Scotland’s new drugs strategy The Road to Recovery[1]  signals a very welcome step change in Scottish drugs policy. But will it mark a turning point for thinking about drugs policy in the UK generally?  Their new vision, in which ‘drug treatment services and rehabilitation are based on the principle of recovery’[2], may not sound radical but believe me it is.  It is one that the rest of the UK would do well to adopt.

But in the Orwellian world of British drugs policy it is unlikely to be that simple.

It might seem self evident to the lay man that the point of drug treatment and the justification for the money spent on it is to get people off drugs and get better. But this has not been so for the ten years of New Labour’s policy - premised on the idea that ‘services’ can reduce the harmful consequences of individuals’ drug use whilst accepting that individuals may continue to use illegal drugs.

The ‘Towards Recovery’ Addictions Report I authored for Iain Duncan Smith’s Social Justice Policy Review last July, revealed the costly (in economic and human terms) and bureaucratic mess that the government’s ‘cutting crime and saving lives’ drugs treatment agenda has become.[3] The evidence we collected suggested that far from reducing drug use the effect has been to entrench addiction; that far from falling, drugs deaths and blood borne virus incidence, long term methadone dependence and topping up on illicit drugs, second and third generation addicts, were all rising - despite the ever increasing millions spent on ‘harm reduction’ measures of methadone prescribing and needle exchange. We exposed a commissioning system that had marginalised rehabilitative treatment.  We found that ‘abstinence’ had been dropped as a goal of treatment policy or precondition of recovery.

Subsequent calls for a reformed recovery oriented treatment system fell on stony official ground.   The National Treatment Agency insisted that current provision was proportional and reflected the need to manage ‘chronically relapsing’ addicts through their ‘natural’ course of an average of ten years of dependency per client.

Even Mark Easton’s humiliating (for the NTA and Government) revelation  earlier this year that of the 180,000  odd people signed up for treatment, less than 3% left the government programme free of illegal drugs failed to provoke real reflection. It elicited instead a new and defensive determination the part of the NTA to ‘convince the public that money spent on drug treatment is money well spent.”[4]

Now at a National Treatment Agency conference next week will be an interactive session on how we should define “recovery”.  Professor John Strang, of the UK Drug Policy Commission, and long term advocate of substitute prescribing and pharmacological interventions, is to present the findings of a working group which is meant to have explored and reached agreement on defining recovery.

But the ‘definition’, as reported, defines recovery in terms of controlled continued drug use.  As such it effectively excludes the 12 step NA, AA and all other similar approaches to recovery – in fact the very thinking that has re introduced the need for abstinence based recovery and stimulated this debate in the first place.  This would not be so bad but for the fact that it is less than a well kept secret that the UKDPC is keen to establish a consensus for their revisionist version.  As one of the members of the PANDA Forum said they are just “seeking to define the hegemony again.”

When the Government published its revised drugs strategy this March[5], paying lip service alone to abstinence based recovery, they missed the opportunity, which the Scottish Executive has now clasped, of reviewing its misconceived policies.

It now seems unlikely that Scotland’s Pauline conversion will jerk the NTA into reality.  Scotland, as Professor McKeganey has pointed out, has  “seen the remorseless growth of the methadone programme encouraged along its road of expansion by doctors claiming that it keeps addicts alive, reduces crime, reduces the risks of addicts acquiring life threatening blood borne infections…...’ Yet, ‘… with virtually 22,000 addicts on a methadone programme we (still) have record levels of Hepatitis C infection, drug related deaths running at a rate unequalled in Europe and no noticeable reduction in drug related crime and tens of thousands of children living with a drug dependent parent.” This singular lack of progress is despite, ‘a methadone budget that over the last ten years may have cost something in the region of £600,000,000.’

This is the problem faced, not just by Scotland, but by all of the UK.

On Scotland’s new approach Neil McKegany has said, “We now have a new drug strategy that commits treatment services to enabling addicts to recover. Thank heavens for that. It is a long time coming but it is very welcome.”[6]

But how much longer does the rest of the UK have to wait?