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)

Azaz, on Syria's northern border with Turkey. Photo: Getty
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Syria's broken people: how Assad destroyed a nation

 Whoever leads the country after this conflict comes to an end will inherit not just the rubble and ruins, but a ravaged people, too. 

For a moment, the residents of al-Fu’ah and Kafriya dreamed of a better future. After living under siege for more than two years, civilians from these two Shia villages in the rebel-held Idlib province of north-western Syria were finally allowed to leave earlier this month.

Buses arrived to evacuate them to regime-held areas in Aleppo province, snaking through hostile territory. They eventually stopped at an agreed crossover point, between regime- and rebel-held areas in the Rashideen district of western Aleppo.

These journeys are long: it can take hours, sometimes days, to travel just a few miles. Checkpoints, angry negotiations and deep distrust between opposing factions (even when they are apparently on the same side) ensure that such transfers are never as efficient as they should be.

As families waited at the Rashideen checkpoint, with some disembarking to stretch their legs or to let their children play outside, a powerful car bomb exploded. More than 126 civilians were killed in the blast – the deadliest attack of its kind in more than a year.

The fatalities included 60 children. The act was made all the more unconscionable by the way that they were deliberately targeted. A truck ostensibly providing humanitarian relief parked beside the buses and began distributing sweets and ice cream, causing the children to swarm towards it. Then  it exploded.

One of the most striking features of this conflict is its seemingly endless capacity to spiral into greater depravity. Both sides have butchered and brutalised one another in a fashion that would make the Marquis de Sade recoil. At times, it can seem as if each side is competing with the other to adopt more sadistic and cruel methods. When they do, it is ordinary civilians who invariably pay the biggest price.

Even children have not been spared from the privations of this vicious war, as the events in Rashideen demonstrate. Last August, it was the image of Omran Daqneesh, the stunned and bloodied five-year-old boy in the back of an ambulance, which epitomised the suffering of another besieged group: the mainly Sunni residents of eastern Aleppo, encircled by government forces.

To characterise the Syrian conflict as wholly sectarian is reductionist, but factional infighting has become one of its defining elements. The imprimatur of sectarianism is leaving indelible marks across the Levant, tearing the region apart.

Bashar al-Assad, Syria’s embattled president, set the tone for this when the uprising first began in 2011. To undermine the protest movement, he characterised the opposition as Sunni extremists who were driven by sectarian hatred (Assad is from the minority Alawite community; a heterodox Shia sect).

His unaccountable loyalist militia, the shabiha (“ghosts”), brutalised the opposition not just physically but also with sectarian slurs, introducing a caustic and corrosive mood to the uprising. This pathology has continued to metastasise ever since.

The current policy of displacing besieged residents has further enhanced the sectarian aspects of this war. For years, the Syrian regime has used siege warfare to bring rebel areas under control. Once the inhabitants have been worn down, the government moves them to rebel-held areas, away from its sphere of control. In this way, President Assad has consolidated control over important and strategic areas closer to home while edging disloyal elements further away.

Occasionally, new residents are brought in to repopulate evacuated areas, typically from minorities more inclined to support the government. What is taking place is a slow demographic recalibration, in which errant Sunnis are moved to the periphery and loyalist minorities are moved closer to the core.

These transfers are now so common in Syria that a dedicated fleet of green buses is used in the process, and has become an iconic image of this conflict. The buses catch the eye and are used for moving besieged people. Their sanctity is not to be violated. In a conflict that has ignored almost every norm, this one had lasted – albeit with occasional violations – until the assault in Rashideen.

There are moments when important leaders appear to transcend the divide. Moqtada al-Sadr, an Iraqi Shia cleric who rose to prominence after leading a militia against British troops in Basra after the 2003 invasion, recently called for Bashar al-Assad to step aside.

In doing so, Sadr became one of only a few prominent Shia leaders to publicly acknowledge Assad’s bloodshed. His comments came after the chemical weapons attack in Idlib earlier this month, which claimed more than 80 lives.

Statements such as Sadr’s have huge symbolic value, but are easily forgotten in the aftermath of the next atrocity. Speaking to the American broadcaster NBC last October, General David Petraeus summed up the mood of many military planners in Washington when he concluded that Syria may have passed the point of no return. “Syria may not be able to be put back together,” he said. “Humpty Dumpty has fallen and again I’m not sure you can piece it back together.”

His comments came even before the most tumultuous events of the past six months, which have included the fall of Aleppo, the emergence of a more empowered jihadist coalition (composed principally of al-Qaeda members), the use of chemical weapons and now the Rashideen bus bombing.

Petraeus’s remarks were prescient. As a result of the cycle of bitter vengeance and retribution, often fuelled by deep sectarian suspicion, the Syrian Civil War will continue its descent into chaos. When Assad first unleashed the shabiha to quash the protest movement, the militia warned the opposition: “Assad, or we burn the country.”

In this respect, at least, it has kept its word. Whoever leads the country after this conflict finally comes to an end will inherit not just the rubble and ruins but a ravaged people, too. 

Shiraz Maher is a contributing writer for the New Statesman and a senior research fellow at King’s College London’s International Centre for the Study of Radicalisation.

This article first appeared in the 20 April 2017 issue of the New Statesman, May's gamble

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