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Let's put health at the heart of drug policies

Posted on 14 January 2013 by Averil Mansfield  14 comments

Drug policy has been a major topic for discussion following the Home Affairs Committee report Drugs: Breaking the Cycle, published at the end of last year, and yesterday’s All-Party Parliamentary Group on Drug Policy Reform publication calling for a change of direction.

But behind all the statistics, the statements and the reports there are thousands of individual people with unique stories and far too often their health needs are neglected.

Today the BMA joins the debate by producing its own report — Drugs of dependence: The role of medical professionals and calls for health to be central in policies on illegal drug addiction.

One of our case studies focuses on a 42-year old man, Mr HT, who has an extensive criminal history including five periods of imprisonment. One of the first things he did when he got out of prison was ‘score’ heroin. When he was found sleeping on the streets he was offered a bed in a hostel and he started a rehabilitation programme.  With the right kind of help this individual recovered.

The BMA report does not come down on one side of the debate — our focus is patients and their health needs.

We believe that addiction to illegal drugs is a medical condition that needs to be treated like any other illness. It’s important to remember that no one sets out to be addicted to drugs and a simplistic moralistic approach may not be helpful.

Yes, we need to look into why some people turn to drugs, and more importantly, what makes people become addicted and of course we should be tough on crime.

But we should also show understanding when it comes to managing an illness.

The BMA report explores the role of medical professionals in dealing with illegal drugs of dependence. We want to reframe the debate through the eyes of the medical profession and use our expertise to improve health to help our patients.

We want to hear about your views on the report and how you think we should take this debate forward.

Professor Averil Mansfield, chair of the BMA Board of Science

Posted in:  Health and well-being

Tags:  drug dependency substance abuse illegal drugs science and public health class a drugs class b drugs cannabis class c drugs cocaine heroin

Comments

  • shradha

    15 January 2013

    It's true that being addicted to illegal drugs is similar to some illness and it should be treated like any other disease.But the fact we cannot be ignorant about is the complications associated with the same.If country gives permission to treat addiction and regard it as a illness then people will find it easy to commit crimes in the name of disease

  • Dr Chris Ford

    15 January 2013

    Well done Professor Mansfield and BMA to publish this important book stating clearly the role of the medical profession in the management of people who have drug problems; and pointing out how important it is to have health at the heart of drug policy. We can see very clearly from the experience in Switzerland, Portugal and others where this has been done that it works. We know that there is plenty of evidence that healthy drug policies improve health and even more of the reverse.

    For me a healthy drug policy is one which consists of a balanced and integrated whole system including: prevention, controls on supply, good evidence based treatment, with choice, for all who request it, with the person who needs help firmly at the centre. Systems which work are those that meet needs and comply with evidence rather than opinion and which are subject to regular review and evaluation.

    Over the last two years we have been building IDHDP (International Doctors for Healthy Drug Policies) which aims to bring the doctor's voice, which has been sadly lacking, to the drug policy reform debate. We now have members in 55 countries with many in the UK. Join us by going to the website www.idhdp.com and join the debate.

  • Hem Laljee

    15 January 2013

    Addiction is a social symptom of present day failure of indivuals realising their goal in life for one reason or another. It is not a disease or sickness of mind and nervous disorder. As a whole the society has lost its direction. It is bad for the young who have not had chance in life. For a rich individual it is the boredom and loss of self satisfaction. Drug addiction as whole produces an escape from responsibility. Once this fact is brought back to these persons concerned by their own realisation of wastfulness of life by drug addiction we have achieved the cure int hat paerson. How do one reason with individuals who are lost in unrealities of life?

  • blue

    16 January 2013

    Legalise and regulate soft drugs.
    Provide medical regulated hard drugs and begin harm reduction slowing new users and identifying vulnerable individuals.

  • Daniel Gerrard

    16 January 2013

    I am a recovering drug addict and alcoholic, I welcome this report from the BMA. As a director of www.addictionhelper.com we offer a free helpline for drug addicts and family members to call. We see first hand the damage of the lack of information offered to the addict and family from the various organisations in the UK. Addiction is undoubtedly a medical illness, We conduct assessments on every call and we find in 90% of assessments there is another family member with some from of addiction. We would welcome a chance to offer our input and debate into this terrifying disease.

  • Nick Jefferies

    17 January 2013

    For a welfare state, criminalizing people whose lifestyles and self-experiments conflict with moral squeamishness makes no sense. It creates criminal trades who pay no taxes, corrupt law enforcers, and whose practitioners and customers are effectively subsidized as they take up time in the criminal justice system, are cared for in prisons and also receive health care, pensions and child support. Society's indulgences should rather be licensed and taxed to an extent that covers the state's expenses in caring for casualties. We've largely manged with alcohol, and even though that seems to be currently challenged by an imported culture with a strong home-distilling tradition it is probable that the advantages of state-defined quality control will eventually become clear to these consumers as it has to the mainstream. It might be expected that the same thing would happen with other intoxicants. And the terrorist organizations that fund themselves by trafficking opium and cocaine derivatives, and bathtub synthetics, into the world's drug markets need to know that they will also be funding the troops and bullets that come back at them. New drugs which currently appear as "legal highs" can be easily classified into a taxation bracket, and those who trade without suitable licenses can be prosecuted under a well-tried set of statutes. And that all goes for the sex trade as well, where licensing could only protect the state, consumers, and the direct providers who it seems are often exploited victims themselves.

