Archive for the ‘decriminalisation’ Tag

Dr Death joins the decriminalisation debate

Friday, June 14th, 2013

Some sad news – another death from PMA (para-Methoxyamphetamine). This is the fourth in Derbyshire in recent months, with two further deaths just over the border in Macclesfield, and a total of eleven deaths recently linked to the drug in the UK. This poor lass was a 24-year-old mental health worker who had been on a river party cruise in Nottingham. Later that night she started convulsing at home in Ilkeston and was dead by the time she reached hospital.

The drug, which is being sold as ecstacy, is not only very toxic, but the toxicity quickly multiplies as doses increase. Couple that with the slow onset of its effects while users are expecting the quick hit of ecstacy, and you have a scenario where people neck more thinking they have a batch of dud pills. It works in much the same way as antidepressants, by inhibiting serotonin reuptake, and so is really not a good idea for anyone on these type of medications.

It seems that only the tabloids are interested in this story. Using their impeccable ability to turn any story into a soap opera, they have named the drug ‘Dr Death’. I’m not quite sure what it has to do with Harold Shipman, or why they feel the need to anthropomorphisise a substance by turning it into an evil physician, but it sparked fury on the Mail’s comment pages. Those able to read the article then type a response missed the point that the victims thought they were taking ecstacy, with comments such as “You’d think that since the drug is called “Dr. Death” people might actually doubt whether it’s safe to take” and “The clues in the name!” (his lack of apostrophe, not mine), or the more resigned “This is what teenagers do these days” *sigh*. My personal favourite, a statement which manages to misconstrue any educated facts into Jeremy Kyle bullshit – “Ecstasy kills. Heroin kills. Crack kills. It may not kill you the first time you take it, or even the 5th but it will get them eventually, that goes without saying. So kids, please, put the common sense into action and live”. Hey kids, just say no, or Dr Death will sneak into your room at night and bum rape you TO DEATH. That goes without saying, it’s common sense. In the name of sweet baby jesus, take the aptly-named Amy Winehouse’s lead and use something safe like vodka – because it’s not a drug, it’s a drink.

In contrast, this story makes me genuinely sad. Yes, people took the drug of their own volition, and yes, drugs are illegal, but these were all young people having a good time, taking what they thought was ecstacy, which they had probably taken many times before. But the sad truth is – the deaths were completely unnecessary. If, as previously considered here, drugs were decriminalised and monitored by Trading Standards, people would know what they were taking, how much, and could even gain access to information about the interactions between the drugs they were taking, for example how PMA interacts with MDMA (which causes serotonin syndrome, leading to severe overheating and convulsions).

Or, in the Netherlands, thirty ‘drop labs’ have been commissioned, where people can take their drugs for free testing. This not only gives users access to information about what they are taking, leading some to claim that it allows them to hold dealers accountable and therefore has improved the quality of drugs being sold locally (meaning increased safety as people know what they are consuming) – but also enables national monitoring of drug trends and purity, and hence improved opportunities for harm reduction interventions. However, this approach of course will only work in a society where attitudes to drugs are more liberal, where there are testing labs in every town, and where people are organised and motivated enough to utilise the facilities. But it’s a start.

If only one of the sensible newspapers would report this story, it could be used to support the decriminalisation debate, then maybe this argument would reach people with influence and we wouldn’t have to see stories like this. I would just like to point out that I am available for freelance work…

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Santos speaks out

Wednesday, June 5th, 2013

While we are all whining on about the impact of drugs on our communities, and the effects on individuals, South America and Mexico continue to deal with the shocking human cost of producing and distributing cocaine, methamphetamine, cannabis and other drugs. Much like the opium situation in Afghanistan, cocaine and cannabis are cash-crops – but unlike Afghanistan, it’s not just the fluffy types at the UN wanting the curb the trade. Pressure on South American and Mexican governments from the USA to stop the export of cocaine and other drugs has meant tough penalties for those manufacturing and trafficking, because failure to adhere to these US-enforced policies means risking international relations with their closest, richest neighbours and vital trade partners. This has caused a full-on war between the authorities and organised criminals, leading to death rates that surpass most genocides. In Mexico alone, between 2006 and 2011, it is thought that around 60,000 were killed or ‘disappeared’, many of whom remain unidentified after being found in mass ‘narco-graves‘.

In an unusual (and strangely under-reported) move, Columbian president Juan Manuel Santos has this week published an article in The Guardian’s ‘Comment Is Free’, outlining the main points of a report produced by the Organisation of American States (OAS) in partnership with Oxford University. The report suggests ways in which the issue could be tackled, not from a moral perspective (ie what should happen) but from a pragmatic standpoint (what could happen). Santos states that this new set of approaches broadens the debate past the polarised ‘warriors’ and ‘legalisers’ arguments – after all, this is not Star Wars, there is no good versus evil, and neither extreme offers valid ideas to vastly improve the lives of ordinary people.

