issue 140 October 1984
Dealing with the drug problem
Clamping down hard -
this seems to be the only response governments come up with to a rise in drug abuse.
Yet it never works. Don Aitken argues that the policy of making drugs illegal has had its day.
THE worldwide drug control system is falling apart. Third World countries are realising that the stringent controls applied to their own natural products are not matched by those applied to the synthetic drugs produced in the industrialised countries. India and Pakistan, for instance, are required not only to limit their exports of cannabis and opium but also to prohibit the use of these drugs in traditional medicine by 1989, while no effective controls prevent the dumping of dangerous synthetics by western pharmaceutical companies.
A number of drug-producing countries, most notably Colombia, are discovering that their enforcement agencies are now effectively out of control as they become a battleground for American dealers and American narcotics agents, both with big money to throw around. Just as these countries are prevented from taxing or controlling the drug trade, so European countries like the Netherlands are losing patience with the traditional law-and-order approach to drug problems.
The international drug control machinery suffers from many faults, but by far the most important is prohibition. The theory is quite simple. If the use of certain drugs is deemed to be dangerous or otherwise undesirable the appropriate response is to make their use illegal.
This doesn’t work — and it never has done. Yet the only response governments come up with to an increase in drug use is to raise both the penalties and the resources devoted to law enforcement. In the UK in 1984 precisely this response is being made to the current dramatic upsurge in heroin use; a number of MPs have urged an increase in the penalties for heroin trafficking, apparently in the belief that 14 years’ imprisonment is not enough. The Government, presumably thinking along the same lines, has refused to reduce the penalties for cannabis offences as recommended by its official advisory body, on the grounds that such a step would only encourage people to take it.
The logical outcome of such thinking is being demonstrated in Singapore, where the death penalty for drug offences is now applied almost as a matter of routine. And in the UK the demand for criminal penalties against glue-sniffing is becoming almost irresistible, while even the use of the criminal law to control tobacco-smoking is becoming a popular cause among the politically innocent.
The effects of prohibition are now well understood by criminologists — and they apply to gambling and prostitution as well as drugs.
One important point is that demand for drugs doesn’t fall by very much even if the price rises steeply. Once they’ve been banned, people who refuse to break the law cannot supply it. This means that those who are prepared to break the law are protected from competition and can raise the price as they please — this effect is known as the crime tariff. The more effective the law-enforcement, the less competition there is and the higher the price and profits go.
Another effect of prohibition is that users are turned into criminals — and that makes the health risks much greater. Those who become addicted to opiates as a result of medical treatment (and thus receive supplies legally) tend to survive for a normal life-span and suffer few if any physical complications. By contrast the ‘street addict’ is 20 times more likely to die than someone else from their age-group. There are many reasons for this: illegal drugs are often mixed with other unsafe substances: they’re likely to be taken in unsterile conditions, and users are often forced into crime in order to pay black market prices. Prohibition is supposed to protect the consumers — instead it victimises them.
People in favour of prohibition tend to assume that ‘if it wasn’t illegal everybody would be doing it’. It should be obvious that the number of people likely to be attracted by such a practice as self-injection of heroin is fairly limited. Furthermore, for every person deterred by a drug’s illegality there are likely to be several others attracted by it - and those attracted will be much more susceptible to any harm it may cause than those deterred. It is virtually certain that banning a drug does more damage than lifting a ban.
The drawbacks of the prohibitionist approach are now widely recognised by workers in the drug field. A number of European countries — notably Italy and Spain — have recently changed their laws so as to decriminalise the possession of small quantities of any drug for personal use. This policy is based on a realistic understanding of the limitations of using the criminal law. It is plainly futile to add the damage done by the law to that done by the drug.
The international drug control establishment — ‘the gentlemen’s club’, as they have been aptly called — have had things their own way for long enough. The internationalisation of law enforcement in the drug field, with its systematic exchange of data derived from electronic and satellite surveillance as well as undercover agents is a dangerous precedent. It has been tolerated only because it has generally been assumed that the harm done by drugs is thereby reduced. There is no reason to suppose any such thing.
