Addiction is not a moral issue - on Rennie, the Record and Labour

On Thursday afternoon, the Scottish Parliament debated the Scottish Government's Drugs Strategy, which has been in place since 2008. In general it was a pretty intelligent debate as you can see from the Official Report. The Government even accepted amendments from the Liberal Democrats and Conservatives, which passed. They would not, however, accept a Labour amendment after the opposition party has been supporting the Daily Record's campaign against methadone prescription. Because pharmacists who dispense methadone have extra costs in so doing, they get extra payments to help them with that. It's a maximum of £2.49 a prescription, so for Labour's Jenny Marra to describe the pharmacists as "methadone millionaires" is a bit much. 

Labour and the Record seem to have gone for full scale demonisation, not only of addicts, but also the health professionals on the front line who dispense their medication or who make judgements about care. Labour's attitude seemed to be more about trashing methadone than recognising it as part of the tool kit for treating people with addiction. It can stabilise lives, and to suggest that the heroin substitute was solely responsible for half the drugs deaths is wrong.

I was pretty unimpressed with Jenny Marra's rhetoric on this, and so, to be honest, was the Parliament. Very few speakers, even Labour ones, agreed with her line. Not, of course, that you would have guessed from the  Daily Record's coverage the next day which failed to point out that Liberal Democrats, SNP and Tories all spoke against Labour. When you can't even get the Tories to agree with your ill-judged and prejudiced stance, then surely you know you are on a hiding to nothing.

The paper edition of the paper (which I actually went out and bought), had a special section on Willie. It accused him being out of touch for, get this, suggesting that health professionals and not politicians should be making the decisions on appropriate treatment for people. If I go to see my MSP Angela Constance, I don't expect her to give me medical advice, or to tell me what my doctor should be doing for me.And nor would she ever do so.

I guess you can't really expect a sensationalist tabloid to understand the nature of addiction - although it would be good if they tried. You expect a bit more, though, from the people who make the laws that could potentially affect the treatment people are offered. I've become increasingly worried at the way Labour are treating addiction as a moral issue in the same way as the Tories, and, yes, sometimes Labour too, treat poverty and joblessness as some sort of personal failing. Don't swallow Labour's sanctimony on welfare - one of their first acts in Government way back in 1997 was to remove certain benefits from lone parents.

When I was at Liberal Democrat Conference in Brighton, I attended a fringe meeting on civil liberties at which one of the speakers talked about how people with addictions were often handed ASBOs and, then, when the inevitable breach happened, they were carted off to prison rather than given the help that they needed. I tweeted this and Labour MP for Glasgow South Tom Harris started on about how decent people needed to be protected from adults. We then had quite a long conversation on Twitter, some of which has been blogged by Zoe over at Complicity.

I found the distinction between decent people and addicts deeply offensive. I've had people close to me who have really struggled with addictions. If they could have stopped, they would have. Their lives degenerated into a fair bit of chaos but that didn't make them somehow not decent people. The struggle, torment and suffering they went through was immense, over many years. And there was a time when they actually were free for several years before, suddenly, just losing it again. It was horrible for us and horrible for them.

But, no, Tom took pride in how he'd had an addict evicted because they were making a constituent's life hell. He didn't seem to realise that the addict was his constituent too and was quite happy to see them made homeless rather than given help to recover. I just found that lack of compassion astounding, and very worrying.

Contrast with Willie Rennie's people-centred contribution to the debate:

There are about 60,000 drug users in Scotland. I met one of them, whom I will call Mary, when I visited Turning Point Scotland’s facility in Glasgow. She had a young son and her ambition was to be able to take her young son to school in the morning after giving him breakfast. That was her lofty ambition—something that for us would be quite normal. If we have kids, we do such things every day, but for her it was an amazing ambition, because she did not see in what circumstances she could achieve it. Her son was getting looked after by her brother on an almost permanent basis.

I said that about Mary because we talk about big numbers and big programmes, but at the end of the day people like Mary are normal people who deserve a chance like anyone else. Some of the ways in which we talk about them and whether they do or do not contribute to society demonise them but, for me, they deserve a chance. They would love to go back and have another chance, and we should respect them for the tremendously difficult challenges that they go through. They go in and out of drug use; sometimes they are in remission and sometimes they relapse and go back into serious drug use. Such is the chaotic life that those people lead.

