Examination of Witnesses (Questions 180
- 199)
TUESDAY 20 OCTOBER 2009
MS SARAH
GRAHAM AND
MR MITCH
WINEHOUSE
Q180 Chairman: Of course and we are
most grateful for that, Mr Winehouse. Tell us about your documentary,
which you have been involved with, where you have been talking
to families and talking to those who use cocaine.
Mr Winehouse: Heroin mainly.
Q181 Chairman: You have been looking
at the rehabilitation services.
Mr Winehouse: Yes.
Q182 Chairman: What kind of information
can you share with the Committee as a result of this very detailed
analysis in which you have been involved?
Mr Winehouse: Yes. First of all,
I find it frightening, if I may say. We were very fortunate—my
family were fortunate, we were able to afford the best doctors,
the best clinical psychologists, the best rehabilitation, the
best hospitals, but of course we are making a film not about people
who can afford it but about people who cannot afford it, and unfortunately
what we found after I spent a lot of time with families of addictive
people—mothers, fathers, uncles, brothers, sisters—is
that there are very few facilities and very little help available
to people like that.
Q183 Gwyn Prosser: We have touched
on this whole thing of "work hard, party hard", which
particularly seems to impact some industries—showbiz, media,
banking and so on. Can we think why that might be and, Sarah,
it is eight years ago, I think, ago since you started to get your
life back on track? Have you any idea what it is like now compared
to what it was like ten years ago, say?
Ms Graham: There is still very
much a cocaine culture. As I said, this drug is much more widely
available. It is also fair to say that in some senses this Committee
is already slightly out of date in that the "influencers"
within popular culture are moving into other substances. I have
recently written an article for Addiction Today talking
about the emerging crystal meth problem which is starting in the
gay club scene. I talk about cocaine in my written evidence as
a brand and I think we do need to have that awareness; it is a
brand. It is being marketed as a brand and it is being seen as
a Gucci-like brand, and that brand's currency is on the wane,
at the cutting edge, if you like, of popular culture. Having said
that, many people are still buying into that cocaine dream and
we have many people who are using it recreationally (I hate that
word "recreationally") who are going to find, when they
get to the point when they want to stop using, when they are trying
for a family or when they want to move beyond their clubbing or
their university life or whatever, that they cannot stop using.
Certainly I find that a lot now in my client work. I am getting
many people contacting me who want to start a family and find
that they are continuing to use. Maybe they managed to stop for
the time that they were pregnant and then they find that cocaine
is creeping back into their lives and when you have got a young
child that does not sit very comfortably, so we do need really
good treatment provision for these people.
Q184 Mr Streeter: Do you want to
come in, Mr Winehouse, on why it impacts on particular industries,
or seems to?
Mr Winehouse: If I may I would
like to talk more about the problems that families are facing
with addiction.
Chairman: Indeed.
Mr Streeter: Please do.
Q185 Chairman: What is the biggest
impact on families in situations of this kind?
Mr Winehouse: The biggest impact
on families is that, as I say, there is very little help available
to them. If, for instance, their son is an addict, especially
if they are a non-offending addict, the first port of call for
the addict would be the GP. He would refer them to the local health
authority. The local health authority would insist on a period
of abstinence before they would even interview him to decide what
kind of treatment. The problem is, and of course this impacts
on the family as well, that, as we have found through our research,
even in London there is normally a period of about a year before
any treatment can commence. In certain areas of Great Britain,
in certain parts of Scotland, for instance, it is two years before
they can even talk about chemical intervention. That is, as our
friend said before, Subutex or methadone. You therefore have a
situation where the addicts themselves decide, "I have had
enough. I really need help". That is the first stage of awareness.
He knows that he cannot continue. The second stage is that he
decides that he needs outside help to deal with that addiction,
and then he goes to his GP, he goes to the local health authority,
and the local health authority, after a period of abstinence,
say to him, "Come in a year's time. There might be a place
available to you residentially in a year's time", and, of
course, as we all know, there is many a slip betwixt cup and lip,
so it is very difficult. The reason for this, if I may say so,
is that the majority of the government funding, which last year
was approaching £400 million, is being taken up by the criminal
justice system. For instance, and this happened in my family with
my son-in-law, if, let us say, a burglar who is an addicted burglar
is going up to face the judge and he is going to be sentenced,
the judge will offer him a period of residential rehab. The analogy
is that a convicted speedster is going to get three points docked
off his licence but then a speed awareness course comes through
that he can go on for three hours and not take the three points.
It is a similar analogy and they would choose generally the residential
rehab. Of course, they are being coerced into the residential
rehab, so now we have a situation where a non-offending addict
and his family are looking for help but there are very few resources
available to them, and this is the problem that we find.
