The hope is that such a protective vaccine will be an effective therapeutic option for those trying to break their addiction to heroin”.

The Scribbs Research Institute’s study was recently published on the Journal of Medicinal Chemistry of the American Chemical Society, and reported by EurekAlert!. It shows how heroin’s euphoric effects can be blocked by specific antibodies produced by the vaccine, which provoke an immune response of the organism.

When metabolized, heroin degrades into multiple psychoactive compounds each with psychotropic effects on the brain, making the previous attempts of other researchers to create an efficacious vaccine difficult and often times misleading.

“Heroin, however, presents a particularly challenging immunotherapeutic target, as it is metabolized to multiple psychoactive molecules. To reconcile this dilemma, we examined the idea of a singular vaccine with the potential to display multiple drug-like antigens, two haptens were synthesized, one heroin-like and another morphine-like in chemical structure,” wrote the authors.

Therefore, the innovation of the vaccine developed by Janda’s team consists exactly of targeting not only heroin itself but also the other compounds, such as morphine and 6-acetylmorphine (6AM), blocking all the euphoric effects that can be produced.

“Heroin is lipophilic and is rapidly degraded to 6AM, both readily cross the blood-brain barrier and gain access to the opioid receptors in the brain, explained G. Neil Stowe, a research associate in Janda’s laboratory and first author of the study.”Critically, the vaccine produces antibodies to a constantly changing drug target,” added Stowe. “Such an approach has never before been engaged with drug-of-abuse vaccines.”

“A key feature in this approach is that immunopresentation with the heroin-like hapten is thought to be immunochemically dynamic such that multiple haptens are simultaneously presented to the immune system,” explained the authors in their study.

The results seem to be very successful. The responses to the heroin vaccine of the rats subjected to the study are very encouraging. They generated strong antibodies and also showed good response regarding heroin addiction. Out of seven addicted rats that received the vaccine only three kept on self-administering heroin by pressing on a lever after several boosters. In contrast, all the control rats self-administered the drug.

“To have an animal vaccinated and not show a response to heroin is pretty amazing,” said George F. Koob, chair of the Scripps Research Committee on the Neurobiology of Addictive Disorders and co-author of the study. “We saw a very robust and specific response from this heroin vaccine. […] I think a humanized version could be of real help to those who need and want it.”

The study also demonstrates the specificity of the vaccine which produces antibody response only to heroin and 6AM, and not to other opioid drugs tested such as methadone, naloxone and naltrexone.

“The importance of this is that it indicates these vaccines could be used in combination with other heroin rehabilitation therapies,” said Janda.

The study was funded by the National Institute of Drug Abuse of the National Institutes of Health and the Skaggs Institute for Chemical Biology at Scripps Research.

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A homemade substitute for heroin called ‘krokodil’ is rotting Russian addicts to death, its uncontrolled availability causing alarm among rehabilitation centers in Russia. The drug appeared in 2002 in Siberia and the Russian Far East but heroin addicts across Russia first discovered how to make it four years ago. Its use has since spread with dangerous proportions.

Possession of the home-cooked substance is illegal in Russia and with the boost in drug control within the last couple of years, the national Federal Drug Control Service (FSKN) reportedly confiscated 65 million doses in the first three months of 2011 alone.

“As recently as five years ago, there were only one-off instances of catching this drug,” Victor Ivanov of the FSKN told Time Magazine. Since 2009, the amount has increased 23-fold.

The reason why krokodil is eating up junkies is the unimaginable mix of household items. The high comes from cooking off codeine from non-prescriptive painkillers and mixing it with gasoline, paint thinner, hydrochloric acid, iodine and red phosphorous — the latter is usually produced by scraping off the tip of matchsticks. The drug takes between 30 and 60 minutes to cook and once mixed, the caramel-colored thick substance is injected into the vein.

Unlike heroin, which may last several hours, this type of desomorphine can only sustain a high for about 60 to 90 minutes. Though, for serious addicts, the process, which often requires the user to continuously prepare and inject a new batch, is a cheap and easily obtainable alternative to heroin. The street price for heroin is estimated between £20-60 per unit while the key ingredient for the desomorphine, only costs £2 per pack — turning usage into a fast-growing epidemic.

The result is grim. An online search on ‘krokodil addiction’ reveals explicit images and videos of rotting skin, exposed bones and amputation. The acidity of the drug kills the tissue in the area where the addicts shoot up, aided by the risk of missing a vein or ‘skin popping’ (injecting a substance directly into the skin due to damaged veins) and an army of infections;  the user’s skin literally rots off the bones. Krokodil addicts will typically die within three years.

It is estimated that Russia currently has up to two million heroin users. This devastating situation has been linked to the explosion of poppy production in Afghanistan in the last decade, which the Russian government has angrily blamed on the U.S.-led war.

However, Russian authorities and other drug control agencies have in recent years made a great effort to crack down on illegal imports of opium and while the result has been a moderate success, the increased risk for traders caused the price of heroin to go up. Rehabilitation centers and addicts cited this as the main reason why krokodil use is spreading, especially across poorer areas.

According to an article by the Independent, 30,000 people are killed annually in Russia from heroin addiction, which accounts for a third of heroin related deaths worldwide. Over the last four years, krokodil is said to have addicted 100,000 people, adding to the worldwide statistics.