The scenarios proposed in the report, which has been released as the OAS leaders meet this week in Guatemala, involve providing better health, education and employment opportunities to offer real economic alternatives to those embroiled in drug production and trafficking and their communities; strengthening public institutions to improve the welfare of citizens; better (and, I would imagine, less hierarchical) co-operation with international partners; and redirecting budgets currently spent on international priorities (law enforcement in an attempt to stop the drugs being produced and exported) to local priorities. Clearly some of these approaches will require international support to be implemented – as long as the US and the rest of us keep pushing for the problems to be contained, the internal wars and consequential deaths will continue.

However, the headline-grabbing proposal made in the report is to look at alternatives to criminalisation, starting with the legalisation of cannabis. It seems to me that the OAS have seen an opportunity to use the current cannabis debate in the US, which has resulted in Colorado and Washington legalising the drug, cleverly to their advantage. The report suggests South America and Mexico follow suit, and so appears to be jumping on the US bandwagon. After all, it would be highly hypocritical for the US to claim that the rights they offer their citizens were not applicable to the citizens of their neighbouring countries. But it also uses the US model to politely point out that the problems the War On Drugs causes the USA might cause one or two little problems in their countries too – and they don’t just have over-run prisons and drug treatment centres, they have pits of nameless dead.

Luckily, President Santos does seem to be getting some parallel support from this side off the pond. A letter from a group of MPs and celebrities to our Government was published in The Times this week, signed not only by candyfloss-haired minted powerhouse Richard Branson, marathon-shagging squealer Sting, and you-get-loads-of-sex-how? lanky slime-ball Russell Brand, but also politicians from the Conservatives, Labour, and the Liberal Democrats. The movement is being led by Caroline Lucas of the Green Party, whose personal stake in the matter may be the destruction of vast areas of rainforest as chemical byproducts of drug production are illegally dumped. The letter questions the validity of the War On Drugs and asks how the Government can justify their £3b a year spending on their current approach, suggesting that possibly an evidenced approach might be a better use of public money. (You know, try to see if something works before you spend our hard-earned cash implementing it. Just a thought.)

Whilst the letter does not make direct reference to the situation in America, it is yet another high-profile attack on existing drug policy – and only adds to the ever-increasing international momentum for things to change. It seems to me that we are on the cusp of the greatest social paradigm shift since the abolition of slavery. But then I am a bit of a drama queen.

Heroin for the poor, cannabis for the sick, and the death of an anti-capitalist dream

Friday, May 3rd, 2013

There have been some interesting additions to our previous ponderings in the news this week.

Drugs in medicine

A US collaboration between a medical research team and a centre for substance misuse research have found that cannabanoids can reduce the replication of the HIV virus in white blood cells. This may also relieve inflammation of the central nervous system, reducing symptoms of HIV-related neurocognitive disorders. The broader applications of these findings to other disorders are now being considered.

If we think back to Cancer Patients With Acid Smiles, here is another example of the US striding ahead because they are changing their angle on substances. Cannabis is no longer illegal in some American states, making it free game for medical research, and, as Professor Nutt pointed out, we are slowing down progress in tackling some of our worst illnesses by limiting the substances we consider for treatment.

By way of comparison, a prescribable Naloxone injection becomes available in the UK this week. I have been reading recent discussions on American websites about the huge problem that opiate (illicit and prescribed) overdose is causing over there, as I waved the British flag with news of the work being done in Wales where heroin users and their families have been trained to administer Naloxone. It seems, given the market launch of the product, that this life-saving product is now available to anyone over here. Hooray for harm reduction.

Afghan heroin trade continues to boom

The United Nations has apparently released data suggesting an eighteen percent growth in Afghanistan’s opium trade in the last year. As I suggested in Smacktastic Britian, this correlates nicely with the Government’s poor-battering, and we are bound to see a new wave of heroin use across the country. Maybe David Cameron should read Cameron Does Cocaine and get the bloody stuff taxable sharpish. It would certainly fit in with his other policies if he could provide an actual opiate for the (poor) people. Make it half-price on election day to keep the buggers at home. Although given that the CIA have reportedly been sending over suitcases stuffed with cash for eleven years now, maybe that trade route has already been baggsied. After all, the Americans are the originals (and the best) when it comes to using substances for social control.

Silk Road taken down by hacker

And finally, the website Silk Road was briefly closed down by hackers this week. It is thought the anonymity software Tor, which became known as ‘the dark web’ because of its uses for the grimier side of the net, is to blame for the problem, and that vulnerabilities in the system may have been exposed. This has come in the same week that the Bitcoin system has also been breached, as a software specialist illegally ‘mined’ an amount of the currency for himself. Unsurprisingly, the virtual currency continues to drop in value.

