#Drugs #Addiction – The Political Debate(s)

Many of the impacts we face in our day-to-day life are mostly resulting from the choices we make.

But what if those choices are not real ones or worse, they are significantly influenced by the society we live in and how that society is managed by its leadership?

A prime example of how politics and society can influence and impact upon our lives is the current social-ill of problematic substance misuse disorders.

Irrespective of any rights and wrongs in the democratic process,  it’s so much harder to swallow consequences of our choices when somebody else is (partly) to blame, for the choice we almost felt obliged to make.

The rot sets into that democratic theory if or when, the people we elected aren’t doing what we want. Or worse, as has been shown on several occasions over recent decades, are actually serving their on self-interest under a label of public service. All of which is, has been and will continue to be… stories for another day.

Often, the best we can do as members of our society is watch, listen, challenge and feed into the political debate, where possible. It is worth taking some time and effort to try and drive forward our desired outcomes and hold the politicians to account, but doesn’t often feel that way.

But today, this is arguably easier than ever before with social-media opportunities but again, even if you feed into the power of democracy, still the voice of so many in our society often isn’t heard. Even more so  when the demographic in our society is already disconnected and/or marginalised. Speaking up for them is important however, feeding information into the political process is often problematic and fraught with difficulties. Even when you happen to have the inclination or capability.

Too often some subjects, like substance use disorders and addiction, are looked upon by our elected voices as;  a political ‘hot potato’ or worse still, unlikely to be ‘sexy’ enough to be a vote winner. So, facts needed to fuel ‘informed’ political debate have to permeate the choking smog of so many past political blunders or worse, the constant hot-air cloud of self-worth seeking populist endeavours.

Yes, it’s wrong but also kind of understandable. But, if given a little thought; public feelings or social requirements, irrespective of the fact and supporting evidence, will only ever be heard after prolonged constrained journeys through the conduits of sustained civil service attenuation.

And that is a known fact, one that was always expertly and succinctly explained with satire by ‘Yes Minister‘ in the past.

In real-terms, a great deal of how society chooses to address issues like addiction is no different.

I beg to move, That this House has considered the human and financial costs of drug addiction. (Craig Mackinlay, Conservative MP for South Thanet)

But have they really ‘considered’ the impacts, probably. Will much come from that consideration? Possibly not.

A recent debate transcript would suggest the answer could be yes, or at least in part?

The Drug Addiction debate at Westminster Hall on 22nd November 2017 (see here) confirms that politicians are talking about the issues we face, but talk is often cheap, especially if/when only limited action ever arises from it.

What can also impact upon outcomes is when politicians apply their own perceptions and views to the debate, sometimes with stark disregard for ‘evidence’ and known fact.

Pleasingly, two Members raised drugs issues at Prime Minister’s questions today. They probably sought to steer us towards their views about liberalisation and legalisation, which I must say are somewhat the opposite of mine. (Craig Mackinlay MP)

Despite the (mostly undisputed) fact that, the so-called War On Drugs was and is still a monumental fail, too many politicians still perpetuate a mistaken belief i.e. we can ‘combat’ the impacts drugs and addictions by legislation, mostly in isolation from any other intervention or action.

It is right that we continue to fight the war against drugs… the incredible damage [drugs] can do to families and the individuals concerned – Theresa May (PMQs 22nd Nov 2017)

What? Despite of her own research indicating its failures? She went on to explain “I ​have a different opinion from my hon. Friend on drugs” which despite being entitled to an ‘opinion’ that doesn’t turn opinion into fact. But to suggest here opinion may dovetail with those of all “those dealing with people affected by drugs” is wrong, oh so wrong!

In addition, as pharmacists warn us that Govt cuts ‘will leave needles in the streets’ and, £43m is slashed from addiction budgets, any right-minded person with a modicum of social interest would have to ask; where are we heading with these problems, politically?

This issue cuts across many Departments. It is not just a health issue; it cuts across policing, justice and home affairs, health, border matters and education, and it is even an issue for the Treasury. (Craig Mackinlay MP)

So, why would anyone with this apparent understanding, choose to resort to failed opinion based upon punitive rather than supportive and restorative methodologies?

It doesn’t make any sense (to me) that supposedly educated people can continually formulate their opinions around (mostly) discredited and disproved (old) evidence. It smacks of the old ideology which says; that’s the way we’ve always done it, so why change now?

Delivery of any real change comes from an acceptance which says; you won’t achieve new outcomes by maintaining old habits. Any ex-drug user in recovery is capable of teaching us that.

There are myriad health, crime and social impacts of substance misuse but they are also still inadequately addressed, continually blaming the ‘addict’ will do little to change that fact. Now, rather than later IS the time for some new thinking.

Many of the known problems here also fall out of the mistaken belief, that substance misuse disorders are mostly self-inflicted… a matter of life-choice. Wrong. Many of those ‘choices’ if/when they actually exist, are also dictated by the society in which we live. Which in turn, is developed from from the politicians who too often mismanage it and us, out of self-interest.