Victor Ivanov of FSKN spoke to the Independent about a visit to a drug-treatment centre in Western Siberia: “they told me that two years ago almost all of their drug users used heroin. Now, more than half of them are on desomorphine.”

The treatment of krokodil addiction is equally as terrifying as using it. A doctor at a treatment center in Tver explained to the Independent that desomorphine causes the strongest level of addiction, which is equally hard to cure.

“With heroin withdrawal, the main symptoms last for five to 10 days. After that there is still a big danger of relapse but the physical pain will be gone. With krokodil, the pain can last up to a month, and it’s unbearable. They have to be injected with extremely strong tranquilisers just to keep them from passing out from the pain,” said the doctor.

Krokodil addiction has so far expanded without preventive action from the state and the Russian rehabilitation system is equally left in the snow by the government. Financing relies heavily upon religious initiatives while the state only contributes a fragment. To make up for lost effort, it seems, Dmitry Medvedev has made calls for the closure of the websites that explain how to cook the destructive drug and that mandatory drug testing be introduced in schools, according to Time Magazine.

However, a ban on codeine or introduction of prescription-only for the tablets, which are currently an over-the-counter drug, has yet to move from aimless talk to action. Government officials say that restrictive measures take time, while anti-drug campaigners say pharmaceutical companies are pressuring for passivity.

Mr. Ivanov explained: “these tablets don’t cost much but the profit margins are high. Some pharmacies make up to 25 per cent of their profits from the sale of these tablets.”

This means although the pharmacy knows the purpose of the sale, they continue to supply the deadly addiction, without questioning — simply for profit.

“It’s not in the interests of the pharmaceutical companies [...] to stop this, so the government needs to use its power to regulate their sale,” adds Mr. Ivanov.

Until that happens, krokodil will be the horrific end of more drug addicts in Russia and while there has been no reported use outside the country, it is not improbable that addiction will drive junkies in other countries into the same pattern.

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The head of Russia’s drug control service (FSKN) Viktor Ivanov recently slammed the Central European countries as well as NATO for their failure to effectively address the explosion of drug-trafficking and drug related crime since 2001. Mr Ivanov trace the source of the problem back to Afghanistan and their poppy farmers who produce 90% of the pure heroin worldwide. A UN resolution has previously described the narcotics flow from the Central Asian country as a threat to international peace and stability, according to the Russian news channel RT.

Mr Ivanov was outspoken about the Russian impatience with the international community in what he categorized as a lack of “an appropriate reaction” from NATO whom he holds responsible for controlling the war-torn country’s heroin situation. The reason for Russia’s fury can be found in the dramatic surge in heroin related deaths in their country since US forces invaded Afghanistan almost 10 years ago. In October last year, the head of FSKN explained to the Carnegie Moscow Center that although the amount of opium harvested in 2010 was half the amount produces the previous year, it is still twenty times higher than it was before the invasion. The decline in last years production, Ivanov attributes to ‘climate factors’ and crop disease rather than the eradication efforts. He based his conclusion on the fact that the number of acres planted had not changed since the previous year, according to RT.

The consequences of the heavy production in Afghanistan has been unprecedented for Russia. According to FSKN, 549 tons of heroin is consumed in Russia – compared to 212 tons in North America and 711 tons in Europe which have nearly four and over five times as big a population respectively. Mr Ivanov revealed that “at least 30.000 young Russian lives” are lost each year to heroin addiction and it is estimated that an annually 100.000 people worldwide die from consuming the Afghan opiates.

On top of this, Ivanov is gravely concerned about the rapid expansion of the Central Asian drug cartels who consider Russia a vast market for drug-trafficking. The Russian war on drugs have revealed a ‘mafia structure’ in the cartels which uses simplified visa rules and cargo deliveries for Commonwealth of Independent States (CIS) citizens. Ivanov blames poor migration control as one of the main factors hampering the fight against drug trafficking inside of Russia. But his main critique is that the root cause of Russia’s national problem is far from being addressed adequately internationally.

One of the points is that farmers are expected to join the Taliban if efforts are made to destroy poppy crops. Mr Ivanov rejects this explanation. “When the US says you can’t deprive farmers of their livelihood, it actually sends a message to the Afghan leadership as well, saying they shouldn’t do it because, first, this will destroy people’s livelihoods and, second, you push farmers into the hands of the Taliban,” Ivanov told RT in an interview. “I think this is merely an excuse.”

The Russian frustration with NATO’s efforts in Afghanistan is also aimed at the coalition members. “The taxpayers of the coalition countries invested more than $300 billion into resolving the Afghan problem,” Ivanov argues. “In exchange, they received 5,000 tons of heroin, half of which landed in their stomachs, while global criminal and terrorist networks earned $1 trillion.”

In response to Russia’s criticism, Afghan Counter Narcotics Minister Zazar Ahmad Osmani told the RT “Afghanistan only produces opium, but you need additives, or precursors, to turn it into heroin, up to 1300 tons. Afghanistan does not produce them. Where do they come from? Obviously, there’s an international network trafficking these precursors. That’s why we say that the drug problem is not localized in Afghanistan – it’s international. When we say that millions of Russians die from drugs… 960,000 Afghans are addicted too.”

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