Prescription heroin

Prescription future for heroin drug treatment

Doctors will be encouraged to prescribe pharmaceutical heroin to addicts in order to slash drug-related crime, the Liberal Democrats have said.

At a conference on Drugs, Race and Discrimination held by drugs charity Release on Thursday, Liberal Democrat Home Affairs spokesman Chris Huhne MP said that it was time addiction was seen as a public health issue.

Arriving directly from the Liberal Democrat Party conference in Brighton, he said: “We must treat addicts as a matter of public health not as a matter for punishment. They are people who have no option but to try to feed their addiction, and there is nothing to gain from threatening them with prison.

“GPs and clinics should be given the right to prescribe heroin in cases of addiction. The principle is clear.”

The Liberal Democrats’ policy is informed by trials in Switzerland and the Netherlands where around 1,000 addicts were prescribed diamorphine – pharmaceutical heroin, in injectable or pill form. The results were a sharp fall in crime, improvement in the addicts’ health and a better rate of beating the addiction than those using methadone, an alternative heroin treatment. The results also showed after three years on the programme they had more friends who were not addicts, stable housing, and jobs.

The MP and former economist was fiercely critical of the current attitude towards drugs and crime, adding: “If we ran economic policy the same way we ran criminal justice policy we’d be in a perpetual recession. There is an enormous gap between the clear evidence that exists and practice.”

Prison sentences only serve to disrupt the treatment of addicts, the UK Drug Policy Commission has said, and, with drugs available in prison, cannot even act as a period of ‘cold turkey.’

Though doctors can prescribe diamorphine doing so requires meeting stringent regulations and obtaining a Home Office licence, which the Lib Dems would relax. The introduction of methadone in the 1960s and 1970s means that now only a handful of doctors do so – of the UK’s population of 300,000 ‘problem drug users’ and 40,000 registered heroin addicts, only around 300 to 400 addicts deemed as ‘treatment-resistant’ are offered diamorphine as a last resort from 128 licensed clinics.

Steve Rolles, head of research for drug policy reform group Transform, said that, uniquely, it was possible with heroin to compare both legal and illegal use.

He said: “It’s as if there are two alternate realities running in parallel; one where drug users are buying street heroin on the corner, robbing people to fund their habit, catching diseases from dirty needles and dying. At the same time you have medical facilities prescribing safe diamorphine in a controlled environment to addicts who are drawn towards the support services, aren’t committing crime and are living more stable lives.

“One works very well and the other is a complete disaster.”

A growing number of voices are advocating a less punitive approach towards addicts. Parliament’s Home Affairs Committee stated in 2003: “If diamorphine treatment could be offered to all problematic users who do not successfully access other treatments, we believe it could play a useful part in managing the social problems generated by this group of people.” On the committee was a Conservative MP, one David Cameron.

The Chief Constable of North Wales Richard Brunstrom in 2004 suggested legalising heroin to undermine drug-related crime, and Scottish police chief Clive Fairweather and the president of the Association of Chief Police Officers, Ken Jones, recommended prescribing diamorphine as a more “realistic” approach to long-term drug abuse, pointing to overcrowded prisons choked with drug users.

HM Prison Service figures show that in July there were 12,814 inmates sentenced or held on remand for drugs offences. An estimated 60 per cent of acquisitive crimes are drug-related, costing the taxpayer around £12 billion a year. If those on theft, robbery or burglary charges were included the total prison population held because of drug use, and their prohibition, could be as high as 27,524.

However, many doctors have strong ethical reservations about supplying addictive drugs, and baulk at describing it as a ‘treatment.’ There are also concerns over the extra cost of supervised ‘shooting galleries’ where users can inject or take their diamorphine, and fears that prescription drugs given to be taken away may end up sold on the black market, as happened in the 1960s.

In 2006, the Addiction Research Unit based in London’s Maudsley Hospital started trials similar to those in Switzerland, and the Home Office plans a future review in the light of its results.

 

[This article originally appeared in The Big Issue, September 2008]

 

Family court changes comes at glacial pace

Dad's army

“If your partner is reasonable, stay as far away as possible from the court system. They are rife with litigation instead of mitigation. Find a support group and don’t give up, your children need you.”

– John Baker, former chairman of Families need Fathers, speaking on Radio 4’s Woman’s Hour.

After five years of the sight of spandex-clad men dressed as comic-book superheroes on motorway bridges, government buildings, even Wimbledon’s Centre Court, campaigners hope that new laws will stem the rising tide of parents denied access to their children.

Activist group Fathers 4 Justice has used humour, pithy punchlines and high-profile stunts to focus the media’s attention on the parlous state of the Family Court, and the unreasonable manner in which one parent, all too often the father, can be denied access to their children.

With family court proceedings taking place in private behind closed doors, the group argued that there is little accountability for the decisions of the courts, a tendency to grant residence to the mother, and insufficient rigour paid to examining claims of abuse, violence or fear.

This week, Fathers 4 Justice’s founder, flamboyant father-of-three Matt O’Connor, announced that after six years he was closing not just the support group but winding up the campaign in order to spend more time with his three sons.

Speaking to The Big Issue, Matt said: “We don’t have the resources or the training to help people who are clinging to the cliff face. We never started it for that, but it evolved from awareness-raising to self-help,” Matt said.

