Memorial mural to recently-deceased actor Philip Seymour Hoffman. Photo: Garrett Ziegler / Flickr
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The international mood on drug use and addiction is shifting from punishment to treatment

The UN has added its voice to the growing cry to rebrand substance abuse disorders as an issue of public health – a matter for doctors, not police.

The NHS estimates around 2 million Britons suffer from addiction. This is probably a gross underestimate - just take a look at nicotine. There are 6 million adults in the UK alone who say "they would find it hard to last a whole day without smoking". Cigarettes kill more than 100,000 people annually, but addiction means two-thirds of smokers say they're struggling to stop. Our society actively supports those trying to kick the habit, though, with things like e-cigarettes and nicotine patches, and it works. Evidence-based anti-smoking campaigns have been hugely successful, enabling almost half of all tobacco users to eventually quit

Unfortunately, this is not the case for most addictions. Where the substance being abused is illegal, a stigma exists that has repulsed efforts to effectively combat it. The police, rather than the NHS, are in charge - and addicts are criminals to be apprehended, not patients to be treated. That hypocrisy was the subject of a discussion featuring Nora Volkow, the director of America's National Institute on Drug Abuse and an expert on how drug addiction affects the brain, at the World Science Festival two weeks ago:

Addiction is a disease of the brain... Unfortunately - even though the science has shown it's a disease of the brain - it has been very difficult to incorporate into the healthcare system.

And as a result of that, many cases of drug addiction are never recognised. Or prevented. Or treated."

Addiction is a contentious issue. Entire areas of our health and drugs policies are influenced by the way we view addicts, and our criminal justice system is inextricably linked with substance dependence. It informs our attitudes on every poverty-related subject from homelessness to welfare. Most damagingly, it has led us to participate in a bitterly destructive war.

It follows that both policymakers and the public should be well-informed of the nature of addiction. Yet in a society where drug addicts are viewed as feckless criminals - lacking either the desire or the willpower to quit - there is a mounting body of evidence to suggest our perceptions are off, and as a result a growing number of nations are starting to put international pressure on changing the global war on drugs. A recent report by the United Nations’ Commission on Narcotic Drugs (CND) has adopted resolutions recognising that:

[S]ubstance use disorders can result in chronic, relapsing conditions requiring, like other health conditions, treatment based on scientific evidence, support for those affected and, where indicated, governmental and community initiatives to promote recovery and facilitate reintegration”

Essentially, addiction is a disease, which requires effective medical treatment and support from society - and historically neither of those facts have been popular with the public.

Writing in The Spectator last year, Russell Brand - a recovered heroin addict - struck upon the source of our hostility towards substance abusers:

It is difficult to feel sympathy for these people.

Can there be any other disease that renders its victims so unappealing?

Would Great Ormond Street be so attractive a cause if its beds were riddled with obnoxious little criminals who had ‘brought it on themselves’?”

The notion that addiction is a choice - and the underlying insinuation that addicts are getting their dues - is incredibly pervasive. They are, as is often the case, a plausible scapegoat for all of society's troubles. This ‘othering’ of drug addicts is so common in government and media that the Society of Editors published ‘Dealing with the Stigma of Drugs - a Guide for Journalists’.  Executive director Bob Satchwell described the negative effect using words like “junkie” can have:

The award of a deviant social status to drug users may serve to discourage use but it does little to assist those most in need of help. Studies have consistently shown that perceived devaluation and worthlessness on behalf of the user does little to spur them towards recovery.

The ‘shame’ of addiction is a reason why people with drug problems - and their families - often do not seek help.”

This deep-rooted stigma also goes some way to understanding why there is such disparity between political decisions and the scientific advice. The UK Drug Policy Commission’s 2012 report recognised the UK's attitude towards drugs as a barrier in effective policy-making:

The UK is unusual among EU countries in that the Home Office is the lead department for drug policy; most countries situate their leadership in the Ministry of Health.

It has been suggested that the Home Office leadership encourages a view of drugs as a crime issue rather than a matter of health.”