Chairman: We are going to change the
order of questions since you have opened the issue of treatments
up and ask Mr Russell to come in with his contribution.
Q186 Bob Russell: I am most grateful
for that last response, Mr Winehouse, because I think that is
a very telling point which this Committee hopefully will take
on board when it comes to the recommendations. From your documentary
work, and we have heard some of it, what treatments seem to be
available to users of drugs and which is the most effective? You
have explained that the criminal fraternity are getting helped
and the non-criminal people are not.
Mr Winehouse: Anecdotally, and
it is anecdotally and one of my colleagues is here with me now,
we have spoken to addicts who have told us that people are desperately
committing offences just so that they can have a chance—and
it is still only a chance—of receiving treatment. As I say,
if the family of the addict or the addict themselves can afford
to pay for themselves to go into The Priory or go to Antigua or
any of these places there is a wealth of facilities and help available
to people, but, again, this documentary is not about them; it
is about people who cannot afford it. The truth is that there
is very little of any kind of treatment available to people who
walk in off the street and say, "I need help". Let us
say, for argument's sake, the family of the addict seeks help.
It is almost impossible because the local authority generally
will not talk to the family without the addicted person present.
It is a minefield and it is very difficult. I really do not know
what the answer is. In Portugal they found similar problems and
that is why they decriminalised usage. I am not advocating decriminalising
usage but at least now their funding for addiction is going into
the right areas because they are not having to fund criminals
basically on a jolly.
Q187 Tom Brake: I was just wondering,
Mr Winehouse, both perhaps for treatment and also rehabilitation
afterwards, whether one of the most important factors is getting
people out of the environment in which they are living.
Mr Winehouse: How do you do that?
Q188 Tom Brake: You can relocate
them, I assume. I am just thinking that, if you have got a scenario
where someone who has had a habit has perhaps had treatment and
gone into rehabilitation and then the only option is to come back
to where they were living before in the same environment as the
dealers on the corner and so on, that is not going to be a success.
Mr Winehouse: Mr Brake, it is
a very difficult question to answer and I have not considered
it. Clearly, it would be better if the recovering addict did not
go back to the area that triggered the addiction in the first
place, the drinking, the cocaine, but practically how would that
be achieved?
Ms Graham: We talk about addiction
being a progressive illness and many people's addiction is progressive
to the point where many addicts who want recovery do desperately
want to be removed out of their environment. I was living near
Shepherd's Bush and I knew so many dealers around and about. My
whole life was surrounded by drinking and drugging. It is endemic
in the culture that I was in. I knew that I needed to leave and
the treatment that was on offer to me was a day programme in the
local community and I knew that that was not going to work for
me. I was very fortunate; I could pay The Priory to take me, and
I was in there for eight months. I think many people do need that;
they want residential treatment, but if you look at what has been
happening with the treatment policy in this country, the NTA has
moved away. Rehabs are shutting all over the country. Addicts
want to go to rehab because they know that is where they are going
to get well, but these rehabs are being shut down and we have
had this move towards day programmes. I think it is also fair
to say that you do need to learn how to live in your local community.
Many people return, but it is a very long, slow process. Once
you take all drink and drugs out of your system it is like going
back to the point at which you started using and you have to learn
to live again. Even going to the supermarket can be scary because
there is wine everywhere you look. You really do have to integrate
back into the community in a very staged, staggered manner if
you are going to be successful in your recovery.
Q189 Mr Streeter: Just coming back
to the issue of people going through the criminal justice system
and taking all the rehab places, and I think we have heard about
that before, what is the solution to that? Should we be looking
at allowing half the places in rehab to be for people who have
not committed a criminal offence? Has anyone given any thought
to how we can unblock that particular system, apart from spending
vast sums of money on rehab which, of course, the country does
not currently have? How can we solve this problem, please?
Mr Winehouse: I just caught, as
I came in, what one of the gentlemen over here was saying. It
is not a cure. The only start to the cure or a recovery is residential
rehab; there is no question about it. It is how you unblock the
system and how you then channel the funds into the people that
deserve and really need and, more importantly, want the rehabilitation
because, as Sarah will tell you as a counsellor, if you do not
want to recover you will not recover. If you want to recover you
have got an excellent chance of recovering; we all know that.
The people that are going into jail and are being offered a place
in rehab, I am sure a percentage of them want to recover but I
am also sure that the vast majority of them do not want to recover.
