From: wex@castle.ed.ac.uk (John Wexler)
Newsgroups: soc.culture.british
Subject: Re: Fight against drug -- British way
Date: 31 Dec 92 11:31:51 GMT
Organization: Edinburgh University Computing Service

In article <SHIBUYA.92Dec28231808@chute.bl.applicon.slb.com>,
shibuya@bl.applicon.slb.com (Hiroto Shibuya) writes:
|> I was very fascinated by a report in 60 minutes (CBS News Documentary
|> Program) last night, which was about the tactics that British
|> government is employing to fight drug problem in England.

It sounds as if 60 minutes misrepresented the situation.

The prescription of drugs for addicts is not a new system, Neither the
medical profession nor the government claims that it is winning the drug
war.  It is helping those few addicts who see their addiction as an
illness and who present themselves to a doctor for treatment.

There are a number of well-known treatments, and none of them is always
successful; there are also a number of palliative measures.  Some of
these include maintenance doses of the drug of addiction.  Some doctors
choose to use these treatments.  What this means is that some, but a
very small number, of drug users can get them on prescription, for as
long as the doctor believes that the treatment is helping or stabilizing
the patient's condition. 

Under the NHS scheme, there is a fixed charge for any prescription. 
This means that an addict who is prescribed some hard drug gets it cheap
compared with the street price.  There's a strong temptation to sell
half the dose on the street and make a good profit.  There are three
medical reactions: (1) not to continue prescribing a treatment which the
patient is not using; (2) to prescribe doses so small that their street
value matches the prescription price; (3) to prescribe a substitute
which has the same medical effect but a lower street value. None of
these is attractive to an addict who is not really serious about wanting
treatment.

In view of all that, you can see that there is not a lot of heroin being
handed out free to anyone who fancies it. 

|> It is basically a controlled legalization of drugs (heroin, cocaine,
|> etc..)
No it isn't.  Medical use of these things has, on the whole, never been
illegal.  If there had been a good medical argument for prescribing
heroin for addicts in the past, it would have been legal to do so, and
some doctors did it.  Others, who disagreed about the medical benefits
and the ethics, did not do it, but even they would have claimed the
right to use the drugs in other conditions than addiction if they had
thought them beneficial. 

|> British authority is claiming that this program is greatly reducing
|> drug related crimes.
This is not a claim which I have heard.  I have heard people "in
authority" saying that there has been some success in some areas, but
nobody pretends that this is "winning the battle" or "saving thousands
of lives from ruin". On the whole, this approach is still being
evaluated, and, if it has some benefits, it also has some costs.

|> Drug legalization always sounded to me as attractive option for
|> reducing drugs related crimes, but at the same time, realized as
|> fantasy considering the unpredictable shift of addict population.
That has been tried far more comprehensively in other places than
Britain. Our experience will not tell you whether or not it is a good thing.

|> This report gave me impression that British government managed to
|> realized legal drugs as well controlled mechanism, and effectively
|> reducing the drug problem in relatively cost effective manner.
We might wish it were true, but there is no magic answer to be found
here.

Stephen Wilcox writes:
|> ... I think it would be a
|> wonderful idea, but unfortunately the present government tends to be
|> a little short-sighted and sees addicts just as criminals rather than
|> as victims too. 
Not so.  Addiction is not a crime.  Pushing is a crime.
Some addicts also engage in "ordinary" crime such as theft, and there is
dispute about whether whether their treatment as sick people or as
criminals should take priority.  However, the medical professions cannot
normally treat somebody for sickness who does not present him or herself
voluntarily for treatment.  The exceptions require the person to be
commited for treatment by legal action (e.g., for insanity), and that
overlaps confusingly with the treatment of criminals.

Anyway, the British government has no settled policy about this.  The
argument is left to the medical profession, the police, charities and
voluntary bodies, and pressure groups.  There certainly IS an argument,
sometimes quite vitriolic, at those levels, and sometimes professional
groups have attempted to coerce one another into changing their
practices and attitudes, but this is not a controversy which is much in
the public eye. 

Doctors are neither compelled nor forbidden to use these treatments. 
Some do, some don't.  Practice varies from place to place and from time
to time. 

    John Wexler
    Edinburgh