Drugs Policy Debate

WHAT DO WE DO WHEN THE DRUGS WAR STOPS?

Liberals Think They Have The Answer On Drugs - More Treatment And More
Education. But These Remedies Fail Just As Badly As The War On Drugs,
Argues The Author Of An Important New Drugs Policy Report.

No one now believes in the war on drugs.

The government are quietly dropping their khaki slogans and downgrading the
battle against cannabis. Even the right-wing press denounce policies that
waste millions and, more importantly, could land their university-educated
children with criminal records. But there is no agreement on how the
government should withdraw from the battlefield, or what the principles of
a new approach would be.

The liberal mantras are more treatment, more education and more
health-care. But the hard truth is that the liberal remedies of choice have
been scarcely more effective.

Nine-tenths of all treatment fails: most addicts go through the revolving
door of treatment and relapse for decades.

The central failure is to treat drug addiction as a "disease". The
biomedical approach to drug treatment focuses on weaning addicts off drugs,
using opiate substitutes such as methodone and buprenorphine to satisfy
their cravings.

But dispatching an addict to the most comfortable of rehab clinics far from
home only temporarily reduces their physical dependency on drugs. As soon
as they return to their home environment, mix with drug using friends, and
face the listless boredom of homelessness or unemployment, they easily relapse.

Drug use is a social rather than a medical problem.

An ever-expanding army of therapists has failed to acknowledge that social
ills are not caused by the substances themselves but by the unstable lives
of those using them. Seventy per cent of American frontline servicemen used
heroin during the Vietnam War yet only three per cent continued using back
home. Returning to quiet, civilian lives in Middle America, most had no
desire to continue using. Surveys throughout the 80s and 90s in Britain
proved that drug use only becomes problematic when it occurs in combination
with social isolation or deprivation.

Most teenagers who take ecstasy in clubs on Saturday nights are not at risk
of getting an entrenched drug problem because they have emotional and
social support that the homeless, long-term unemployed and very poor lack.
Cocaine users in the City often check their habits when their performance
in the office suffers.

Very few have the kind of 'addictive personality' which enslaves the user
after a few hits.

Even drugs education, the one policy that wins plaudits all round, isn't
the powerful deterrent that its advocates claim.

Campaigns which give the impression that one drag on a joint leads to ruin
are seen as laughable by a generation of teenagers far savvier than their
teachers.

The "Heroin Screws You Up" posters of the 1980s were withdrawn after
evidence that they had become a darkly glamorous fashion accessory.

A recent study by the Drugs Prevention Advisory Service of 14-16 years who
had been through a Drugs Education course found that, one year one, the
lessons had no impact on their drug-taking.

It should be no surprise that the evidence shows that the most effective
way of reducing drug misuse is, unsurprisingly, to encourage
self-disciplined and purposeful lives.

Many Western health-care professionals would write this philosophy off as
"unrealistic" and "bullying". Asked to explain the poor record of drug
treatment programmes, they will attribute this to a morally conservative
climate and inadequate resourcing. No doubt these do provide barriers to
success.

But those involved in drugs rehabilitation in India and Pakistan face these
problems in spades, and would see western conditions as utopian: yet they
achieve much greater success rates with innovative projects.

In Dehli the Sharan project has helped slum-dwellers that have become
addicted to the glut of heroin on the streets - where it is cheaper than
cannabis or home-brewed alcohol. 90 per cent of Dehli's drug users were
homeless; many were imprisoned, persecuted, contracted AIDS or were
disowned by families ashamed of their behaviour.

Prejudice against drug users is deep-felt: the official position 10 years
ago was that drug users should be left to die. Against a background of
fatalism and inertia, the project has combined needle and syringe exchanges
and substitute prescribing with training and work. 80 per cent of permanent
staff - doctors, managers and general drug workers - are now drawn from
ex-users.

Unlike most training centres in this country, these schemes do not expect
addicts to have overcome their habit before they begin training or work.
Instead, they help them through the difficult transition phase, from days
dominated by the need to find money to pay for the next hit, to lives
filled with training, work shadowing and eventually full time employment.
Many of the projects are run by ex-addicts and pay their bills by operating
as small businesses - undertaking work as varied as reconditioning jeeps
and building houses.

The pioneering Kaleidoscope project in London, where I work as Development
Director, has implemented some of the lessons of these Asian success
stories - creating treatment that combines education, training and
treatment in one small organisation. The government could also apply this
philosophy to benefit system.

In Newcastle there are factories that find it difficult to recruit, despite
families on the other side of the city where there are three generations of
unemployed. Most addicts will fall through even schemes targeted at the
socially excluded - by failing to commit to training or keep regular
appointments. The government should do everything it can to get them into
work - providing transport if necessary to deliver them to work direct.

Though this seems expensive, the absolute priority must be to get users
back into the structure provided by work. Of course, employers won't want
to deal with the messy social problems that addicts bring with them.
Private recruitment agencies should be paid by the government to run
programmes that combine recruitment, training, management, social support
and transport.

There must be recognition by the government that every society in history
has had its drug of choice.

Instead of promising to halve the use of Class A drugs among young people
by 2008, there should be a pledge to reduce the harm associated with drugs
misuse.

Though legalisation would not be a cure-all, changes in the law could limit
the problems associated with drugs. Licensed venues should be established
for the safe consumption of drugs and greater penalties should be given to
those involved in supplying children.

While British policy remains frozen, other parts of the world are
developing drugs policies that are showing de facto signs of success.

It will be a major blot on a progressive government's record if it lags
behind countries in which the political climate is far more conservative,
maintaining drugs policies whose cost - in resources and lives - has
already been far too high.