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