A Land Fit for Heroin?

Transcription

1 A Land Fit for Heroin?

2 A Land Fit for Heroin? Drug policies, prevention and practice Edited by Nicholas Dorn and Nigel South Macmillan Education

3 Editorial matter and selection Nicholas Dom and Nigel South 1987 Chapters 1 and 4 Institute for the Study of Drug Dependence 1987 Chapter 2 Gerry Stimson 1987 Chapter 3 Geoffrey Pearson 1987 Chapter 5 Susanne MacGregor and Betsy Ettorre 1987 Softcover reprint of the hardcover 1st edition 1987 All rights reserved. For information, write: Scholarly & Reference Division, St. Martin's Press, Inc., 175 Fifth Avenue, New York, NY10010 First published in the United States of America in 1987 ISBN Library of Congress Cataloging-in-Publication Data A Land fit for heroin? Bibliography: p. Includes index. 1. Heroin habit-great Britain. 2. Heroin habit- Government policy-great Britain. 3. Drug abuse- Government policy-great Britain. I. Dorn, Nicholas. II. South, Nigel. [DNLM: 1. Health Policy-Great Britain. 2. Heroin Dependence. 3. Legislation, Drug-- Great Britain. WM 288 L253] HV5822.H4L '938' ISBN ISBN (ebook) DOI /

4 To John Auld Friend and colleague, who suggested the title and whose companionship, creativity and critical comment we greatly miss

5 Contents Acknowledgements Notes on the contributors List of abbreviations x xi xiii Introduction 1 1 Heroin today: commodity, consumption, control and care 11 ISD D Research and Development Unit Origins of heroin 11 Availability 12 The range of effects sought by users 13 Patterns of use and their consequences 16 Overdoses 23 Criminality and heroin 25 Health and welfare responses 29 A new balance of control policies 32 2 The war on heroin: British policy and the international trade in illicit drugs 35 Gerry Stimson The medico-centrism of British policy 36 The heroin market 39 Law and order and the 'war on drugs' 41 The effectiveness of the law enforcement response 44 Policy options - the issues and the questions 55 vii

6 Vlll Contents 3 Social deprivation, unemployment and patterns of heroin use 62 Geoffrey Pearson Some initial confusions and complexities 63 Neighbourhood studies: unemployment, housing and heroin 69 Activity or passivity? Messages from North America 76 Life on the dole: killing time and creating meaning 83 4 How families and communities respond to heroin 95 Martin Donoghoe, Nicholas Dorn, Christine James, Stephen Jones, Jane Ribbens and Nigel South A town lies in wait 97 Case study: a problem in the family 102 Parents drawing upon the resources of the 'parent movement' 105 Public activism as a context for parental care 110 State and professional initiatives 116 Conclusion From treatment to rehabilitation - aspects of the evolution of British policy on the care of drug-takers 125 Susanne MacGregor and Betsy Ettorre How serious is the drugs problem in Britain? 126 Treating heroin addicts: the development of the 'British system' 128 The emergence of rehabilitation as an adjunct to treatment Current government strategy and the Central Funding 131 Initiative (CFI) 138 Criticism of existing services 140 A pragmatic approach: a full response linked with the awareness of gender and race 141 Conclusion Reconciling policy and practice 146 Nicholas Dorn and Nigel South The stances of the political parties 148

7 Contents ix A framework for policy at local, national and international levels 150 Grassroots strategies: learning from experience 151 Innovative national or local strategies to reduce drug distribution 160 Contradictions at the international level: tackling the problem at source? 165 Bibliography 170 Author index 181 Subject index 184

8 Acknowledgements We thank our colleagues at the Institute for the Study of Drug Dependence, in particular Jasper Woodcock for his helpful suggestions. The authors of Chapter 4 add thanks to the Department of Health and Social Security and to a charitable trust for funding two studies drawn upon, and further thanks to Lorraine Lucas and Valerie MacNeshie for transcribing endless taped interviews and drafts. Nicholas Dorn Nigel South x

9 Notes on the contributors Martin Donoghoe is a student in the Department of Applied Social Studies in the Polytechnic of North London. Nicholas Dorn, PhD, is Assistant Director (Research) at the Institute for the Study of Drug Dependence (ISDD), London. He is author of Alcohol, Youth and the State and of several works with Nigel South and others and is a consultant for the United Nations Development Programme. Betsy Ettorre, PhD, is a Research Associate in the Department of Politics and Sociology at Birkbeck College, University of London. She is author of Lesbians, Women and Society and has conducted studies at the Addiction Research Unit, Institute of Psychiatry, London University. Christine James is a Research Officer at ISDD where she is working on community responses and youth-work practice in relation to drugs. Previously she worked in community work and has studied sociology and health education. Stephen Jones is a student in the Department of Applied Social Studies in the Polytechnic of North London. During 1986 he and Martin Donoghoe were placement students at ISDD. Susanne MacGregor, PhD, is Senior Lecturer in the Department of Politics and Sociology at Birkbeck College. She is author of Politics and Poverty and a co-author of Dealing with Drug Misuse and is directing a major study of the government's Central Funding Initiative on services for drug users. xi

10 xii Notes on the contributors Geoffrey Pearson is Professor of Social Work at Middlesex Polytechnic. He is author of The Deviant Imagination and Hooligan: A History of Respectable Fears and recently conducted a study of heroin in the north of England. Jane Ribbens is a postgraduate student in the Department of Sociology at Essex University. She was formerly a Research Officer at ISDD and co-author of a short book, Coping with a Nightmare: Family feelings about long term drug use. Gerry Stimson, PhD, is Principal Lecturer in Sociology at Goldsmiths College, University of London. He is author of numerous publications on drug problems including Heroin and Behaviour and (with Edna Oppenheimer) Heroin Addiction; Treatment and Control in Britain. Nigel South, PhD, is a Research Officer at ISDD. He is co-author with Nicholas Dorn of Message in a Bottle and of Helping Drug Users and is author of Policing for Profit: Private Security in Britain.

11 List of abbreviations ACDD ACMD ADFAM CFI DAWN DDU DHSS ED FA GP HMSO ISDD NACRO NIDA OPUS PNCB RCMP RCS SCPS UNFDAC Advisory Committee on Drug Dependence Advisory Council on Misuse of Drugs Aid for Addicts and Families Central Funding Initiative Drugs Alcohol Women Nationally Drug Dependency Unit Department of Health and Social Security Enumeration District (census) Families Anonymous General Practitioner (family doctor) Her Majesty's Stationery Office Institute for the Study of Drug Dependence National Association for the Care and Resettlement of Offenders National Institute on Drug Abuse (USA) Organisation of Parents under Stress Pakistan Narcotics Control Board Royal Canadian Mounted Police Regional Crime Squad Society of Civil and Public Servants (UK) United Nations Fund for Drug Abuse Control xiii