The battle to tackle drug addiction is not lost

The debate about legalisation is a distraction.

It is impossible not to be moved by the plight of communities in Mexico and other drug-producing countries across the world. Crime and violence related to the supply of drugs are without a doubt causing extreme grief to citizens and governments. But reaching to decriminalise or legalise those drugs in the hope that it will overcome those communities’ deep-rooted problems offers them a false prospectus, and overlooks the nuanced picture of drug use and addiction which in this country at least, is in decline.

For many producer nations, drugs are one of a number of complex factors contributing to adverse conditions within their countries.  Legalisation would compound the devastating effects of drug use and the drugs trade, as former UN head of drugs and crime Antonio Maria Costa argues, especially if the structural issues that leave those states without the resources to tackle the causes and consequences of their drug problem are not addressed.

The legal framework in this country does not prevent those with drug problems from being treated humanely and effectively. Drug treatment is freely and quickly available via the NHS in England, and offers users the prospect of stability and recovery from the chaotic lives inherent in addiction. Over the last six years, 340,000 mainly heroin users have got help for their addiction, of whom around one third successfully completed their treatment, which compares favourably to the international evidence of recovery. Addicts are treated as patients in the health service, and if there are other crimes to account for, addiction treatment is offered for offenders in the community and in prison in line with NHS standards.

Drug use in this country is falling, particularly amongst young people. Heroin, crack and cannabis are being used by fewer people, and whilst there are more young people taking so-called legal highs and novel drugs, their numbers are nowhere near the levels we faced when setting up the nation’s treatment response primarily for heroin addicts more than a decade ago. At the same time, more people are recovering from drug addiction in England. There is no cause for complacency, in fact we are accelerating efforts to orientate drug treatment towards recovery, but it is worth pointing out that the trends on use, addiction and recovery are heading in the right direction.

Domestically and globally, the public discourse about drugs tends to exaggerate the power of the drug, and minimises the impact of social and economic circumstances. Compared to the 2.8million who use illegal drugs there are around 300,000 heroin or crack users in England, over half of whom are in treatment each year. Probably another 30,000 or so are in treatment for dependency on other drugs e.g. powder cocaine, cannabis and ecstasy. Those who become addicted tend to be seen by the media as the victims of hedonism, the random by-product of widespread recreational drug use. A steady trickle of millionaires’ children and celebrities fuel this myth, playing to the anxieties of middle class readers about their own children. Too often, those in the public eye think they understand drug addiction because of personal or family experiences which bear little relation to the multiple disadvantages experienced by most addicts.

In reality drug addiction is targeted. The 300,000 heroin and crack addicts are not a random sub set of England’s regular drug users. If they were, they would be as likely to live in Surrey as Salford, to have been to Westminster School as Wandsworth Prison, and their childhood would have been as likely to have been overseen by a live-in nanny as much as by Newham Borough Council.

Addiction, unlike use, is concentrated in our poorest communities, and within those communities it is the individuals with the least capital who are the most vulnerable to succumb and least able to extricate themselves. Compared to the rest of the population, heroin and crack addicts are male, working class, offenders, products of the care system, with poor educational records, little or no experience of employment, and a history of mental illness. Increasingly they are also in their forties with declining physical health. They will tend to struggle more than most to make sound personal decisions, which contributes to their other problems.

The reputation of heroin is such that few people will even try it. Of those who become addicted, the majority will recognise where they may be heading and stop. Amongst them will be people who are intelligent, resourceful and ambitious who will realise they are in “in over their heads”, pull themselves up sharp, and sort themselves out. Others will not necessarily have the innate resources to do this but will have family and friends to support them to achieve the same outcome. Key to this success will be the existence of an alternative life with the reality or realistic prospect of a job, a secure home, a stake in society and supportive relationships. The access to social, personal and economic capital not only enables individuals to overcome their immediate addiction, but to avoid relapse.

The government’s 2010 drug strategy recognises that treating addicts in isolation from efforts to address their employment, their housing status and the myriad other problems they face is unlikely to lead to long term recovery. According addiction primacy as a cause of poverty, criminality, worklessness, and child neglect denies the fact that it is as much a consequence of individual family and community breakdown as its genesis. Drug addiction exacerbates problems, and unless it is addressed will inhibit or even prevent progress in other aspects of people’s lives, but addressing it in isolation is not a silver bullet.

Drugs are not the unique barrier to normal social functioning for most addicted people. Drugs are not the unique barrier to a better, fairer and safer world in drug producing countries. The debate about legalisation is a distraction from facing and comprehensively addressing the social and economic factors that underpin drug use, addiction and the drugs trade.