Mary was on methadone, along with 24,000 other people. However, for me the central methadone issue is about health professionals choosing the right way to proceed. It is not for politicians to decide which treatments can and cannot be used; it is about giving the health professionals the tools. They have the evidence and the know-how and are the best people to make decisions to help people out of their circumstances. Recovery means different things for different people. Sometimes it is about being able to stay alive; for other people it is about getting back into work. For Mary, it is about being able to take her son to school in the morning. That is why it is regrettable to see some of the stuff that has been happening in the Daily Record, supported by some in the Labour Party. Demonising pharmacists just for doing their job is deeply regrettable.

Often, we focus only on the medical aspects of drug use, but much of the issue is to do with a person’s whole life experience. Perhaps they have mental health problems, housing problems or debt. Perhaps they have a chaotic family life and have been divorced. Perhaps they have had experiences in the military that have led them into drug use or alcohol use. We must sort out those issues as well if we expect people to recover long term. However, we must also recognise that sometimes people will have a chaotic lifestyle for some time. The simplistic view is that somehow we can get people into recovery automatically, if only we change one little thing, but that is just not going to happen.

I have been to some projects, including the Lothian and Edinburgh abstinence programme—LEAP—in Edinburgh. I saw its abstinence regime. It is not right for everybody, but it is right for some people. They brought the whole family in to share the experience and ensure that people were able to recover on a long-term basis.
It is a shame on this country that we have such a high proportion of drug users when we have such wealth. Poverty—the pockets of poverty that we have in many communities—is the root of much of the situation. Again, we must deal with that if we are to expect any longer-term benefits.

On methadone, the HIV rate among drug users in Russia, where they do not have the same kind of programmes as we have in Scotland, is about one in three. In Scotland it is less than one in 20. I do not know what more evidence we need than that simple statistic. In addition, lots of scientific studies show that hepatitis C is reduced by about 80 per cent as a result of needle-exchange and methadone programmes. Elish Angiolini’s report on Cornton Vale shows that when a lot of the women sent to the prison were taken off the methadone programme, the self-harm rates shot up. That is no coincidence, because significant benefit can be got from methadone.

Annabel Goldie is right when she says that the treatment is not necessarily right for everyone and is not perfect, and I accept that. However, we should not say that methadone is the reason why so many people are dying, because it is not. Other drugs were involved in 60 per cent of the cases in which someone’s death was connected to methadone, and alcohol was involved in 40 per cent. 

 Further, in many of those cases, the methadone was illicit, rather than being part of a programme. To simply say that all of those people are dying because of methadone is wrong. Methadone is part of the solution, not part of the problem. We need to be careful about demonising the programme and the pharmacists, because we might undermine the good work that is under way.

Almost every subsequent speaker expressed some sort of agreement with Willie. Maybe there's hope for this Parliament yet.

Later on, in his closing remarks, Willie talked about how hard it was to persuade people that addicts were people who needed help and compassion, not condemnation:

There is a big divide between drug users and the communities in which they live. I put up a Facebook posting about drug use the other day, and the response showed that a lot of people believe that drug users should be cut off. We need to recognise that there is a huge divide. People do not understand why drug users receive support, and we have a big job to do to convince people about the merits of providing support.

The approach by some members of the Labour Party is quite disgraceful in fuelling the lack of understanding. Politicians are supposed to show leadership, not pander to people's ill-informed prejudices, whether they're on human rights, immigration or addiction. Having a wide range of treatment options and not imposing the sort of one-size-fits-all approach that Labour is instinctively so keen on, is going to get more people better. That will benefit everyone, including their communities.

Making policy based on rational evidence is always a better option than subjective moral judgement. Labour would do well to learn that.

Willie Rennie talks about drug treatment on Sunday Politics Scotland

Yesterday, Willie Rennie went on Sunday Politics Scotland to take part in a discussion about drug treatment with the SNP's Mark McDonald and Scottish Conservative leader Ruth Davidson.

