SOCIAL JUSTICE
DIFFERENT CLASS
Society has always taken a different view of middle class and working class drug use , says Mark Gilman – and the results are plain to see
I
n the 1990s I wrote a lot about drugs , class and culture . The basic premise of most on my writing back then was that it was OK for middle class people to use drugs , but the use of mind-altering chemicals by the working class was a major cause of societal concern .
If a middle class person were to develop some concerning issues with their consumption they had a ‘ drug problem ’, but when a working class person developed a similar issue they became a ‘ drug problem ’. Middle class drug problems were to be medically treated in expensive private clinics . Working class drug problems were to be policed and controlled , as they were perceived as a threat to public health and safety . The goal of middle class drug treatment was detoxification and abstinence . The goal of working class treatment was social control .
The rationale of government investment in the expansion of drug treatment since the 1980s has always been clear – reduce drug-related crime and prevent the spread of infectious diseases from the working class to wider society . Since the advent of public health in terms of drug treatment investment , a further goal has been added – the reduction of drug-related premature death . This latter goal has seen a more empathetic response to working class drug treatment .
The message to working class drug users is now threefold – don ’ t commit crime , don ’ t spread diseases and don ’ t die too early . The method of controlling working class drug use by way of drug treatment had three elements – get them in , keep them in , get them out . Providers of drug treatment were monitored and rewarded or penalised by their ability to juggle these three elements . Some third sector providers grew to dominate the drug treatment sector by their adeptness at juggling these balls . The NHS , as a slow and lumbering bureaucracy , wasn ’ t that good at juggling and lost many of its historic contracts .
There is now in the UK a drug treatment industrial complex . Have things changed for the better ? Have we managed to control working class drug use to the satisfaction of government and middle England ? Are the prospects for a working class person with a drug problem better now that they were in
1985 ? If you ’ d been in a coma since 1985 and woke up in 2024 , would you see substantive change for the better ?
There have been improvements as a result of continued government investment . People with an opioid use disorder now have more choice in medication . Methadone is still available and various preparations of buprenorphine are around . Heroin-assisted treatment has been made available to some .
Working class people now have greater access to detoxification and residential rehabilitation , often in the form of ‘ recovery housing ’ provided by people with ‘ lived experience ’. There is much greater access to various forms of ‘ mutual aid ’. There are ‘ LEROs ’ – lived experience recovery organisations . However , if you came out of your coma in Piccadilly Gardens in Manchester ( a place I ’ ve been familiar with for over sixty years ) you might be forgiven for failing to appreciate these improvements . You
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24 • DRINK AND DRUGS NEWS • OCTOBER 2024 WWW . DRINKANDDRUGSNEWS . COM