“The final straw for me was Brian Philcox, who killed his children. The headlines spoke about a ‘Fathers 4 Justice link’, as if we were responsible for what he did.”

However, the high-profile posturing of the caped campaigners has led the government at last to turn its attention to some of the more intractable problems of the Family Court.

Some 200,000 parents separate every year leading to around 25,000 to 30,000 single residency court orders, where the child lives at one parent’s home.

In the majority of cases, courts award custody of the child to the mother, and once a routine has been set it is harder for the father to get access.

A common “standard issue” arrangement handed out by the courts is alternate weekends and half the summer holidays, but this falls far short of the time required to build relationships.

Policy officer Becky Sabine from Families Need Fathers, set up over 30 years ago, said: “It is difficult to make up time apart, court cases can take six months or more and that’s a long time in a child’s life. It is important to have quality time, based on mundane things like picking kids up from school, shared mealtimes, parents’ evenings, bedtime stories – not just a few days out.”

Sabine is hopeful that courts will use the new powers under Children and Adoption Act 2006, which comes into force in November, to compel parents to cooperate and create a culture of genuinely shared residency. Officers from CAFCASS, the government agency which prepares reports for judges on the parents and children involved, have also been given an expanded role of mediating and befriending the parents to help in hostile relationships.

Family Law practitioner Miranda Fisher from legal firm Charles Russell said some progress had been made over the last five years.

“The changes that have happened are largely due to Fathers 4 Justice because their efforts have brought it into the spotlight,” she said.

“There has been a shift in the attitudes of the court towards shared residence orders, but though courts have always been sympathetic towards strong and meaningful relationships with both parents, the problem lies in enforcement.”

The lack of effective measures against resident parents that continually block the visiting parent’s access to their children has led to furious criticism of the Family Courts and CAFCAS.

In May, Lord Justice Alan Ward gave the system an unprecedented savaging when ruling that a father have no contact with the daughter he has been fighting to see for 12 years.

Laying blame squarely on the mother, Lord Justice Ward said her “drip, drip drip of venom” had led her daughter to believe false claims that she had been abused by her father – claims rejected in court 10 years ago. As seeing her father only upset her, he could not allow contact.

He said: “The father complains bitterly, passionately and with every justification that the law is sterile, impotent and utterly useless. But the question is: what can this court do? The answer is nothing.

“This is a truly distressing case. It may be typical of many, but in some ways it borders on the scandalous. It is certainly tragic.”

Such cases are termed “intractable hostility” by the courts, also known as Parental Alienation Syndrome. While many thousands of parents whose relationships break down settle their differences themselves, difficult court disputes for the most part arise when parents are blinded to doing the best by their children by their animosity toward each other.

Such hostility can often lead a young child or teenager to become alienated from the non-resident parent after constant exposure to the feelings of the resident parent, for example the delusional beliefs of the mother in the case above.

In part, the courts are to blame as the system encourages an adversarial approach, and judges have been reluctant to punish, arguing that a heavy fine or prison stretch for the mother or father would hardly be in the child’s interest.

Miranda Fisher said: “When people divorce they lose sight of what’s good for the child. We need to help parents to help their children through a divorce, and remind parents of the effects on their children of seeing two people they love ripping each other to pieces in front of them.”

Others have gone so far to say that, with the weight of evidence demonstrating the negative effects of having only one parent in a child’ life, deliberately denying the child access to both its parents is tantamount to child abuse.

A Canadian Judge, John Gomery said: “Hatred is not an emotion that comes naturally to a child. It has to be taught. A parent who would teach a child to hate the other parent represents a grave and persistent danger to the mental and emotional health of that child.”

Mothers Apart from Their Children, MATCH, supports those mothers separated from their children, as both mothers and fathers can use the child to alienate the other. One member, Linda, found her ex-husband blackening her name in the court to keep her away from her children. She said: “He told me that my children would grow up with only bad memories of me and he would make sure that they would hate me so much they would wish me dead. Parental Alienation is real, it is emotional abuse and should be recognised by the law.”

The Ministry of Justice said the new measures would “give the court new ways to help find solutions where there is a serious conflict between parties.”

Sabine from Fathers Need Families said that it “cultural change” is required: “It must become unacceptable for one parent to deny another the right to see their children, in the same way drink driving or domestic violence has become unacceptable.

“A child has two parents and needs them both.”

John Fyfe, 37, came home one day to find his house empty and ransacked, and no sight of his wife and children. Neither the police, nor social services would tell him where they were, but Families Need Fathers helped him to get a court order to bring his wife to court. Over six months, he pieced together the story that his wife had run off with another man by whom she was pregnant, changed her name having run up thousands of pounds of debt and taken their five children with them.

John had asked 42 solicitors firms for help, but as the cheapest was £140 an hour he represented himself, including cross-examining his own wife at the final hearing.

In all, he went to court nine times and saw a different judge on each occasion.

Although he was granted a shared residence order in February, his house was burnt down in an arson attack, leaving him able to see them only every Saturday.

Though he maintains a good relationship with his younger children, aged six, nine, 11 and 15, he has not spoken to his eldest son since.

He said: “She used the children to shield her from the law, from work, and from me. It didn’t matter what I said, or how she acted, the courts would never give me custody.

I completely trusted and loved her, I had no reasons to be suspicious of anything. I’ve completely lost my trust and confidence in women now.”

 

[This article originally appeared in The Big Issue, September 2008]