ReageraMera

No problem is so large that drugs will not make them larger!

In European terms, Sweden has been relatively successful in containing the abuse of illicit drugs. It was in fact in Sweden that the European drug epidemic first emerged after World War II and then spread to neighbouring countries.

In the period 1965-67 Sweden carried out an abortive experiment in legally prescribing drugs. This experiment proved a failure and in fact served only to fan the flames. Our organization, RNS (The Swedish National Association for a Drug-free Society), was founded in 1969 as a reaction against the highly permissive national drugs policy at the time. Our efforts to bring about a restrictive drug policy towards illicit drugs met with heavy resistance from large parts of the Swedish establishment and media. However, our message gradually started to make itself heard among the public at large and eventually met with a highly positive response. The late 1970s and early 1980s in Sweden were a period of fierce debate and intense internal opposition. However, we succeeded in persuading the policy makers that it was vital to tackle access to illicit drugs methodically, first and foremost by reducing exposure at the individual level.

In 1980 we were successful in getting the Prosecutor General to direct all the country's public prosecutors to pursue all possession of illicit drugs, irrespective of amount. In 1988 we were also instrumental in persuading the Swedish Parliament to declare the consumption of illicit drugs illegal. These are two of the most important decisions underpinning Sweden's drug policy today.

A study published by UNODC in 2006 found that Sweden, more than other countries, recognized the importance of placing the individual at the centre of the efforts to combat the abuse of drugs, because it is the consumer who is the only irreplaceable link in the entire drugs chain.

The main driving force behind this policy was the late professor of social medicine, Nils Bejerot. He was also the founder of RNS which I have had the privilege of representing for almost 40 years. Not only did Bejerot maintain that demand was the most decisive factor in the emergence of a drugs market but he also understood the importance of harnessing borad popular support for a restrictive national drugs strategy.

Nils Bejerot liked to quote the old beatnik and connoisseur of illegal substances, William Burroughs, who in his novel Naked Lunch compared the drugs market with a pyramid of numbers, I quote:

"If we wish to alter or annihilate a pyramid of numbers in a serial relation, you alter or remove the bottom number. If we wish to annihilate the junk pyramid, we must start with the bottom of the pyramid: the addict in the street, and stop tilting quixotically for the ‘higher ups' so called, all of whom are immediately replaceable. The addict in the street, who must have his junk to live is the one irreplaceable factor in the junk equation. When there are no more addicts to buy junk, there will be no junk traffic.

We at RNS maintain that it is drug consumption that is the root of the problem. Virtually all the spread of drug abuse occurs via those who are already addicted; distribution is almost entirely in the hands of the addicts themselves. The most important reason for the superiority of the demand strategy is that it is the only one that has proved effective. All other strategies have, without exception, failed.

In spite of our relative success in Sweden, the question of what constitutes a genuinely restrictive policy has remained a controversial issue. Without boring you with all the ins and outs of the Swedish drug debate, I would like to address three misunderstandings which are important because they stand in the way of a realistic view of the drug epidemic and the kind of measures that must be taken.

Firstly, the view that only people with psychosocial problems choose or are chosen by drugs. WRONG. This assertion ignores that fact that the longer a drug epidemic - or more correctly an epidemic of addicts - is allowed to spread, the less experimenting with drugs becomes a breach of norms and less individual susceptibility plays a part in being drawn into it.

Secondly, the belief that addicts generally want treatment. WRONG. What is true is that the majority of addicts now and then want care on their own terms. In other words, they want relief from the complications which accompany addiction and their lifestyle without necessarily being willing to sacrifice the high which the drug experience gives them. It is not until the habit becomes difficult and risky - what the literature calls ‘care motivation' - kicks in. Please note that we are not advocating harder measures and longer sentences. We do, on the other hand, call for early discovery and early intervention.

