DEMONISING DRUGGIES WINS VOTES. THAT'S ALL THAT COUNTS

Our Drugs Policy Is Clearly Disastrous. Over The Past 30 Years, It Has
Resulted In A Thousandfold Increase In Heroin Addicts, Many Ill And
Destitute. But, Concludes Nick Davies, Politicians Are Too Scared - Or Too
Stupid - To Admit It

It is a strange but revealing fact that hundreds of thousands of people in
this country are currently afflicted by a dangerous and highly infectious
disease and that, even though the government has been warned repeatedly
that many thousands of these people will die, the current position of the
Department of Health is that it is reviewing the report of an advisory
group to decide whether it might then set up a special working group which
might then develop a strategy to deal with it.

The disease is hepatitis C, which attacks the liver. Even though there are
probably at least 300,000 sufferers in the UK; even though specialist
doctors say that 100,000 of them will suffer cirrhosis or cancer of the
liver in the next five or 10 years; even though the infection is still
spreading: the position remains that the Department of Health has set up no
system to monitor the epidemic, has failed to fund any kind of public
information campaign, refuses to offer systematic screening or testing for
potential carriers, has established no prevention strategy at all and
refuses even to treat many sufferers.

The explanation for this extraordinary lack of action appears to be that
almost all of the victims of hepatitis C belong to one of the least popular
political minorities in Britain - drug users, who contracted the illness by
using dirty injection equipment.

Dr Tom Waller, who chairs the medical pressure group Action on Hepatitis C,
says it is "a distinct possibility" that this is the cause of the problem.
"This is life threatening to a large number of people. You'd think the
Department of Health would want to stand on its head if necessary to
prevent it."

As it is, many health authorities simply refuse to fund the best available
treatment, which involves a combination of interferon and ribavirin.

There is no arm of British healthcare which has been so perverted by
politics as the treatment of drug users. In the early days of American
prohibition, this was the politics of racism - spics and niggers smoked
marijuana, chinks smoked opium, and they would all get what was coming to them.

In the 60s, it was the politics of reaction - hippies smoked everything and
attacked the establishment, so the establishment attacked them back. Now,
it is simply the pure politics of power: you win votes by waging war on
druggies.

You can see the politics perverting the healthcare with particular clarity
in New Labour's adoption of Drug Treatment and Testing Orders. The problem
here is not just the moral one of whether it is acceptable to compel drug
users to undergo treatment under threat of punishment. Nor is it simply the
practical problem of allowing those who have broken the law to jump the
queue for treatment in front of those who have not. The real problem with
DTTOs is that they are a political project built on a foundation of falsehood.

It was the Home Office minister Paul Boateng who last September announced
that courts all over England and Wales would now be allowed to impose DTTOs
to compel offenders to undergo treatment for their drug problems. Mr
Boateng explained that his decision followed three pilot schemes, in
Croydon, Liverpool and Gloucester, which had proved to be successful.

Among those who took part in the pilots, he said, there had been a
"dramatic" fall in the number of offences they committed and in the amount
of money which they spent on drugs. The reality, however, was rather different.

One of the key questions for these pilots was whether drug users would
cooperate with treatment which was being forced upon them. The researchers
who were hired to study the three pilot schemes found that, even though the
210 offenders had been handpicked, nearly half of them (46%) vanished or
were thrown out of the scheme long before it finished its trial run;
numerous others were warned for breaching its conditions; and the
researchers found that "failure to meet conditions of the order was common
in all three sites".

Mr Boateng simply did not mention any of this. One of the "dramatic"
results to which Mr Boateng referred was that within a month of being put
on the order, offenders had cut their weekly spending on drugs from ?400 to
only ?25. This was, indeed, a dramatic fall, which sat oddly with the
conclusion of the researchers that "quite clearly, many offenders in all
three pilot sites were continuing to use illegal drugs".

It turns out that this supposedly dramatic result was based entirely on
untested claims made by those offenders who had not already been thrown off
the scheme and who knew that if they were caught taking drugs, they were
liable to be sent back to court for a harsher punishment. Furthermore,
these offenders who were claiming to have cut their spending on drugs by
94% had been failing urine tests throughout the scheme: they had failed 42%
of their heroin tests, 45% of cocaine tests and 58% of methadone tests.