The impression I've had from what Willie was saying is that he's fed up of politicians pontificating about stuff they know nothing about, and making sweeping pronouncements about care. He thinks that everyone's different, that what works for one might not work for another and it really needs to be left to health professionals on the ground to choose the best way of treating each individual from a range of options.

We've seen the use of Methadone come under attack by politicians and the media. Willie described the Daily Record's demonisation of methadone "deplorable."

Speaking ahead of his appearance on the programme, Willie was keen to stress that the debate on addiction must put medical necessity ahead of moral prejudice:

The debate around drug misuse and the connected methadone programme has taken a disturbing turn in recent months with moral rather than professional judgements dominating the drugs dilemma. Drug related deaths reached an all-time high last year so it is vital that we give professionals all the tools they need to help people, including tools aimed at reducing the harms associated with drug misuse.  

While much of the recent focus has been on the overall number of deaths in which methadone was involved, other substances were involved in nearly 60% of these deaths. This shows that drug addiction is an extremely complex issue.  The suggestion from Labour that methadone treatment should be time or cost limited risks undermining the work that drug professionals are doing every day in our communities. Methadone is responsible for saving and stabilising many lives and could be regarded as a success for thousands of individuals. 

The key issue is getting people into treatment as soon as possible and ensuring that a whole range of recovery options are available. Another big issue is whether individuals stay engaged with treatment and enjoy a good relationship with the key workers involved in their care. Every drug addict is different. There should be no one-size-fits-all approach. We need a flexible and patient focussed approach. Politicians should not seek to restrict options for moral reasons but ensure that trained professionals are able to deliver the service they think best for the patient. 

You can watch him here.

The Scottish Parliament will be debating drugs strategy from 2pm on Thursday 8th November. 

If you know a politician........

.....sit them down, make them a nice cup of tea, confiscate their Blackberry and get them to take an hour and 16 minutes to watch the video below.

It's the drugs policy debate that took place at Liberal Democrat Conference last week - but the principles behind the motion adopted have support across all parties, and this is one issue where we should all work together.

Ewan Hoyle said in his opening speech that Nick Clegg should take this motion and put it on David Cameron's desk and make him take it seriously. The adoption of this motion is the end of a long process within the party, but the beginning of another, to actually get it implemented.

At around 57 minutes, you'll see Dr Ian Magrath. He lost his son Alastair in May, who had been sent to the West Indies to act as a mule. One of the condoms containing drugs had split inside him, causing a fatal overdose. Ian's account is harrowing and he received a rare standing ovation for sharing his story.

So, now it's time to persuade others that our traditional approach to drugs has failed and that by adopting the methods which have been shown to work in places like Portugal, we have more chance of protecting communities and families from the appalling damage caused by drugs. It's time to make policy according to the evidence, not the tabloid press.

Video: Ewan Hoyle's speech proposing drugs policy motion at #ldconf

I have rarely been prouder of my party than I was late last Sunday afternoon when we passed new policy, championed by Glasgow's Ewan Hoyle, calling for the consideration of the Portuguese system whereby people arrested for possession of drugs aren't put through the criminal justice system, but helped with the issues that led them to drugs in the first place, whether that be mental health, poverty, poor housing, or family problems.

I published Ewan's speech in full the other day, but he's now put it on You Tube. Please can you circulate this far and wide - it's so important to win this argument and get this policy implemented. Lives depend on it.

Ewan Hoyle's speech proposing Drugs policy motion

This is Glasgow's Ewan Hoyle's compelling speech proposing a new, evidence based drugs policy. If implemented this will save lives and free up money spent on pointless prosecutions to spend on real help for people. This motion passed, after a high quality debate, with just a handful of votes against. I'm going to print the whole thing for you to read. The passing of the motion has to be seen as the start of the process, not the end. This needs to be implemented as soon as possible I was incredibly proud of Conference on Sunday and particularly of Ewan.


For too long drug policy has been a no-go area for politicians, and
there is a simple one word explanation for why: Cowardice. Cowardice
plain and simple.

I have talked to Liberal Democrat representatives from councillors to
the most senior members of the parliamentary parties and the first
thing they ask is “How do we sell this to The Sun? How do we sell this
to the Daily Mail?” I'll have just described policies that could
massively decrease crime, bring young girls working the streets back
to their families, take dealers out of communities so that the kids
growing up there have a fighting chance at success. And the default
position of politicians is “Nah, can't be done. The press will crucify
us.”