The reasons behind this are evident. The “tough on crime” line is a tried-and-tested vote winner, appeasing our fears with strong rhetoric and firm action. Yet it flies in the face of the scientific recommendations. Criminalising drug addicts only exacerbates the problem. Dr. Volkow (also chairperson of the working group advising the CND) discussed the dangers of this attitude at a Kavli Foundation-hosted teleconference last month. The three neuroscientists spoke of unanimous agreement amongst members that “substance use disorders are a disease ... and thus should be addressed within a public health framework".

Unfortunately, the notion of the British government ignoring science in favour of politics is nothing new - particularly when it comes to drugs. Neuropsychopharmacologist David Nutt was sacked from the Advisory Council for the Misuse of Drugs after criticising the government’s failure to listen to its recommendations. In a post on his blog (aptly titled "Evidence not Exaggeration") he explains that turning a blind-eye to scientific advice is foolhardy: 

Approaches which explicitly reject an evidence-based public health approach, but instead focus on incarceration and criminalisation of addicts, continue to utterly fail, at enormous financial and human cost.”

Instead, policy-makers must be prepared to accept the findings of its advisors - even when they disagree with convention. Nutt goes on to examine Switzerland’s successful strategy - a programme of providing supposedly-untreatable heroin addicts with a clean supply of the drug, which has flourished in the face of sharp political criticism:

It has stabilised chaotic lives, allowing users to be socially reintegrated, getting homes and sometimes jobs, and as well as removing the health harms associated with polluted, inconsistent street drugs. Addicts in this treatment get fitter, they virtually never overdose, and very few die.

Unlike those in other regimes, most stay in treatment, allowing some to progress later to abstinence. "

The idea of providing free, clean drugs to addicts is steadily gaining momentum as further evidence emerges for its effectiveness. Chief Constable Mike Barnett echoed this sentiment when he declared "it is time to end the war on drugs" in an article in the Observer last year. "[Addicts] must be treated and cared for and encouraged to break the cycle of addiction. They do not need to be criminalised."

In a blogpost after the 57th session of the CND in March, Dr. Volkow summarised what is now rapidly becoming scientific consensus:

The recommendations of our committee crystalize a paradigm shift in how the problem of substance abuse and addiction are viewed by modern societies.

Shifting the problem of drug abuse and addiction from the legal (or moral) sphere to that of science and medicine, where it properly belongs, is a crucial step toward successfully tackling the problem."

So the call for a radical rethink of our approach to drug policy continues to grow. A large part of this is intrinsically defined by the way we view and treat those suffering from substance disorders. But it is perhaps inevitable - given the continual dehumanisation of drug addicts - that discussion about addiction would eventually lose focus on those suffering from substance dependency and switch to a more pressing issue for the government.

On the Swiss clean-heroin policy, Nutt declared:

It isn’t just the addicts who benefit; crime fell enormously once users could access heroin from the State rather than profiteering dealers. The State, and taxpayers don’t lose out in this arrangement, the expensive program more than pays for itself in healthcare and law enforcement savings.”

An appeal to the economics of patient-centred treatment might be just what's needed to convince the Coalition to rethink their plans. Not only would a health-focussed approach save lives, it would save money as well. Surely that’s a language the Home Office can understand?

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Thanks to social media, ordinary people can now influence elections more than tabloids

The Conservatives spent £1.2m on online adverts – but the internet came up with anti-Theresa May memes for free.

Who or what spread the single most influential message of the 2017 general election? Was it Britain’s top-selling tabloid, the Sun, which chose 7 June to chastise us all with: “Don’t chuck Britain in the Cor-bin”? Was it Facebook, home to Theresa May’s £1.2m anti-Labour adverts that pleaded: “Don’t risk Corbyn in charge of Brexit”? Or was it Jennifer ­Agnew, a 21-year-old administrative assistant from East Kilbride?

You’ve probably heard of the first two. Since the newspaper first claimed as much in 1992, it has been a popular idea that it’s the Sun wot wins elections. This year, much has been made of “dark ads” on Facebook – paid-for messages that political parties can spread across the social network, beyond the gaze of the Electoral Commission. You’ve probably not heard of Agnew, but you might have seen her viral tweet.