In some cases, they were failing more urine tests at the end of the
18-month pilot than they had been at the halfway point. Indeed, their
consumption of drugs remained so high that, by the end of the trial, all
three schemes had stopped even requiring them to be drug free, asking only
that they "make progress in addressing" their drug problems. Mr Boateng did
not mention any of this either.

The other "dramatic" result on which Mr Boateng relied for his success
story was that, within a month, offenders were committing far less crime -
only 34 offences a month compared to 137. But this, too, was based on
nothing more than asking the offenders who stayed in the scheme whether
they had been out thieving. Mr Boateng failed to mention that some of these
law-abiding guinea pigs were actually arrested for committing new offences
during the pilots.

At the end of the 18-month scheme, the researchers could find only 27 of
the 210 offenders who "seemed to emerge drug free" - and they were able to
come to that conclusion only by a) overlooking the fact that only 13
offenders passed the final urine tests and b) ignoring their use of
cannabis. The best that the researchers could say was that the scheme was
"promising but not proven".

However, none of this troubled Mr Boateng. Even though these pilots had
been set up explicitly "to enable the Home Office to decide whether or not
to extend the order across the country" and even though the results were so
equivocal, Mr Boateng went ahead and declared them "successful" and
invested ?60m of taxpayers' money in rolling them out nationally.

He managed to square this with the results of the pilot studies with one
brilliantly effective tactic: in a move which left his researchers
"flabbergasted", he simply did not wait to be told the bad news and made
his decision months before the results of the research were known. And this
really did not matter at all because even if the scheme does fail, its
no-nonsense toughness on druggies has been a great success from the
political point of view.

The real problem, however, lies deeper - in the profound and alarming
ignorance of the power elite. There are vocal politicians and senior
officials who make policy on drugs and there are leader writers and pundits
who support them, and yet they genuinely do not know the first thing about
them.

Specifically, the politicians' love of prohibition identifies the drugs
themselves as the source of danger to their users. As the Guardian showed
yesterday, the truth is that the real dangers come from the black market
which has been created by prohibition.

By refusing to acknowledge this medically verifiable fact, the politicians
have created a treatment strategy which consistently pushes highly
vulnerable drug users into extreme danger. Take heroin as an example.

Until the early 70s, Britain was a haven of enlightenment: every doctor in
the country had the right to prescribe heroin for the welfare of patients.
This reflected the idea, powerfully proposed by the Rolleston committee in
1926, that drug use should be seen as a problem which needed help, not as a
sin which needed punishment.

There were fewer than 500 addicts in the country, most of them musicians or
Chinese. With a clean, legal supply of their drug, they remained healthy
and were able to live normal lives. Then three London doctors were caught
selling inflated prescriptions; there was a moral panic; and Britain's
resistance to prohibition started to crumble under political pressure, some
of it from the United States which was already committed to imposing a
global policy of prohibition.

The result was that doctors generally were forbidden to prescribe heroin to
addicts, who were thus forced to buy their supplies illegally: the black
market started to grow, inflicting illness and infection on addicts and
embroiling them in theft and prostitution to find funds. A small detachment
of common-sense realism slipped under the fence, but was soon pinned down
by hostile political fire: the Home Office agreed to license specialist
psychiatrists to continue to prescribe for heroin users.

This might have saved addicts from disaster, but, as the babble of the
prohibitionists drowned the voice of reason, the Home Office - apparently
under more pressure from the United States - undermined the system by
insisting that these licensed doctors should prescribe heroin substitutes,
such as physeptone and methadone, instead of heroin. Furthermore, the Home
Office insisted, these substitutes should be prescribed only in rationed
and rapidly diminishing quantities.

This sealed the catastrophe: most heroin users did not like physeptone and
methadone and sold their supplies; those who did like them found their
supplies were rapidly cut off. In either event, to satisfy their addiction,
they were pushed back on to the black market, back to the dangers. The
British system of support for addicts, which had been admired around the
world, was dead.