OK, managing anything (correctly), let alone a country and it’s population, requires the appropriate application of balance. In all decision-making there has to be considerations around both sides of a debate however; how any government can condone, let alone justify, the 16% reduction in drugs and alcohol treatment over the last four years, still defeats me. Especially when you consider the correlation that; for every £1 of investment in addictions services there is a £2.50 saving for the public purse.

It’s a sad fact but, a significant proportion of all the negative factors surrounding addictions are (probably) attributable to politicians and their policies, at least in some respect. In short, of their own bloody making or at the very least, resulting from the actions and inactions of their predecessors. I subscribe to the views and feelings of many of my colleagues working within the addictions treatment and support sector; describing them as “incandescent” would hardly start to cover it.

Given my propensity for having a pop at our political establishment, many might see my next comment as being, at the very least a tad naive however; the 2017 Drug Strategy (.pdf download) will go some way towards providing improved professional direction. And hopefully, start to deliver increased positive outcomes.

That has to be something that we should all aspire to, despite stringent and constant (mostly) unwarranted political interference. Success will, thanks to government induced austere constraints, require much head scratching for some new ideas. Thankfully, most working within the addictions sector are providing the ‘action’ we need, as opposed to more self-important hot air.

They also display greater empathy around the plight of those they support, more than any politician, despite any contrived or well rehearsed crocodile tears. The politicians are mostly the people hanging service users out to dry, in what for so many is a social cesspool.

Politicians, at national and local levels, have consistently created financial constraints impacting upon the services which create (evidenced) positive outcomes. Again ludicrous!

Returning to the original debate (above), Mackinlay was right in his assumption; the UK does ‘catch a cold’ if the USA sneezes, a factor that is far too relevant in many circumstances.

The analogy may have come from the finance sector, been used in the drugs debate but also, expands into many areas of this debate, not just the horrendous, prevalent and worrying outcomes we are currently witnessing. But also, the actions and inactions we adopt to mitigate against the issues.

In simplistic terms; our society (and its leadership) appear happy to continually roll out (mostly) punitive measures on service users who hold the inherent  belief which says – “if I feel shit, there’s a drug that can make me feel better” – an unseen consequence of (mostly American) ‘Big Pharma‘ methods and their marketing strategies.

It may, in part, all be part of some monumental conspiracy theory however; when you start following the cash-cow money trails, you can start to spot some connections here. Money is and always has been a powerful driver of most things, either the lack of it or how to make lots of it, unfortunately it’s a prominent factor here.

The debate continued and highlighted the fact “our drugs policy in this country is failing”  – a correct assumption, in many respects.

It rambled on with phrases including; “we have invested” and “we continue to invest” topped off with the defeatist conclusions to suggest “there’s no money left” bollocks, there is always money, it just depends whether or not we are prepared to spend it, and on what. Once again a balancing of priorities and it would appear, addictions services just aren’t ‘sexy’ enough to attract political interest.

I have to agree with Norman Lamb, (LibDem Spokesperson on Health) who said;  “…the most depressing thing said in the Chamber today was the Prime Minister’s reaffirmation of the commitment to the war on the drugs” – again, we are missing out on opportunities by maintaining this worn out political rhetoric.

Irrespective of their political hue, too many politicians are still happy to sit behind the old Blair phrase; “I’m tough on crime and on the causes of crime“, but was Tony Blair really so tough?

If so, what did that toughness really achieve? It’s all part of their [politicians] competitive nature, something inherent within the self-interest quest for earning public popularity races.

I know of people who would cheerfully wring his neck for much of the domestic crap he left behind him. And all that before you even start to consider his resounding and well-known international failures. Some of which (allegedly) bordered on war crimes, according to numerous political commentators.

Yes, crime has become a prominent issue within politics, especially around the subject of drugs. But again, this could easily be attributed to the folly of following that ‘sneeze & cold’ analogy.

That said, even the American timeline of crime policy around drugs has (rightly) experienced peaks and troughs (see here). The old ‘Tough on crime’ rhetoric can (arguably) also be seen as the root cause of our current prisons crisis (see here). As Polly Toynbee recently suggested; “It’s time for justice to be rational” fair and restorative, not just punitive. There is only so much of our social imbalance and injustice, that we can hide behind the doors of prisons.

Continually incarcerating already marginalised ‘victims’ of our social disparity does little to achieve much. Save for providing a little smug warmth for the politicians celebrating their job well done. Mitigation against the inherent lack of humanity in today’s society, will always require so much more.

The “throw away the key” sociopolitical strategy is long past its sell-by date. All it does is help to overburden the already straining seams of a close to bursting penal system. A system that despite all its best efforts, is continually striving to provide ‘criminal’ rehabilitation and addictions recovery support. Always assuming enough of that (required) capability ever truly existed at the outset.