They have got no intention of giving up drugs. How we unblock
that system I cannot say. In the recent trials, as you know, the
RIOT Trial, the Random Injectable Opioid Treatment Trial, I think
it was telling in that they chose the most entrenched addicts,
127 addicts in three locations, and they studied them for a three-year
period, and during that period they were, as you probably all
know, given the heroin or methadone orally free of charge, but
during that time as well they were counselled, they had therapy,
they had help with their housing and their benefits and, as a
by-product, I think 75% of them were using crack cocaine and that
reduced, which was not expected, but I think the results were
very encouraging. My solution is not to give every single heroin
addict free heroin but something has to happen now to stabilise
these people and maintain them so that they can stop committing
crimes and stop vandalising people and impacting on their communities
while we are able to treat them; otherwise it is just a vicious
circle. These people on average, although these statistics are
three years old, have spent something like £300 a week on
street heroin. Subsequently they committed £300 worth of
theft or whatever they did on the street to pay for that heroin.
At the end of the trial they were spending £50 a week and
the incidence of the crimes they were committing went down by
two-thirds. If that was rolled out nationally can you imagine
if drug crime was reduced by two-thirds? It would be incredible.
Q190 Mr Streeter: I think Sarah wants
to respond.
Ms Graham: We are here to talk
about cocaine and one of the points that Mitch made was talking
about the waiting lists.
Q191 Chairman: The waiting lists
for rehab?
Ms Graham: The waiting lists for
rehab but also the waiting list to get into a local community
treatment programme and that may be a day programme. One of the
appendices that I have submitted to you is a stimulant treatment
model and I really ask you to look at that because the success
of the stimulant drug treatment service I set up and ran was largely
because people could walk in pretty much off the street and come
and be assessed, and then they could come in and engage in treatment.
As I said, this is a progressive illness. Why wait till somebody's
illness has got them to the point where they cannot carry on their
duties, they cannot go to work? Is it not better to have a treatment
system that responds very proactively at that moment where a person
says, "Actually, I don't want another weekend like that"?
Is it not better to have a service that runs on a Monday, that
picks up those people, brings them into treatment, actually works
with them one-to-one, in a group environment, with psycho-education
interventions that teach them what the cocaine is doing to them
and stop them going down to those lower levels, stop them getting
to that stage where they start using heroin along with the cocaine
or when they move from powder cocaine to crack cocaine? Especially
for young people this is vital. We have got a whole generation
of young people who are being exposed to powder cocaine. They
are not being viewed as problem drug users (PDUs) because that
definition is heroin and crack. Powder cocaine is not even in
that classification, which is missing the young people. We need
to be working with those young people and I would strongly suggest
you refer to that stimulant drug treatment model because it would
stop these people ending up on those waiting lists.
Chairman: We will certainly look at that.
Q192 Gwyn Prosser: You have talked
a little bit about people who take cocaine or something like that
rather than perhaps some other drugs. Can you talk a little more
about them, that sort of progression, if you can call it progression?
Do people who use cocaine recreationally move on to crack cocaine
and then on to heroin? Is that the sort of path or is it just
a matter of chance? From what you have told us in your very helpful
introduction you seem to have stayed on straight lines on coke,
if I can put it that way, during your usage.
Ms Graham: My illness progressed
from alcohol and cigarettes through cannabis, through speed to
cocaine. I did do crack cocaine and I did smoke heroin a few times
and snort heroin. Fortunately, I did not go down that path with
those two drugs. This distinction between crack cocaine and powder
cocaine to my mind is in some senses a false distinction. It is
the same drug; it is just a different delivery method. It is being
marketed at different populations within our community. When you
look at young people, as I said, alcohol is the elephant in the
room. We need to really be looking at young people's binge drinking
because it is alcohol that is the gateway drug. I work with young
people who tell me that they would never have tried cocaine if
they had not been in the park completely pissed off their heads
when some handsome boy that they had fancied for along time offered
it to them. That is the kind of situation that we have with young
people so we really need to address the alcohol as a matter of
urgency. This division that we have in government between alcohol
and other drugs really is harming young people.
Q193 Gwyn Prosser: A powerful part
of your message was that people who are successful in their careers
and are taking cocaine do not remain successful for very long.
In your personal experience, that first night in that club, you
were surrounded by producers and other successful programme makers.
When you look back at those people, and I do not want to know
who they are, are they still in place?
