Moral paternalism, drugs, pollution and the hypocrisy of the British State

AirPollutionDeathsUK
Image source: Friends of the Earth Scotland

This week Friends of the Earth Scotland highlighted data from various sources outlining the extent of air pollution in Scotland and the rest of the UK. These figures, detailed in the graphic above, are shocking on their own, but I wanted to compare them to another major cause of death in the UK in order to make a point about the kind of moral paternalism our government espouses: drugs.

You see, one of the major justifications put forward by the UK Home Office – the Government department responsible for the UK’s drug policies – is the stuff of moral paternalism; in banning certain psychoactive substances the government claims to be acting in our best interests. Drug laws are purportedly designed to reduce harm in relation to drug use (the fact that these policies do the exact opposite is another matter), and what’s wrong with that? Aren’t we lucky to have a government that wants to protect us and keep us healthy? A more cynical person might question that motive; they might even doubt the moral basis of the government’s decision to ban certain types of drug use altogether.

And this, I hope, is where we can draw an interesting parallel between the UK State’s drug policies and their environmental policies. First, lets look at the mortality figures related each to illicit drugs and air pollution. While there were 2,248 drug-related deaths (specifically illicit drug-related deaths) in England and Wales* throughout 2014, there were 29,000 deaths related to air pollution (source above). That’s just under 13 times as many deaths due to air pollution as compared to illicit drugs.

What’s important about these figures, and what does drug policy have to do with environmental policy? It all comes down to the approach and spending on what are ultimately both health-related problems with negative health-outcomes for the public. While, as demonstrated, environmental pollution causes far more deaths in England and Wales than do illicit drugs, the government spends around £4.4 billion on illicit drugs once proactive and reactive expenditure across the healthcare and criminal justice systems are combined. The ‘drug problem’ – and more recently the ‘legal high’ problem’ – are continually reiterated as one of the major social and moral issues facing UK society.

So, given that air pollution is a much greater killer than illicit drugs, what are the UK Government doing to tackle the problem? The UK Government, like any other EU member state, is legally bound by the EC Ambient Air Quality Directive, which sets out stringent targets for reducing air pollution. Sadly, according to Friends of the Earth, many UK streets and locales regularly fail to meet these targets (same source as above). But we can’t put all of the blame onto the Government, can we?

Unfortunately it’s not just cars that create air pollution. The UK still regularly burns fossil fuels as one of it’s main domestic energy sources, including dirty coal-fired power stations. Coal-powered stations are to be phased out in the next 10 years, however the gas-fired power plants, which will largely replace coal in addition to nuclear, still produce deadly greenhouse gases and contribute to local air pollution as well as global climate change.

OK, so they are trying to improve the situation. Or are they? The UK Government are currently doing their best to help the TTIP trade agreement to pass through EU legislators. Without going into too much detail this agreement will allow corporations equal or greater legal rights to that of entire countries, overriding the democratic sovereignty of the people of those countries. One of the first things to happen – and it’s happening already in parts of England despite warnings from other countries – is that ‘fracking’ (unconventional gas-extraction) companies will be let loose on the British countryside. One of the main criticisms of fracking is the impact it has on air quality, among other issues like pollution of the water table. If the UK Government were so concerned for our health – as they claim to be in relation to drug policy – then why are they trying their hardest to allow the activities of an industry that will almost certainly increase air pollution – and therefore deaths.

And that’s not all. Despite saying all the right words at the recent Paris Climate Summit, David Cameron’s Government have recently announced cuts to subsidies for renewables such as solar and wind energy production across the UK. These are the projects that would have finally shifted the UK away from fossil fuels, even gas, and onto a Greener future – reducing air pollution in the process. Scotland achieved 50% renewable energy for the first time in 2015, but since most of this comes from wind-energy production continued progress towards sustainable energy is in danger of stalling. As if cutting subsidies to renewables isn’t enough, the UK Government subsidises the UK fossil fuel industry roughly £6 billion per year (to profit-making, environmentally damaging, socially irresponsible corporations). That they can hand over billions to companies such as BP while the government body responsible for monitoring air pollution, Defra, has been hit with the largest portion of cuts out of all public bodies in the UK, is scarcely believable.

