Drugs: why we should medicalise, not criminalise – TBS

Here’s a Throwback Sunday post from 2006 on a call for more drug maintenance and my take on some problematic underlying assumptions.


Lowering_The_Bar_Cover_2010.09.22This sounds so rational. When you read the whole column (originlly published in the Sunday Times), it’s also wrapped in the language of social justice. However, her arguments are so flawed that it’s difficult to know where to begin.

Of course we should try to get drug addicts off their drugs. It is good that waiting times are now shorter for rehabilitation. But treatment doesn’t work unless users really, really want to give up. And even then, they often relapse because the cravings are so strong. So it is not surprising that enforced treatment and rehabilitation is so unsuccessful. A National Audit Office report on the Government’s Drug Treatment and Testing Order, a court-administered mandatory programme for addicts, found that 80 per cent of offenders were reconvicted within two years.

It is much more sensible to prescribe a maintenance dose for addicts, which they must take under supervision so they cannot sell it on, until they are ready to try to give up. That way, they can attempt to lead a normal life, to refrain from crime, to stay off the streets, even to hold down a job, until they can wean themselves off the drugs.

Among the flawed assumptions are that:

  • addicts don’t want help;
  • treatment is only helpful if they’re in the “action” or “preparation” stage of change;
  • the failure of their lousy treatment system means treatment doesn’t work;
  • legalization would be a panacea for consuming countries and producing countries;
  • crime should be the measuring stick for the effectiveness of drug policy;
  • abstinence focused treatment is ineffective;
  • doing more would be too expensive;
  • we have to choose between legalization and maintenance

I’m struggling to find the words, but I also find it troubling that among some HR advocates there is something resembling a fetishizing of heroin addiction or vicarious derivation of street credibility. While speaking to some harms, they fail to grasp the pain and demoralization that addicts experience when they call it an illness but treat it like a lifestyle choice. Why such half-measures when addiction is concerned? Why is the case for treatment on demand framed as a symptom of some kind of moral panic? I suppose I am guilty of moral alarm at the “suble bigotry of low expectations.” (Now, now, principles before personalities.)

Posted in TBS