Do we need hypertensionologists?

market, the rest of the scene gradually moved with them including the substantial proportion of drug users who preferred obtaining their prescriptions from less conspicuous chemist shops. Although the chemist proprietor reported in 1983 that the number of addict maintenance prescriptions he dispensed halved in the second half of 1982, after the publicity over Dr Khan's case, the thriving market in pharmaceutical drugs from the overspill from doctors outside drug dependency units continued to focus around this chemist shop even though most drug users obtained their drugs from chemist shops elsewhere. Such a shop was, of course, the natural focus for a scene that was becoming a major outlet for legitimately obtained prescriptions. Conclusion Although fieldwork in late 1982 was based on informal observation alone, opinions were also obtained from a substantial number of addicts well known to me and there was a general consensus among them on the subject of overprescribing by doctors outside drug dependency units. This, and my knowledge of the scene, suggest that an important change has occurred in Piccadilly. This is corroborated by the recent article on overprescribing doctors by Bewley and Ghodse.3 The focal part Piccadilly plays in the London pharmaceutical drug black market and the relatively small number of doctors outside drug dependency units who prescribe for addicts must be taken into account when evaluating the opiate overspill in Piccadilly. Not all doctors from Harley Street and the surrounding area or doctors outside drug dependency units in general are injudiciously overprescribing to addicts. Nevertheless, it would seem reasonable to conclude from the substantial amount of pharmaceutical opiates appearing on the black market in Piccadilly prescribed by doctors outside the clinics, that a considerable proportion of opiates prescribed by medical practitioners from Greater London, the Home Counties, and the Harley Street and surrounding area in particular, is finding its way on to the black market in Piccadilly. As such, the situation gives cause for concern and would appear to need urgent attention. Hypertension is far and away the commonest medical condition that requires drug treatment. It is the most important single treatable risk factor for both coronary heart disease and stroke, which, combined, kill more people than all other causes. Despite this there are few specialists in British hospitals who list hyper-tension as their main interest. In the past hypertension specialists tended to be highly academic scientists, concerned mainly with the blood pressure of …