All of which is proof that, if someone is clever enough to develop a system, there will always be someone clever enough to cheat it. It saddens my socialist ideals that the person who tried to take on the banking system wasn’t superiorly intelligent (in my mind he is a masked hero called Merchant Wanker – make love, not profit), but, as we have to accept, there are vultures everywhere, and nobody likes a clever clogs.

Cancer patients with acid smiles

Tuesday, March 19th, 2013

The New York Times reported last year that psychedelic drugs were being trialled in cancer treatment – not to encourage remission, but to help people face their own mortality. Far from being smacked up to the eyeballs to achieve this anxiety release, patients undertaking the trials experienced long-lasting benefits in terms of mood and attitude towards life – and death – from a single administration of psilocybin, the psychotropic substance found in magic mushrooms .

When taken in controlled conditions which encourage the participants to think about their lives and those they share them with, an emotional catharsis appears to take place. Subjects report being able to experience the emotions felt by their loved ones relating to their illness, and a spiritual connection to the world which enables them to see life as part of a process, therefore removing the fear of death. Effects were immediate, and scores on depression and anxiety scales were consistently lower at six-month follow-up.

Now this research is only small-scale, but if you cast your mind back, some of you will have read about David Nutt(bag)’s campaign to enable LSD and MDMA (esctacy) to be used in clinical trials to look at their efficacy in treating depression. Now I acknowledge that it’s probably the fault of the media, and it’s not that I contest what he has to say – I just find myself frustrated that I can see the world isn’t ready for his outlandish statements, so why can’t he? The man needs Alistair Campbell.

However, below the media hysteria that hangs precariously off his every word like a failed snot-rocket, are some incredibly interesting points, which not only support the research findings around treating the fear of imminent death, but have some potentially broader-reaching implications. Psilocybin, for example, has been found to reduce symptoms of depression and anxiety disorders, by shutting down parts of the brain associated with the unhelpful and repetitive thought processes on which the illnesses feed. It has also given some insight into the neuropsychology of schizophrenia. MDMA appears to enable post-traumatic stress sufferers to revisit problematic memories without experiencing overwhelming fear. It seems that the drugs associated with free love may in fact be capable of breaking introspective thought patterns and giving us back our sense of perspective. (Which, let’s face it, most of us in the western world would benefit from.)

Now I am not suggesting that wigging oneself out on pills and mushrooms everyday is a health intervention. Far from it. We all know the pie-eyed star-gazers who went a bit too far for a bit too long and, after a brief spell of drug-induced psychosis, now shuffle around talking to themselves, looking constantly surprised, devising conspiracy theories about the Government. Too much of these substances can cause long-lasting damage to the grey stuff. But who is to say that measured doses of these active ingredients couldn’t have their place in mental health treatment? Or, for that matter, addiction treatment?

Anyone who has ever had cognitive behavioural therapy, solution-focused therapy, hypnotherapy – pretty much any psychological intervention – will know that the their fundamental bases are breaking unhelpful, engrained thinking patterns. If you can help people lift their heads to see above these negative cycles, they realise that life doesn’t have to be like this. Now if a controlled dose of psilocybin can achieve this, a) the massive financial burden of treatment for depression, anxiety and addiction would be minimalised, and b) I’d be out of a job. Sounds like a plan.

In his usual ‘all right David, tone it down a bit’ way, Professor Nutt has claimed that it’s “outrageous” and “a scandal” that further studies into this have not been done, but I think he has a profound point – the only thing complicating this research taking place is the illegality of the substances involved.

Whether or not you agree with decriminalising drugs as a whole, I think there can be little argument that these substances should not be made available to medical researchers. And this is in a country where George Osborne is making beer cheaper. (How thick and easily-pleased do you actually think we plebs are, George?) I increasingly struggle to understand the arbitrary disparity between the Government’s treatment of different substances… Maybe I’m going a bit Nutts.

Theresa May’s Skirt

Tuesday, March 12th, 2013

It’s hard not to pull another ‘Theresa May or may not’ pun in light of this week’s news, but I think we can all be pretty confident that impartiality will not play a part in her ‘what works study’, and so we might be best steering away from language that implies an absence of foregone conclusion. After all, “The Government does not believe there is a case for fundamentally rethinking the UK’s approach to drugs”, and despite the recent peer review which suggested otherwise, “a royal commission is simply not necessary” (with ‘simply’ here meaning ‘in my opinion, and I hold a position of great power, so frankly the rest of you can go fuck yourselves’).