I really don't know what disappoints me more. The lack of the moral
instinct to say what needs to be said to help communities stay healthy
and safe, or the politicians' complete lack of faith in their ability
to communicate important ideas effectively.

And it is vital that we communicate these ideas. The War on Drugs is
not working, but it is essential that we keep fighting. Drugs are
harmful. They can take young people to places that are every parent's
worst nightmare. Insanity, disease, destitution, prostitution, death.
We have to keep fighting in the best way we can to stop more young
people from all walks of life slipping into lives of misery and early
graves. But we are still fighting a massive 21st century drug problem
with 20th century weapons.

So how should we fight the war on drugs? In countries like Portugal
and Switzerland they saw their drug problems getting rapidly worse.
But instead of resorting to tough rhetoric and knee-jerk policies,
they cut cowardly politicians out of the loop and asked experts in
medicine, sociology, psychology and law to recommend how they could
best address the problem. When those experts came back saying that
drug use and addiction were medical issues and not issues of morality
or criminality, the politicians accepted their recommendations. Public
and political reaction was divided at first, but when the results
started to become clear, the public and politicians accepted that a
better way had been found.

The drug problems of these countries have never even come near to the
problems we face in the UK in 2011. But politicians are too scared to
question the status quo and they ignore the expert advice from the
Advisory Council on the Misuse of Drugs which challenges it.

Legal regulation is one policy that experts find it hard to recommend,
for to follow such recommendations would be to defy the UN drug
conventions: Well-intentioned documents that nonetheless seriously
undermine the 3 pillars of the UN's work: peace and security,
development, and human rights.

The illegal drug market in the UK is estimated to be worth around £6Bn
each year, it isn't taxed, and  the vast majority of the profits go
into the hands of organised criminal gangs, This includes millions of
pounds for the Taleban in Afghanistan with which they can purchase the
bullets and bombs that murder our brave soldiers.

We have to stop enriching criminals. In the wake of the riots
commentators bemoaned the lack of authority figures in deprived
estates. But there are authority figures. They have fancy cars,
expensive jewellery and a defiant masculinity that the kids can't help
but be attracted to. The cash-in-hand jobs in the drug business that
they provide mean many kids simply don't need to engage with the rest
of society in order to succeed.

We could undermine these criminal idols if we removed their control of
the drug trade and placed it into the careful hands of the state. This
motion calls for models of cannabis regulation to be investigated. I
personally favour sale from pharmacies. If we want to send a message
that cannabis is harmful – and we should - how better to do so than
through a health professional at the point of intended purchase. No
pharmacist is going to suggest a customer progress to the use of
heroin or crack, and no pharmacist would sell to a child. With the
illegal cannabis dealers we have at the moment we do not have that
security.

It is important to remember that this motion is not calling for a
radical leap in policy. It merely requests a level-headed examination
of the weapons that are available to us for our new 21st century war
on drugs. Have no doubt. There are better ways to restrict the ability
of drugs to do harm. Ways which do not themselves harm individuals and
the communities in which they live. How much courage does it take to
ask for expert help in identifying them?
Trust in politicians is at an all time low so I think this is a good
time for politicians to reflect on just what their job is. Surely it
is to identify, support and communicate policy that will improve the
lives of their constituents. Rather than take the easy route to a few
swing votes, it is time politicians looked voters in the eye and
attempted to explain complex concepts. If they see us striving always
to do the right thing rather than the popular thing then the trust
will return and the votes will follow.

This is not a party political issue.

To demonstrate Chris Mullin wrote this in his diary when he was Labour
chair of the Home Affairs Select Committee in 2002 “Is it possible to
have a mature discussion about any difficult issue in this country?
Instead of wobbling around in the middle of the road, attracting flak
from all sides, wouldn't it be nice to do the right thing for once and
tell Rupert Murdoch, Paul Dacre, Conrad Black et al. to fu...” (cough)

well you get the idea

And with that in mind I want Nick Clegg to walk into David Cameron's
office, lay this motion on his desk and say this is part of what is
needed to get this country out of a serious hole. Cameron knows this
is the right path. He was on that same Select Committee in 2002 and
shared Chris Mullin's conclusions, but there is one thing that will
give him pause for thought.

