From today's The Independent UK
Britain’s past holds the key to breaking the deadly cycle of heroin addiction and crime
Britain’s “war on drugs”, which began nearly half a century ago, is failing. As drug users have entered prisons rather than treatment programmes, the cycle of addiction and crime has not just continued but taken an even tighter hold, with a boom in organised crime gangs now running supply lines from the cities into rural areas. So what is the answer to breaking the cycle? Where can we look for an alternative way to approach the issue?
The answer could lie in Britain’s own past. In 1926, heeding the advice of medical experts, the Conservative Party began prescribing heroin, paid for by the taxpayer, to great success – with countries across the world following suit. Indeed, the policy continues today on a far smaller scale. Hundreds of people across the UK are currently prescribed medical-grade heroin (diamorphine), quelling their need for unpredictable and sometimes deadly street drugs and taking power away from increasingly violent organised crime groups.
Dr Prun Bijral had about 70 patients as a frontline doctor in 2010, many of whom received prescription diamorphine. He is now medical director at the UK’s largest drug treatment provider, Change Grow Live. “I witnessed how it can help transform people’s lives and give them stability where previous things hadn’t been successful,” he says.
Although this figure now pales in comparison to the number of people receiving methadone (around 0.002 of patients are prescribed the drug), Britain successfully used heroin as its major form of treatment for 50 years. As it was the only country in the world to do so, this became known colloquially as the “British System”.
Despite warnings from experts that it would simply open up the heroin market to exploitation by crime groups, the Dangerous Drugs Act was passed in 1967, which stopped GPs from prescribing diamorphine, leaving methadone and morphine as the only alternatives. The Act also legally entitled GPs to refer addicted patients to the Home Office, after which they could be offered diamorphine by specialist doctors in new “drug treatment centres”. But there were delays in the building of these specialist treatment centres, and those that eventually opened operated a policy to reduce the number of patients eligible for diamorphine.
Our “war on drugs” had begun. The heroin epidemic that unfolded over the following two decades is notorious. By the mid-1990s, nearly half a million people in the UK were addicted. Neil Woods, a former police detective who spent 14 years undercover infiltrating increasingly violent and widespread gang networks, has co-written a book detailing the British System called Drug Wars. He says most people in the grips of heroin dependence have three main ways of funding a habit: they can allow themselves to be sexually exploited, they can steal or, vitally, they can find new customers.
Woods believes the heroin epidemic was largely caused by the demise of the British System. Organised crime stepped in with a tactic of encouraging users to become dealers and fund their own use by turning new people on to the drug, at a time when war in Afghanistan stimulated unprecedented supply to Margaret Thatcher’s Britain.
Heroin accounts for 90 per cent of the county lines problem and fuels organised crime more than any other drug, according to former undercover detective Woods. He recalled meeting a “cheeky 16-year-old” gang member while undercover in Leicester. Six months later the boy was a “terrifying 17-year-old” because “that’s what the trade made him ... the most successful drug dealers are the ones who are most intimidating because they don’t get grassed up. By policing drugs we’ve created this Darwinian situation and the personalities of our young men are being changed as a result.”
Drug users are simply “caught in the crossfire in this war”. Woods is now chairman of Law Enforcement Action Partnership UK, which advocates an end to the war on drugs. “Policing never reduces demand,” he explained. “It never reduces the size of the market and it never can because this is a health issue.”
While the UK’s first heroin crisis spiralled out of control and the British System was largely forgotten, other countries looked to our history for a potential solution. In 1989, Swiss researchers visited Dr John Marks’ clinic in Merseyside and were reportedly impressed by the health and wellbeing of his patients. Five years later, Switzerland created the first heroin-assisted treatment (HAT) centre.
Expanding upon the British System’s basic premise of take-home heroin, the drug (diamorphine) is prescribed two to three times daily by specialist doctors and self-administered in the presence of healthcare professionals. The treatment is available only to those for whom two less intensive treatments, methadone and buprenorphine, have been unsuccessful – around 10 per cent of users. This cohort, now catered for by the government, used to account for 50 per cent of the country’s entire heroin market.
Since its introduction, Switzerland has seen street prostitution eliminated, drug deaths drop by two-thirds and burglary reduced by 50 per cent.
HAT is proven to be an effective treatment for many in this group where others have failed and, it’s widely believed that in conjunction with reinvestment in existing services, could play a key role in reversing the fortunes of some of the most vulnerable in our society.
“Heroin may be the most destructive and difficult drug but it’s certainly the easiest one to regulate and it’s the one that will have the biggest impact on society if we get to grips with it,” Woods said. “Even if people don’t care about the plight of somebody self-medicating with heroin to deal with childhood trauma, once it’s explained that this can significantly reduce crime like no other policy, they start to get it.
“Once you explain you’re taking this money away from gangsters by taking their business away from them, they really start to get it.”
This, he says, is the first step in that journey.
Much, much more...