Pubdate: Sun, 9 Dec 2007
Source: Sunday Herald, The (UK)
Copyright: 2007 Sunday Herald
Contact:  http://www.sundayherald.com/
Details: http://www.mapinc.org/media/873
Author: Neil McKeganey
Note: Neil McKeganey is Professor of Drug Misuse Research at the 
University of Glasgow

NEIL MCKEGANEY ON DRUG MISUSE RESEARCH

LAST WEEK politicians on the health and sport committee of the 
parliament were told that government spending on tackling Scotland's 
drug problem had topped UKP431 million. The winners and losers in how 
that money had been divided were drug enforcement, drug treatment and 
drug prevention.

Drug treatment saw its share of the 2007 budget increase by 11% over 
the figure in 1999, while the allocation for drug enforcement fell by 
9% over the same period. Drug prevention attracted only 11% of the 
drugs budget in 2007. Given that Scotland has a drug problem greater 
than almost all of our European neighbours, one might have thought 
that the proportion of the budget allocated to drug prevention would 
have gone up rather than down.

The first question anybody would ask about a drugs budget nudging 
towards half a billion a year is whether that money is being wisely 
and effectively spent. Unfortunately, that is virtually impossible to 
answer. The reason is because of a number so small that you almost 
need scientific instruments to spot it. That figure is one third of 
1%, which is the proportion of the drugs budget allocated to 
research. What this means in effect is that 99.6% of the drugs budget 
is being spent on the basis of evidence obtained on the basis of the 
remaining one third of one per cent.

On the basis of those proportions, if we identify a successful way of 
tackling our drug problem in Scotland it will be a matter more of 
luck than judgement. What is more likely is that we will continue to 
throw ever larger sums of money at tackling the drug problem without 
really knowing if we are being effective.

The scale of our ignorance in tackling Scotland's drug problem is 
staggering. Here are a few examples of things we should know but 
don't know. How many people on our UKP12 million-a-year methadone 
programme are leaving the programme drug-free? The answer: "Don't 
know". What is the effect of giving community sentences rather than 
custodial sentences to those found guilty of dealing drugs in 
Scotland? Again: "Don't know." And what do we know about the 
long-term effects on children of living with a drug addict parent? Is 
it better for them to continue to live with their parents or for them 
to be moved to a family without a drug problem? "Don't know".

Importantly, these are not matters of abstract ivory tower concern, 
but are of enormous practical and urgent importance. In Scotland 
today we have doctors providing more methadone, to more drug users, 
at more expense, than at any time in the past. We have courts 
awarding community sentences to drug dealers and we have social 
workers struggling to decide whether it is in the child's best 
interests to live with their addict parents or to be moved to a place 
of safety. For the most part these decisions are being taken on the 
flimsiest possible evidence base.

The current Scottish government may end up being more supportive of 
research in this area than previous administrations. It is a sad fact 
that they will have to do so little to achieve that laurel, but the 
prize will be in finding out whether the half-billion pounds of 
public money spent on tackling the drug problem is being wisely and 
effectively targeted.

The answer to that question is a necessity, not a luxury.
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MAP posted-by: Richard Lake