Cowardice. Cowardice plain and simple.

In closing I would like to dedicate this motion to Tom Alderton, whose
passion and bravery in telling his story first inspired me to set off
on the road that has lead me here. Tim Farron had Cathy Come Home (as
inspiration for getting active in politics). I had the documentary:
Killer in a Small Town. I would also like to apologise to all those
families that have been afflicted by insanity, illness, destitution,
prostitution and death since I set off on this road for not getting to
this stage sooner, and to all those who will be afflicted in the
future should my words today not have had sufficient power to bring
change.

Expert calls for licensed sale of Cannabis

One of the country's most senior experts on Cannabis has called for the drug to be made available on a licensed basis - both for the seller and the purchaser.

Professor Roger Pertwee, is the professor of Neuropharmacology at Aberdeen University so there's not much about the effects of the drug on the human body that he doesn't know.

While he acknowledges that there are issues with Cannabis, he argues that the current approach of decriminalisation does more harm than good and has suggested a way forward. Today's Independent quotes him as saying:

"You'd need to have a minimum age of 21, and I would suggest you might even have to have a licence," said Prof Pertwee, from the University of Aberdeen, who pioneered early research on the effects of cannabis in the 1960s and 1970s.

"You have a car licence and a dog licence; why not a cannabis licence?"

The idea would mean only those not suffering from a serious mental illness or at risk of psychosis would be legally allowed to buy the drug.

He was clear that:

"We're allowed to drink alcohol and smoke cigarettes. Cannabis, if it's handled properly, I think is no more dangerous than that."

I think there might be some merit in what he's saying. If there was a proper licensing regime, the Police could concentrate their efforts on the people who operated outside that system. I wondered if there would be an illiberal element to restricting eligibility for licences - but we have that principle anyway in the way we deal with shotgun and driving licences. 

What is clear is that the current policy isn't working. By insisting that all drugs should remain illegal, the potential for someone using a less harmful drug to be lured by an unscrupulous dealer into a much more dependent relationship on substances which will rule and ruin their lives is clear.

I think we really need to have a proper, open debate about drugs and the best way to minimise the harm that they cause. We should make policy on the basis of evidence and not on the basis of prejudice or fear. It's quite strange that it's perfectly legitimate, even acceptable to say you have a hangover, or you got absolutely hammered on booze at the weekend. However, if someone came into work and said they'd been stoned on Saturday night, they'd likely be sacked on the spot, even though both activities for most people have the same amount of risk.

It's time to cast aside the blinkers and take a cold, hard look at the evidence.

Senior doctor suggests drug decriminalisation

Do you remember the Liberal Democrat Conference in 1994 when LDYS submitted a motion suggesting the decriminalisation of Cannabis? This is why we jokingly sing at the Glee Club (for the uninitiated a last-night-of-conference singalong) about the leadership "getting all hot at the thought of pot available sweetie counters".

In those days there were very few people calling for any drug to be decriminalised to help tackle addiction and they were pretty much all hippy liberal types. These days, there is increasing concern that prohibition just isn't working. Today a senior doctor, in fact, one of the most prominent in the country, the outgoing president of the Royal College of Physicians, Sir Ian Gilmore,  has suggested that decriminalising drugs would not only reduce crime but also improve health..

He said:

"There's a lot of evidence that the total prohibition of drugs, making them totally illicit and unavailable, has not been successful at reducing not only the health burden, but also the impact on crime. I'm trying to take a fresh look, as many people have done. There is a strong case for trying a different approach. I'm not saying we should make heroin available to everyone, but we should be treating it as a health issue rather than criminalising people."

He joins a growing list of lawyers, academics, police officers and fellow doctors, all of whom have seen the terrible consequences of our current failure to tackle addiction. Professor David Nutt lost his Government job but enhanced his professional credibility with comments last year that alcohol was more harmful than Ecstasy.

We really need to have a proper debate about drugs policy and make our decisions based on the evidence available, the experience of other countries, like Portugal, and not via the ill-informed opinions of the tabloid press.