Since then, it has emerged that the government's favourite heroin
substitute, methadone, is more addictive than heroin and also more likely
to cause fatal overdose. In a detailed study, Methadone and Heroin, an
exercise in medical scepticism, Dr Ben Goldacre found that: "Methadone is a
more dangerous drug than heroin, and causes more deaths than even
adulterated street heroin."

A study by Dr Russell Newcombe, senior lecturer at John Moores University,
Liverpool, found that methadone was four times more likely than heroin to
cause a fatal overdose. And yet - for entirely political reasons - this is
the drug which the government insists be prescribed to heroin addicts.

The bottom line now is that after 30 years of prohibition, the number of
heroin addicts has rocketed from less than 500 to as many as 500,000.
Around 20,000 of them are being given the arguable benefit of a limited
prescription for methadone. And the number of heroin addicts who are
allowed a limited prescription for a safe supply of the drug to which they
are addicted is less than 500. The hundreds of thousands of others are are
thrown out on to the black market, condemning them to precisely the dangers
from which which the politicians claim to be saving them.

New Labour's strategy for the treatment of heroin users compounds all of
these errors - consistently increasing the risk to addicts. So, for
example, ignoring more than 15 years of medical warning on the relative
danger of methadone, the Department of Health's new 1999 prescribing
guidelines, known as the Orange Book, continue to advise doctors who care
for heroin addicts to prescribe methadone instead of heroin.

And, repeating the policy which for 30 years has pushed addicts into the
dangers of the black market, the Orange Book continues to urge that doctors
should generally prescribe only in rationed and rapidly diminishing quantities.

The Orange Book makes matters even worse by giving GPs an explicit
responsibility not just to prescribe the approved quantity of methadone but
then to ensure that "the drug is used appropriately and not diverted on to
the illegal market". GPs have no such power. The result is that, spurred on
by the government's ferocious rhetoric, police have moved in on doctors
whose patients have sold their methadone or overdosed: GPs in Carlisle,
Essex, London, Luton, Plymouth, Portsmouth, Suffolk and Surrey have found
themselves in serious trouble.

This, in turn, has had a chilling effect on other GPs who might have
considered prescribing methadone to local users as a temporary refuge from
the black market. Professor Gerry Stimson, of Imperial College London, who
has studied illicit drugs for 30 years, told us: "We're seeing court cases
against doctors and other drugs workers, or police attention to prescribing
doctors, which is actually scaring many doctors away."

Across the field, the government's professed desire to offer more treatment
to drug users is being undermined by its hardline politics. Chemists who
try to supply prescriptions of methadone or diamorphine report hostile
visits from police. The All Party Parliamentary Drugs Misuse Group last
year took evidence of a psychiatric ward where drug users seeking treatment
had been confronted by police with sniffer dogs.

A north London priest, Father Peter Anderson, found himself denounced by
the local coroner for supposedly condoning criminal activity because he had
allowed homeless drug users to sleep in the grounds of his church. A
Release conference last year heard that, if a drug user overdoses, other
users are often scared to call an ambulance for fear of being arrested.

Professor Stimson says the root of the problem is the government's
ferocious rhetoric: "It sets the wrong tone. You are dealing with people
who are already quite marginalised and stigmatised and, if you are having
that sort of rhetoric, then you are pointing the finger, scapegoating
people. But also politicians get carried away with that rhetoric and they
become tougher, they dream up new legislation, they dream up tougher ways
of doing things which can backfire and can have adverse effects."

So, for example, the government wants police to be able to deny bail to
anyone they suspect of being involved with drugs (so users will be
discouraged from carrying their own clean needles or drugs-advice
leaflets); to introduce new licences to limit the number of doctors who can
prescribe injectible methadone as opposed to the oral linctus (so users who
like to inject will end up using black-market needles in dirty conditions);
to remove the passports of anyone who has a drug offence (so no past user
will ever be able to enjoy a normal life).

