Home Affairs Committee - Drugs: Breaking the CycleWritten evidence submitted by User Voice (DP171)

1. Introduction

1.1 I was born into a family which combined religious extremism with heavy drinking and violence. A teenage drunk, drug abuser and criminal, I was jailed for violent crime aged 17. In my 20s raves and the accompanying drugs became my life until by 28 the party ended and I was living on the streets of London’s West End, homeless, emaciated and addicted to crack and heroin. Facing a choice between death and rehabilitation, I chose the harder option.

1.2 After primary, secondary and tertiary rehab I started a tree surgery business. My policy was to employ other recovering addicts and ex-offenders. I won, among other accolades, a Pride of Britain award for my work. My best selling autobiography, Wasted, was published in 2007 and has since been published in over 20 languages and countries.

1.3 I went on to become a policy adviser to The Prince’s Trust, then the Government and the third sector. In 2009 I founded a charity, User Voice, to offer policy-makers access to the unheard and marginalised voices in society, of those with experience of criminal justice and addiction. My intention is to create a dialogue between policy makers, practitioners and service users which is mutually beneficial and results in better and more cost-effective services. I have since been appointed a Board member for London Probation, elected an Ashoka Fellow, a Visiting Associate at the University of Durham, have had a monthly Guardian column for three years and am about to become a Board member of Addaction.

1.4 I have a very good oversight of drug treatment in this country from a personal and professional perspective in prison and in the community. My views of drug treatment have been well documented in my Guardian articles, details of which are enclosed as an Appendix.

1.5 They regularly attract comments from a range of stakeholders, often causing a great deal of controversy. What is interesting to note is that it is often those with the agenda to protect their market interest, service providers, which are critical of my views. Yet the most supportive comments are from those who have either personal experience of drug addiction or people with family or friends who are addicts, who have lived experience of the reality.

1.6 There are two main issues to which I would like to draw the Committee’s attention, which are discussed in greater length in my articles: treatment for children and young adults and the maintenance/abstinence debate.

2. Treatment for Children and Young Adults

2.1 It can cost as much as £600 a day to keep a young offender in a secure unit designed for children. Most youth justice resources are concentrated on the incarceration stage but, when released, children—often returning to neglectful, chaotic or addicted families—frequently revert to old behaviours because of a lack of support.

2.2 What better place for freeing children from addiction? Safe, well staffed and highly resourced, secure units could do the job for kids that residential rehabilitation does for adults. Except they don’t. A skills’ deficit when it comes to understanding drugs, plus bureaucracy and an opaque legal system mean that, despite the fact that Robbie has begged for detox, units feel more comfortable managing children’s addictions instead of treating them. Management, whatever your age, usually means one thing: methadone (discussed further below).

2.3 Like all serious addicts, to leave heroin behind children under 18 need intensive residential treatment, starting with detox and then moving on to the various stages of rehabilitation. Addicts need long-term counselling from specialists, help with learning to live a normal life and the love and support of other recovering addicts.

2.4 Unfortunately, this treatment is not available to anyone under 18. The secure units cost a lot but they can only hold the children—they can’t help them deal with their drug problems or support them on release. There was one treatment centre for children in the UK, Middlegate. It closed last year.1

2.5 Child addicts are brought up by adults in an addicted household, learning addiction and criminality from adults, adults sell them drugs, they are incarcerated by adults and are sent to a hostel where they are surrounded by drug-using adults. Yet children are being denied treatment for their problem. Instead, we are content handing out methadone like candy.

3. Maintenance vs Abstinence

3.1 The National Treatment Agency (NTA) attacked one of my earlier articles2 on their website3 which promoted abstinence based recovery, promoting harm reduction which was at the time Government policy. The argument was that we should accept that the addicted will always be with us and, instead of trying to change them, we should limit the damage they can do to society. Just get them on a programme of controlled drug use and the public will be protected from the crime and chaos that are the bedfellows of addiction.

3.2 Recovering addicts who have made the long journey to successful living are bitterly opposed to this philosophy. Health professionals call these prescriptions “treatment”. We disagree. Helping addicts not to take drugs is a better definition of treatment. And we prefer the dictionary definition of abstinence, which says you no longer use drink or drugs, not the new definition that says abstinence means replacing street drugs with prescription drugs.

3.3 But the views of addicts in this debate are, as usual, shouted down or ignored by health professionals, who think their evidence is more relevant than our experience. More importantly there is a lack of real measurement of the effectiveness of drug treatment, not outputs of how many people complete a course, but the long term impact on their life. P—ASRO (Prisoners—Addressing Substance Related Offending), the intervention delivered to offenders in custody whose substance use means they are more likely to commit crime, has never been evaluated. Yet millions are spent each year on it being delivered in prisons.

3.4 Heroin addiction can start when you’ve taken it only a few times. The physical effects afterwards—addicts call it rattling—are so hideous that you alleviate them by taking more heroin so you can start to feel normal again. Methadone is a sickly sweet synthetic heroin substitute that will take care of your rattle. The problem is that methadone takes longer to withdraw from than heroin, and the chances are that, once on methadone, you’ll stay there—for years. The cost of the methadone programme is spiralling, and still we have just as many drug addicts. As for prisoners who have methadone doled out to them in jail—after all, it has a role to play in keeping overcrowded prisons quiet—they return to the streets with the same desperate need that put them inside.

3.5 When the Coalition Government policy changed to one of abstinence based recovery so too did the NTA’s. This highlights that it is not service providers who have the answer but service users and commissioners who need to need to be much more closely aligned in order to change service provision. Only in way will we find solutions and effective drug treatment.

3.6 I welcome the shift in policy from maintenance to abstinence but this has created a skill deficient within drug treatment. Most of the current workforce has been educated and trained to prescribe and not to treat the underlying reasons why people use drugs and to promote a lifetime of abstinence.

3.7 Which of the following would a victim of drugs-related crime prefer to know: that the offender is, at the taxpayer’s expense, daily gouging out in his cell on a class A drug, or that he’s taking part in a rigorous programme of abstinence and self-analysis that could change his life and stop his repeat offending? Writing a prescription is writing people off. No civilised society should ever treat its sick that way.


Guardian Articles Related to Drugs

All articles can be access here www.guardian.co.uk/society/series/insideout.

Articles of relevance include:

“It’s time to treat drug-addicted children as adults”, 17 January 2012.4

“Drug users’ voices must be heard in the battle against addiction”, 20 January 2010.5

“Rattling out prescriptions writes off addicts”, 16 December 2009.6

“Addiction is a sickness, and so is criminalising your child”, 18 March 2009.7

February 2012

1 www.guardian.co.uk/society/2010/mar/03/middlegate-drug-alcohol-rehab-young-people

2 www.guardian.co.uk/society/2009/dec/16/prescriptions-drug-addicts-jail

3 www.nta.nhs.uk/ph-response-guardian-prescriptions.aspx

4 www.guardian.co.uk/society/2012/jan/17/treat-drug-addicted-children-as-adults

5 www.guardian.co.uk/society/2010/jan/20/mark-johnson-inside-out-drugs

6 www.guardian.co.uk/society/2009/dec/16/prescriptions-drug-addicts-jail

7 www.guardian.co.uk/society/joepublic/2009/mar/18/drug-addiction-young-people

Prepared 8th December 2012