When two seemingly unrelated policies are compared – drug policy and environmental policy – the hypocrisy of the UK Government becomes clear. While on one hand the Government claims the moral high-ground in justifying a punitive (and ineffective, at least in terms of reducing deaths) drug policy, on the other hand they not only fail to reduce air pollution – a much greater cause of deaths in the UK – but they cut back on renewable solutions and actively encourage large corporate polluters through generous subsidies.

The hypocrisy of our Government’s moral paternalism is clear to see: when the profits of large-scale corporations are involved, economics comes before the health of the population. Just why, then, do they maintain the charade of protecting the public from drugs? My guess would be that politics – in particular obtaining votes – trumps both economics and public health in the minds of our political elite, and the ‘tough on drugs’ stance is a tried and tested vote winner – particularly for the core of Conservative voters.

"I know what's best for you; trust me, I'm a politician."
“I know what’s best for you, trust me, I’m a politician.” (image source: flickr.com)

Next time the Government uses morality as a justification for policy, remember just how much their ‘morals’ can be swayed by money and the needs of their corporate friends. Then ask yourself how much you really trust them.

 

 

 

 

*I haven’t combined the drug-related death figures for England and Wales with that of Scotland or Northern Ireland because drug-related deaths are recorded slightly differently in each region and to do so would therefore skew the figures. Figures for spending on drug policy and related issues are only available as a UK-wide figure.

Will Brazil be next to reform drug policy?

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Photo credit: Tomaz Silva / Agencia Brasil

Brazil looks set to be the next country to decriminalise possession of small amounts of drugs for recreational use. Brazil is one of several Latin American countries to consider steps towards a more progressive approach to drug use.

For Brazil the emphasis on the ‘victimless’ nature of drug use – where no third party is harmed – has prompted a reconsideration of the law. This follows a relaxing of penalties for possession and use in 2006 which, although designed to lessen the punitive treatment of drug users, has unfortunately achieved the opposite. The choice given to courts to prosecute as possession or trafficking coupled with no real definition of what constitutes either has meant Brazil has seen a marked increase in incarcerations for trafficking.

This was announced shortly before the United Nations declared punitive drug policies around the world to be in breach of human rights. In March the UN Development Agency also attacked drug policies for their role in hampering international development. This potentially signals a global shift away from a punishment-based approach towards one focused on health and human rights. Well, maybe…

Despite this several countries within the UN, such as China and Russia, still support punitive policies while remaining highly critical of harm reduction policies or a health-focused approach. Recently Russia has ceased provision of basic harm reduction measures such as needle exchange. China has been the leader in a bid to classify Ketamine as an illegal narcotic at the global level (at present only individual states have legally controlled Ketamine). In addition there is political opposition to decriminalisation in Brazil itself.

Meanwhile Saudi Arabia, a country which routinely executes for possession of even cannabis, now chairs the UN Human Rights council (with leaked documents suggesting this might be the result of dodgy dealings between Saudi and the UK government). This could potentially pose problems for reform at the global level.

With the UNGASS 2016 fast approaching it is a very interesting time for international drug policy. Watch this space with fingers crossed – 2016 could be the only real chance of reform for decades to come.

wpid-wp-1443983342424.pngRead the full article on Brazil’s move towards decriminalisation, originally published by Talking Drugs, below:

Brazil’s supreme court could rule in favour of decriminalising drugs – http://wp.me/p4jSGm-dD

Image credit: Transform Drug Policy Foundation (2015)

Heroin-related deaths increase – reform could save lives

supportdontpunishHeroin-related deaths in England and Wales continue to rise. Punitive drug policy facilitates an illicit market which allows fluctuations in purity as well as adulteration. Prosecution and stigmatisation only create barriers to treatment and worsen the situation. Our current drug laws lead directly to the death of someone’s brother, sister, mother, father or friend.

