ServiceS
6 |
drinkanddrugsnews
| November 2015
T
he distressing reality of drug dependence alters little over
time, but society’s response to drugs and drug users has
changed markedly over 30 years. During this time the
field has developed an avoidance of the drug reform
debate including decriminalisation, legal regulation and
the role of criminal sanctions in treatment.
So why has this happened? The even-handed position we took
then was usually a pragmatic one stemming from overriding
priorities at the time; firstly to call for services for drug users in the
1980s, and then to argue the necessity and priority of harm
reduction in the 1990s. Treatment providers were urgently distancing
themselves from the moral panics stirred up in the tabloid press
about drugs and HIV/AIDS, placing themselves within a safe, rational
medico-therapeutic narrative.
For those on public platforms or official business representing
treatment services it was a necessary but painful tactic to close
down legalisation questions quickly, to ensure that the message
about services wasn't derailed by being ‘legalisers, soft on drug
users’. Statements such as ‘my organisation is involved in treatment
not politics’ became a default position.
It now appears that the parameters of acceptable debate have
shifted to ‘recovery’ and little else. Despite a major upsurge in overdose
deaths, talk of ‘harm reduction’ is increasingly taboo – and completely
absent from government communications. The term ‘recovery’ has
become a banner for anything broadly related to care, self help, therapy,
coaching, training, social support, treatment and mutual aid. ‘Full
recovery’ is the government’s preferred term, signalling a shift away
frommethadone towards abstinence-based interventions.
But the deployment of ‘recovery’ to mean everything to everyone
leads again to the avoidance of debate and an inability to take
positions. In 2015 this feels distinctly out of step with most informed
opinion and global debate, disdainful of service user arguments for
equality and
social justice and
ultimately negligent
in reducing the risks and
harms of drug use.
We all know that
drug dependence only
affects a very small
minority of the many
people who use drugs to
the extent that they may
require significant interventions.
It is these clients of drug treatment services in the community and
in prison that are cited by ministers as the justification for the
Misuse of Drugs Act and the reason why legal regulation will not be
entertained.
Treatment providers’ fear of biting the hand that feeds may have
strong historical justification. But the factors that prohibition
creates – a thriving black market with easy credit and violence –
reduce the ability to provide treatment, undermine the
communities in which drug use is most prevalent and demonise
people who use drugs.
Now that’s what I call an obstacle to recovery and it’s time for
the field to find its voice. It’s time to recognise that between those
in recovery and those who provide treatment, care and support,
there is a tremendous expertise that could articulate a way forward
that is broad-based, constructive and reformist.
Disappointingly, it seems that the sector is content for almost
anyone else to lead the way in this debate – even though it has
potentially profound implications for them and their clients. Most
recently police and crime commissioners have called for a
‘comprehensive review of strategy’ in a letter to the home secretary,
with many chief constables also supporting reform.
When Portugal decided to decriminalise possession and replace
it with a health response it wasn’t because they had discovered a
radically effective approach to treatment; it was because they saw
the criminal justice-led response as being both ineffective and
harmful. In adopting a health-based policy they were choosing
treatment approaches that have been used in the UK for more than
25 years – methadone, rehabilitation, detox, care planning, social
Off track?
Drug treatment is
being derailed by the
sector’s refusal to push for
reform, says
Ian Sherwood
