Pubdate: Sun, 24 Mar 2002 Source: Observer, The (UK) Copyright: 2002 The Observer Contact: http://www.observer.co.uk/ Details: http://www.mapinc.org/media/315 Author: Rowena Young Note: Rowena Young is Development Director at the drugs treatment agency Kaleidoscope. Her report From War to Work: Drug treatment, social inclusion and enterprise is published on Monday by The Foreign Policy Centre. See www.fpc.org.uk for more information about the report. 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.