Check out this great article for more information:

Shocked and saddened by drug related deaths figures for 2014

#DrugPolicyReform #SupportDon’tPunish

Drug policy is determined by politics, not evidence

Drug prohibition isn’t about reducing harm, and it never has been. 

History has shown that drug policy is very rarely about preventing harm and more often concerned with issues of race, profit, morality and politics.

Recently the Home Secretary of the UK, Theresa May, has been under fire from Drugs Minister Norman Baker, as well as several drug policy reform charities, for the alleged suppression of a report discussing drug policy reform. The report, which has been available for publication since July, examines the policies of several other countries in an attempt to improve upon current policy in the UK.

Despite successive governments claiming that the current approach is working, prohibition has undeniably failed. Drug use and drug-related health problems including deaths have generally either remained stable or increased, while drug-related crime has also risen. This is despite the UK government spending an estimated £19billion per year on enforcement efforts, anti-drug education in schools and healthcare associated with drug use. This isn’t surprising given that evidence from worldwide studies shows there is no link between harsh enforcement and lower levels of drug use.

Globally an estimated 200,000 drug-related deaths occur per year, and drug-related violence in producer states has continued to escalate with a huge impact on local populations; the drug war in Mexico has claimed over 100,000 lives in the last 9 years, with mass graves becoming a common feature as the corruption worsens and law enforcement efforts become more militarised.

The report in question could be the first real step towards drug policy reform in the UK, but the Conservative Government has refused to publish it. Danny Kushlick of Transform Drug Policy Foundation, speaking to The Independent, suggests a reason for the government’s reluctance to publish the report; “Both Tory and Labour governments have a long and shameful history of withholding drug policy analysis that contradicts the prohibitionist orthodoxy”. The reality is that this report is just the latest in a long line of reports which have been ignored by the government because they run counter to the prohibitionist orthodoxy.

So why is a report that could improve the lives of thousands of drug users being ignored? The answer is that drug policy has never been about reducing harm or protecting the public. Prohibitionist drug policy has come about instead because of a need for governments to control certain groups of people, and as a means of attaining political kudos through ‘being seen to be doing something’. The humanitarian objective which politicians and policy makers pay lip-service to is nothing more than a cover for this fact.

As commentators such as Noam Chomsky have noted, the government and the media are often complicit in spreading propaganda as a means of provoking a reaction from the public which justifies tighter social controls and maintains the interests of the elite. As Chomsky states in a 1998 interview in High Times “this engineering or manufacture of consent is the essence of democracy, because you have to insure that ignorant and meddlesome outsiders – meaning we, the people – don’t interfere with the work of the serious people who run public affairs in the interests of the privileged”.

The way in which prohibition has been used as a tool of social control can be seen in the history of drug control policies. Opium prohibition in the early 20th century, one of the earliest examples of punitive drug controls, was enacted as a way of controlling Chinese immigrant workers in the United States by exploiting fears about white middle class values and working class jobs. The fact that there was little evidence of a serious problem existing as a result of opium use was irrelevant.

In much the same way cannabis prohibition occurred in the United States in the 1930s as a way of controlling the Mexican and African populations. The head of the Federal Bureau of Narcotics, Harry Anslinger – an outspoken racist, and the anti-cannabis lobby (including the timber and chemical industries, for whom hemp was a threat to profits) exploited depression-era anxieties and xenophobia about cannabis-using Africans through propaganda films like Reefer Madness. Racism and private business interests were the motivation for the prohibition of cannabis, not a desire to reduce harm.

Contemporary examples of ‘drug scares’ have moved from demonising the groups using drugs to demonising the drugs themselves (although that doesn’t stop drug users from being unfairly criminalised and stigmatised). The use of drugs like ecstasy, widely associated with the rave culture of the 1990s, has been held forth as a sign of the moral corruption of youth, where users are portrayed as unwitting and irresponsible victims. Drugs like ecstasy supposedly hail the beginning of the end for civil society, according to the mainstream narrative.

