Ending drug prohibition with a hangover?
| Author | Julian Buchanan |
1980s: From abstinence to harm reduction
In the 1980s, working as a probation office in Bootle, Merseyside, I was confronted by two particular social problems; mass unemployment, and a heroin ‘epidemic’. While in the past, illicit drug use had been largely associated with enhancing life-experiences, such as attending parties, music festivals or socialising at university, the 1980s wave of heroin use was confined largely to discarded working class youth who used the drug to create a 'euphoric oblivion’, to block out depressing life experiences (Buchanan & Wyke, 1997). Not surprisingly, this heroin epidemic spread rapidly across the most deprived areas of England, those hit hardest by de-industrialisation and mass unemployment (Dorn & South, 1987). The received wisdom in the early 1980s surrounding problematic drug use was clear and robust; all illegal drug use was inherently dangerous, would lead to addiction, destroy families and communities, and ultimately result in early death and tragedy. The national response to this drug epidemic was to rally communities and agencies together against this new threat, and to utilise every means possible to get young people off (illegal) drugs. This ‘crusade’ against the drugs ‘enemy’ resulted in a proliferation of new community groups and organisations, often with the phrase ‘against’ drugs in their title.
As a new probation officer, I acquiesced and embraced this misguided dominant discourse, and did my utmost to coerce people to stop taking illegal drugs. After pressurising and persuading heroin using offenders who were awaiting sentence in Court, to give up illegal drugs, I’d often take them in my car to a detoxification centre or a drug rehabilitation centre, far away from their home, only to see them back on the streets of Bootle, Merseyside, a few weeks later using heroin. I soon realised, not only was a coerced abstinence not working; it was actually part of the problem, they were now more entrenched, and further alienated following my unsuccessful attempt to force them off drugs. Supporting the crusade to rid them of illegal drugs did more harm than good. In particular the approach didn’t meet people where they were at; it didn’t assess or listen to what they were ready, able or wanting to do; instead, I was pursuing my agenda, not their agenda (Buchanan, 1991). In so doing, I was setting them up to fail, and this created further conflict and relationship breakdown between them, their family, friends and importantly, the criminal justice system, which saw the offender breaking their promise to become drug free. By imposing an unrealistic, and probably unachievable expectation upon the offender, I had inadvertently encouraged deceit that made the person more damaged, isolated and at risk.
Learning from this experience, when the Merseyside Probation Service appointed me as a drug specialist in 1986, I helped pioneer and promote a risk reduction approach (Buchanan & Wyke, 1987) that was subsequently adopted as Merseyside Probation Service drug policy. Risk reduction (now widely referred to as harm reduction) doesn’t exclude abstinence: if somebody is ready, able and wanting to pursue abstinence, they’ll be supported to do so, but risk reduction engages and fully supports people in a pragmatic, non-judgmental manner, while they continue to use drugs. Risk reduction is dedicated to reducing the risks (legal, social, psychological and medical) to the person using drugs, their friends, family and wider community, and doesn’t require a commitment to abstinence (Newcombe, 1992).
By the mid/late 1980s the dominant anti-illicit drug discourse in the UK that demanded ‘drug’ free lives and communities, was largely replaced by a harm reduction strategy. This new approach engaged more people in treatment and was more successful at reducing harms (O’Hare et al., 1992). However, it is important to be clear, the motivation for this paradigm shift away from abstinence, was essentially a pragmatic move to protect the wider community from the new and greater threat of HIV/AIDS, posed by the drug injecting community, through unprotected sex and sharing of needles, the paradigm shift didn’t reflect a policy change towards accommodating illegal drug use (ACMD, 1988).
1998 - The empire strikes back
The United Nations General Assembly Special Session (UNGASS) gathered in New York in 1998 to launch a new ten-year global drug strategy, accompanied with the slogan: ‘A drug free world - we can do it’ (Blickman, 2008; UNDCP, 1998). This far-fetched and questionable aspiration was an overt attempt to reclaim and re-assert abstinence. In my view a ‘drug’ free world is as deluded, naïve and useless, as a 10 year plan for a crime-free world. Worse, while the notion of a crime free world has merit, the notion of a drug free world is bizarre. It is a vague ideologically driven crusade; one that is irrational, contradictory, unachievable and undesirable, and as I will argue, drug policy driven by prohibition has caused considerably more harm, than the drugs it purports to protect us from (Rolles et al., 2012).
