So easy to start

It is a bind being addicted to opiates—a real nuisance. Particularly when your sole supply is obtained through your work. Towards the end of the week, if you are unfortunate enough not to be working at the weekend, you start scrabbling around trying to organise locums so that you can remain at work. The same happens with annual leave.

Thus it was for me—as an anaesthetist addicted to any and all opiates. My favourite tipple was fentanyl, usually taken intranasally. Because of its short half life a forced abstinence of more than a few hours resulted in particularly nasty withdrawal symptoms. Not quite textbook stuff, more unbearable anxiety and insomnia than sneezing and diarrhoea. My appetite was so tiny in any case that diarrhoea would probably have been a physical impossibility. Access was, and no doubt is, ridiculously easy, and even when I was not officially working it was a relatively straightforward procedure to obtain more supplies.

I have often been asked how it all started. Looking back I had no doubt always been susceptible to substance abuse since my schooldays. The first time I remember taking fentanyl was one particularly busy night on call, to treat a headache. Rather like using heavy artillery to kill …