Quick fix for the heroin epidemic is a counsel of despair

Published on 26/11/2006 00:15

BACK in the days when I was a crime reporter in Newcastle, I got to know a heroin user. To fund his habit, Sean became a self-styled "Border reiver". He and his team would make trips to Scotland where they would carry out raids on social clubs, petrol stations and newsagents. On his return, he would stop off at a house in the former pit town where he lived and emerge with a piece of paper containing his next fix.

Sean was in and out of prison, but it didn't stop him using or offending. Always in some scrape or other, he died in his 20s. And, despite the efforts of police and Customs officers to crack down on dealers, there were plenty more users to fill the gap.

Today, there are an estimated 240,000 heroin addicts in the UK, committing an average of 435 crimes a year each to raise the 30,000 it costs to keep them in the drug. They differ from Sean only in that their crimes are more often perpetrated in their own backyards: against poor people living in tower blocks on deprived estates.

With their total damage to society estimated at 45,000-a-head each year, and methadone programmes widely believed to exacerbate rather than alleviate the problem, it is little wonder police chiefs are urging the government to take a more radical approach to heroin use.

The suggestion last week by Howard Roberts, deputy chief constable of Nottinghamshire Police, that the most problematic addicts - those who have abused for 10 years or more - should be prescribed the drug on the NHS (and the revelation that small trials were already ongoing) caused a predictable moral panic in some quarters. The Daily Mail accused the government of putting junkies before cancer or Alzheimer's patients, who are being refused certain drugs on the grounds that they are not "cost-effective". They missed the point, since the move would be aimed at providing relief not so much to the heroin addicts themselves as to the beleaguered communities who bear the brunt of their habit.

In fact, from a financial perspective the argument for dispensing heroin is incredibly seductive: if the average drug addict causes 45,000 of damage a year, then spending 15,000 on giving them heroin means an overall saving of 30,000-a-year per addict. And that's without taking into account the cost of drugs deaths and the benefit to the economy if some of those addicts are able to reintegrate into society.

Proponents of this strategy tend to cite Switzerland, where heroin has been given to a small proportion of hardened addicts since the mid-Nineties, as a beacon of good practice. There, drug-related crime has dropped and the lives of some long-term users have been turned around to the extent that they have had their children returned from care and are able to hold down jobs.

Because the heroin is pure and is administered in clean, safe surroundings, the incidence of infections, abscesses and Hepatitis C has decreased, and the number of overdoses has dropped dramatically. Those who sign up to heroin programmes tend to stay on them, and many gradually reduce their consumption over a number of years.

A decade after Trainspotting, the UK's affair with the heroin shows no sign of abating and so it makes sense to launch a damage limitation exercise. And yet isn't there is something a little desperate about placing our faith in a strategy that can at best provide palliative care to a limited number of hardened users, and, at worst, might actually increase the number of addicts? By so cynically presenting the prescription of free heroin in terms of profit and loss, aren't we reducing human life to an exercise in accounting?

What the police chief is selling as an inspired way out of the drugs morass is in fact an admission of defeat. The message it sends out is not that we could be at the cutting edge of treating heroin addiction, but that, when it comes to drugs, we are clutching at straws.

The problem with using the Swiss model as a template for our approach to heroin addiction is that it leaves so many questions unanswered. Without a doubt the lives of many of those involved have been stabilised. But can three quarters of people remaining on a drugs treatment programme be judged an overwhelming success when the treatment involved is the provision of the drug they wanted in the first place?

And what of those whose addiction is not judged serious enough to merit free prescription: those who have abused the drug for only eight or nine years, for example? Is their offending likely to be reduced? What motivation do they have for trying to detox if they know that in a year or so they will be able to get the drug for free? And there is always the danger that the legally-prescribed drugs will find their way into the illegal market place.

Even if prescribing heroin doesn't exacerbate the problem, it seems to channel resources too far down the line, when addiction is already entrenched. Wouldn't it be better to invest these sums of money earlier on, when there is a realistic prospect of weaning people off heroin?

Detox programmes tend to be dismissed as useless, with the majority of people who go through them eventually returning to heroin. But then they are desperately underresourced. Those who decide they are ready to come off the drug often find themselves on a waiting list of up to 18 months, services are disjointed and there is a lack of aftercare. I can't help wondering what would happen if we invested 15,000 per addict a year (3bn) more on improving the work done in such centres.

It's not that I'm against prescribing heroin to addicts per se. Sure, do it in the short-term to cut crime and help a handful of socially dysfunctional people play a more productive role in society. But don't let's present it as anything other than a stop-gap measure until we come up with something better. A society that consigns tens of thousands of its citizens to a life of heroin addiction is not one that has seen the light: it is one that has given up hope.