Similarly the use of ‘legal highs’ (most often not legal) has been conflated with anxieties about the increased use of the Internet by young people and the supposed threat which this now poses to the morality of youth. There are also hints at underlying anxieties about foreign invasion in the tabloids, given that these substances are thought to be produced largely in China (the racial element of drug control seems to have gone full circle in this case).

Mephedrone, one of the most popular ‘legal highs’ in recent years, was often referred to as a “killer drug”, by the tabloid press. The mainstream media chose to obsess over mephedrone-related deaths and the bizarre behaviours apparently associated with its use, despite the fact that mephedrone deaths accounted for only 1.2% of all drug related deaths in 2012. That’s 18 deaths related to mephedrone compared to 8,367 alcohol-related deaths, but we didn’t consider banning alcohol.

The majority of these deaths were later found not to be the result of mephedrone (although there were, unsurprisingly, no retractions to be found in the newspapers). Regardless, the crisis had been framed and the public outcry, which was guaranteed by the media-driven moral panic, led to the prohibition of mephedrone in 2010. This occurred despite the fact that much of the evidence suggests that the rise in popularity of ‘legal highs’ was largely due to the impacts of prohibition on the price and purity of substances like cocaine and ecstasy. Incidentally, the figures quoted above refer to post-ban mephedrone deaths, which were lower before the drug was prohibited in 2010.

Cheaper and purer mephedrone, available for convenient online purchase and delivery, was seen by drug users as a way of avoiding adulterated and expensive drugs like ecstasy and cocaine, as well as a way of avoiding dealing with the black market. Similar motivations are driving the rise of so-called “deep web” marketplaces such as Silk Road. Now that mephedrone is illegal it has risen in price and dropped in purity, as well as being mixed with other illegal drugs like ecstasy.

As a result of years of being used to demonise undesirable groups, as well as being demonised themselves, drugs have come to symbolise many of the underlying fears of contemporary society; the corruption of youth, radical challenges to the political status quo, xenophobic fears over immigration and foreign invasion, and most of all a sign of rampant hedonism which is frowned upon by Western societies which are still suffering from the hangover of Puritanism and the days of the temperance movement.

Drug users are dehumanised and attributed with negative characteristics in order to be presented as the modern ‘folk devils’, and are consequently disowned by the rest of society. It is assumed that drug users are morally deficient, mentally or physically ill, and possibly even dangerous. Why else would you use drugs, submitting yourself to the perils of certain death or inevitable addiction?

The fact that these assertions do not stand up to the realities of drug use in the 21st century is irrelevant to those who enforce and maintain the orthodoxy of prohibition. Evidence that demonstrates that most drug use is not problematic is repeatedly ignored in the deliberately narrow mainstream debate. At the same time the favoured stereotypes and misinformation are perpetually circulated by the mainstream media, politicians and other groups who have a stake in maintaining the status quo. Despite the slow emergence of arguments to counter the anti-drug narrative the general debate around drug use remains largely uncritical and therefore unchanged.

Decades of accumulated propaganda and the demonisation of drug users has led us to a situation where it is impossible to challenge the orthodoxy of prohibition in the mainstream. This is the reason Theresa May and the Conservative government are scared to appear ‘soft’ on drugs; they know it would be almost certain political suicide because of the pervasive public fear of the ‘folk devils’ and myths about drugs which the prohibitionists themselves have created. It would also be to admit that they have continued to allow drug users to suffer, and society to keep paying the social and economic costs of prohibition, just so that they can further their own political careers.

So how do we challenge the prohibitionist orthodoxy? One way in which this is currently happening is through the Internet, where drug using minorities who have no voice in the mainstream can be heard by millions. The internet is ubiquitous; it cannot be controlled by a government or state because it does not fall under the domain or control of one government or state.  The government monopoly over information, which facilitates propaganda and social control, has finally been broken. It is no wonder then that the government has attempted to censor online critics of the “War on Drugs” and the UN has described the Internet as a “weapon of mass destruction”.

