Supplementary memorandum submitted by
John Mann MP
Further to my verbal evidence to your committee
I would make the following observations.
There is no published medical evidence anywhere
that I am aware of about the addictive nature of cocaine as a
substance. Instead the evidence suggests that it is a psychological
craving for the high that cocaine gives that can become addictive.
Thus in prisons, a cocaine "addict" has no withdrawal
symptoms in the way that heroin addicts "cold turkey".
Instead the craving have been observed to re-emerge on the eve
of prison release.
Similarly with crack cocaine, which is designed
to give a quicker high, crack addicts have been noted for consuming
the available crack in one session but not to have an automatic
requirement for crack the following day.
This difference with physically addictive substances
like heroin is vital to evaluating treatment success.
You will note from press reports how celebrity
users of the Priory have been observed to be repeated visitors
and clients of the service. Whilst residential stays have a health
benefit, their ongoing effectiveness in dealing with substance
abuse is highly questionable. Medical opinion in most countries
puts the success rates of rehabilitation in eliminating substance
abuse as low as 2% of clients.
This is not to suggest that they have no value.
In Germany and surrounding countries the use of spas for short
term health benefits is a long standing tradition and clinics
like the Priory should be viewed in this context.
The British system tends to lump all drugs and
treatments together and I strongly recommend that you study research
available from practitioners ands national addiction centre in
New Zealand, Australia, Sweden, France and Holland in order to
gain a clearer rational of why treatment should not be generic
for substance misuse and why residential rehabilitation has only
a very minor role to play in tackling the UK drugs problem.
I suggest that instead local GPs should be the
primary point of contact for all substance misuse issues
February 2010
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