It doesn’t sit comfortably with me making the point that Theresa doesn’t have children of her own, as it drives me mad that every prominent female figure has their personal life and physical appearance analysed, while their male counterparts can walk around looking like someone ran over their fat faces, sticking bits of themselves into anything that will let them (and some things that don’t), and no-one bats an eyelid or feels the need to pass comment. However, on the issue of drugs, I can’t help thinking that being a parent might make Theresa somewhat less glaringly out-of-touch with what is happening on the street, if ya get me, blood. If she had a teenager with friends on Facebook that used words she didn’t understand, or had to carefully vet nights out to ensure none of those state school kids were going to be at this dance – or even, god forbid, had a child who disclosed cannabis use but hadn’t developed schizophrenia or grown another set of arms in their sleep (probably for stealing) – she might be less focused on figures showing heroin and crack use to be at their lowest levels, and more on the scary prevalence of ‘legal highs’.

However, her claim that she will “review new evidence of what works in other countries” is nothing more than an exact word-for-word restating of a commitment made in her 2010 drug strategy. It is not hard to see through the flimsy smokescreen that this is, in fact, a statement that they are going to do nothing – other than funding some Lib Dem to go on a jaunt, despite better evidence being available via academic studies on the internet. (“Best send one of theirs, David – gets one of them out of the way for now, focuses the matter on opinions instead of hard facts, and means we can completely ignore his findings whilst avoiding those ghastly ‘party divided’ headlines.”) The action falls short of offering anything that wasn’t already promised three years ago, but is released as a news story for no other reason than to spin some yarn that the Government is doing something, anything, in response to public and peer pressure to genuinely review drug policy.

You might think it’s a clever skirt, Theresa, but us plebs aren’t quite a thick as you might like to think. Nice legs though, love.

An eye for an eye

Wednesday, January 30th, 2013

There have been some big stories in the news over the last week which raise some fairly weighty moral questions. There is the grandmother who has been sentenced to death by firing squad in Bali, a series of deaths related to dodgy ‘ecstacy’ use, and a bereft father who killed his son’s friend who he believed was responsible for his son’s ecstacy overdose death.

Whilst the reporting of these stories is, largely, one-sided and either takes the line that the subjects were pitiful victims or deserving criminals, it’s not hard to see how these stories sell newspapers, as they make a controversial statement which the reader either agrees of disagrees with. But if we cast our minds back to last week’s blog, ‘Drugs are bad, kids’, it’s maybe worth considering that this value-load is unhelpful in getting to the core issues.

What anyone promoting the decriminalisation of drugs must accept is – regardless of legal status, drug use will take its casualties. Yes, the recent blight of PMA in tablets believed to be ecstacy, which has killed a number of people in Lancashire and Derbyshire, was avoidable, and probably wouldn’t have occurred had the Trading Standards legislation recommended by the peers’ review been in place. Under these suggested changes to the law, the ‘ecstacy’, had it been bought through a trusted supplier and not on the black market, would have been labelled as PMA, with the relevant health warnings and expected effects, and, in all likelihood, would never have been ingested or even purchased by the now dead users, as it was not the drug they wanted to take or had experience of using relatively safely.

The Lindsay Sandiford case again exists as a byproduct of the international ‘War On Drugs’ and goes something like this – drugs kill people, drugs are only here because people bring them, so the solution is to… kill… people… No it doesn’t make sense to me either. I mean, I understand why they want to make an example of her, but they could probably achieve the same minimisation of risk she personally poses by sending her home and taking her passport off her.

And then there’s the newest development: a charity is advising her to sue the Foreign Office for not supporting her on appealing against the sentence – a decision which, although she has clearly made an informed choice with obvious consequences, does seem a bit harsh given that we are, I think, still harbouring Abu Qatada. I would think the money spent on the legal case attempting to extradite him would have been better used by the British Government supporting her appeal and attempting to get this admittedly stupid, but probably not evil, woman back to the UK. Again, it seems that replacing morality with logic would make more sense (although I acknowledge my own moral belief in this argument that killing someone is just plain wrong, and do find it difficult to separate morality from reason – hence using words like ‘evil’ – spot the *ahem* deliberate mistake). Also, I’m not quite sure what she’s planning on doing with the money if she wins her case…

However, possibly the most morally-complex case, and the one which no amount of changes to the war on drugs would have made the blindest bit of difference to, is that of Roy Allison. Roy’s son, Roy Jr, was found dead the morning after celebrating his 28th birthday with friends. The cause of death was noted as an ecstacy overdose (I have to admit I would like to know of they came to this conclusion as he had also been taking cocaine and alcohol, but I’m sure these coroners know what they’re doing), and after several months becoming suicidal and “consumed with grief”, Roy Sr killed his son’s friend, who he believed had supplied the ecstacy, and then killed himself.

I find this story incredibly sad. It’s like a Shakespearian tragedy. Even the murdered man’s mother said “He wanted some kind of justice, he wanted a life for a life, it’s just a shame that it was my boy”.

Drug-related deaths are not going to disappear because of changes to the law. The law, or rather the Government, are going to leave themselves wide open to criticism when people, although probably in smaller numbers, continue to die from taking drugs. Families of the dead, looking for scapegoats to make sense of their grief, will blame those in power.

