Heroin Assisted Treatment – Labour Party's opportunity to create a realistic drugs strategy

Imagine if your friend was trapped in a vicious cycle of desperation and inner conflict. Would you severely punish him and give him medicine that doesn’t work and at worst, could kill him? I would imagine the answer is no. Yet, this is what we are doing right now to around 25 thousand people addicted to heroin in the UK.

I should know. Because I grew up in Tower Hamlets in the nineties where I saw many friends became addicted to heroin and how it shredded families apart.

The worst part of this is that the government response to addiction actively maintained and worsened the situation. Police raided homes, psychologically traumatising whole families by the ordeal, putting misusers[1] in prison to punish them out of the addiction.

And what happened when they came out? They took heroin inside prison, coming out with mental illnesses that if they didn’t exist before, helped to worsen it. Upon coming out, they continued to take heroin, often taking more to cope with the trauma of being arrested and being in prison and the continued fear of being caught again. Just stop taking it then! I hear you say? Well, it’s not called addiction for no reason.

Methadone, the usual treatment didn’t work for everyone and I still know many who take heroin. In fact, around ten percent of 265,000 heroin users in England are resistant to methadone, and are responsible for the vast majority of drug-related criminal behavior.[2]

Yet we know that Heroin Assisted Treatment (HAT), in other words, giving diamorphine (pure and clean heroin), has been legal in the UK since 1926. An overwhelming body of evidence have shown that it has caused ‘a major reduction in the extent of street heroin use, improvements in general health, psychological well being and social functioning as well as major disengagement from criminal activities across all trials.[3] In fact, HAT is now legal in many European countries including the Netherlands, Germany, Switzerland and Denmark.

But you wouldn’t know HAT even existed as this treatment is shrouded in secrecy from the public. So why aren’t we using HAT to treat those dependent on heroin?

The first argument

The most popular argument given including by my friends who I have spoken to is that taking heroin is a criminal offence. Yet, we know that the vast majority of prisoners keep reoffending as they come out, so why do we keep repeating the same strategy hoping things will be different this time?

Secondly, if heroin addiction is a criminal problem because it is a dangerous and addictive drug then why not make alcohol addiction or a tobacco addiction a criminal offense? It’s well known that both those drugs have harmed millions of people around the world. The fact is heroin addiction is a health, not a criminal issue.

 The second argument

We will encourage more people to take heroin. It should be made clear that HAT would be made available only to the most difficult cases and it should be twinned with a robust prevention strategy. In fact, evidence shows that HAT is the prevention strategy. HAT used in Switzerland cut out the illegal heroin trade by 30% as misusers received diamorphine for free.[4] This practically means that those who look to buy heroin would find it harder to find dealers who they could buy off heroin. So if anything, HAT is probably the best prevention strategy there is.

The third argument

It’s just too expensive. Yet we pay the government to keep one person in prison for 44k a year.

I know of a family whose son, who had a wife and daughter, went into prison for four years for taking heroin. He took heroin in prison, became seriously mentally ill, came out and went straight back into it, selling it to fund his habit. That was 176k to keep him in prison with no change in outcome, and if anything, it damaged his daughter’s childhood and his family suffered financial hardship as they spent hundreds of pounds per trip to visit him in prison in the Midlands, where he was sent.

We know that HAT costs around 15k a year. With 176k, we could have funded him to take HAT for 11.7 years instead. This would mean his daughter would have 11.7 years with a father with a better mental health, a father who is around for her instead of being abandoned because he is in prison or outside dealing so he can maintain his habit. For the community, that is 11.7 years of an absence of a drug dealer on the streets, getting more people addicted in the community to fund his habit, spreading the problem further. That is 11.7 years with a high likelihood of a change in outcome for everyone.

But so far, the political establishment has taken the cowardly choice to continue its regressive response in fear of the cultural conservatism in the UK. So my community must bear our crosses, silently suffering because of the stigma created by this passive choice. But we in the Fabian Society and the Labour Party can change this. We can change our Victorian attitude and stop this cycle of destruction.


[1] The term misusers is used in this article throughout to describe those addicted to drugs, as the drugs field regards the term ‘addiction’ as inappropriate.


By Young Fabian Member, Nadia Mira Islam.

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