THE LOCK AND KEY TO DRUG REHABILITATION

I have just spent an hour talking with a man who reckons that the best
way to treat heroin addicts is to lock them up for six months. I agree
with him. The view may sound authoritarian, but it comes from a
soft-hearted streetworker who's sick of seeing addicts undergoing the
standard seven-day "detox" and then heading back to the streets, where
they run into old friends and fall back into old habits. Some of them
will even "OD" because their short period of abstinence will have
reduced their tolerance to the drug.

Henry Nissen, a former Open Family streetworker, now with the Emerald
Hill Mission, doesn't want to send addicts to jail. Instead, he wants
to see them spend six months under lock and key in hospital-like
facilities that would be part health farm, part rehabilitation
program, part training facility - places, he says, where addicts can
begin to construct a new life. Of course, a lot of addicts won't like
such an authoritarian approach to their problem. "They'll fight you
all the way," Nissen says, but "free will" issues are irrelevant with
people who are committing crimes because they are "slaves to the drug".

"Until they've worked the drug out of their system, they're not in the
position to make a rational decision. You need to keep them in for a
minimum of three months. Six months would be ideal."

The Bracks Government is taking steps in the right direction here,
having set aside $77 million for drug treatment and opened a range of
new beds over the past six months, some of them in existing
facilities, some in new ones. But longer-stay institutions are
horrendously expensive to build - and to run. So a planned new 15-bed
unit where young drug addicts can stay for up to a year remains the
exception, not the rule. And, for all the new initiatives, most
addicts are still detoxing either at home or in a short-stay set up.

A seven-day detox, Nissen points out, is all that is needed to rid the
body of the physical craving for heroin - and that's enough for a
highly motivated minority.

"The rest will go straight out feeling so wonderfully well that the
first thing they do is use again. They are physically over the
withdrawal, but mentally they are still 'hanging out'. And they
remember the wonderful buzz (they used to get from the drug)."

A "drug-addict health farm" might need, initially, to keep newly
detoxified addicts locked up in order to get them to stick with the
fitness, education, training and counselling that can form the basis
for a more stable and - ultimately - more satisfactory mode of life
than the flawed but familiar one offered by a user's previous drug
world. Otherwise, too many newly "clean" detox graduates are doomed to
relapse.

It is easy to condemn the many addicts who go through detox, make
appointments for employment advice and psychological counselling and
then go off and use again.

But how well do more "respectable" members of society go when they
attempt to undertake a comparatively minor change in lifestyle by
spending a week on an expensive health farm? Think of all the
corpulent business people who can manage daily exercise and an
alcohol-free, fruit and vegetable-rich diet only when they are under
virtual "lock-up" conditions, far away from the restaurant where they
used to lunch on creamy-sauced pasta.

What do they do on the first Friday night after their return to work
and the rest of the office heads off for an after-work drink? Stay at
their desk with a cup of health-farm spearmint tea? Or go back to
their old habits?

Just like most overweight corporate types, most drug addicts cannot
make drastic lifestyle changes without a prolonged separation from
their old associates. Non-residential support programs are clearly
cheaper, but it doesn't take much imagination to understand the
temptations involved when recovery-associated services are in areas
where unreformed drug addicts congregate.

Magistrates are now presiding over courts crowded with drug addicts
who have committed crime to support their habits. Many of them would
welcome the idea of a long-stay, benevolently run health and education
"farm" as a sentencing option. But civil libertarians would consider
it a violation of free will, while conservatives would slam it as a
"soft" option. All would agree that it seems impossible because of the
many millions of dollars it would cost. Yet every jailed drug offender
already costs society about $100,000 a year - $60,000 for jail and
$40,000 in other services.

A giant health farm project would be viable if governments
decriminalised drugs and used the millions of dollars outlaid annually
in pursuing, prosecuting and punishing drug offenders to fund it.
People who have lost family members to drugs would probably vote for
it. For the rest of the community, it might still seem a bit too radical.