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6 –
Daily Update
– DAY FOUR – Thursday 29 April 2010
‘Keep working for justice’ delegates told
HARM REDUCTION ON MERSEYSIDE
had
begun in 1985 when heroin was an emerging
problem, Julian Buchanan of Glyndwr
University told delegates. ‘I was a probation
officer at the time and we weren’t really clear
what to do,’ he said. ‘So I embraced the
received wisdom of the time.’
This amounted to action to ‘encourage,
persuade and pressurise change’, he said.
‘After months of adopting this abstinence-
based strategy I realised it wasn’t working, that
I was setting up people to fail, and that I’d
abandoned a number of basic principles from
my social work training. It was important to go
back to these – principles that didn’t seem to
apply when working with drug users.’ These
included listening, understanding, empathy,
respect, being non-judgmental and giving the
client space, he said.
‘As long as I was reducing risks – to them,
their families, the community – it was worth
engaging,’ he said. It proved hard to change
the practices of the time, however, so a number
of professionals eventually formalised into a
group – ‘a motley crew’, he said. ‘It was the
beginning of a new approach, a new team. We
produced a report in 1987 talking about risk
reduction and we were allowed to move
together into a single building.’
The group included a psychiatrist, a
probation officer, psychiatric nurses, social
services counsellors and an Aids outreach
worker. ‘There was a climate for change. Not
because people cared about drug users
particularly, but because the panic around HIV
and Aids opened the door to a more humane
approach.
‘The momentum has now dwindled in my
mind,’ he told the conference. ‘The UK aligned
itself with US policy, there was a ten-year
strategy in 1998 on the back of the
appointment of a drugs czar, there was the
Drugs Act of 2005, the yo-yoing of cannabis
classification and coercive drug treatment. I
think we’ve been hijacked by the war on drugs,
and the first casualty of that war is truth. We
can have wheelbarrow loads of evidence but
while this war is going on we won’t make much
progress. It’s strange where we are now, but
we have to keep working for justice.’
Harm reduction ‘shouldn’t be God’
‘I HAVE FOUR QUESTIONS
for you,’
psychologist Stanton Peele told delegates in
the
Theories and philosophies of harm
reduction
session. ‘Is smoking addictive?
What does addiction mean? How does this
help us? And why aren’t I more popular?’
One document in the history of addiction
was more powerful than ‘any other
document ever’ he said – the first surgeon
general’s report on smoking and health in the
US in 1964. ‘It caused 40m Americans to
quit smoking and lowered addiction rates
from 40 per cent to 20 per cent. It certified
the relationship scientifically between lung
cancer and smoking.’
At the same time, however, it also said
that smoking was not addictive, he told
delegates. ‘Why did it take the trouble to do
that? Because ideas of addiction change.
There was one family of drugs considered
addictive at the time – opiates – and heroin
addicts were seen as antisocial psycho-
paths. Smoking was not intoxicating and
smokers weren’t antisocial psychopaths, so
it couldn’t be addictive.’
Now the definition of addiction had
changed, he said. ‘You don’t have to
be a criminal psychopath. You just
have to really want something.’
Hence, cocaine had been cate-
gorised as addictive in the US in the
1980s, marijuana in the ‘90s and
gambling in the last decade. ‘The
mistake they’re making in addiction is
that it can’t be defined by an object –
it’s defined by people’s relationship to
something. You can’t just keep
adding things like videogames and
sex to a list of millions of other things.’
Of all the people who had ever
taken heroin, cocaine or crack in the
US, fewer than 10 per cent were
currently using these drugs, he told the
conference. ‘But we all know people who
can’t quit their addictions. That’s not the drug,
it’s the relationship the person has with the
drug.’ In the 1980s, half of US smokers had
quit, ’95 per cent of them cold turkey’ he said.
‘These days 65 per cent do it on their own.
‘God didn’t chisel addiction in stone,’ he
continued. ‘Thinking affects addiction, and
harm reduction shouldn’t be God.
Methadone maintenance may say to a
person “you were born to be a heroin
addict”. Harm reduction should not be in the
position of selling to people that they may
have a lifetime of addiction. Don’t reify
yourselves into godlike status and say “you
can’t quit your addiction so use something
we give you as your only alternative”. I’m for
harm reduction – but only human beings can
overcome addiction.’
Julian Buchanan:
‘I was setting up people to
fail, and... I’d abandoned a number of basic
principles.’
Stanton Peele:
‘That’s not the drug, it’s the
relationship the person has with the drug.’