British Drug Rehabilitation Program - Pre 1970's

Many years ago, I remember hearing that the United States should follow the British example, their program was described as “Addicts register with the government and are given drugs and shown how to administer (inject) them so the veins are not destroyed. And, addicts are encouraged to enter rehabilitation programs, but this is not required.” According to memory, the program was successful in eliminating much of the profits to organized crime and eliminating the need for addicts to turn to theft to support their habit. But the program was ended at the request of then President Nixon as part of his “war on drugs”.

My questions: Is this a reasonable description of the program? Should this be revived? (I suspect that it could not be, the consequences of handing out some of the newer more addictive drugs would be terrible.)

This lasted well into the 1980’s.

I also remember when it was stopped - we had US experts being interviewed in morning tv and they actually told us that it was a terrible idea to stop the program and that we really had no idea of the severity of the impact if we did stop it.

However at the time we had a right wing Tory administration spouting law and order nonsense and it was indeed halted.

Result, an explosion of heroin dealing as addicts turned to pushing hard and dealing in order to support their own habits. Just another of those things that I hold that evil Tory scumqueen Margeret Thatcher responsible for. Exactly the result that those US drug experts had predicted.

…and yes, I was working in prisons and saw the effects first hand - eventually we started a methodone program in prisons but that was all tied to reducing dosage instead of maintenance, and every addict I ever met - which was many hundreds - told me that Methadone was more addictive than heroin.

Heroin has largely been replaced with Spice which is much cheaper - but also causes loads of delusions, mental health issues, self harm and has no subsitute substance that can be used for maintenance that I am aware of.

[Moderating]

“Is this an accurate description of the program” is mostly a factual question, but “should it be revived” is not. Since I suspect that the latter will get more discussion, let’s move this to GD.

Although the USA was responsible for stopping heroin and morphine maintenance programs in several countries, they aren’t the only force preventing their re-implementation.

China is the prime example of a country that dealt with their opiate problem by changing from a system of de facto legality to criminalization, and in England opiate abuse was traditionally associated with what would now be called a “safe injecting room” but were then known as an “opium den” or a “doss house”, and in particular one of the charities that has always dealt with the fallout of opium abuse and alcohol abuse (The Salvation Army), has always had a policy of total-abstinence and criminalization of supply.

Where I am, it’s a 3 corner fight: In one corner, the epidemiologists, reporting that prescription programs are successful, in another corner, police and local residents demanding punitive action, and in the 3rd corner, the Salvation Army, who gain their place in the debate by caring for people and actually providing social services for addicts, social outcasts, criminals and the poor.

There are a number of treatment drugs to replace heroin, so you would use those instead of giving the heroin:

"Medications developed to treat opioid use disorders work through the same opioid receptors as the addictive drug, but are safer and less likely to produce the harmful behaviors that characterize a substance use disorder. Three types of medications include: (1) agonists, which activate opioid receptors; (2) partial agonists, which also activate opioid receptors but produce a smaller response; and (3) antagonists, which block the receptor and interfere with the rewarding effects of opioids. A particular medication is used based on a patient’s specific medical needs and other factors. Effective medications include:

Methadone…
Buprenorphine…
Naltrexone…

https://www.drugabuse.gov/publications/research-reports/heroin/what-are-treatments-heroin-use-disorder

That would have been Presidents Nixon and his War on Drugs campaign to criminalise his enemies in the anti-war and civil rights movements in 1971. I expect a lot of Vietnam War veterans returned to the US with serious problems. It updated the laws in the US and Nixon launched a global campaign against drug use through the UN. In the UK the government passed the Misuse of Drugs Act in 1971 and this introduced a system of classifying drugs into different categories A, B and C with different penalities associated with each. Heroin and Cocaine are Class A with the biggest penalties.

Prior to the UK had a system of drug control administered by GPs. You could get Heroin on prescription from a doctor if you the right one. This was when the number of addicts was just a few hundred. There are some doctors who were famous for this and many lurid ‘Dr Death’ stories in the sensationalist tabloid press. But there were some progressive voices amongst the medical profession.

The next big tightening of drug laws came in the 1980s, when the economic rececession led to mass youth unemployment and an epidemic of heroin addiction.

Now was it the uncomfortable memory of Margaret Thatcher and her right wing government? This document suggests it heroin became a political issue because of the a radical left wing leader of Liverpool council. One Derek Hatton. Anyone remember him? He ran a campaign to highlight the worrying extent of drug dependency in the public housing in Liverpool. Calling it ‘Smack city’ called on the government to address the issue of the young unemployed living in poverty. I was all punk rock and heroin. This led to a big expansion in drug treatment services until the HIV epidemic in the mid 1980s became a priority public health emergency. Since then there have been many changes to drug policy in the UK. Most involving increasing control and penalties and a lot of moralising from politicians. The UK has been slow to adopt the public heath approach it once had before 1971 and the prevailing policy assumes that drug addiction can be solved by criminalisation and remedial treatments.

There is a committee, Advisory Council on the Misuse of Drugs, whose job is to advise the government on drugs policy. The classification of drugs into categories is now quite archaic and is not consistent with the dangers as they are understood today. Cannabis use is a bone of contention.

However, woe betide an expert who expresses an opinion that the government does not want to hear.

This guy was sacked for suggesting that alcohol and tobacco were often more dangerous that drugs like LDS, MDMA and cannabis.

I always think of this guy when I hear the government dealing with COVID insisting that they listen to the best scientific advice.

This report says something interesting with respect the change in UK drugs policy in 1971, questioning the influence of the US and Nixons campaign.

‘Many commentators, particularly American commentators (Schurr, 1963; Schur, 1964; and Trebach, 1982) have pinpointed this moment as the time when Britain abandoned the ‘New British System’ and opted instead for a US-style penal policy. This is however, a misreading of the facts…’

There was more going than an eagerness to please the US.

UK drugs policy is the responsibility of the Home Office. This government department is responsible for Law and Order issues. As such it plays an important role in dealing with issues that are of great public concern when it comes to an election. Both the Conservative and Labour parties usually put a poltician as Home Secretary whose job it is to fend off any criticism of the government being too lax on Law and Order issues. They always adopt a stern, authoritarian position, thinking up new, longer sentences for crimes, restrictions on asylum seekers and people smugglers and foreign criminals. Stronger measures to prevent terrorism. Drug policy is also in the Home Secretaries remit and they are not interested in any reforms. There are no votes in being nice to prisoners or drug addicts. When the public has a moral panic a politician is obliged to provide a quick solution.

So we have crowded prisons where drugs are easy to obtain and on the streets of many UK towns there will be the depressing sight of chronic drug abusers scaring passerby with their eyes wide and mouths open as they stand motionless after a hit of one of the highly potent derivatives of THC.

At the same time there is a rational approach to these problems and committees and reports written advising the government on policy. But political priorities always trumps science.

Scotland has a more progressive drugs policy and it might show the way forward for the rest of the UK…one day

Thanks to everyone who replied. I learned quite a lot.