A third misunderstanding is that the drugs problem can only be vanquished by effectively fighting organizing of crime. WRONG. Criminal gangs and drug syndicates are actually belated consequences of a constantly growing demand on the part of an enthusiastic market driven by the psychosocial contagion of addiction at the individual level. This means that every gang that is busted today and every drugs baron who is put beind bars will be replaced by a new, better organized one as long as it remains so enormously profitable to supply the demand for illicit drugs.

Having worked with the care for addicts and at the heavy end of correctional care for most of my professional life, I am the last person to reject the necessity of proving treatment as long as it is based on scientific evidence and proven practice. I am, between you and me, a true supporter of the ‘twelve-step culture', which I see as one of the most important rehabilitation factors.

But solving the drugs problem is not chiefly an issue of care resources but rather one of strategy. Regardless of how important the therapies offered by the care services may be - not least in humanitarian terms - treatment will never be anything else but a defensive strategy. Neither does it have any appreciable effect on the drugs epidemic because virtually the entire spread of drug abuse, from established addict to novice, has taken place long before the addict possibly comes to the conclusion that he or she needs help.

Here we should bear in mind that addiction in its early stages is often a ‘fun state' to be in, characterized by denial. At this stage the addict romanticizes the kick that the drug experience gives him or her and often wants to share it with others. We should also remember that the vast majority of illicit drugs users today are what I would call hobby consumers with jobs, family and a reputation to safeguard. This group of socially established customers forms the economic backbone of the drugs market, yet they do not regard themselves as junkies or abusers.

Rather than trying to restrict the addict epidemic by means of a consistently strict drugs strategy, we are in fact investing ever more resources in the treatment of those who are already hooked. An old English rule of thumb in social medicine says, very aptly, that "a pennyworth of prevention is worth more than a pound of treatment." Yet these days we have an individual-centred approach to therapy which has increasingly lost sight of the crucial role of general prevention. Proponents of a liberal drugs policy are found today not only among the users of drugs; a whole culture of helpers and people caring, for example, has emerged whose entire professional life and energy is devoted to dealing with the end of the problem, turning their back to early prevention. Many have also embraced the social determination that flourishes among the guilt-ridden middle classes and which narrowly insists that drug-taking and crime can be exclusively attributed to outsidership and marginalization.

In short. A country's drug policy in its entirety is of fundamental importance for both treatment and prevention. A drugs strategy must be proactive, not merely reactive. This is of utmost importance for the success of both treatment and prevention.

Once a culture of drug abuse has been created, a liberal and permissive drugs policy will emerge among illegal drug users, which in turn will give rise to the need for extra police powers and greater investment in a care apparatus which often sees its clients as helpless, irresponsible victims. George Vaillant, a professor at Harvard and a giant in the field of alcohol research, was one of the first to warn about this ‘professional permissiveness* which he saw as a serious threat vis a vis the weak or lacking impulse control which is so characteristic of drug addicts.

The increasingly medically focused treatment philosophy which is gaining ground and which concentrates on individuals who are already heavily addicted, legitimizes the demotion and undermines policies which focus on prevention. That adds numerous new drugs to already existing problems and create confusion among the public and professionals alike. This medicalisation chooses to see the drugs problem first and foremost as an issue for medical specialists. By exaggerating the success potential of this philosophy, the implementation of primary and secondary preventive measures, which would be more effective, is delayed. Treatments are generally preferred for reasons of ideology or convenience because they give the appearance of being effective and also help to persuade the anti-drugs sections of public opinion that strong measure are being taken.

An effective drugs policy must combine a whole range of measures coordinated within the framework of a strategic plan. To be credible, this plan must place the norm-breaking and responsibility of the individual at its centre. It must also recognize that it is the possession and consumption of drugs by individuals, rather than international syndicates or growers in distant parts of the world, that forms the economic foundation for the expansion of the market.

History teaches us that when a devastating problem threatens or attacks society and its children, people will come together and protect them. The bad and evil can get some but never all the power. With so many dedicated people here today, there is hope. Organised knowledge is power and hope!

Together we stand, divided we fall.