But let’s not worry too much. I’m more likely to get spiked with PCP and eat my own face off than I am see David Cameron change drug policy. Because, much like Lady Macbeth, he doesn’t want blood on his hands.

Drugs are bad, kids

Sunday, January 20th, 2013

I’ve just read another engaging, scary article from America about their drug policy – Reefer Madness Redux: If You Smoke It, You Will Become Addicted! Much like the Storyville documentary I recommended last week (see Wonkblog for an interview with the director), it points out the freakish hysteria that surrounds drug policy in the States – which is frightening not only because of its extremity (reminiscent of Brass Eye’s ‘cake’), but also because it exposes the origins of our own society’s beliefs about drugs and those who use them.

I have to admit, the recent blogs I have written on decriminalisation, the comments that have followed, and then the paper released a week ago by, of all people, the supposedly stuffy old folk from The House of Lords, have had quite a profound effect on me. Possibly because the primary focus of my work for so long has been heroin users, I have discounted the idea of legalising drugs as a ludicrous notion. The cycle of hard dependency is awful, debilitating, inhumane even, and to enable that process, to support it, is just not right. If you prescribe a heroin user heroin, he will always be a heroin user. Where is the motivation to stop? And hence he will always be trapped in that miserable existence, always dependent and disempowered.

And to be fair, whilst working with heroin users, I couldn’t really muster up the energy to even entertain the discussion. I didn’t read newspapers, I didn’t watch the news, I didn’t even watch documentaries which I knew would be interesting but which required some emotional investment and deep thought. My coping mechanism to manage the daily adrenaline come-down and affective exhaustion was to shut down any chance of a conversation, social or internal, with something so conclusive and sharp that there was really nowhere for the enquirer to go. And so the topic of decriminalisation remained, as with anything else contentious, packed at the back of my mind, stacked underneath more important and unattended issues such as ‘stopping smoking’ and ‘life direction’.

But recently, for the first time, and from the perspective or decriminalisation instead of legalisation, I thought about it more fully. Heroin users make up a small proportion of illicit drug users (I think there are about 160,000 heroin users in treatment at present, which is tiny percentage of the population when you think about it – I mean, in the UK 10 years ago, 500,000 people were taking ecstacy every weekend night, by way of comparison) and I realised how fixated I had become on the misery of opiate addiction.

And so, thanks to this blog, my mind has been reopened to the debate. The questions I am asking myself, and the possible conclusions that could be drawn, are honestly head-mangling. Here are my confessions…

The first thing I have realised, which may sound obvious but clearly I’m not that bright, is – drugs have been conceptualised in our society as being ‘bad’ (as in “Drugs are bad kids, m’kay” – Mr Mackey, school counsellor, South Park). Of course I appreciate that there are obvious links between drug use and crime – if you have a physical dependence on heroin, you are more prone to stealing something to avoid painful and anxiety-provoking withdrawal symptoms. However, how many ecstasy, or cannabis, users do you know that have ever stolen anything? Anyone who went clubbing during the height of ecstacy use will know that you were more likely to leave a club with a selection of random presents (eg a dog made out of drinking straws, a crown made out of flowers – people were very creative in showing their boundless pleasure to meet you) than you were to get your wallet or phone snatched. And in terms of violence, you were a hundred times more likely to get an exuberant hug from some sweaty random on the dance floor than you were a slap.

And where the American Government got the idea that cannabis smokers were likely to be violent… You’re more likely to get a fight out of road kill.

Now I have always known that the Americans made most of this scare-mongering up to maintain control – my understanding was that, in the case of cannabis, it was to ensure the ongoing success of the cotton trade on which the American economy depended, to safeguard against the main market rival, hemp. The documentary I keep banging on about, The House I Live In, states it was used as a method of controlling and criminalising the Mexican population. The article I mentioned at the top of this page points out that as these theories have become unsustainable, the fear-badgers are claiming that 1 an every 6 adolescents who try cannabis will become addicted, develop mental health problems and need treatment.

The jump for me is to see the bare truth of this process – making drug use and drug users immoral – in our own country and with all the drugs that come somewhere on the sliding scale between cannabis and heroin. To disclose drug use outside of closed drug-using circles is social suicide – people will look you differently, watch next time you go to their house to make sure you don’t nick that fiver they’ve left on the side, and definitely not trust you with their children. Now these are moral judgements. They are not based on any evidence about you as a person, nor are they based in evidence about drug use. (Well they could be, you might be a right dodgy little scally for all I know, I’ve got no idea.)

