VERDICT ON TREATMENT

Britain's New Drug Policy in the Dock

For those who believed we were finally making progress on tackling
drugs, Nick Davies's two-part series this week will have made
dispiriting reading. We were supposed to be in a new era where
treatment was finally being given an increased priority, and the
impossibility of the old policy's goals, stopping the suppliers, was
more widely and realistically accepted. As recently as 1998, some 75%
of a UKP1.4bn drug control programme went on enforcement and a mere
13% on treatment. But in a forensic scrutiny of three prongs of the
new programme - drugs action teams (DATs), drug treatment and testing
orders (DTTOs), and arrest-referral workers - Mr Davies documents
devastating shortcomings.

He went to Bristol where he found the local drugs action team, with a
budget of UKP3.5m a year, had produced just five extra NHS
detoxification beds; the arrest-referral team after three years could
provide no evidence that even one user had completed a treatment
course; and in a city with 12,500 chaotic drug users the local courts
last year issued just 48 DTTOs. More serious than these particular
policy problems are the structural deficiencies that Mr Davies
catalogues: the 44 different funding streams; the 68-page treatment
plan with its 82 targets; the central micro-management with its
detailed national guidance and constant reporting back. In the weary
words of the former manager, who claimed he was left with only 40% of
his time to organise services: "They don't know very much about drugs,
but they do know about management and monitoring and data collection.
So that's what they do."

To be fair to the policy-makers, a succession of independent auditors
have pointed to a wide variation in local services. Bristol is one of
the worst areas. There are 149 DATs nationally. They should not all be
judged by Bristol. But even the good ones will be suffering from the
micro-management and multiple funding streams that Mr Davies
documents. Here are two issues that the new national treatment agency
must take up.

Whitehall should also be reviewing its own policy-making process.
DTTOs were an excellent idea, seriously damaged by poor
administration. The admirable aim was to ensure drug users who are
committing crimes to feed their habits, are treated in the community
rather than prison. The programmes are designed to be intense and
well-structured to reassure the courts and community. They are
expensive (UKP6,000 a year) but still far cheaper than prison
(UKP35,000 a year). Offenders are tested for drugs twice a week, spend
at least 15 hours a week in sessions designed to bring some order to
their chaotic lives, with regular reviews by the courts of their
progress. But a recent report by probation inspectors found the scheme
had been bedevilled by the failure of Whitehall to produce a national
plan and a launch which coincided with the reorganisation of the two
key players - probation and primary care trusts.

Mr Davies's second report concerns the readiness of Britain to return
to an old remedy for dealing with heroin users: medical prescribing
where addicts receive pure heroin rather than the adulterated drug
from the black market. It is the adulterants - powders, sugar, starch
- - that cause the damage, not the heroin, which does not pose a
physical threat, beyond its serious addiction problem. Although
dropped by Britain in the last three decades, medical prescribing has
successfully been taken up by Switzerland, Germany and the
Netherlands. Mr Davies suggests the Home Office is going to be more
timid than initially thought. Here is surely an issue for parliament.