Paul Hayes is the Chief Executive of the National Treatment Agency for Substance Misuse (NTA)

Opium poppy buds in an Afghan field. Photograph: Getty Images

Paul Hayes is the Chief Executive of the National Treatment Agency for Substance Misuse (NTA)

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How to end the Gulf stand off? The West should tell Qatar to reform its foreign policy

Former defence secretary Geoff Hoon on the unfolding crisis in the Gulf. 

Only one group stands to benefit from a continuation of the crisis in Gulf: The Quartet, as they are now being called. Last week, The United Arab Emirates foreign minister tweeted that Qatar and its Gulf Cooperation Council neighbours are heading for a "long estrangement". We should take him at his word.

The European political establishment has been quick to dismiss the boycott by Saudi Arabia, the UAE, Bahrain and Egypt as naïve, and a strategic mistake. The received wisdom now is that they have acted impulsively, and that any payoff will be inescapably pyrrhic. I’m not so sure.

Another view: Qatar is determined to stand up to its Gulf neighbours

Jean-Yves Le Drian, France's foreign minister, was in the region over the weekend to see if he could relay some of his boss’s diplomatic momentum. He has offered to help mediate with Kuwait, clearly in the belief that this is the perfect opportunity to elevate France back to the top table. But if President Emmanuel Macron thinks this one will be as straightforward as a Donald Trump handshake, he should know that European charm doesn’t function as well in the 45 degree desert heat (even if some people call him the Sun King).

Western mediation has so far proceeded on the assumption that both sides privately know they will suffer if this conflict drags on. The US secretary of state Rex Tillerson judged that a Qatari commitment to further counter-terrorism measures might provide sufficient justification for a noble reversal. But he perhaps underestimates the seriousness of the challenge being made to Qatar. This is not some poorly-judged attempt to steal a quick diplomatic win over an inferior neighbour.

Qatar’s foreign policy is of direct and existential concern to the other governments in the Gulf. They will not let Qatar off the hook. And even more than that, why should they? Qatar has enormous diplomatic and commercial clout for its size, but that would evaporate in an instant if companies and governments were forced to choose between Doha and the Quartet, whose combined GDP is almost ten times that of their former ally. Iran, Turkey and Russia might stay on side. But Qatar would lose the US and Europe, where most of its soft power has been developed. Qatar’s success has been dependent on its ability to play both sides. If it loses that privilege, as it would in the event of an interminable cold war in the Gulf, then the curtains could come down.

Which is why, if they wanted to badly enough, Le Drian and Tillerson could end this conflict tomorrow. Qatar’s foreign policy has been concerning for the past decade. It has backed virtually every losing side in the Arab world, and caused a significant amount of destruction in the process. In Syria, Libya, Egypt and Yemen, Qatar has turned a blind eye to the funding of Islamic revolutionaries with the financial muscle to topple incumbent regimes. Its motives are clear; influence over the emergent republics, as it had in Egypt for a year under Mohamed Morsi. But as we review the success of this policy from the perspective of 2017, it seems clear that all that has been achieved is a combination of civil unrest and civil war. The experiment has failed.

Moreover, the Coalition is not going to lift sanctions until Doha suspends its support for the Muslim Brotherhood. When Western leaders survey the Gulf and consider who they should support, they observe two things: firstly, that the foreign policy of the Quartet is much more aligned with their own (it doesn’t seem likely to me that any European or American company would prefer to see a revolution in Dubai instead of a continuation of the present arrangement), and secondly, that Qatar would fold immediately if they applied any significant pressure. The Al Thani ruling family has bet its fortune and power on trans-Atlantic support; it is simply not credible that they would turn to the West’s enemies in the event that an ultimatum was issued. Doha might even welcome an excuse to pause its costly and ineffective programmes. Even if that involves some short term embarrassment. It is hardly going to lose support at home, with the highest GDP per capita in the world.

It would be necessary to make sure that the Coalition understands that it will have to pay a price for decisive Western intervention. The world will be a more dangerous place if our allies get the impression they can freely bully any smaller rival, knowing that the West will always come down on their side. That is however no great hurdle to action; it might even be a positive thing if we can at the same time negotiate greater contributions to counter-terrorism or refugee funding.

Unfortunately the reason why none of this is likely to happen is partly that the West has lost a lot of confidence in its ability to resolve issues in the Middle East since 2003, and partly because it fears for its interests in Doha and the handsome Qatari contributions in Western capitals. This cautious assessment is wrong and will be more harmful to Qatar and the aforementioned interests. The Quartet has no incentive to relent, it can’t afford to and will profit from commercial uncertainty in Doha the longer this drags on. If the West really wants this to end now, it must tell Qatar to reform its foreign policy or face sanctions from a more threatening ally.

Geoffrey Hoon was the UK defence secretary from 1999 to 2005.