Time to Rethink Drug Treatment

It seems incredible, but there was a time when heroin did not have such a strangle hold on certain parts of society. When I started out in 1985 there was some glue sniffing, abuse of cough mixture (still containing opiates) and some cannabis use, but the main drug problem was alcohol. In those days drug addiction of any serious nature was referred to a Regional NHS unit, complete with admission and treatment beds - oh how things changed over the following years when widespread heroin use and associated offending began to be the predominant feature of the majority of probation work. I remember a senior police officer telling me it arrived in my small town in the boot of a black BMW in 1991. Sadly, as the problem grew exponentially, the resources to deal with it have proved woefully inadequate. Residential treatment beds became as scarce as hens teeth, and if located, funding proved a bureaucratic nightmare. For whatever reason the answer was felt to be methadone treatment in the community - cost must have been a factor, but it soon became clear to me that this 'one size fits all' approach was clearly not working. Client after client would describe to me how much more difficult it was to come off methodone than heroin. They said things like 'it gets into your bones' and many chose the nightmare of 'cold turkey' from heroin rather than go back onto a methodone script. As the years have rolled on, I've become aware of increasing numbers of clients on maintenance doses of methodone, rather than the reduction programmes that have clearly failed - and yet as a society we remain wedded to this failed model.

I once had the chance to speak to Hilary Benn when he was probation minister - he was lamenting the state of many neighbourhoods littered with sharps when I said 'well why don't we prescribe heroin?'. He said 'you know, you're the third person to have said that to me today'. Sadly he was soon promoted to Overseas Development and you have to start again with another minister. The reason we don't of course is because all ministers are scared witless of public opinion and especially by the right-wing press such as the Daily Mail. Nevertheless, there have been quiet prescribing experiments taking place in a couple of cities and the results are confirming what has been found to be the case in Switzerland - it works in weaning off those that are well motivated, is safer for those maintained and offending dramatically reduces. So, the question is, does the new coalition government have the bottle to finally signal a rethink on drug treatment - and sod the Daily Mail?