But the shocking realisation for me is that I have, to some degree, internalised this moral code and perpetuated it. Despite my education, despite the years spent surrounded by drug users, and despite even my own substance use, it is only now that I realise that I accepted, at some subconscious level, that drug use was bad. People who took them were either to be pitied for needing them, or deserved what they got because they were choosing to break the law. And breaking the law must be immoral, because why else would these rules be made if not to protect us? God, it is scary acknowledging one’s own indoctrination. And yes, possibly my substance use served to prove what I had always known – that I was frankly a pathetic and despicable human being (Catholic-style guilt, must beat oneself with a stick).

Yet despite this, I still worked with people, to some degree, by categorising them in one of these two genii – to be pitied or getting what they deserved. To some extent, I understand that a) this was a survival technique, one can’t manage a horrendous caseload AND be philosophical, and b) there is some truth in these sub-groups – people do make choices, both as a result of their past experiences and their present, informed options. But what if I dumped the value-load? What if drug users were just people who chose to put substances in their bodies, not bad or sad?

Were this standpoint adopted, it would have an impact on the drug treatment system. For a start, a significant group currently receiving drug treatment would not want it. Without the label of illegality, those just trying to avoid prison would almost certainly lose their motivation to engage with services. This could be a positive and a negative thing – but it would free up resources for people who wanted to make changes to their lifestyles (instead of the pointless, endless investment in people who have no interest in reducing their drug use or making it safer, as per current service provision), and would certainly make drugs workers’ jobs less depressing.

However, it would open drug treatment to a much wider group – those who don’t want negative repercussions, such as having their drug use recorded on their medical records, which could cause problems with insurance or employment in the future, or those with children who fear judgement by the authorities and worry that by speaking about their problems with substances they may lose the right to parent. These people, surely, deserve access to advice and support as much as any other – and think about how the country would run if the next generation weren’t burdened with the hidden harm of substance misuse.

The epiphany for me is – it is not just our legislation that needs to change in this country, although of course this is a major part of social change (look at what the smoking ban has achieved). It is our conceptualisation of drug use, a paradigm shift from the domain of morality to that of health and economics. Again, look at the changes to social perceptions of smoking since the introduction the ban in public places, which has been, in some ways, the reverse process – smoking is bad now, and people who do it are wrong for polluting other people’s air. But that was for a substance at the other end of the scale, that was too sociably acceptable, to the point that it was difficult to enjoy a meal in a restaurant, going out in the evening came with a guarantee of waking up smelling like an ashtray, and those in the pub trade were becoming ill and even dying because of other people’s substance use. What I am starting to realise is that drugs that have been, for many years, unacceptable even in one’s own home with no negative impact on anyone but possibly oneself, need to be ‘less bad’, or even not bad at all, for there to be any honest discourse about the real problems they cause people. Imagine a smoker refusing to present for lung cancer treatment because they thought they would have their kids taken off them.

There is really no difference, morally, between the smoker with lung cancer and the amphetamine user with psychosis. Or between the businessman who drinks every day and has a heart attack, and the heroin user with a deep vein thrombosis. All make choices to use a substance that puts them in need of a health intervention. Without that health intervention taking place as early as possible, the cost of the intervention itself will increase as the problem becomes more complicated and effects other areas of the individual’s health. The person’s level of productivity and function will decrease. This all costs the taxpayer. So, like it or not, moral judgements can be expensive.

Sweet jesus, first I acknowledge my secret affiliations with the Iron Bitch, now I’m putting my hand up to judging drug users. I’m doing a pretty good job of discrediting myself and my life’s work. Well done me.

Summary of new drug policy recommendations

Tuesday, January 15th, 2013

So I have now ploughed through the full document, ‘Towards a Safer Drug Policy: Challenges and Opportunities arising from ‘legal highs” and thought it might be useful to provide my non-executive summary. I’m not attempting a full review – I’m just picking out a few bits that might be interesting. Please feel free to circulate if useful.

– A new psychoactive substance arrived on the market on average every 6 days in 2012, with a new marketplace – Internet and social media.

– Drug laws were developed from moral disapproval, when little evidence existed.

– The Misuse of Drugs Act intended to classify substances according to risk – however politicians have not responded to evidence by down-grading safer drugs, and there is now a lack of correlation between drug harm and classification.

– Young people often don’t care about risk, the focus should be on information and support.

– “Drug use in the UK is described as common if not normal activity”, with 16-19 year olds the most common group, and twice the percentage of young people in the UK using ‘legal highs’ than the European average.

– Banning one substance can make matters worse as it may be replaced by something more dangerous and about which even less is known. It does not decrease use.

– Drugs being sold under the same name may have widely varying contents.

– A need for Trading Standards, health and safety legislation, and a national testing centre, encouraging suppliers to focus on product safety and protecting vulnerable consumers.

– Countries which have introduced decriminalisation have not seem an increase in drug use but have seen positive results in terms of employment, housing, family relationships and costs to the taxpayer.

– New Zealand model: onus is on supplier, not state, to evidence low risk of harm, and harm of regulations should be not greater than harm of the substance being regulated.

