MEMORANDUM 71
Submitted by Andrew Winterbottom
1. I work for social services as a specialist
Drug and Alcohol Social Worker but I write as a private individual.
The comments are not intended to have a "whistle blowing"
purpose. I have worked for four years in my present role as part
of a multi-agency statutory drug and alcohol (treatment) team.
Prior to such I undertook a six month student social work placement
with the same team and I have two years of work experience in
an Alcohol Project providing Detox, Day Centre Services and Dry
Hostels run by Turning Point in Manchester. I have further work
experience in a homeless men's hostel.
2. Drug Laws? Cannabis: My view is that
the prohibition of cannabis causes far more social harm than any
of the negative consequences of use that prohibition was originally
intended to prevent. It criminalises many individuals who would
otherwise be law abiding causing career prospects to be adversely
affected and unnecessary humiliation to those caught in the criminal
justice system. It sets up an antipathy to, and alienation from,
the police of a significant proportion of the populace, especially
amongst young people. It illegitimatises drugs education messages
in many young people's eyes. It leads to huge amounts of money
going into the black economy and to organised crime both in this
and other countries. It means that police resources for more serious
crime fighting are curtailed. It leads to young people hiding
cannabis use from parents leading to a lack of communication in
this respect when clearly a more constructive course of action
would be for potential harms to be discussed. My view is that
permitted home cultivation for personal use as in Switzerland
would reduce or eliminate many of the problems above. Model "award
winning" cafes such as "The Greenhouse" in Amsterdam
where health promotion literature and chemical composition listings
are provided, digitally weighed cannabis is sold in a safe and
"over the counter" manner and where no hard drugs or
alcohol policies are effectively enforced would also provide functional
alternatives.
Other drugs: Many of the same issues apply whichever
the drug but clearly the potential for dependence is greater with
heroin, cocaine and amphetamine. Whether or not illegalising such
actually helps reducing dependence is unclear to me. Certainly
the illegal nature of heroin and amphetamine in my area leads
to significant crime and a reluctance to seek help or advice at
an early stage. My view is that individuals with a vulnerability
to dependence on drugs or alcohol are often highly socially disadvantaged
and marginalised even prior to drug dependence and the illegality
of drugs doesn't really act as a great deterrent.
3. Effect of decriminalisation on the demand
for drugs? It is my understanding that in countries where more
liberal policies are pursued such as Holland there is actually
a slightly less serious heroin problem and the local population's
"soft" drug use is no different to other countries.
Demand in my view is more likely to be addressed by tackling causes
of problematic use, not attempting to stifle all use. Not every
drinker becomes a dependent drinker after all, just as most teenagers
who take ecstasy or cannabis are highly unlikely to become heroin
addicts. Implied here is the need for much more wide ranging,
effective and thorough work with those vulnerable to problem drug/alcohol
use. Also work directed at preventing vulnerability in the first
place (ie more effective help for children in need such as those
in families where domestic violence occurs). Simply expecting
every school child to see the logic in abstinence from all drugs
after being educated on the subject clearly hasn't been working
(DH 2000).
4. An alternative to illegal heroin? Heroin
could be prescribed again in the treatment of dependence this
time under very different conditions. Prescribing would need to
be conducted on a very time limited short term basis leading to
either detoxification or substitute buprenorphine or Methadone
prescribing. I feel this would pull many more people into treatment.
Important would be the availability of supervised dispensing and
a far greater availability of counselling and treatment centres
to cope with the demand. I would not recommend any such prescribing
to be a part of primary care.
5. Ten year drug strategy. Treatment: I
live in an area with over a 100 people on the waiting list for
an assessment let alone treatment and a long wait of around three
months for anyone but high risk/priority. Clearly an individual
can become demotivated in such a time. The range of service provision
is not adequate in my locality with a serious lack of supervised
consumption places, detoxification beds, access to residential
rehabilitation, therapeutic groupwork and services for affected
families (partners and children). Currently a significant proportion
of Devon has access to only four detoxification beds, often closed
due to staff shortages, which are for drugs and alcohol clients
and are part of an acute psychiatric ward, the last place many
clients tell me they would want to be during detox. More specialist
provision would involve resources and while there is now more
money becoming available as part of the strategy I do not feel
it will necessarily be adequate to meet demand.
6. The CARAT scheme needs revision. The
joke in addiction services is that once people leave prison the
through care teams are "through" with your care. Unless
the local social services happen to have any money to pay for
residential placements following prison and the local drug services
are available to conduct an assessment prior to release and arrange
a placement, many prisoners who had been receiving help in prison
return to exactly the same circumstances.
7. Alcohol and a National Alcohol Strategy:
Alcohol Concern's arguments for such a strategy are surely irrefutable.
The policy vacuum in this respect badly needs addressing given
the level of social harm and costs associated with alcohol use.
This could be considered within a revised drug strategy.
September 2001
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