CHOKE OFF DEMAND, AND SUPPLY DIES

The only way to make some impact in society's campaign against heroin abuse
is to begin prescribing the drug to addicts, suggests Fintan O'Toole.

This week a London court confirmed a very long jail sentence on one of
Dublin's major drug dealers, Tommy Mullen. For those whose lives have been
blighted by Mullen's cynical and cruel career in the heroin industry, this
was some small satisfaction.

The human cost of making people like Tommy Mullen rich was brought home by
the death toll from the circulation of contaminated heroin in Dublin.
Perhaps more shocking was the way they highlighted the "normal" death rate
among heroin-users. The usually invisible background levels of squalid
catastrophe were briefly illuminated by an added tinge of horror.

At the same time, too, there were disturbing reminders that such
high-profile triumphs for law enforcement as the jailing of Tommy Mullen do
little to alter the underlying reality of drug abuse in Ireland. The
European Union was presented this week with a report suggesting that 13
gangs controlled organised crime in Ireland, much of it fuelled by the drug
trade. When one drug boss is jailed, another steps in. This cycle will
continue so long as there is a demand for the products these gangs peddle.

Two stark facts emerge from these disparate but related events. One is that
even the prospect of a terrible death does not deter addicts from feeding
their habit. Asking her users to stop using heroin, as the Minister of
State, Eoin Ryan, who co-ordinates the National Drug Strategy, did yesterday
is like asking bees to stop making honey.

The other is that the drug war has been lost. Whatever the Garda or the
international law enforcement agencies do, the demand will always be
supplied. That the heroin on the streets in Ireland is cheaper and purer now
than it was 10 years ago tells us what we most need to know about the
success or failure of the drug war.

Anyone tempted to believe it can be won with more laws, bigger police forces
and more prison cells needs only to look at the US, where phenomenal levels
of spending on the drug war and extraordinarily harsh laws have failed to
stem the supply of illegal drugs on the streets.

Together, these facts raise fundamental questions about drug strategies in
Ireland. At the very least, they demand a rational and well-informed
reappraisal of how this society deals with substance abuse. That rethink has
to start, not with how right-thinking people would like things to be but
with the uncomfortable realities of how they are.

It may well be that, if the State had responded differently to the
beginnings of the heroin crisis in working-class Dublin in the early 1980s,
the drug culture would not have taken hold. But as the official Drugs Task
Force report acknowledged in 1997, "For a decade or more, this State failed
to tackle effectively the spread in the illicit trafficking and pushing of
opiates, the destruction of the lives of individuals, the havoc wrought in
communities".

That neglect was disgraceful, but its consequences cannot quickly be undone.
The drug culture that was allowed to grow then has set down deep roots. It
will be a fact of life for a long time to come.

It no longer makes sense, moreover, to see drug abuse as a weird affliction
at the fringes of society. One of the few certainties about the American
presidential election this year, for example, is that the next leader of the
world's most powerful nation will be a former abuser of illegal drugs.

The Republican candidate, George W. Bush, had a serious cocaine habit for a
long period. The Democratic candidate, Al Gore, like the majority of people
of his age and class, was for a time a frequent smoker of cannabis. If the
president of the United States is a reformed drug-user, how can we pretend
that junkies are social freaks?

It is becoming clear, too, that in all parts of the State large numbers of
young people, who function perfectly well as decent members of society, use
illegal drugs like cannabis and ecstasy, at least occasionally.

Their parents, of course, tend to favour legal drugs like alcohol. Few
medical professionals or social workers would argue that the damage to the
health of individuals, families and communities done by alcohol addiction is
significantly less than that of heroin or cocaine addiction.

What we have, then, are huge numbers of recreational drug-users, some of
whom go on to become addicts. In such a situation the real question is not
"How do we cut off the supply of drugs?" It is "How do we stop recreational
users from becoming addicts, or, if they do develop addiction, how to help
them out of it?" When that kind of question is asked, the focus shifts from
law enforcement to public health.

In many respects, that shift has already happened in the State. For
practical purposes, the ordinary use of cannabis has been effectively
decriminalised, largely because strict enforcement of the law would
overwhelm the judicial system. The provision of treatment, though still
inadequate, has increased hugely throughout the 1990s.

With the use of methadone maintenance and needle-exchange programmes, the
State itself has taken on the role of supplier to many addicts, recognising
that if people are going to use narcotics, it is best they do so safely and
without resorting to crime to feed their habits.

The logic of this new emphasis, however, still comes up against the narrow
limits of official thinking. International drug strategies are still heavily
influenced by the militaristic rhetoric of the American drug war in which
all the disastrous consequences of Prohibition in the 1920s - the rise of
vicious gangsters and the creation of a huge market for dangerous,
uncontrolled alcohol - are taken to new heights.

This rhetoric makes it difficult for those who actually work with addicts to
be heard when they argue for "unthinkable" policies. In recent years, for
example, Father Gerry Raftery of the Franciscan Justice Office and Father
Sean Cassin, a member of the National Drugs Strategy Team, have argued for
new approaches, including the provision of heroin to addicts on
prescription.

Father Cassin argued before a Dail committee: "We're not in favour of
anybody using or injecting drugs. But today some 10,000 injecting drug-users
are going to take heroin. They're going to inject it and find or rob or
steal the materials necessary to inject it."

Given that reality, he said, the State should adopt the Swiss strategy of
prescribing heroin for addicts.

Such a policy would go a long way towards preventing the kind of disaster
unfolding among heroin-users in Dublin. It would also be a far bigger blow
to the drug pushers than anything the Criminal Assets Bureau, for all its
good work, can deliver. By choking off the demand that delivers the inflated
profits created by an illegal market, it would hit them where it hurts.

By being ready to think the unthinkable, Irish society might begin to create
a situation in which far fewer families had to bear the unbearable.