– Decriminalisation in Portugal has reduced number of young people addicted to drugs and reduced drug-related deaths.

– New drugs are substitutes for old, possibly less dangerous drugs, so it makes sense to also decriminalise these.

– USA trials have shown that preventive interventions should be interactive, involve parents and their parenting, and be community-based (nothing too ground-breaking there).

– Information on drug properties and prevalence needs to be pooled and made available to public service workers.

– Police seizing white powders currently do not know whether they are removing legal substances and arresting law-abiding citizens until a drawn-out and costly forensic analysis has taken place.

– Introduction of Club Drug Clinics.

– Drug taxation is being considered.

For those bothered enough to read the whole thing, I finally found the full doc at http://www.clearuk.org/wpcontent/uploads/2013/01/APPG_NPS_INQUIRY_PRINT_FINAL1.pdf

Possibly also of interest is a documentary that was on BBC4 last night about America’s ‘war on drugs’, which was excellent, and although at times went a bit too far down the pro-drugs road for my liking (trying to imply that crack and methamphet are falsely associated with violence???), it was an intense and honest review of the use of drugs legislation as a method of social control. One scary figure was that 13% of drug use in the US was by black Americans – exactly proportional to the 13% of the overall population they represented – but that 90% of those incarcerated on drug offences were black. Scary stuff. It was a broad-reaching documentary though, looking at how the political and media hysteria around drugs has got to where it is today, watch it.
http://www.bbc.co.uk/programmes/b01pzz69

Cheer the Peers!

Monday, January 14th, 2013

So, today’s news tells us that a cross-party group of peers has advised that certain drugs be decriminalised and even sold by the Government. Not that David Cameron will listen, of course. But even so, the report has come as a pleasant surprise. I admit I am pretty jaded when it comes to politics, but this report seems to be me to be research-led instead of media-hysteria-led, and has some pretty good points to make. The idea of avoiding unknown adulterants and even involving Trading Standards by having similar labelling to food and alcohol, and the opportunity of providing harm reduction information at point of sale, all seem like jolly good ideas to me. However, this would presumably still not allow for these products to be taxed, which raises the question of whether the recommendations go far enough.

As regular readers will have realised, my position on this issue has changed since the influx of ‘legal highs’. Whereas peer information about the old faithfuls (heroin, cocaine, cannabis – all of which have been used for thousands of years and about which we have plenty of information) is generally good amongst user groups, almost nothing is known about the new generation of drugs. This makes using these substances dangerous, and means that we as workers have no information about how to make it less so. An obvious example discussed on an earlier blog is MCat (mephedrone) and its sister drugs. It’s rapid introduction into the UK and the panic that followed inverted the relationship between drug users and the public services meant to be protecting them – they had no idea what they were taking, we had no idea how to respond, and the relationship had to be turned on its head as we asked users for information because we had nothing. If health services genuinely want to reduce the harm people choose to cause themselves, the gap between substance users and the authorities needs to be reduced and an honest discourse needs to begin, and the only way to do so is to reduce the risk of criminalisation for those that have first-hand experiences that are vital for gaining much-needed harm reduction information.

There is no doubt that the old Misuse of Drugs Act needs updating, and whilst few people want to see drug use promoted, we need to accept that times have changed – and that drugs are freely available to anyone with an Internet connection. We don’t know what these drugs are or what harm they can cause, but one thing is for sure – if we keep these substances, and the people that use them, on the fringes, there is no way of predicting what this will cost our public health services. The only way to make using such substances safer and less damaging is to not just enable but encourage people speak honestly about their experiences, and to collate and distribute this information as soon as it becomes available. Maybe the reduction in costs from no longer treating the matter as a criminal offence could even help fund research as new drugs come out so that advice and information could be timely, relevant and accurate.

However I am still pleasantly surprised that a group of peers could be so objective and apparently unbiased. Maybe there’s hope for the old country yet…

Decriminalisation: And the point is….?

Wednesday, December 12th, 2012

In response to my post on MCat (Maurice the Feline), and following the media coverage this week, someone got in touch to ask me my opinions on the decriminalisation of drugs. It’s a tricky one.

If you’re wanting a short, sharp answer to be able to fire off in the office or at dinner parties to make you look intelligent; firstly, you’re in the wrong place, and secondly, sorry but I have more questions than answers on this one.

