DDN welcomes your letters
Please email the editor, claire @ cjwellings. com, or post them to DDN at the address on page 3. letters may be edited for space or clarity.
‘ there were 950,000 Americans reporting heroin use in 2016, but that number is dwarfed by the number misusing prescription opioids, at 11.5m...’
Quadruple bypass
America’ s opioid epidemic has been big news for a while now, but amongst all the headlines and documentaries and think pieces one issue seems to be consistently overlooked – and it’ s an issue that’ s a bit of an inconvenient truth for the ever-more powerful and vocal legalization lobby. According to the US Centers for Disease Control, the number of drug overdose deaths rose from just under 17,000 in 1999 to nearly 67,000 in 2016 – i. e. it quadrupled. And according to the presidential commission on the crisis,‘ not coincidentally’ the level of opioid prescribing quadrupled over the same period( DDN, September 2017, page 5). There were 950,000 Americans reporting heroin use in 2016, but that number is dwarfed by the number misusing prescription opioids, at 11.5m( DDN, November 2017, page 5). What’ s more, according to a recent Economist article on a major study of the crisis, a huge number of these deaths are happ- en ing in relatively affluent communities, rather than the populations usually decimated by drug harms.‘ The epidemic is caused by access to drugs rather than economic conditions,’ it says.
So the only conclusion to draw from all this is that the argument endlessly trotted out by all the usual suspects – that a legal, regulated market would drastic ally reduce levels of harm – is, as many of us have always said, utter nonsense.
Paul Bennett, by email.
pedantic semantics
Despite no longer working in the field, thank God, I like to keep up with the latest pronouncements of the thought police, and so it was with increasing incredulity that I scrolled through the Global Commission on Drug Policy’ s new report about language and stigma
( see news, page 5).
All very laudable in intention, obviously, but in it we learn that there was a‘ moral panic’ about crack use in the US in the’ 80s and’ 90s, based on a‘ misconception’ that use was‘ exploding’. That this was a‘ misconception’ may come as surprise to people who lived in deprived American inner city areas during those years, but what do they know, eh? A bunch of rich people in Switzerland are happy to put them right.
My favourite part, however, is the table on page 30 that explains which language is OK and which is no longer acceptable.‘ Drug user’, bad;‘ Person who uses drugs’, good.‘ Drug habit’, bad;‘ Substance use disorder’ or‘ Problematic drug use’, good. Not to be pedantic, but according to the commission’ s own criteria aren’ t‘ disorder’ and‘ problematic’ more stigmatising than the innocuous-sounding‘ habit’?
‘ Recreational, casual or experimental user’ are all bad, we discover, and instead we must use‘ person with nonproblematic drug use’( trips off the tongue). That’ s in order to distinguish them from – and therefore stigmatise, I’ d venture – someone with‘ problematic’ use. Then it starts to get truly deranged. Despite being used by almost every agency I ever encountered,‘ opioid replacement therapy’ is now unaccept- able, and you would be a fascist to use it, while‘ opioid substitution therapy’ is fine. So that’ s that cleared up then.
It’ s also good to see commission member Nick Clegg offering his opinions on all this in the pages of the Guardian and the Mirror. One can’ t help thinking, however, that if he was so concerned about the welfare of drug users – sorry, persons who use drugs – perhaps he should have thought twice before en ab- ling a Tory government that went about slashing treatment budgets to the bone.
Molly Cochrane, by email
MEDIA SAVVY
The news, and the skews, in the national media
2018 is already a watershed in global drugs policy. Cannabis is partially legal in most US states; Canada will follow soon; Germany, France and Italy are all reviewing policy … When you consider what a green wave could do for Britain – freeing police and court time and saving lives, as well as unleashing innovation, raising revenue – our approach seems absurd. The only people who benefit from the current situation are criminals. Instead of a safe, regulated market we are awash with psychotic skunk controlled by violent gangs. Richard Godwin, London Evening Standard, 3 January
There’ s appetite to reform the UK’ s drug laws, but it has to be done right. The public are ahead of politicians, with recent polling showing that more people support a legal, regulated cannabis market than oppose it. The government’ s silence on this crucial issue is deafening. Daniel Pryor, Guardian, 18 January
In this climate of punitive neglect, addiction and obesity are dismissed as diseases of choice, which to use that most classbound of Tory insults, the‘ nanny state’ cannot cure. It’ s true that breaking free from heroin, alcohol or sugar requires an effort of individual will. It is equally true that it is easier to summon the strength to quit when others are on hand to help. These truths ought to be self-evident. But they are not evident in Britain. Nick Cohen, Observer, 7 January
Lazy stereotypes also let us off the hook when we really should be getting to grips with the deeper social issues that are the cause of problematic drug use. One reason people use drugs is to cope with difficult life circumstances. People who have been through trauma or abuse are more likely to find their drug use leads to dependency. These are people who need our support – they don’ t need to be labelled, condemned and pushed further away. Nick Clegg, Mirror, 10 January
With many medical schools failing to include addiction in their curriculum this sends a clear message early on in doctors’ medical careers that patients with drug dependence problems don’ t matter … The derogatory language we use to describe people who use drugs is merely a symptom of a deeper problem. The danger of adopting a new vocabulary while retaining the same values and attitudes is that we sound more accepting but really nothing has changed from the patient’ s point of view. I hope I am wrong. Ian Hamilton, BMJ, 17 January www. drinkanddrugsnews. com February 2018 | drinkanddrugsnews | 19