Select Committee on Home Affairs Memoranda


Submitted by Dr Karl Schmidt

Does existing drugs policy work?

  The answer must surely be negative. The reasons are:

    (a)  No clear goals have been set. I would have expected the formulation of a clear goal in the 1984 Task Force Report, the 1998 National Strategy from the Office of the Drugs Coordinator, the 1999 Guidelines and in other documents. There is certainly none in terms of achieving a significant reduction in Prevalence.

    (b)  The policy has shortcomings in its methodology, its use of neuro-biological knowledge and in its concept of epidemiological effectiveness. Effective treatment programmes must deal with four aspects of the human personality (i) the physical ie the neuro-biological, (ii) the psychological, (iii) the social—most addicts live in dysfunctional social systems and (iv) the existential/spiritual—if you have no goals in life why not become an alcoholic or other type of addict?

  So far as (i) is concerned my experience has shown that cure of addictions is possible and can lead to epidemiological change. In order to lay the basis for a curative programme it is necessary to overcome the Drug Withdrawal Syndrome (DWS). We have shown that this can be done by non-pharmacological means (thus avoiding further drugs) through the use of electro-stimulation (ES). This has no connection with ECT treatment and is entirely different being non-invasive and controlled and administered by the client him/herself.

    (c)  there appears to be an imbalance in priorities if (as The Guardian said on 22 September 2001) the system spends 62 per cent of its budget on enforcement which does not work and only 13 per cent on treatment which my experience shows can work.


  A slight initial increase in demand is likely but not to the extent of changing the statistics for ill-health measurably. There would obviously be no increase in dealing whereas one could predict a fall in acquisitive crime.


  The Home Affairs Committee report of 8 June 2000 clearly stated that the law does not seem to be a deterrent even though it is strong in terms of fines and imprisonment. The Committee did not see a deterrent in the law working.

  The WHO Officer in Charge of addictions stated in 1991 (at the 13th IFNGO Conference in Manila) that however much money was spent on the prevention of trafficking there was no evidence it could be reduced irrespective of the number of seizures.

  I believe that any significant decriminalisation would need to balance by an energetic campaign for the concept of responsible living and wider, easier availability of curative treatment.


  There is considerable hard neuro-biological research demonstrating the mechanisms in the human body which produces and releases the endorphinergic group of neuro-transmitters. These help bring about a harmonious physical state ie the "feel good factor". Much of this research which is easily available in specialist journals and major works eg The Role of Endorphins in Neuropsychiatry (The Max Planck Institute, Munich) appears to be neglected in current treatment approaches.

  The point is that in the case of the addict this natural mechanisms is suppressed and replaced by a drug induced mechanism. Remove the drug and the addict no longer has the means to feel good. Further, use of methadone which is itself addictive actively interferes with this mechanisms and the body's in-built healing process. There is a strong case for treating DWS by non-pharmacological means which do not impact upon the body's natural "feel good" processes.

  A crucial and well known paper from the Maudsley team in 1984 dismissed ES as a valid treatment for DWS. Though the paper is outstanding in its way, however, the data does not appear to justify the conclusions reached. Further the practice of my own teams (one in Somerset) and associates has shown different results.

  One problem with the Maudsley conclusions is that they were reached on the evidence of a single trial with a small number of cases. As Dr Guy Edwards noted in the BMJ in 1992 a single trials rarely if ever justifies an unequivocal claim of superiority there being potential imperfections eg selection bias and chance factors. It is also a fact that certain therapies have in the past been dropped on inadequate evidence and the verdict has entered the collective consciousness of mainstream psychiatry. Dr N Stratton, an Australian psychiatrist, highlighted this in 1990.


  The reported reduction in criminality among those investigated is very encouraging as is the reduction in the volume of addictive substances consumed. However:

    (a)  was anyone cured or converted into an abstainer?

    (b)  there is no percentage figure for relapse over, say, two years;

    (c)  also missing is a record of the number of clients who returned to work and became taxpayers;

    (d)  there seems to be an uncritical acceptance of methadone programmes; and

    (e)  the research is very thorough but there is no clear statement of Prevalence of addictive behaviour in the communities studied or nationwide. Nor is there any reference to incidence. Without these it is impossible to set goals which can lead to favourable epidemiological effective change.


  The goal of addiction management should be epidemiological change. A significant reduction of Prevalence of addictive behaviour should occur. Such a goal is poorly if at all defined in available Government and Government-associated publications. Thought should also be given to a reduction in incidence.

  The curative programme which we designed and practised within the NHS in East Somerset between 1980-82 achieved a significant reduction in addiction problems. We did not do so well with alcoholism because we had not then discovered that three times weekly follow-up for two years was necessary. Our relapse rate (all addictions) was 10 per cent over two years.

  I have seen marked cases of lowered incidence in my various overseas appointments.

  I should be happy to offer my services in both the curative and epidemiological fields.

September 2001

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