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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Donald Trump's cartoon nuclear rhetoric draws on a culture of American jingoism

Senior Republicans avoided condemning Trump's incendiary speech, and some endorsed it. 

From recent headlines, it seems as though Donald Trump isn't content with his Emmy-by-proxy. The US president told the United Nations General Assembly this week: “The United States has great strength and patience, but if it is forced to defend itself or its allies, we will have no choice but to totally destroy North Korea.” Trump’s speech raised eyebrows for its bellicose tone, especially when contrasted with his predecessor’s endorsement of a war-averse approach. 

A widely circulated image of Trump's chief of staff John Kelly with his head in his hand might suggest that most listeners loathed the speech. But Trump said many outrageous things on the campaign trail and voters - at least a critical number of them - agreed. So how did his words go down at home? 

My contacts in international security were unwilling to go on the record condemning it. They were mainly Americans in their twenties, hoping for a government job one day, and fearful of saying anything that could be interpreted as "un-American".

The one person who would speak to me asked for their name to withheld. A former military analyst in the US Department of Defence, they told me that “the US has the military capability and legal responsibility to address threats to itself or allies". What Trump said, they suggested, should be seen in the context of the wider US institutions. "While Trump may have advocated for isolation in the past, the political and military forces he leads are built to enforce the adherence to international law and regional security," the former analyst said. "They provide a real counterweight to the bombast in Pyongyang.”

Trump's speech may have been colourful - his nickname for the North Korean leader Kim Jong-un, "Rocket Man", is a reference to Elton John’s mid-Cold War musical hit – but the speech should be seen as yet another reassertion of US military dominance. North Korea may boast of its Inter-Continental Ballistic Missile (ICBM) development,  but its arsenal is simply not well-equipped enough to present the same existential threat to the US that the USSR did at its peak. 

Rather than lacking comprehension, the analyst said of the speech: “Trump's rhetoric is intended to galvanise recognition that the current rules based order is threatened by North Korea's actions”.

Trump’s jingoism is not unique amongst the current American elite. Back in 1983, in his book, The Wizards of Armageddon, the liberal journalist Fred Kaplan characterised the hawkish US military strategy as simply ejaculating combative statements without a long-term plan. Kaplan quoted Herman Kahn, one of the early nuclear strategists, who called one proposal targeting the USSR a “war orgasm”. 

The US Senate recently passed a defence policy bill to increase military spending to $700bn, which includes $8.5bn for missile defence purposes. Overtly catastrophic language, meanwhile, has long been a staple of US foreign policy debates. In 2015, Trump's rival for the Republican presidential nomination, Ted Cruz, made headlines when he vowed to carpet-bomb Isis until he found out "if sand can glow in the dark". While most leading Republicans chose to stay silent after Trump's speech, a few, such as Paul Ryan and Rand Paul, publicly endorsed the message. Cruz, despite the rivalry, was among them. 

On social media, the American public are vocally divided. Some called for Trump to be denounced for his inflammatory speech, but others tweeted #MakeAmericaGreatAgain. Even some Trump sceptics agreed that the North Korea “nuclear summer” needed to be kept in check.

By contrast, overseas listeners have perceived the speech, and this administration’s foreign policy, as unnecessarily incendiary. Matt Korda, a Canadian research assistant on strategic stability at the UK-based Centre for Science and Security Studies,  told me: “Kim Jong-un perceives his nuclear weapons to be the only thing guaranteeing his regime's survival”.

“He will never give them up, no matter how much Trump threatens him," Korda added. “On the contrary: Trump's threat to ‘totally destroy’ the entire country (including millions of innocent and oppressed civilians) will only tighten Kim's grip on his nuclear weapons”.

The effects of Trump’s speech are yet to fully play out, but it is clear that his words have rallied at least a section of American society, and rankled everyone else. The Donald may seem to be mirroring the culture of nuclear recklessness his North Korean opponent helped to create, but this is also the kind of hostile and hyperbolic rhetoric which fuelled his rise to power. In reality, once Trump’s unpleasant vernacular is decoded, he can be seen to be echoing the same global view that has long pervaded the collective American consciousness. Trump's speech was not addressed at his UN doubters, but rather at his domestic fan base and his allies in the South Pacific. This is not a shift in US foreign policy - it is tradition with a spray-tan.

 

 

Anjuli R. K. Shere is a 2016/17 Wellcome Scholar and science intern at the New Statesman