Ms Graham: One of the things about
the media and certain other careers is that as your addiction
progresses certain behaviours which would not be tolerated in
a normal job actually can be spun to be part of your creative
genius or part of your extraordinary personality. Some of those
people are still in place. Some of them are behaving in off-the-wall
ways and are enabled left, right and centre. People bow down to
them and let them get on. Some of those City traders have still
got their jobs. They have taken incredible risks partly because
the cocaine has been affecting their decision-making. Their gambling
addiction combined with their cocaine addiction has meant that
they have gone out on a limb but they are still in post. Some
of this stuff is rewarded. It depends where you are and who you
are. After I did rehab I was a postwoman for a year because my
counsellor wanted me to do a really down-to-earth job that was
away from the media and all of that stuff, and cocaine unfortunately
had got to the level that some of the young people I was with
in that environment were starting to experiment because they can
club together and buy a small wrap ... I am not too sure I am
going with that point.
Q194 Tom Brake: Ms Graham, I think
you said that from your point of view alcohol is the gateway drug
and the authorities need to concentrate more on addressing that
to stop young people starting with alcohol and then moving on
to other drugs. Do you feel that, had that been the case prior
to you taking up cocaine use, that would have stopped you?
Ms Graham: My case is my case.
I am a spokesperson for FRANK and I think that FRANK does do some
incredible work. One of the reasons I give my time to them is
because they do some really good work around drugs and I think
they have had a major impact if you look at the stats for the
number of young people contacting them, the brand awareness, the
fact that it is a trusted resource, but unfortunately the cocaine
campaign for FRANK, the Pablo Campaign that Mr Vaz mentioned,
was only launched last December. I think that we really need to
address this on every level.
Q195 Tom Brake: Has that been effective?
Has Pablo been effective?
Ms Graham: It has been very effective
in terms of young people being able to tell you some of the health
messages that were enclosed in that campaign around the impact
on the heart, the impact on the nose, mental health, the fact
that it is a dangerous drug. A lot of young people had no idea
that cocaine was a dangerous drug, but that work on its own, as
was also said by some of the previous speakers, needs to be supported
within our schools, within the curriculum. I feel very strongly
that drugs education needs to be built into the curriculum from
a very young age. Unfortunately, these drugs are available to
young people in their communities and they need to have those
messages before they start considering entertaining the offers
that are coming their way.
Q196 Tom Brake: Mr Winehouse, when
you were meeting families and talking to them were there any messages
that came from them to you about what they thought would have
been effective in preventing their loved ones from getting involved
in drugs?
Mr Winehouse: I think the overriding
message I got from most families, including my family, was one
of guilt. Almost every one of them said, "If only I had done
this a little bit better. I only I had done that", and I
can honestly say that I felt the same way. A lot of them also,
I must say, said that the addicted person was a heavy drinker
beforehand and it led through to the heavy drugs. As Sarah said,
I think it goes hand in hand, but the overriding sentiment from
the families was one of guilt of themselves.
Q197 Tom Brake: Was that because
they simply did not know anything about the drugs scene, for instance,
and did not realise what was happening and therefore were not
able to intervene? Was it about better information for the families
or for the general population about what drugs are about?
Mr Winehouse: I think most families
would agree that unless you are involved with an addicted member
the family would know very little about the drug scene. It has
been levelled at me by people who should know better: "Why
did you not have your family member incarcerated? Why did you
not have them sectioned under the Mental Health Act? If it was
my daughter I would lock her in the room". It is all nonsense,
of course. It is ignorance. The general public is ignorant of
what really is going on and until you are in that unfortunate
position you just do not know.
Q198 Chairman: Thank you. Mr Winehouse,
of course, you do not have to answer this question because it
is directed at Sarah Graham. What influence do you think the media
has had on glamorising drugs, the use of cocaine? Witnesses have
mentioned previously the celebrity culture. Does this in your
view mean more young people are using drugs?
Ms Graham: This is quite a complicated
one in terms of communications because with certain individuals,
Amy being one, Pete Docherty being another, their addiction progressed
to the stage that the pictures that we were seeing, car crash
pictures of pain and agony, horrible images, can make drug-taking
look not very attractive to the majority of young people, but
there will always be some young people who see that as rebellion
and will be attracted to that. What is more dangerous and more
damaging and what I suggest really needs to be worked on in terms
of relationships with business is when we have a person who is
ostensibly successful in the public eye who is exposed to drug-taking
and then is apparently rewarded by big business because their
celebrity status has gone up, so the company then cashes in on
that status and gives them a new contract and so the message that
goes out to young people is that that person is more successful
because of their drug-taking, I think that is a real problem.
Q199 Chairman: So you think the contract
should be terminated?
Ms Graham: I think that big business
needs to be far more responsible. Any business that is marketing
its products to young people needs to think about the impact that
they are having, the message that they are giving those young
people. If that model or whoever is hired by them and given a
new contract for hundreds of thousands of pounds, millions sometimes,
that has an effect.
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