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					                           CENTRE FOR POLICY STUDIES




                                        PandA
                   (Prisons and Addiction Policy Forum)
                               The 2008 Drug Strategy
                    The continuing nationalisation of addiction


Who could fail to disagree with the sentiments behind the government‟s revised drug
strategy (Drugs: Protecting Families and Communities, 2008 -2018 Strategy, Home
Office, 27 February 2008)? Strengthening communities, working together, “a clear
commitment to meet the needs of all our diverse communities”, and “preventing harm to
children, young people and families affected by drug misuse” are hardly controversial.
But does this report avoid controversy because, like its predecessors, it lacks direction,
critical reflection, and a fundamental understanding of the complex problem at hand?

In fact this new strategy is even more all-encompassing, woolly and vague. Instead of
challenging the incompatibility of addicts‟ wants – of their aspirations for normalcy along
with continuing drug dependency (whether on licit or illicit drugs) – the Government
continues to ask us to suspend disbelief and to muddy the waters of policy by asserting
that it has met, is meeting and managing this incompatible demand.

Unsurprisingly then the strategy document fails to look critically at the treatment system
of its own creation, one that is overburdened by bureaucracy but undermanned in terms
of real skill and knowledge in relation to treatment.



Recovery or harm minimisation?

An effective drugs strategy should be grounded on the need to move people from a
culture of addiction into a culture of recovery. Helping people to get better is what the
public expects and is crucial to a healthy civil society. Allied to this must be an
understanding of the behavioural change involved in getting better.




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Yet this plays little part in current Government policy.

The Government‟s preferred but unachievable aim remains to reduce the harms of drugs
use, primarily in terms of crime. This approach is a misconceived „early retirement‟
strategy to reduce crime by pasturing addicts out on prescribed substitute drugs. The
necessity of abstinence, which in other European countries is recognised as the key step
on the road to recovery, is absent from UK treatment policy. The revised strategy pays lip
service to it – possibly in response to recent criticism of poor policy outcomes – but
mentions it is only as an optional add on, not as a fundamental.

“Harm minimisation” is central to the government‟s drug strategy. Again, who could
disagree with this? We all want to reduce drug-related harm (social, psychological and
medical) to the lowest possible level. But the harm reduction techniques that are espoused
to achieve this goal seem to rely almost entirely on replacing one substance (say heroin)
with another (methadone).

This failure ha been exposed by Mark Easton, the BBC‟s Home Affairs Editor:

       The real business of this strategy is about spending something like £4 billion of
       public money over the next decade on drug treatment. Now, the point about that is
       that this strategy was actually written after the Treasury last year agreed its
       funding for all of this, based on the same targets as the old strategy. So frankly,
       whatever the press release says, we can be confident that this new plan will be
       very similar to that old one, based primarily on measuring how many people are
       signed up for treatment, and the problem with that is it doesn't tell you whether
       treatment is actually doing any good. If you remember, last October on the Today
       programme, we revealed some figures which showed that of the 180,000-odd
       people who were signed up for treatment, 20,000 never actually had any
       treatment, 80,000 didn't complete their treatment, and just 5000, less than 3%,
       left the government programme free of illegal drugs. Now, since that report, one
       academic in the drugs world said it was, ‘like a rocket fired into the English drug
       treatment structure, an Emperor's New Clothes moment’.

                     Mark Easton, BBC Home Affairs Editor Today 27th February 2008




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This failure cannot be excused by the nihilistic argument that drug addiction is a
„chronically relapsing condition‟ – nihilistic because it ignores the international evidence
that recovery is possible, common and more likely without rather than with government
intervention.



Government bureaucracy

For the last ten years the government has mirrored the incompatible aspirations of the
addicts themselves. It has promoted the prescription of methadone as the panacea that can
reduce the harms of drug use despite the reality that it is maintaining (euphemistically
described as managing) drug users‟ dependency, indefinitely putting off their day of
reckoning. Though dressed in the language of the need to engage families in treatment,
though espousing the need to „safeguard‟ communities, nothing in the strategy suggests a
fundamental review of what constitutes treatment. The policy of moving addicts,
(described as „service users‟), from one dependency to another, in which „treatment
managers‟, „substance abuse‟ workers and policy advisers, as well as addicts, are caught
up, remains intact. Those „drugs workers‟ who are employed by and who have „grown
up‟ under the aegis of the National Treatment Agency, know little else.

The National Treatment Agency has become the pinnacle of a monolithic treatment
bureaucracy. Its commissioning edicts and care protocols must now be implemented by
the 150 local area bureaucracies (Drugs Action Teams or DTAs). Yet when the DTAs
were first formed in the mid-1990s, it was in recognition that no single agency could deal
with the drug problem in its area on its own. Since the formation of the NTA in 2001,
they have, however, become part of the state machinery. Commissioners and co-
ordinators have grown in prominence and use public funds without much accountability
or transparency. The names of DAT „chairs‟ are not even published, only those of their
co-ordinators and commissioners.

Today, rehabilitation is the treatment of last, not first, resort and only then when the
addict, rather than the system, is seen to have irredeemably failed – by which time the
destructive impact of his or her dependency is likely to have had far-reaching and
negative consequences.



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                           CENTRE FOR POLICY STUDIES

Today „fast-tracking‟ into prescribing treatment via the criminal justice system is the
norm. The 150 Drugs Action Teams, idealistically established on a joint services
partnership basis to commission treatment, have become little more than expensive
quangos. The current treatment requirement is a demand for limited co-operation. It is not
a challenge to or support for recovery. Voluntary access through the health system and
through social services, where such problems can and should be picked up, has remained
under-developed.



Trapped in addiction

In engaging in a policy of mass prescription, in believing that incompatible wants can be
met, in making doctors and counsellors act to meet political goals rather than patients‟
needs, the government has taken upon itself an extraordinarily interventionist, ethically
questionable and contradictory role. It is guilty of worse than over-promising and under-
delivering. It is guilty of effectively legalising drug use by the back door at the tax
payer‟s expense; and of trapping addicts in the condition they need to escape from.

It is also responsible for a burgeoning addiction industry funded to the tune of £7 billion
over ten years, replete with vested interests in its continuation. Few involved in the
complex commissioning funding framework can afford to be totally honest about the
problem even when they understand it.

Through this treatment hegemony the Government has institutionalised the pretence that
addicts can have it both ways. They cannot. Neither can the Government.




Kathy Gyngell
Chair, PandA Unit, Centre for Policy Studies
April 2008




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