Soon after the 1998 UN conference, the UK appointed Keith Halliwell, an ex-Chief Constable, as a new US-styled Drugs Tsar, and he too launched a ten-year drug strategy. This appointment marked a shift in the UK away from a health approach to the ‘drug’ problem, and criminal justice took centre stage; it also marked a significant alignment towards abstinence-based US drug policy, and extended the war on drugs (Buchanan, 2010). By this time, I was working at Liverpool University and carrying out qualitative research that explored the lived experience of people on Merseyside struggling with chronic problematic drug use. In an article entitled ‘A war on drugs, a war on drug users’, Lee Young and I, argued a prohibitionist, tough law enforcement drug policy that meted out severe punishment for drug violations, was not only an attack on illicit drugs, but more importantly, it was an attack on the people who used illicit drugs (Buchanan & Young, 2000). It was clear, the drug war in the UK focused on working class communities, and specifically young people whose futures had been ravaged by de-industrialisation, disinvestment, poverty, and major social, economic and political changes (MacGregor, 1989). Bootle, where I worked as a probation officer and drugs worker, was a tragic example of a community blighted by socio-economic change, which resulted in a generation of unskilled youth, whose labour was rendered worthless and useless. Young people in Bootle were unable to follow in their parents’ and grandparents’ footsteps in Bootle, suddenly couldn’t find work, and wondered if they’d ever work. In the 1980s it seemed that almost overnight a new section of society appeared - the discarded working class whose labour was surplus to capitalist requirements and who would be punished and scapegoated for being unable to secure work (Dorn & South, 1988; Rojek, Peacock & Collins, 1989).
This group of unskilled youth, lacking qualifications, unable to secure a stake in society, couldn’t legitimately access employment, struggled to find their own accommodation, were unable to afford consumer goods, and inevitably many drifted into a drug-centred lifestyle which offered a daily routine and network to escape their grim daily reality. Labelled ‘addicts’ and ‘smack-heads’ they were presented as an enemy within the community, and the cause of community despair. As Chomsky (1998) explains, this demonisation served a political purpose:
‘The Drug War is an effort to stimulate fear of dangerous people from who we have to protect ourselves. It is also, a direct form of control of what are called "dangerous classes," those superfluous people who don't really have a function contributing to profit-making and wealth. They have to be somehow taken care of.’
Historically, drug prohibition has almost exclusively targeted the discarded working class, and enmeshed with racist thinking and racist targeting (Alexander, 2013; Nadelmann, 2014). In the late 1800s Chinese people living in London who used opium (rather than alcohol) were portrayed as a threat to morality, a people who used their drug in ‘opium dens’, a stark contrast to British attitudes towards the opium using ‘Lakeland Poets’ (Keats, Coleridge, Wordsworth and De Quincey) earlier that century. In 1914 the New York Times headline ‘Negro Coke Fiends’ presented Black African Americans who use cocaine as peculiarly dangerous criminals, suffering insane addiction which equipped them with an ability to withstand bullets (Williams, 1914). More recently the disparities between crack and powder cocaine sentencing in the USA, even though it is virtually the same drug – have resulted in concerns about racist drug laws. To receive the ten-year mandatory minimum prison sentence for possession of powder cocaine (predominantly used by the white population) the threshold was set at 1000 grams, whereas the threshold for crystallised cocaine (predominantly used by the Black population) was set much lower at 10 grams. Belatedly acknowledging these gross disparities, the US Fair Sentences Act 2010 eventually adjusted the threshold level, although the present 18:1 ratio is still unfairly balanced (Washington Post, 2010).
Prohibition
Drug prohibition has caused global harm and great cost to society, arguably far greater than the harm arising directly from illicit drugs (Rolles et al., 2012). Further, prohibition has been ineffective and has failed to demonstrate any significant reduction in drug use, drug supply, or drug harm (GCDP, 2011 & 2014). Since President Nixon declared the ‘war on drugs’ in 1971 (see Fig. 1), the US have witnessed a sudden and rapid increase towards mass incarceration (Alexander, 2013), with vast numbers held in prison for drug-defined crimes (possession, supply, cultivation etc.), (Kerrigan, 2012). A similar pattern of spiralling prison...
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