If a new drug panic is about to hit us, as seems very likely. it is vital that an informed public opinion should ensure that mistakes which have been made so often in the past should not be repeated yet again.
Don Aitken is on the management committee of the Standing Conference on Drug Abuse.
Colin Davey / CAMERA PRESS
...still dealing with the drug problem
The needle in the junkie’s arm — this is everyone’s image of the drug addict.
But most people who use illegal drugs never become dependent.
Dave Turner explains why understanding the drug user is so vital.
AS soon as society identifies a problem, it mounts a grand search for The Answer. The drug field is littered with the shattered illusions of those who believed that they had found The Answer. Unfortunately drug dependence is not a single problem with a universal solution.
The way forward in dealing with ‘the drug problem’ is to recognise that there are different kinds of drug use. It is particularly unhelpful to concentrate all our attention on the chronic drug users, the ‘addicts’, because the problems they experience will be different from those encountered by other drug-taking groups. The more sensitively people’s differing needs and problems can be identified, the more successful their treatment is likely to be.
There are four different kinds of drug user:
the experimental, the recreational, the regular and the chronic.
Experimental drug users are trying out drugs as they might have tried out alcohol, tobacco, glue-sniffing or a range of other activities which adults might disapprove of. They are not addicts and may have no intention of becoming so. The most successful services for this group of drug users are the ones that recognise this fact and build on it. There may be pressure on the experimenters from their friends to continue using drugs, The counter-balance has to come from the family and influential adults. One recent article began ‘Agh! is not a helpful response to drug misuse’ but this is too often the response which parents give.
In Italy, one service for people with drug problems has concentrated its attention on parents, teachers and social workers. Its goal has been to provide information and training to these groups so that they are able to distinguish between different types of drug use and not feel impotent faced with someone using drugs. This is important not least because the young person is too often much better informed about drugs than those who are expected to guide them.
The recreational drug users, the chippers, the pill-poppers, use drugs for social occasions. It may be as normal a part of their lives as drinking alcohol or smoking tobacco may be for others. Using drugs is an occasional activity, not a necessity. And it doesn’t matter too much which drug they use, cannabis, amphetamines, heroin or cocaine. For recreational drug users, the essential thing is to offer information designed to reduce harm which might arise from ignorance.
In the United States, the Do It Now Foundation has made a valuable contribution, producing factual material in a form which is relevant to the recreational drug user. This has allowed drug users to make informed decisions about what drugs they use, knowing the possible consequences. In Britain, Release has acted as the agent for Do It Now and has produced its own material in a similar style. Alternative magazines and books have also been important sources of information. They start on the basis that their readers are already occasional or recreational drug users, not innocents.
Unfortunately, both in the United States and in Britain, attempts are being made to censor the available drug literature. In the States, this has taken the form of attempting to withdraw previously published works which do not carry the present ‘party line’. In Britain, prosecutions under the Obscene Publications Act are taking place in an attempt to declare many books and magazines obscene — capable of depraving and corrupting. If these prosecutions succeed, then much drug literature will disappear. As a result, there may be many more drug casualties.
The regular drug user conforms most closely to the traditional middle-class addict before the 1960s. Most commonly, their drug use is of heroin, cocaine or a synthetic opiate like methadone. They continue to be employed, to be housed, to have a family, and their drug use is just one part of their lives. Rarely, if ever, do they increase the amount of drugs they are using, and if they do, it is occasional and more akin to the heavy drinking which alcohol users sometimes engage in at special events.