Even several mainstream publications, such as the Guardian and the New York Times, have recently criticised the current approach to drugs, and so the widespread misreporting of drug-related issues in the mainstream media is also changing. However, challenging the orthodoxy is just one part of the problem; the governance of drug policy itself also needs to be addressed before a pragmatic and rational drug policy can be developed.

A recent research series into drug policy governance by Australian academic Caitlin Hughes and her colleagues refers to governance in the drug policy context as “the processes and mechanisms by which policy is directed, controlled and held to account”.

Improving governance then means a more transparent and evidence-based policy process which can appropriately respond to drug related problems by referring to best practice and available evidence. Most importantly a process which guarantees transparency and accountability would not only highlight the lack of evidence on which current policy is based, but ultimately expose self-serving politicians like Theresa May who are reluctant to challenge orthodoxy for fear of damaging their career.

In a policy environment characterised by good governance, and where media misinformation is challenged, the report previously gathering dust somewhere in the Home Office would have been published immediately and reform would now be on the table. In the context of a less politically and morally charged policy process the report may potentially never have been required in the first place; perhaps one of the several that came before it would have been heeded and acted upon.

Norman baker has now resigned as Minister of State for Crime Prevention, shortly after successfully pushing for the report into drug policy reform to be published. He cited the difficulty of working with Theresa May and the rest of the Home Office as a factor in his resignation, stating that there was little support for “rational evidence-based policy” in the department.

So what did that report say after all? It found that decriminalisation was the best way forward for UK drug policy, mainly because there was no evidence to support the idea that harsh punishment reduces drug use. And what was the response from the Home Office? “This government has absolutely no intention of decriminalising drugs”, which can be read as “this government has absolutely no intention of following the evidence”.  Until the narrative on drugs drastically changes in the UK it looks likely that this report, like those before it, is doomed to be ignored while drug policy reform remains a distant dream.

This article was originally published by Fair Observer.

 

 

 

 

 

 

Home Office International Drug Policy Conference 2015

Is the UK Government finally changing it’s approach to drug policy in the run up to UNGASS 2016? 

SSDP UK’s Katie Anderson and Kieran Hamilton were recently invited to attend the Home Affairs Select Committee International Drugs Conference in Cambridge, where the Committee discussed the findings of the recent Home Office report Drugs: International Comparators in the wider context of international drug policy, policing, treatment and of course the relevance of the report for UNGASS 2016.

Chair Keith Vaz MP (Labour) opened the event by discussing the global context of drug trafficking and the social and political harms that result from the international drug trade, particularly in Latin American countries, and the role that the UK plays as a consumer nation.

Closer to home Mr Vaz highlighted the increasing issue of prescription medication addiction, which is largely hidden in the UK, the relationship between acquisitive crime and problematic drug use, and the need to reduce demand for drugs overall while acknowledging that the current demand reductions approaches of  punishment and anti-drugs education have been ineffective and counterproductive.

Dr Julian Huppert MP (Liberal Democrats) then went on to discuss the work of the Committee to date, including the report’s focus on the inefficacy of a punishment based approach that relies on deterrence. Overall the Committee have found that punitive measures to reduce use are ineffective, and Dr Huppert highlighted the fact that despite over 40 years of punitive policy the Misuse of Drugs Act hasn’t delivered in reducing drug use, while echoing comments from the former head of MI5 that expenditure on the War on Drugs had been ‘fruitless’, and that international efforts tended only to move the problem of production and trafficking from one state to another.

In highlighting international issues in relation to drug policy Baroness Meacher spoke of the damage caused by crop eradication and the social and political harms caused by drug cartels in producer countries. One example provided by Transform’s Danny Kushlick was Mexico, where 100,000 people have died in fighting and killings related to drug interdiction and drug cartels have corrupted government and police officials.

Baroness Meacher also spoke of human rights breaches carried out in the name of the global Drug War, including the 33 countries which still execute for drug supply and possession. Dr Roberto Dondisch, of the Mexican Ministry for Foreign Affairs, supported these comments and called for united action in dealing with what he described as a ‘world problem, that cannot be dealt with by one country alone’.