The continued tightening of the isobars, in a perfect storm already brewing, only serves to increase the likelihood of another deluge of negative impacts. For a service already in crisis!

But again, as Peter Clarke, (HM chief inspector of prisons) recently published in his annual report; prisons “get scant attention in the media and still less in parliament” (see here) – until something goes tragically wrong – again it ain’t a ‘sexy’ topic!

But even with media attention – “England’s prisons are war zones. Unless austerity ends, things will get worse” (see here) and “Violence and self-harm in UK prisons continue to surge” (see here) our government responds with some “graduates trying to solve the prison crisis” (see here).

Many in the know would also suggest that prisons are in crisis as a direct result of ‘perverse’ government overhaul (see here) and interference. So is it really any wonder that violence in our prisons has hit a record high (see here)?

As with the past police [political] overhaul before it, the application of a little academia really isn’t the panacea for all corporate and social ills. But sadly, it remains a belief that too many politicians still too often fall foul of.

I have to concede to the fact; at just over halfway through [the debate], I lost my original desire to dissect the content and unravel all the hot air, in my desire to get to the facts and viewpoints. As with so many political discussions, it’s very easy to lose your will to live, trudging through the mire of self-important rhetoric and diatribe takes its toll.

So what happens now? Where is addiction recovery service provision going? How will support for one of the most vulnerable and needy demographics in our society pan out in the future?

Providers have already been micro-managed and subjected to almost constant time and productivity examinations. They have expended often undervalued time, effort and cash, reporting on their activities.

Data has been fed into the National Drug Treatment Monitoring System (NDTMS). Bureaucrats within Public Health England (PHE), who hold responsibility for monitoring the nation’s drug treatment system, have measured performance against local and national targets.

The academics have completed their observational, empirical, theoretical, conjectural, hypothetical and anecdotal reviews of the piles and piles of spreadsheets, containing statistics from thousands of treatment outcome profiles.

Their educated response has been returned to the bureaucrats, allowing some more cooking of the books adjustments of reports to feed into policy and strategy.

The VIPs in political circles, after claiming large possibly liquid lunch expenses, have had their best bib and tucker dry-cleaned (don’t forget the receipt), before gathering under the crumbling edifices of our democratic hub. And now the opportunity to puff up their chests and spout their ‘informed’ oratory, but mostly based around self-serving popularist hot-air. Note: It’s amazing how such an important subject, with so many social impacts, can be bottomed out in a 90 minutes debate.

But don’t forget, now we have a strategy, whoop de do! The document was actually published back in July 2017 but hey, I can accept “new” in political parlance… so what now?

Well, the politicians have shuffled off to the Palace of Westminster watering holes, will have consumed a colossal sycophantic lunch and exchanged platitudes of mutual adulation, before retiring to the back benches for a well-earned celebratory snooze.

Meanwhile, the Whitehall civil servants and PHE bureaucrats raced back to their offices, preparing to develop a string of new ideas to shaft the system. – If you had that capability of perpetuating additional work to keep you in a job, wouldn’t you do the same? Even more so if it can be seen as new evidence to support the probability of a departmental promotion!

Finally, the caring, empathic and mostly professional staff and volunteers of our struggling public and third sector addiction service provision battle on regardless. They continue striving to deliver the much-needed, mostly successful qualitative outcomes for vulnerable and marginalised in our society.

Only this time, they’re now obliged to do ‘more with less’ …that old chestnut again, oh yes, and don’t forget the extra work to support the new targets requiring of extra data input. A good deal of head scratching looking for “new and initiative ideas” that can “deliver outside the box” results is definitely on the cards!

Can’t help but think it would be so much easier if all this background time, effort and cash was spent at the front end of the issues?

No doubt I’d be told (by bureaucrats and politicians)… “What, that’s just far too simplistic for such a complicated problem requiring robust strategic management!”

Towards the concluding submissions in the debate I saw; “It remains essential for us to offer those with a drug dependency the optimal chance of recovery” – yea …something I can finally and wholeheartedly agree with, and without feeling any need to examine the sentiment or roots of the assumption!

How we will manage to do that is a whole different ball game, one that mustn’t be kicked into the long grass or lost. Looked upon as game to be played on another day!

How the likes of Robert Peston and Tom Bradby before him, continually sift through this comma inducing, often self-serving shite on a daily basis I’ll never know. It makes Peston’s recent ‘WTF‘ political observation even more succinctly appropriate. Perhaps he [Peston] could give me/us a few pointers about how do we fix this mess or even explain who runs Britain but I think I know that one.

Note to self: “more bedtime reading required” but, despite warming to some views expressed by Owen Jones in the past (insidious annoying little twerp). I’m probably best avoiding his form of political activism, at least for today… Now where did I put my soothing Billy Bragg CD?