No quick fix

London
has 25 per cent of the UK’s problematic drug users despite
having 15 per cent of the nation’s population. No wonder then
that the agencies who are trying to deal with the problem are
creaking under the strain. Ruth Winchester reports.

In the
year 2000 to 2001, the National Crime Squad seized more than
£260m worth of drugs including 1,390 kilos of cocaine, 768
kilos of heroin and 1 million ecstasy tablets. Despite this massive
policing effort, the availability and purity of drugs on the
UK’s streets continues to increase, and the price continues
to fall. A gram of heroin now costs around £40, as opposed to
£80 a decade ago. A gram of cocaine costs as little as
£10, compared with £50 to £60 a decade ago. The UK
cocaine market is now worth an estimated £2-3bn.

Drug use
is endemic across the country. But London’s drug problems are
of a different order of magnitude. The capital is home to 15 per
cent of the population, yet has an estimated 25 per cent of the
UK’s problematic drug users – around 50,000. It has a well
established sub-culture of long-term heroin users – particularly
among the homeless population – and an accelerating problem with
crack cocaine. The city also acts as a magnet for people from other
areas whose drug use has become a problem – partly because of its
anonymity and partly because of the flourishing drugs markets.

A third
of all acquisitive crime in London is drug-related. And the city
operates not only as a sales ground but also as a distribution
centre for drug traffickers and dealers shipping drugs to other
parts of the country. Most drugs in the UK will have passed through
London at some time.

Drug
workers report that use in the capital is on the increase despite
the best efforts of law enforcement and successive government
campaigns. Paul Fenton is project manager for a direct access
opiate service in Southwark, which is run by the largest voluntary
sector drugs service in south London, Community Drugs Project. He
says: “Our experience is that drugs are becoming more widely
available, they’re cheaper, and more people are using them.
All the money that has been thrown at the drugs problem in terms of
reducing supply and cutting demand has had absolutely no impact
whatsoever.”

But
alongside these changes in the demographics, there are also changes
in the way people use drugs. There is evidence that people are
starting to get involved with drugs earlier in their lives, and the
way they use them is changing. According to one drug policy expert
who did not wish to be named: More people are using lots of
different drugs these days. In the past you’d have people who
were just heroin users – now people are more likely to use a
variety of drugs in addition to their drug of choice. And whereas
in the past people would just use heroin and not really use alcohol
much, now you’re getting people who use heroin when they can
get it, and do a lot of alcohol and other drugs when they
can’t. That causes a problem for services because most of
them are still geared up to being either drug or alcohol services –
not both.”

This
situation also presents a problem for some of the better
established service providers – many of whom were set up in the
1970s and 80s by former addicts and which as a result tend to cater
primarily for older, white male heroin users. These providers are
having to realign their services to cater for poly-drug users who
may have a serious crack-cocaine problem as well as a heroin
addiction.

Unfortunately, crack cocaine is likely to become an increasingly
significant problem within London over the next few years. Unlike
heroin, where addicts can keep themselves relatively stable despite
using every day, crack gives an instant intense high which
doesn’t last long, leaving users looking for money for their
next fix. Crack users tend to live chaotic lives and often become
prolific offenders, and crack is associated with increasing levels
of gun crime in the capital. By contrast, so-called “dance
drugs” such as amphetamines and ecstasy are not really
associated with crime – most users pay for them with their
wages.

Fortunately, the problematic drug users who resort to crime to
finance their habit are a relatively small minority. Many more
people use drugs on a “recreational” basis, and most
never come into contact with services. In fact, even those whose
drug use becomes a problem often “mature out of it”
without any significant input from services.

That
said, the drug problem in the capital is becoming increasingly
multicultural and, as the nature of the problems change, so
services are having to adapt and develop to keep pace. Communities
which have traditionally been regarded as being immune to drug
problems are starting to see their protection diminishing. Services
are increasingly being geared to the fact that families from some
ethnic groups cope with the shame of someone’s addiction
within their community by hiding it and trying to cope alone.

In Tower
Hamlets a consortium of community groups and youth organisations
have set up a culturally sensitive education, treatment and
outreach service, Nafas, targeted a local young Bengali people
among whom heroin use has been increasing. Another service, Uplift,
is targeted at young people aged 11-25 from the African-Caribbean
communities in Haringey, Hackney and Islington. And a Vietnamese
drug worker in Deptford is helping to ensure drug users in the
Vietnamese community have access to

culturally appropriate services.

While
there is a broad agreement that drug use is increasing in general,
many observers feel there is cause for optimism, at least among
those with problematic usage. Drug agencies report that access to
treatment services has been dramatically improved since the early
1990s – to the extent that there are now 20,000 people in London
who are in contact with treatment services. The creation of the new
National Treatment Agency – set up in the wake of drug
“tsar” Keith Hellawell’s departure – looks set to
further improve matters. The Agency’s remit is to fund
hundreds of local drug action teams across the country. These teams
look at local need and fund and monitor appropriate services.

This
change of approach may bring dividends for the voluntary sector,
which provides most of the direct drug services in the capital. The
advent of the NTA may mean funding for specific drug services
becomes more stable and longer-term focused, although with that
will come new responsibilities and tighter monitoring. But
according to one senior source, it will be money well spent.
“Without an active voluntary sector, there wouldn’t be
any drugs strategy being delivered in London. The whole thing would
crumble.”

Paul
Fenton agrees: “The voluntary sector’s very important.
In rural areas, perhaps it’s more often mostly statutory
services, but in London most services are provided in conjunction
with voluntary agencies. They tend to score by being able to
innovate and respond a bit quicker Ð they can make decisions
and act on them much faster than a big statutory organisation where
manager after manager has to be involved.”

As it
becomes increasingly clear that spending millions more on cutting
supply and reducing demand would be throwing good money after bad,
the population of the UK may have to start looking for an
alternative. Even senior police officers are now throwing their
weight behind the legalisation of some kinds of drugs, particularly
“soft” drugs such as cannabis, to enable a more focused
approach to be taken against the drugs which cause the most
harm.

At the
same time, calls are growing for the government to reinstate the
old policy of prescribing heroin to addicts. While GPs are adamant
that they should not be turned into legalised drug dealers, there
is little doubt among front-line drug workers that it could bring
an effective and abrupt end to much of the damage done to
communities by drug addiction.