It was disappointing to hear Lynn Featherstone MP (Liberal Democrats), who replaced Norman Baker as Minister of State for Crime Prevention, declaring that mephedrone prohibition had been a success despite widespread reports that the drug is now being used as an adulterant or otherwise miss-sold as other stimulant drugs. This creates potential risks for users who may not be aware of what they are taking or that the substance they are in possession of is illegal. Professor David Nutt was also quick to highlight the fact that mephedrone use may have led to a decline in cocaine deaths, and so the ban on mephedrone is likely to cause more harm rather than less.

The conference also heard from Tom Lloyd, formerly Chief Constable for Cambridgeshire, as well as ACPO National Drug Lead Chief Constable Andy Bliss who gave an account of the Drug War from a policing perspective. While Mr Bliss was clear that the Misuse of Drugs Act had by no means solved the ‘drug problem’, and questioned whether it had ever been intended to, he also discussed the challenges of implementing current policy and the need for integration between policing, harm reduction and health interventions.

Tom Lloyd took this sentiment further by arguing that problematic drug users should be supported, not punished, while also noting that current policy had not only had negative impacts on drug users, but on relationships between the police and communities impacting on the ability of the police to operate effectively in the community.

Ron Hogg, Police and Crime Commissioner for Durham, discussed the limited impact of major drug busts which only disrupt supply for short periods but are resource intensive. He also highlighted the challenge which ‘dark web’ markets present for policing, and the increasing inability of interdiction  agencies to prevent drugs entering or being cultivated in the UK.

Despite the encouraging discussion of the need for reform, Professor Neil McKeganey asserted that the conference suffered from bias and a pro-reform agenda. While professor McKeganey was quick to rebuke the findings of the Committee and the need for policy reform he provided little evidence in support of his position, and perhaps failed to consider that the desire for reform might not be the result of any agenda, but the result of the overwhelming evidence that supports the need for reform.

Also critical of the pro-reform stance was Sarah Graham of the Advisory Council on the Misuse of Drugs (ACMD). While Miss Graham didn’t express support for policy reform, she highlighted the need to address gaps in the evidence. She also noted that drug treatment and recovery tactics are failing to be integrated into mainstream treatment, while also condemning the influence of Big Pharma on drug treatment approaches.

Overall there was a notable change in the language used throughout the conference, with Mr Vaz arguing for a shift towards addressingharmfuldrug use (a possible acknowledgement that not all drug use is harmful?), accompanied by a general acceptance of the need for increased harm reduction. While the majority of the speakers and those in attendance were in favour of reform, opinion of the shape that this reform should take varied, with some such as Dr Huppert proposing a ‘Portuguese style’ model of decriminalisation and treatment, while others such as Keith Vaz spoke against this particular approach, while still advocating a co sideration of the current approach. NORML UKwere also present in force and advocated for medical cannabis provision and the adoption of a cannabis supply model similar to Spanish ‘grower’s clubs.

In the current climate of changing drug policies, with Latin American countries defying the UN conventions and even some US states experimenting with alternative drug polices around cannabis, the reality according to Mike Trace, Chair of the International Drug Policy Consortium Board, is that UNGASS 2016 will still be a challenge.

Many states such as China and Russia are at present reluctant to embrace harm reduction measures or acknowledge the failure of punitive approaches, while others are keen to maintain the status quo.

The main difference for the upcoming UNGASS 2016 in comparison to the previous special session in 1998 is that big players such as the US are starting to shift their policy, forced along by the resistance put up by Latin American and other producer countries to the UN Conventions. Coming away from the conference in Cambridge there is a real sense that the UK is now well placed to advocate for reform at the UN level.

Those who have come out in support of reform, most notably the members of the Home Affairs Select Committee as well as Norman Baker, Nick Clegg, Caroline Lucas and others, should be commended for wanting to put an end to harmful and counterproductive drug policies.