After Theresa May disclosed the “naughtiest” thing she ever did on ITV’s Tonight, Agnew took to Twitter to mock the revelation. “Never have I ever ran [sic] through a field of wheat,” she wrote above a picture of May drinking from a glass of water, riffing on the student party game in which one drinker confesses to a misdeed and others take a sip if they, too, are guilty. Her tweet was shared more than 24,000 times and gained an additional 60,000 “Likes”.

“It was just a joke, really, but also poking fun at the difference in classes,” says Agnew, whose post went on to be retweeted by the pop star Ellie Goulding. “I can’t say I’ve ever run around in a field of wheat as a child being chased by farmers. It seems rather middle class.”

On 8 June, Agnew voted for the SNP. She didn’t intend for her tweet to have political ramifications but describes herself as “a big fan of Corbyn”, saying: “As far as politicians go, he’s honest.” Yet, regardless of Agnew’s intentions, her tweet was political. It was a powerful anti-May message – and it didn’t cost the Labour Party a penny.

Since Barack Obama’s first presidential campaign, it has been widely understood that elections are fought across social media. Algorithms, some claim, boosted the fake news that propelled Donald Trump to office. By adding like-minded people as “friends” and deleting any dissenters, we all became entrapped in filter bubbles, unable to see the 2015 election result coming.

Face­book adverts that were micro-targeted to spread specific messages to specific people helped to bolster the vote for Brexit. All of these analyses are true, but each misses the most transformational aspect of social media. You know: the actual media part.

As of December 2016, the Sun had 1,611,464 readers every day. That’s a lot. But nowadays, people don’t need Rupert Murdoch and a printing press to wield political influence (they do, however, still need a witty pun). According to Twitter’s ­analytics tool, Agnew’s tweet reached over 2.9 million people. Everyone now has the potential to have the reach and influence of a tabloid.

Her tweet isn’t remarkable. It is merely one of thousands of viral social media posts that have spread this election, many of which generated headlines (“This Facebook comment about Jeremy Corbyn is going ­viral” read one on Indy100, the Independent’s sister site).

Hannah Thompson, a 24-year-old PR officer from Surrey, is another meme-maker. When the concept was introduced by Richard Dawkins, a meme was “an idea, behaviour or style that spreads from person to person within a culture”. Now, it most commonly means “funny internet picture”. Yet memes might be just as influential as Dawkins’s original definition implied.

“I pretty much exclusively use Twitter as an avenue for my lame political jokes,” says Thompson, who tweeted a zoomed-in picture of Theresa May with the caption: “Nice wheat field you’ve got there. Would be a shame if somebody . . . ran through it” (7,243 retweets, 22,450 Likes).

“It would be helpful if more politicians understood the ‘social’ element of social media,” she adds. “Then, instead of spending hundreds of thousands just getting views for their posts, they can create things that actually engage people and help shift the narrative in people’s minds. I was really impressed by how Labour encouraged their members and activists to share things online. Seeing posts by actual human beings, rather than a party, is way more convincing than seeing a paid-for ad.”

There is a chance that, by the next election, politicians will have realised that a picture is worth a thousand words. Astro­turfing, the practice of masking the origin of a message to make it seem like a grass-roots opinion, is already common online. Advertisers frequently create profiles for fake teenagers, who then tweet about how much they “love” a product in order to make it seem popular.

After the shock election result, analysis by BuzzFeed revealed that stories published on the websites of right-leaning news­papers (such as the Daily Telegraph, the Daily Mail and the Sun) failed to reach large audiences on Facebook and Twitter. BuzzFeed’s headline read: “Not even right-wingers are sharing positive stories about Theresa May on Facebook”. The most shared stories on social media were pro-Corbyn.

For all of the Conservatives’ power and wealth, their social media campaigns did not take off. Why? Because they weren’t inherently social. Theresa May relied on pounds to push her message, while Agnew and those like her relied on people.

As one social media user put it (receiving 8,790 retweets and 19,635 Likes): “Tories spent £1,200,000 on negative anti-Jeremy Corbyn social media adverts ... And the internet came up with anti-Theresa May memes for free.”

Amelia Tait is a technology and digital culture writer at the New Statesman.

This article first appeared in the 15 June 2017 issue of the New Statesman, Corbyn: revenge of the rebel

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