The UK’s drug policy is allowing a social genocide to go unnoticed – and coronavirus is making things worse

Drug treatment doesn’t enjoy the privilege of being based on evidence – even though we have ample evidence from the government’s own scientific advisors – but in political ideology. That determines who lives, and who dies

Ian Hamilton
Monday 01 June 2020 09:25 BST
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Louise Thomas

Louise Thomas

Editor

We tend to think of genocide as an attempt to eradicate an ethnic or religious group. This is usually an active deed, such as war, but it should apply to a more passive approach to not just ethnic groups but distinct social groups too.

There is no set minimum number of deaths to qualify for this label. Imagine thousands of people belonging to a specific social group dying annually; would that not be be thought of as a form pf genocide? Add to this a clear knowledge of how to prevent these deaths but failing to act, and you have all the makings of deliberate, albeit passive, act of genocide.

It's happening here in the UK. In 2018, more than 5500 people in the UK died as a result of developing problems with drugs such as heroin and cocaine. Worse, those addicted to drugs are dying on average in their forties – four decades before the rest of us. We haven’t seen premature life expectancy like that for over a century.

Prior to the outbreak of coronavirus, some of those in drug treatment for such addictions would be expected to go to a local pharmacy daily to be given a supervised dose of a substitute drug such as methadone. Given the pressure pharmacists face and the restrictions on movement and social distancing guidance, this daily dispensing is not only impractical under lockdown restrictions but increases the risk to all involved of contracting Covid-19.

But there is another effect. The Care Quality Commission has already announced that it is investigating reports of excess deaths (likely due to overdose) in one large national provider of drug treatment which has stopped these daily pick-ups. The CQC added that it is taking enforcement action against the provider before the investigation has reached any conclusions, adopting an approach of guilty until they have enough evidence to prove guilt.

That unnamed provider won’t have made the decision to stop some clients daily pick up’s in a cavalier way; the individual risk of overdose and compliance will have been assessed. Weighing up risk against benefits is not a science, much as we’d like it to be. Instead it uses the best available information to make an informed judgement.

Drug treatment is just as politically and morally charged as drug use – a factor we rarely witness in other areas of health such as cancer or cardiac care. Drug treatment doesn’t enjoy the privilege of being based on evidence – even though we have ample evidence from the government’s own scientific advisors – but in political ideology. This matters not in an abstract theoretical way, but a very real one. It determines who lives, and who doesn’t. The UK already has the highest number of drug related deaths in Europe and every year we manage to set new records for those dying due to drugs.

Rather than treat this problem with the urgency and attention it deserves, the government explains these thousands of premature deaths away by saying they are due to an ageing cohort of drug users. Remember they are describing people in their forties; you must go back far more than a century to find average life expectancy reaching 40.

Instead of adopting evidence-based interventions the government doggedly sticks to its political ideology that everyone who seeks treatment should be given a treatment that produces abstinence as its goal. Sounds admirable, but is as optimistic and flawed as expecting to save the lives of everyone who has cancer. It cruelly sets people up to fail. You can’t recover from addiction if you’re dead.

In 2020 we still think its acceptable to wait until a person who has a problem with drugs to admit to this and find the motivation to go find help to overcome this problem. This passive approach to providing healthcare is unique and outdated. It harks back to an era when we blamed people for “bad choices” and a belief that they had to hit rock bottom before they would be ready to change. That’s the equivalent of waiting until someone with diabetes has multiple hyperglycaemic incidents before intervening, rather than preventing damage to their health before it happens.

As we enter a period with record public debt and the inevitable cuts to public spending to mitigate this, austerity will look like a period of plenty. It’s difficult to imagine how drug treatment will receive the resources it needs or deserves.

Prepare for new records in drug related deaths as a result. But don’t forget that, even while it’s happening, there’s every chance you won’t realise this has happened unless you are one of the families or communities grieving the loss of someone they knew.

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