Let’s hope the spirit of reform expressed at the conference is carried forward to UNGASS 2016; with countries like the US and the UK at the forefront of reform efforts alternatives to the current approach are possible. In the words of Mike Trace, we could see a global change in policy in the next 10 years. To make this possibility a reality we need to work together to put drug policy firmly on the international agenda, and UNGASS 2016 is the first hurdle.

The above article originally appeared on ssdp.org.uk

PhD Research – Novel Psychoactive Substances, Harm Reduction and the Internet

legal_highs_1982456a

I’m currently in my second year of a PhD at the University of the West of Scotland, and my research focuses on the use different sources of information for harm reduction advice on novel psychoactive substances (sometimes referred to as ‘legal highs’  or ‘research chemicals’) and the effect that this has on drug users’ perceptions and use of novel psychoactives in terms overall attitude towards harm, harm reduction practices, novel Vs illicit drugs and policies aimed at novel psychoactives and wider drug use.

For anyone who is interested in social research I’m using mixed methods and coming at the research from a interpretative social constructionist epistemology. I haven’t made the data gathering easy for myself… I’m triangulating data between a survey, semi-structured interviews and a content analysis of mainstream (newspapers, and online news reports) and alternative (Internet forums) media content on novel psychoactive substances, focusing on portrayal of risk and harm, legality and policy, portrayal of users and harm reduction information.

I’m looking for people who are drug users, who also use novel psychoactives (or ‘legal highs’/’research chemicals’) –  a broad (and admittedly somewhat inaccurate) definition by which I mean synthetic compounds and analogues of illicit drugs, as well as herbal and botanical psychoactives which are legally available, and prescription/pharmaceutical drugs which are used outwith the context of a doctors prescription (either for medical or non-medical use). The only stipulation is that respondents need to be 18, for ethical reasons, but can otherwise be from anywhere (I’ve had responses from as far away as China so far). The wider the base of respondents, the better.

I’m considering putting together another site for my PhD research and to blog about wider issues in drug use and policy, but in the mean time I’ve decided just set up this page on my site in the hope of attracting at least a few responses for my survey.

So here it is – My survey on Novel Psychoactive Substances, Harm Reduction and the Internet.

It only takes 5 minutes to complete and all of your answers are confidential and anonymous. If you would be interested in taking part in an interview to better express your views then please leave your email address at the end of the survey (this is kept in strictest confidence and will not be shared with anyone).

If you are able to share my survey on Facebook, Twitter or even by email or over whichever social network you and your friends use then I would be extremely grateful. If you share the survey on Twitter be sure to tag me – @kierandhamilton – so I can say thanks.

Thank you for taking the time to read this. If you have any questions or would just like to chat then please leave a comment, or you can email me – hello@kieranhamilton.org

Best wishes to you all,

Kieran

(Image credit: fromthewax.com)

Glasgow Needs Safe Injection Sites

Syringe W
(Image: Kieran Hamilton 2014)

In the run-down Tradeston district, just south of Glasgow City Centre on the other side of the River Clyde, is one of the City’s needle exchanges. The needle exchange, run in partnership between Turning Point Scotland and NHS Scotland, provides clean needles and injecting equipment, naloxone (a drug developed to prevent death in the event of opiate overdose), and a range of counselling and residential services for those with drug problems. This is a much needed service that makes a real difference to the lives of injecting drug users in Glasgow.

However, as good (and necessary) as these facilities are, they arguably don’t go far enough. The picture above was taken inside an abandoned warehouse just five minutes away from the needle exchange. This was not the only used needle, nor the only evidence of injecting drug use in the building. Some areas were littered with literally dozens of used needles, as well as swabs and other paraphernalia.

