This is the text of an article I wrote that first appeared in the Brighton Argus on 21st June 2011 and in Drink and Drug News in July 2011:
In the last week I bumped into two former clients of Brighton Housing Trust’s Recovery Project. The project offers an abstinence based programme which provides a route to life without use of illegal drugs or prescribed substitutes.
Rob (not his real name) is just finishing his final exams at Sussex University. He looked well although stressed and tired due to lack of sleep. The next day I saw Rachel (again not her real name) who spoke about how much she was loving her new job – she had recently been promoted to become a manager within her organisation. I remember her 15 years ago when many would have written her off as another “hopeless junkie”.
One had left the Project four years ago, the other more than a decade ago. They have remained abstinent and have turned their aspirations into reality. Both are happy. Both are an inspiration to me and others, showing that recovery from addiction is possible.
In the same week I read the comments of two leaders in the City with whom I often agree, Caroline Lucas MP, and the head of Brighton police, Chief Superintendent Graham Bartlett, who have called for the decriminalisation of drugs and a harm-minimisation, health-based response. They said that “the war on drugs” has failed, that a new approach is needed that looks at the problem from a health perspective, with more prescribing to reduce crime and social dysfunction.
Like them I am deeply concerned about the high death rate of addicts in Brighton and Hove. However, I was frankly depressed by their proposals since (apart from the call for formal decriminalisation of private use) they are simply advocating a view which has dominated government policy since at least 1997. It is a policy that has failed. This policy has seen ever-increasing numbers maintained in drug use, with spiralling costs to addicted individuals and the wider community that cannot be sustained in ethical or economic terms.
The coalition government has signalled a fundamental change in approach, although this has yet to be translated on the ground. It says it wants to change the way drug addiction is tackled, with more people with problems diverted away from prison and into treatment as part of what it calls a “rehabilitation revolution”. Its strategy involves “championing abstinence” and the Department of Health said its aim is to get users “off drugs for good”. I support all of this.
The Department says the current annual cost of maintaining treatment for 320,000 problem drug users is made up of £1.7bn in benefits, £1.2bn for looking after their children and £730m for prescribing the heroin substitute methadone.
A key issue is one of ambition or rather what can now be seen, in hindsight, as a poverty of ambition. Do we think that it is acceptable to tolerate the £3.6bn now spent on treating users with drug substitutes like methadone and keeping them on benefits each year, not to mention the wasted potential of 320,000 (a conservative estimate) addicts who are maintained in their drug use. Is it acceptable that addicts who wish to be abstinent have for many years now been all too often either denied the detoxification facilities they need or have been actively encouraged to use heroin substitutes?
It is a simple matter of logic that things cannot improve if much of what we do is to maintain people in their addiction. Clients in the Recovery Project testify that, before entering our abstinence programme and when on maintenance scripts, they ‘topped up’ with street drugs. There is also an active market in prescribed drugs which are sold on by addicts supposedly ‘in recovery’. Those addicted in this way may not use or commit crime at the same rate, but they are certainly still stuck in the drug using culture and often acting illegally and destructively.
It is surely ethical that addicted people should be helped to achieve genuine abstinence since it is only when abstinence is achieved that healthy relationships, safe parenting, genuinely secure housing, education, training and employment become viable options.
I fully support the call made by the think tank, the Centre for Policy Studies (CPS), for “a real transfer of power from large distant organisations to small innovative providers” for
rehabilitation. I agree that small units such as the Recovery Project have a better chance of getting addicts off drugs completely, not least because they tend to involve abstinent users in the planning and delivery of services.
Kathy Gyngell, from the CPS, said prescribing methadone to addicts delays their recovery. “The state is subsidising people to be any number of years on methadone, which has turned out not to be a cheap option and will only subsidise the tiniest proportion – 2% – to go into a rehabilitation unit that would actually free them from dependency and allow them to live their life.”
The CPS states “There is one simple measure of success: that of six months abstinence from drugs.” As the CEO of an organisation which offers both harm minimisation services and genuinely abstinence-based treatment, I am ambitious on behalf of our clients. I maintain that 6 months abstinence is readily achievable and would go a step further. Treatment providers should be judged on whether the client is genuinely abstinent – from all mood-altering drugs – six months after finishing treatment.
Recovery from addiction is possible. Those of us involved in policy making, commissioning services and delivering treatment for addicts have an ethical duty to offer safe care to using addicts, but to ensure that treatment leads, in each and every case, to abstinence. Too many lives depend on it.
