Anyone viewing the recent photographs from the North Wales Daily Post newspaper of the inside of Wrexham Bus Station here and here will be shocked to their core. So concerning are those photographs of an addict lying on the floor somewhere between being alive and dead, discarded needles, blood and a bladed weapon that the paper ought really to have carried a readers’ discretion warning.
These are the signs of a drug problem utterly out of control; publicly visible in its most gruesome respects. In response to such visible public drug use, we are now seeing calls to establish drug fix rooms in many cities throughout the UK. These are schemes that will allow addicts to inject black market drugs under some level of medical supervision. We are also seeing growing calls to provide addicts with heroin. Scratch the surface of those recommendations and you pretty soon end up at the realisation that one of the benefits of those schemes is that they make drug use less visible to a public that might rightly question why we are failing so comprehensively to tackle our drug problem, despite all of the honeyed words from highly paid experts and the hundreds of millions of pounds of public money spent following their advice.
Let us be in no doubt though, the very fact that we are even considering such schemes is a testament to our utter failure to develop effective drug prevention schemes in this country. In 2005 I was asked by the Blair government to prepare a report on what the UK drug problem might look like in 25 years’ time.
My colleagues and I advised that within 25 years we could be facing a reality in which serious drug problems were rife throughout our cities; where addicts were injecting in the streets, where discarded needles and drug related overdoses were commonplace in our public areas, where our police and social and health and educational services were overwhelmed by the visible signs of our addiction epidemic.
The report that we prepared also cautioned that there would be an increase in drug-related corruption as the various organised crime groups sought to hide the proceeds of their trade by investing them in otherwise legitimate companies. To say that government officials were concerned by the report would be an understatement. Their concern though was not about what we had predicted, but about the fear that anybody might think the reality we were foretelling might actually come to pass.
So concerned were officials that our report might be taken as illustrating a possible reality that could actually occur, they agreed to publish the report only by adding a warning that our report described only a worst case scenario, ignoring some of what they felt were the positive signs of a reducing drug problem in the country. As the Wrexham bus terminal photographs now show in brutal detail those predictions are becoming reality.
For decades, we have pursued a policy of tackling our drug problem on the basis that it is possible to reduce the harm of drug use while allowing the drug use itself to continue. This is the policy of harm reduction and it is a policy that we must now see as surely failing. We are not succeeding in reducing the harm of our drug problem despite investing hundreds of millions of pounds in harm reduction schemes that advise addicts how to inject more safely, where to get clean needles, and most recently where they can go to inject their drugs under some level of medical supervision. The provision of clean needles that was heralded as an effective means of reducing the spread of HIV infection amongst addicts is now part of the problem with discarded needles now being found in their tens of thousands.
To solve the problem of public injecting we are now flirting with the idea of providing spaces where addicts can inject their drugs under some level of medical supervision. With the implementation of those schemes we will not see a reduction in our drug problem even if it becomes a little less obvious. In time however even with those schemes in place we will see again the visible signs of drug addiction on our streets – in our bus stations rail terminals and in the toilets of our fast food restaurants.
If we are lucky we will come to understand that it is only by massively ratcheting up our efforts at drug prevention, providing effective abstinence-based treatment for our addicts, seizing the massive assets of those who are profiting from the drugs trade and punishing those who are pushing drugs that we will turn the corner of this downward spiral. If we fail in this respect expect more bodies, in more places, more hand wringing, and more calls to legalise drugs – which will not in any way reduce our drug problem.
Dr Neil McKeganey is the Director of the Centre for Substance Use Research
(Image: Cristian C)