Heroin was legal once, could we regulate it again? Image: Wikimedia Commons
Could we regulate heroin, again? (Image: Wikimedia Commons)

Heroin was legal once, could we regulate it again? Image: Wikimedia CommonsWhy am I highlighting this? Well, the objective of a needle exchange is to reduce the sharing of used needles, and to provide instruction on safer injecting techniques, all to avoid the spread of blood borne viruses such as HIV and HCV, and prevent other health issues connected to injecting drug use. These practices, informed by a harm reduction ideology, have indeed resulted in a reduction in the spread of infections and health issues for drug users (and consequently wider society), but arguably they do not go far enough.

The needles used might be clean, but the environment in which injection takes place certainly isn’t, presenting a risk of infection for injecting drug users. Further still, the use of abandoned and secluded spaces for injecting also poses a particular risk: in the event that an individual overdoses there are no medical facilities or trained medical staff nearby, and paramedics would have to find the overdosed individual in a dilapidated and potentially dangerous building (just think of all those discarded needles, a veritable mine field). Should the individual be alone there is little chance they would be found by a member of the public in time. The risk of death from overdose in this situation is huge.

Current laws prevent the regulation of heroin supply, meaning that there is little we can do to maintain the purity and strength of a drug that is controlled by the black market. It is the variance in heroin purity, or to a lesser extent the nature of adulterants, that results in a large number of overdoses, and death. The heroin you bought yesterday might be much stronger, or weaker, than the heroin you’re buying today, because no one is ensuring consistency. No one is regulating the strength.

So what can we do if the law prevents us from addressing the issue of purity and adulteration leading to overdose? That’s where supervised injection sites, or ‘shooting galleries’ as they have been sensationally termed in the media, can make a difference. While overdose cannot be prevented because of the reasons stated above, we can provide a better environment for those injecting in order to reduce infection and mortality rates. Supervised injection sites mean that drug users can inject in a safe, clean and private environment, where there are medical staff on hand should something go wrong. As if the potential to save lives wasn’t reason enough, safe injection sites, like needle exchanges, can help treatment services to come into contact with injecting drug users who otherwise would not approach services, and this can lead to treatment and recovery further down the line. In short, supervised injection sites can act as a great first port of call for hidden populations of problem drug users. In addition, the number of discarded used needles can be reduced.

Image: InSite (via Wikipedia)
(Image: InSite 2003, via Wikipedia)

And the evidence for safe injection sites speaks for itself: At the Insite injection facility in Vancouver, Canada, one of the most evaluated of international safe injection sites (with three peer reviewed articles evaluating its efficacy) saw a 35% reduction in overdoses within 500 metres of the facility up to 2011. Other benefits that have been noted are a reduction in public drug use, a reduction in needle sharing, and a reduction in discarded drug paraphernalia in the vicinity of the facility. There has also been an increase in referral to treatment services, and on top of that these benefits do not seem to be offset with any other negative developments in the drug using community as a result of the site being in operation. From a crude economical perspective, safe injection facilities are cost effective as well as being beneficial for injecting drug users and the wider community.

Safe injection sites are currently illegal in the UK, where the Westminster government has repeatedly rejected calls for their provision. That just begs the question, if there are so many benefits from these sites, and virtually no negative impacts, then why aren’t we providing them? The answer, unfortunately, is the same for most barriers to improving drug treatment or policy: ideology, moral arguments and political cowardice stand in the way of evidence based practice. The conservative media, increasingly more right-wing every day, see the provision of needles and facilities for heroin users as anathema, and unfortunately the same media outlets hold much influence over public opinion. In turn politicians use the press as a ‘policy satnav’, as Jon Silverman has so eloquently put it, in deciding policy on morally sensitive issues.

It will be a slow process to have these type of facilities rolled out nationally, just like needle exchange services in the late 1980s, but once people see the benefits then they become more socially palatable. Lets hope the UK can learn from other countries who have taken that extra step to the lives of injecting drug users, and reduce the costs and harms to both individuals and society from injecting drug use.

References and further reading:

Insite Website

Supervised Consumption Facilities, Safe Injection Facilities and Drug Consumption Rooms – Drugwarfacts.org

Report of the Independent Working Group on Drug Consumption Rooms – Joseph Rowntree Foundation