The first thing that irritates me is the term ‘drugs’ (which I admit may seem odd given my job title). My dispute with the word began whilst working at a ‘Drug and Alcohol Project’ (I have an issue with this use of the word ‘project’ too, but let’s stick to one pedantic rant for now). So I was a drug and alcohol worker. How anyone working in the field could have missed that alcohol is, in fact, a drug was beyond me. I’m no closer to finding the reason for using this terminology so regularly within the field of substance misuse (another stupid coined phrase – who defines what is use and what is misuse??? Probably the same people who pretend that alcohol isn’t a drug. Idiots). The reason it tits me off so significantly is that alcohol is, clearly, so much more damaging than any other substance I have encountered, both in terms of the poisoning effect it has on the body (compared to, for example, heroin, which in its pure form causes NO damage to internal organs), and the fact that every single regrettable incident in my life occurred whilst under its influence. Therefore, the only reason I can see for separating it from other, less sociably acceptable drugs is for the purpose of corporate sale, and to enable the piss-head policy-makers to put some hazy distance between themselves and the demon drug users.

The second issue I see relates again to categorisation. To use the word ‘drugs’ to represent a homogenous group (apart from alcohol… and prescription medications… and things we drink to wake us up a bit at work…) is over-simplistic and nonsensical. And so to discuss decriminalising ‘drugs’ – well, I don’t really know what that means.

Let’s imagine, for example, that on one hand we have a 40-year-old professional who smokes cannabis at weekends, and on the other hand, we have an 17-year-old NEET (not in employment, education or training) who injects crack cocaine eight times a day. These two people have different relationships with their drugs of choice – one is likely to consider himself a recreational user, the other is likely to consider himself as dependent – and so their interaction with the substance will vary unrecognisably. Cannabis Man (wouldn’t that be world’s most boring superhero) may consider his drug as an old, reliable friend with whom he can relax and enjoy a chuckle after a busy week. Crack man (he sounds like a crap porn star) may see his drug as a possessive and abusive partner, a stalker, following him everywhere, getting into his thoughts, forcing him to do things he doesn’t want to, ruining his life. Now the relationship between the drugs and their users are poles apart; so how can they be lumped together as if we were discussing broccoli and cauliflower?

Consider again Cannabis Man, and compare his cannabis use with that of Cannabis Girl, a 13-year-old who has been brought up between her grandmother and local authority care because her schizophrenic mother is unable to parent her consistently. They are taking the same drug, but their reasons for smoking it, how they get the money to smoke it, where they smoke it, who they smoke it with, the effect it gives them, and the likely outcomes of smoking it, are very different. They may both feel that smoking cannabis enhances their lives – but it doesn’t take a psychiatrist to see that Cannabis Girl is pretty much heading for the nut-house and will most likely spend her adult life receiving transmissions from extraterrestrials and ducking the invisible bats of death.

Now let’s play a little game – I’ll call it ‘Theresa May.. Or May Not Know What She’s On About’. The home secretary was quoted in The Guardian as saying “People can die as a result of taking drugs, and significant mental health problems can arise as a result of taking drugs.” Take this phrase and remove the words ‘taking drugs’, see what other phrases we can put in their place to make the sentence less pointless. (Sensible choices might be ‘base-jumping’, ‘war’, or ‘Big Macs with cheese’, but you can in fact entertain yourself for some time thinking how death-by-…. might occur – and I will guarantee it will be more interesting and less blandly stereotyped than death-by-drugs. Suggestions welcome.)

I think there are few people who believe that Cannabis Man is a criminal, or would see be any real benefit to the public spending their money labelling and punishing him, and most would see that in charging him with possession of an illegal substance we would probably be doing the country a disservice by adding him to the queue at the Jobcentre. But then wouldn’t we say the same if Cannabis Man also had the odd line of coke at a party? Or even if he had a penchant for the occasional smoke of heroin, as a reminder of his time travelling in Thailand, if he did it in the privacy of his own home and still got up for work on Monday morning?

So my point is – it’s not ‘drugs’, or even any specific drug, that causes problems, it is the context in which the drugs are used. You only need to look at the range of experiences available from the current use of alcohol to see that. Or, to drill down the point, to look at khat use amongst Somali refugees – this plant, chewed as a social custom for thousands of years in parts of Africa, and still widely so, has had devastating effects within some Somali communities in the UK. The substance is the same, the people are the same – but the environment is different, the life experiences are different, and the circumstances within society are different. It is these factors, not the drug itself, that has increased susceptibility to abuse.

So I suppose, in terms of decriminalisation, these points would lean towards the ‘yes’ argument, as the drugs that are classed as ‘bad’ are really not all that different to those that are considered fine and even normal.

I have to say though, when we look at the incredibly damaging spread of the ‘legal high’ where, as I’ve said before, ‘legal’ is often wrongly considered synonymous with ‘safe’ – and then consider a group of teenagers explaining to each other the difference between ‘legal’ and ‘decriminalised’ – I am having visions of the off-side rule. (Come on, most people can’t even define a unit of alcohol..)

One last point, which is somewhat extraneous as it is about legalisation instead of decriminalisation – bearing in mind the number of people who already buy drugs illegally, does anyone actually think that the majority this group would buy taxed goods legally? Legal, decriminalised, illegal – there will always be a black market, and it will always be cheaper than the squeaky-clean one.

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