  • Susan Root

    18 January 2013

    As the population of elderly and infirm persons increases exponentially, and many within this increase have used illicit drugs in their youth, I think we will be finding more and more elderly persons seeking to partake of remedies which are currently illicit. This seems a great opportunity to make such substances legally available, taxed to help cover any costs of dealing with problems related to the substances, but permission to find relief from life's miseries through whatever methods might offer succor--a supreme healing possibility!

  • blue

    18 January 2013

    Prohibtion causes far more harm cannabis is much less damaging than many legal substances and recent studies have shown the medical benefit when the proper strains are used.

  • Nick

    19 January 2013

    Criminalising those who are addicted to substances that the world (the UNODC in particular) has designated illegal (Cannabis, Heroin, Cocaine to name but a very small few) is just plain wrong, certainly in a more enlightened 21st Century (or is it really?).
    The Misuse of Drugs Act 1971. What on earth was it meant to do other than drive the whole matter underground and play into the hands of (organised) crime.and real criminals? As we are all aware, when America enforced the prohibition of alcohol in the early 20th Century, this paved the way for Organised Crime Syndicates who flourished and have not looked back. When I heard the quote from a very well respected doctor many years ago, that the World's ways were nothing more than 'ORGANISED INSANITY', this was a comment that surely encapsulates the World's Drug Policy. Total madness.
    As for the UNODC's policy statement of having a 'drug free world' in the early 1970s (which was the catalyst for the miserable failure that is the 'War on Drugs'), has got to be seriously revised. We humans have been on this planet for a couple of million years now and there are antiquated records confirming that we have always experimented with psychedelic substances and we always will. It is part of our story in the evolution of Life on
    Earth. We definitely need a revamp of the UK drug policy let alone that of the world in general. Mexico, Portugal and Switzerland have seen the light, grasped the nettle and made a decision to change things. Well done to them. Common sense isn't it?
    Come on politicians, forget your own party interests and start doing what we pay you for & look after your people properly and with a bit of human dignity. Revise the UK Drug Policy.

  • colin davies

    19 January 2013

    to move the debate forward, we need to take a step back and look what democratic avenues are available for taking this forward,the first place would be to call for a green paper http://www.parliament.uk/site-information/glossary/green-papers/ hope that helps.

  • Dr Thomas

    20 January 2013

    They deserve our attention because of the social disadvantage they face and because they have a mortality rate several times higher than their non using peers. Instead 'The Inverse Care Law' applies.
    Doctors need more training in how to manage the chaos of these patients and how to set boundaries for them whilst still meeting all their needs. Leaving them I agree with Nick above that criminalising drug users is very wrong and indeed very detriemtnal to their care. Once they have a record it is so hard to get included back into society. I don't think keeping users in substitution therapy for years is enough. It has its place for stabilising people but its also collusion, medicalisation of dependency and it has got way out of control. Make addiction treatment a core GP service and put generous targets into QOF for getting users into recovery and things will change. Bring addiction into public health and get it out of the home office and things will change. For prison substitute rehab and things will change. Until those things happen the chaos will continue. The whole policy needs to change drastically. The BMA should shout this from the roof tops!

  • Mick Leach (GP)

    22 January 2013

    Substance use is primarily a social problem, although it can lead to physical and mental ill health. In itself, surely, it is a "dis-ease" but it is not an illness. Many (?most) users do not experience significant ill health. Dr Thomas points out the great social disadvantage users face and their increased mortality rate, but I totally disagree that addiction treatment should be a core GP service with generous QOF targets. Physical health and pyschological health services may form part of the package of help that might be available to substance users, but Medicine is a small part of that programe.

    I copy what Dr Chris Ford puts earlier in this stream: "For me a healthy drug policy is one which consists of a balanced and integrated whole system including: prevention, controls on supply, good evidence based treatment, with choice, for all who request it, with the person who needs help firmly at the centre. Systems which work are those that meet needs and comply with evidence rather than opinion and which are subject to regular review and evaluation."

  • Roy Robertson (GP in Edinburgh)

    23 January 2013

    An excellent report, well done the BMA
    Next move is to lobby Government and change drug policy to a more symaptheic approach.
    I agree with Dr Thomas above about getting it into mainstream general practice and I would suggest mainstream hospital practice. Undergraduate and postgraduate training need to be doing more and resources put into researching this important area of medicine.

  • Dorothy Black{ex SMO. D H SS}

    25 January 2013

    I entirely agree with Dr Robertson,above.Had we not expanded drug misuse services,with earmarked funding from the DHSS in the early 80s,we would have failed
    dismally to address the HIV problem among drug users in the mid 80s .It is pleasing to see the BMA now accepting the role of doctors in provision of services,other than in specialist provision. However without the support of social provision as well as medical services we cannot hope to deal with the often underlying problems giving rise to some drug use or arising from it.

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