Cameron Watt: Conservatives offer addicts hope

Like most activists, I left Blackpool with a spring in my step. It was a good conference; the Conservative Party proved it has the leadership and ideas to reverse Gordon Brown’s failures. Particularly heartening was the raft of measures announced to reverse the root causes of poverty. British society is broken, but it can be fixed.

David Davis may not have shined at conference, but on Tuesday afternoon he made one of its most significant announcements. A future Conservative Government will massively expand abstinence-based drug treatment. Put simply, Conservatives will offer Britain’s hard drug addicts the chance to get clean and stay clean. Abstinence-based Drug Rehabilitation Orders will be introduced to break the cycle of addiction and offending. The orders will require residential treatment or, depending on the nature of the offence and the circumstances of the offender, day care. The orders will provide a more effective alternative to community sentences for drug related offenders.

The UK has the highest level of problem drug use in Europe. Kathy Gyngell and David Burrowes MP produced a devastating critique of the nature and scale of Labour’s failures in their work for the Social Justice Policy Group. Encouragingly, their report underpins the new Conservative proposals.

In response to the drugs epidemic, Government has pursued a policy of management and maintenance, prioritising numbers entering ‘treatment’ over the provision of more costly but effective interventions to break the cycle of addiction. Harm reduction programmes, with their emphasis on substitute prescribing and needle-exchange, have completely dominated. But rather than providing a first step towards abstinence, for most harm reduction has become a dead end. Many addicts live zombie-like existences sustained by high doses of methadone for five, ten, or even fifteen years. It’s as if the authorities are saying to them: “We don’t really care what happens to you, as long as you don’t kill or mug anyone.”

Professor Neil McKeganey of Glasgow University’s Centre for Drug Misuse Research has courageously laid bare the failures of harm reduction in Britain. Programmes have usually failed, even on their own terms, demonstrated by burgeoning rates blood-borne infections among addicts. Last year, Glasgow research showed that 97% of heroin addicts in Scotland were still taking methadone or illegal drugs three years after receiving their first dose. Other McKeganey research indicates that 57% of heroin users want help to quit drugs completely, while only 7% want to be put on methadone. Yet only a tiny proportion of addicts are being offered abstinence based residential treatment.

I have witnessed the effectiveness of many abstinence-based programmes. These include excellent community-based projects such as The Living Room in Stevenage and ADAS in Stockport. In Blackpool Iain Duncan Smith showed moving footage of former crack and heroin addict Elizabeth (pictured) testifying to how ADAS had enabled her to turn her life round and rebuild her family.

Residential rehabilitation is more expensive but considered to be more effective. Amazing work in transforming broken lives is done by the likes of Betel and the Maxie Richards Foundation. As well as removing drug users from malign influences in their home town that might keep them addicted, residential rehab provides a supportive community that reinforces positive choices. Many staff members at all these projects are former addicts, embodying the truth that lasting change is possible.

A large proportion of these projects are run by Christian and other religious groups. With both their faith-basis and abstinence-based approach viewed with suspicion by statutory funders, most of these groups are currently denied a fair opportunity to access government money.

Under Conservative plans, that would change. It’s also likely that mainstream national drug treatment providers such as Addaction and Phoenix  Futures would be prepared to re-balance their provision towards abstinence. After all, the main reason for the current overwhelming bias towards harm-reduction in drug treatment is that all the funding is concentrated in that area.

Harm reduction strategies will continue to have a role. Of course abstinence-based programmes can only succeed where the addict is committed to change. Even when the drug user is exerting considerable will-power, he or she is likely to relapse several times before they finally get clean. And it would be prohibitively costly to offer residential rehab to every addict, even if there were the capacity.

Britain’s drug epidemic can be reversed, but it will take at least a generation. By re-balancing treatment in favour of abstinence-based programmes, a Conservative government can give tens of thousands of addicts the opportunity to reclaim their lives they are currently denied. Conservatives reject Labour’s indifference to drug abuse and the lives and communities it has ravaged. Only a compassionate but hard-headed party can give the addicts and neighbourhoods brought to their knees by drugs the second chance they need and deserve.

Comments

[Tony Makara]

A major problem with drugs is the culture that surrounds it. Very often we see that the music scene becomes the gateway to drug addiction. Music magazines, recording companies and film makers often produce material that openly encourages drug abuse and are frivolous in their approach to drugs. This must end. The future Conservative government must work to ensure that those in a position of responsibility and with access to youth culture, must show a serious attitude to drugs. There are many people addicted to drugs today because they were lured into the drug culture by the drug-friendly nature of the music industry.

[catherine]

Of course abstinence programmes should be properly funded and available to all who want them. But as anyone who works with drug users will tell you, it is not possible to work towards abstinence unless the user themselves is committed to it. Unfortunately there are many who do not wish to come off drugs, and in this situation harm minimization is the most realistic way of helping.

[Anonymous for the purpose of honesty]

catherine I'm not an expert, and as a layperson I can see, as you say, that one is more likely to persuade someone to commence a harm reduction programme vis-a-vis one for complete abstinence. But what does the evidence suggest is the best in terms of getting addicts to become drug-free? It would appear to be the abstinence programmes which are more successful. So why should we go on supporting programmes that don't work?

One of the projects I've worked on in the last 5 years was a proof of concept for a molecule with a novel mechanism of action intended to make it easier for smokers to stop smoking. Would you have agreed to have our drug licenced if we had shown that people on our drug didn't stop smoking, but smoked a bit less for a while, before going back to full-on smoking again? I wouldn't, honestly. I feel the same about harm reduction vs abstinence wrt the users of illicit drugs.

[David Wright]

Harm reduction programmes saves lives - fact
I agree alot of harm reduction providers can end up like methadone feed farms and abstinence programs are needed. Abstinence works for some addicts but not others so a balance needs to be achieved.
Lets look at the definition of addiction in the medical dictionary-A chronic relapsing condition. So the symptoms of drug addiction is relaspe. I ask you what other medical condition are you punished for showing symtoms.
I plea to the new Concervative goverment to work with doctors and not to close the door on harm reduction. Otherwise if you forcebly stop an addicts methadone, subutex etc you will create the revolving door where addicts will go back to street drugs. This will cause a massive rise in overdoses, HIV, Hepatitis C and other blood borne viruses. You can take a horse to water but you can't make it drink. Harm Reduction has it's place and I can't see why it can not work alongside abstinence.