For this group, the British treatment system has proved most successful. The initial goal has been to withdraw the drug user and to assist them to live without drugs. However, where this has failed, a regular prescription for drugs has been provided without increasing the quantity. The drug user has continued to work and to maintain non-drug-using social and family relations. However, because of an unwillingness to respond to the differing needs of groups of drug users, this treatment has only been available on a limited basis, usually by private doctors. The inevitable occasional mistakes, combined with the greed of a very few doctors who have prescribed for money rather than for the needs of the drug user, has meant that attempts are being made to put the last nail in the coffin of the British treatment system. The plans which are now being considered will confine all prescribing to hospital drug units and will inevitably push people towards the black market.
Chronic drug users, the stereotype of the drug addict, live a life centred around drugs. Finding them, buying them, stealing to get money to buy drugs, socializing almost exclusively with other drug users. Services for them have the double task of helping them to survive and to work towards giving up drugs altogether.
The most effective services which have been provided for this group of drug users have been easily accessible drop-in centres called ‘street agencies’. These recognise that when a drug user asks for help the opportunity has got to be taken straight away. The request may be simple or complicated but it is an opportunity to give positive assistance which if not taken may be missed for a long time. Practical help may be provided with a range of problems, such as housing, money or the law. Within the context of these discussions, chronic drug users are pressed to look at how they might change and improve their lives
If they are eventually inclined to attempt to live without drugs, many chronic drugs users need a period of residence in a medium- or long-stay rehabilitation house. These houses aim to help people rebuild a structure for their life without drugs. They are self-help communities, where drug users are required to be committed to working for themselves and for others.
People with drug problems are representative of the society in which they live. Because they use drugs, they do not necessarily have a drug problem. What they do require is a variety of services able to respond to these needs appropriately, not a new form of evangelism determined to convert all to their particular limited wisdom.
Dare Turner is the Co-ordinator of the Standing Conference on Drug Abuse in London.
Worth reading on...DRUGS
The best introduction to the complex world of drugs is The Forbidden Game by Brian Inglis, Hodder and Stoughton 1975. It is primarily a history charting the changing images and uses of drugs through the centuries. But the history is always colourful and accessible, and the futility of banning drugs comes through very clearly. Inglis is also very keen to stress the insights that the use of certain drugs can offer us.
Living With Drugs by Dr Michael Gossop, Temple Smith 1982, is accented more towards the effects that different drugs have on the mind and body. It is clearly written, includes a separate chapter on most of the major drugs, and Dr Gossop takes a very sensible line throughout.
An interesting recent work is Drug Trafficking - A North-South Perspective by Andre McNicoll, North-South Institute 1984. McNicoIl, who works for Canada’s International Development Research Centre, concentrates on the way in which the global trade in drugs follows a colonialist pattern. He also emphasises that the major drug trade now is from North to South rather than vice versa as pharmaceuticals like methaqualone (often known as 'quaaludes’) find their way into the Third World.
The finest writer about drugs as a means of exploring ourselves and the world is still Aldous Huxley. The Doors of Perception, Heaven and Hell and Moksba (all Penguin) deal intelligently with his experience of mescaline and the conclusions he drew from it—Huxley saw it as a profoundly significant spiritual adventure. Carlos Castaneda’s books about his experience of psychedelic drugs and indian magic such as The Teachings of Don Juan, Penguin 1970, are also fascinating but their authenticity now seems dubious - The Don Juan Papers, edited by Richard DeMille, Ross-Erikson 1980 explains why.
Anyone wishing to study the subject of drugs in more depth should contact the specialist organisations in their own countries — each of them has an extensive library and is committed to increasing our awareness of what drugs do to us. British readers can find the Institute for the Study of Drug Dependence at 1-4 Hatton Place, Hatton Garden, London EC1. The Australian Foundation on Alcohol and Drug Dependence is in the T & G Building, London Circuit, Canberra. Canadians could contact the Addiction Research Foundation at 33 Russell Street, Toronto, Ontario 1452 2S1. And in the US the National Institute on Drug Abuse Resource Center is at 5600 Fishers Lane, Rockville, Maryland 20857.