Pubdate: Wed, 22 Jun 2011
Source: Yorkshire Post (UK)
Copyright: 2011 Johnston Press New Media
Contact: http://www.yorkshirepost.co.uk/contactus.aspx
Website: http://www.yorkshirepost.co.uk/
Details: http://www.mapinc.org/media/2239
Author: Kathy Gyngell, heads the Prisons and Addictions Policy Forum 
at the Centre for Policy Studies. She is the author of a new pamphlet 
entitled Breaking the habit: Why the state should stop dealing drugs 
and start doing rehab.

DETOX CAN SOLVE THE CURSE OF DRUG ADDICTION

CARL started smoking heroin when he was 13. By 16, he was on
doctor-prescribed methadone too.

"I felt like an outcast. I was being prescribed four or five different
types of medication and I was seeing my friends start to die. I
overdosed a couple of times in hospital. There was no offer of a detox
- -- ever."

"I didn't want to take methadone any more," Kane echoed. "It wasn't
getting me anywhere; I was still using heroin as well. So was everyone
else I knew. So I told the doctor to keep his prescription and get me
a detox. He told me he couldn't because if I wasn't taking methadone,
I wasn't in the programme."

This is the trap many addicts face today. In Yorkshire and the North
East, 21,000 Carls and Kanes are today zombied out on methadone or
other substitute drugs. Some 90 per cent of them have been in this
form of treatment for more than three years.

The idea was that this would reduce drugs-related crime and deaths.
But it hasn't. Methadone-related drugs deaths have gone up nationally
(85 per cent since 2005) while drug-related offending continues to
rise too.

All it does is impede and delay addicts' recovery. Fewer than four per
cent exit treatment drug and dependency free annually.

"It's a way of masking the problem," Kane thinks. "We'll give you this
so you don't take that -- but we know you're going to take that
anyway. Free drugs, that's all it is. It just messes you up."

Free drugs do not help addicts quit. Yet most addicts do want to come
off. Carl was on various drugs for 22 years, until the Providence
Project, a leading affordable modern rehab, rescued him.

If the cost of getting it so wrong is devastating individually, it is
grotesque nationally. Maintaining the 150,000 addicts in England on
opiate substitutes costs a fortune, both in treatment and in welfare
bills.

Nearly 80 per cent of addicts are unemployed officially (the figure is
higher at most treatment centres). Looking after their children is
another huge cost for the state. At one treatment centre, 33 young
female heroin addicts between them had 79 children, 71 of whom have
had or have social service involvement.

These costs are estimated at #3.6bn a year. Yet scandalously few
addicts are helped to get drug-free. Fewer than a tenth, 9,392, were
given a detox last year. Even fewer, 3,914, had the benefit of
abstinence-based rehab. Half the rehab beds in the country are lying
empty. There are only a handful of rehab units in Yorkshire.

This is a tragedy. Good rehab works. It provides a safe setting that
mirrors right living. It sets rules, supports abstinence, encourages
self-help, mutual support and guides all aspects of helping former
addicts sort out their lives, from education to work to housing. It is
no more expensive than two years on methadone -- and it is greatly
appreciated.

Carl took three months to detox and much longer to learn how to
communicate. He didn't run away; he listened and began to take
responsibility for other people to pay his way during his 15 months in
aftercare. The Providence Project's investment and trust in him paid
off. He has been a fully salaried worker for three years now, paying
tax, putting back into society.

The Prime Minister stated that "the way you get drug addicts clean is
by getting them off drugs altogether, challenging their addiction
rather than just replacing one opiate with another".

The coalition recognises the problem it inherited, and wants to put it
right. But its approach to doing so is fatally flawed. It has set up a
number of Drugs Recovery Payment by Results (PbR) pilots. These are
meant to see what method of treatment best helps addicts.

But these pilots are being run by the NTA and the Department of Health
- -- the two organisations responsible for the previous catastrophic
policy. Existing Drug Action Teams who remain committed to
methadone-prescribing have been awarded all the pilots.

The measures of success set by the DH steering group are negative,
bureaucratic and easy to manipulate. And it remains very expensive.
The small-scale local rehab operators who have the expertise to get
people better, have been excluded from every stage of this process.
Their applications to run a pilot have been turned down. The state
sector and the big operators are smothering the small platoons. The
status quo will win.

There is an alternative, and a Big Society one at that. Solving the
drug problem means recognising that the problem is one of addiction.
The solution lies in freeing people from addiction.

If the Government sets one simple measure of success -- that of six
months abstinence from all drugs -- then all the organisations which
are currently running the trials would rush to find and commission
those rehabs which work.

The Big Society would be the winner. Lives will be saved. And huge
fiscal and social costs will be cut.
- ---
MAP posted-by: Richard R Smith Jr.