Our Outside Left blogger has suggested today that drug treatment figures are misleading because so few of those who go into treatment programmes manage to overcome their addiction. I wonder if he is right or whether the purpose of the programmes is to help people manage their addictions and divert them from crime?

The purpose of the programmes is to meet Governement targets, hence htere are currently large numbers receiving treatment, very few kicking the drug habit.

If the target was changed to, say, number continuing drug free after one, two and three years, there would be some real changes in treament programmes.

the problem with this debate and these figures is that it focuses on people becoming free from using drugs. it does not take into account that there are a great deal of people who are stable on a methadone maintenance programme which for some people works, it enables them to lead less chaotic lives and not get involved in the world of street drugs. i am sure there are many people who are not in favour of this approach but if it works for some people it should be seen as a positive. 

nfortunately methadone has it's own problems. It leeches calcium from the body and so methadone maintenance programmes tend to result in extremely problematic reductions in bone density along with other things. It's often seen as a reasonable means to an end but it's far from an end in itself.

i was thinking more of the social level. By this i mean that for example for every £1 that is spent on drug treatment there is a comparitive saving of £9.50 to the community - mainly in terms of crime that does not happen (University of York) . I also wonder if people are being set up to fail by being entered into a system of treatment, abstinence and relapse when for some people long term prescribing is the answer to a less chaotic lifestyle where they are well enough to look after the kids / family, enetring some sort of education or training and even work all of which is not possible when the day has to consist of finding cash to buy drugs and then taking those drugs ( I am mainly talking about heroin here).

the way i look at is that some people are prescribed anti depressants for a long period of time and are not made to feel bad about it whereas people on methadone are made to feel they should be 'off it' as soon as possible 

I am aware there are medical problems with the use of methadone but I think there must be much more negative effects with the long term use of street adultarated heroin.

the debate about wether drug treatment works has been bubbling about for a while . in 2007 drugscope issued a very interesting  article looking into this argument the link is here it is well worth a read.

http://www.drugscope.org.uk/NR/rdonlyres/2295D061-8DE3-4CF9-9306-0F7CA2533D22/0/Ashton_M_30.pdf?knownurl=http%3a%2f%2fwww.drugscope.org.uk%2fOneStopCMS%2fCore%2fCrawlerResourceServer.aspx%3fresource%3d2295D061-8DE3-4CF9-9306-0F7CA2533D22%26mode%3dserve%26guid%3d15fbd5b3067e4a53a798653553fc588f

 the url  went off the page it was so long try here

Hi Lizzer,

I understand your point and I absolutely agree about the trap of spending all your time funding your habit at the expense of building a life outside of drug use.

However, I still don't see long term methadone as the answer because of the physical damage it does to people. I'd prefer to have a proper debate about legalisation and regulation of heroin use - let's face it prohibition doesn't work and serves simply to provide an opportunity for the black market to thrive in which is ridiculous given the low cost of opiates outside the black market.

Also please forgive me - I haven't gone to the link you posted, not because of disinterest but because I've only got this evening and a couple of hours tomorrow afternoon in which to prepare next week's training courses and also work on a large tender proposal before heading off down South again. So no time to plough through other stuff I'm afraid.

Cheers,

Stuart

I'm with Stuart on this. Methadone is not a long term solution: it has harmful side-effects; it is not a solution that drug users favour; it has a street-market of its own; some users "top-up" with heroin.

An adult debate on illicit drug-use in this country is desperately needed, but Politicians who should be leading such a debate constantly run scared of the tabloids.

When I worked in drug treatment, we were given a number of targets against funding (get the numbers into treatment, get next years budget) which meant that in order to achieve some of our targets we had to put totally unsuitable people through treatment programmes, knowing they would fail. But if we didn't, we risked losing our funding, our jobs, and what had been a previously very well respected drug treatment service. There were large numbers to go on treatment, with an expectation of 50% completing the programme and 20% succeeding in staying drug free (measured oddly enough by being "crime free" - or at least not getting caught again - because it's difficult to enforce drug testing on users who aren't committing offences) for a certain period, usually 6 months. So the temptation is there to really shorten the programme for the ones you are sure will fail, as that then costs less, keep working on a shortish programme with those who will probably fail, but might manage a quick detox (thereby "completing") and keep on methadone or similar those who are in the 20% who you need to stay crime free. Doesn't help them, or help you keep your professional respect, but it does mean the project stays open for the rest of the drug users who want to talk about sensible programmes for getting and staying drug free and recognise that as their problems started 20 years ago with bullying and parental alcoholism and homelessness and abuse etc etc, it's not going to be fixed by a 12 week government mandated methadone detox, but may require 2-3 years of thinking and counselling and lifestyle changes, as well as substitute drugs and willpower and failure and trying again. Detox works - but only if it's recognised that drug use is a coping strategy for huge lifestyle dysfunction - a symptom of a problem, not the problem in itself.

drug use is a coping strategy for huge lifestyle dysfunction

in a small percentage of cases. there are many, probably a majority who enjoy the drugs, the lifestyle and the notoriety and do use it as a social crutch (ah cannae wurk, am oan dla fur my drug problem) these are people who cost the most to society and he taxpayer.and these are the people who should be treated most strictly.

Meaning?

Hi Get1,

You said

" there are many, probably a majority who enjoy the drugs, the lifestyle and the notoriety and do use it as a social crutch (ah cannae wurk, am oan dla fur my drug problem) these are people who cost the most to society and he taxpayer.and these are the people who should be treated most strictly."

This is of course a very attractive 'common sense' argument and I fully understand why you make it. Indeed for a long while I shared your view.

However, as professionals, most of us on this list tend to consider research evidence too. Can I suggest that you have a look at the 'rat partk' experiments conducted by Bruce Alexander into the way that general quality of life affects drug-taking behaviour.

It's difficult to understand this research and still take the view that the majority of drug users simply enjoy the lifestyle with all it's social and economic sanctions.

Cheers,

Stuart

'meaning'

there are people who enjoy theor illicit drug use, the lifestyle, the notoriety and the benefits it brings (dla/a social worker fighting your corner/not having to work/crisis loans amongst others). they are HAPPY with their lot, so many are happy with that.

i also accept there is a minority who want to change and should be given EVERY opportunity and support to do so.

all this applies to alcohol.

i'm quite sure it's very relevant research and has a part to play in policy shaping but not policy in itself. no amout of research will stop people enjoying being off their faces and shirking social norms for a life of no responsability and intoxication.

have you ever heard a junkie/jakie complain about being intoxicated? no.

the problem is the efffects (crime/jail/low mood/withdrawls/nae cash/family hate them/dealers wanting to kneecap them).

cognitive dissonance, plain and simple, 'i know its bad and wrong what i'm doing and i should not be doing it. it's just not got bad enough to change yet'.