The drugs war is a political war. It was political when, as Edward Jay
Epstein recorded, President Nixon gave a shot in the arm to his election
campaign by fiddling the figures to create a non-existent heroin epidemic,
from which he could then promise to rescue the electorate. It was political
when Tony Blair announced his plans to appoint a "drugs tsar" - in a
secondary school full of sweet, vulnerable children in the middle of the
1997 election campaign.

The masters of the war have always been American politicians. When the
Swiss held a referendum on limited heroin legalisation in 1997/8, the US
congressional subcommittee on national security, international affairs and
criminal justice openly intervened. "We wholeheartedly oppose this sort of
government gambit," the committee declared, as though it had some sort of
jurisdiction in Switzerland.

When Dr John Marks was forced to close Britain's most successful recent
project to provide clean heroin for addicts, on Merseyside, the
International Herald Tribune carried a report that American drugs agencies
had been infuriated when they saw the project on CBS television: "Dr Marks
was warned by friends in the Home Office that the US embassy was exerting
tremendous pressure to shut him down and, in the end, it was successful."

New Labour drugs policy has been shaped by political infighting. The Home
Office tried to stop Keith Hellawell setting targets for reduction in drug
use. Hellawell went off to Downing Street and got the prime minister on
side. The Home Office then complained that the targets were too high.
Hellawell persisted and then found reporters were being briefed that his
targets were nonsense since nobody knew how many people were using drugs
now, so there was no baseline to set a future target.

In the meantime, the prime minister announced that anyone who is arrested
will be urine-tested for drugs; Hellawell's people had a fit because they
hadn't approved the plan and, very soon, reporters were being briefed that
the PM's plan would be "kicked into the long grass". And in the background,
Hellawell was falling out with the Department of Health which produced its
Orange Book guidelines for doctors without consulting him. "I am the line,"
he announced.

In this politically charged atmosphere, it is a heresy to question the
value of prohibition. Transform, the only pressure group campaigning for
legalisation, wants to commission an opinion poll which may show
politicians that public opinion has moved ahead of them, but, at the
moment, nobody with any power dares to break ranks. The interesting thing
is that the group who in private are now most keen on legalisation are
chief constables.

We spoke to four of them who were passionately opposed to the war against
drugs. None of them would speak publicly. What they can see, however, is
that there is a way out. The war against drugs is unique in all conflict:
we can win it, simply by ceasing to fight it.

The faith of well-meaning liberals in New Labour's plan to offer more
treatment for drug users has all the moral force of well-meaning Christian
folk in the 19th century who considered the use of child labour in
Victorian coal mines, saw that it was wrong, lacked the political or
intellectual courage to say that it must stop and suggested instead that
their hours of work might be limited. No treatment strategy will succeed
for as long as it is based on the medically false but politically popular
idea that the nature of these drugs is such that they must be banned.

Future historians will look back on our treatment of drug users in the same
way as we now look back on the Victorian treatment of those in Bedlam -
beaten for their pain. Every victim of the war against drugs is a lesson in
the futility of the war, a message of contradiction to the politicians' errors.

They may have become drug users for all kinds of reasons - the pursuit of
pleasure, or obsessive flight from pain - but most of those who have lost
their jobs or homes, most of those who have been driven into prostitution
or thieving, most of those who have become ill or who have died, have been
sacrificed to the ambition of politicians who never did have any reason to
attack them; but they continue to do so now only because they are too
stupid or too ignorant or too callous or too plain scared to admit the
truth, that, with their policy of prohibition, they are themselves the
architects of this disaster.

Milestones in the phoney war

• Until 1971, any GP free to prescribe heroin. Fewer than 500 addicts
countrywide

• 1968 three doctors caught over-prescribing

• 1971 Passage of misuse of drugs act which outlawed heroin

• 1995 Dr John Marks forced to stop supplying clean heroin to addicts,
despite high success rates, apparently due to pressure from the US

• 1997 Tony Blair appoints drug tsar Keith Hallawell

• 2001 number of addicts is estimated to be up to 500,000

Additional research by Max Houghton.

Nick Davies's programme, Drugs - The Phoney War, is to be shown on Channel
Four at 9pm on Tuesday June 19