Cameron: Government Shouldn't Give Drugs to Drug Addicts

David Cameron whipped out some old-school common sense today when he gave his first speech to the Tory party conference since becoming prime minister this summer. Maybe, he suggested, taxpayers shouldn't be paying for drug treatments that don't really work, especially when they involve the government dispensing even more addictive drugs.

U.K. taxpayers currently pay for methadone for over 150,000 recovering heroin addicts. Britain's National Health Service runs a National Treatment Agency for Substance Abuse that spends over $1 billion on drug treatment each year—with the result that in 2009, only 15,000 of the 160,000 addicts treated by the agency were able to kick their addictions (insomuch as you can totally kick a heroin addiction, of course). 

Cameron has had enough and today he opened a discussion on the phasing-out of government methadone clinics as part of a larger reform effort for the British justice system:

We also have to recognise where the state is failing on crime. We spend £41,000 a year on each prisoner—and within a year of leaving, half of them reoffend.

There are 150,000 people in Britain today who get their heroin substitutes on the state, their addictions maintained by the taxpayer.

We have police officers who spend more time on paperwork than they do on patrol. It's here that reform is needed most.

So let's get our best charities to help rehabilitate offenders, our best social enterprises to get people off drugs.

But methadone reform is more complicated than mere cost-cutting: In the U.S., as in Britain, methadone distribution has become an entitlement for certain segments of the population. And we all know how difficult getting rid of those can be.

Last year, Jacob Sullum argued that if we're going to give addicts drugs, we might as well give them actual heroin.

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  • ||

    Why not sell heroin to addicts?
    Step 1 - Identify addicts.
    Step 2 - Register them.
    Step 3 - Profit!

    I know private enterprise would create a more efficient narcotic delivery system than the feds. Still this proposal which keeps the state involved in that which is none of their business could be sold to the public easier.

    We could even use the time tested lie that profits would go to the schools.

    Heroin! It's for the children

  • Old Mexican||

    Re: J sub D,

    I know private enterprise would create a more efficient narcotic delivery system than the feds.

    As for everything else.

  • ||

    but GIVEN prohibition, the delivery system is necessarily going to be much less efficient than it would be in a legal market. in the case where govt. has the monopoly on LEGAL narcotics, they are going to have a more efficient delivery system.

    for example, legal cocaine (which is used in solution form during nasal surgery) is pretty damn cheap through legal channels. so is generic oxycodone, fentanyl, and other analgesic opioids. cheaper than the black market equivalents.

  • BakedPenguin||

    I know private enterprise would create a more efficient narcotic delivery system than the feds.

    And Bayer's patent on heroin has run out, so it could be manufactured as a generic. They might still own the trademarked name, however, so it would have to be diacetylmorphine for the children.

  • cynical||

    I don't see how they can own the trademark, when they haven't used or defended it in so long. It's generic now.

  • ||

    We could even use the time tested lie that profits would go to the schools.

    Well, sure it goes into the general fund but teachers get paid out of that! Why, oh why, do you hate the noble, if exceptionally under-performing, public school teachers? It's the heroin, isn't it?

  • ||

    You jest I'm sure. Some of the less astute people in Michigan still believe that lottery money goes to the schools. That the legislature, when they write the budget, don't factor in the lottery cash when making approiations for public education.

    Sigh. I live on a planet filled with idiots.

  • ||

    It's too bad the limeys don't have an up-and-running supply line to someplace which could supply them with cheap, high quality heroin.....

  • East India Company||

    Bloody right.

  • Ben Bernanke et al.||

    In the U.S., as in Britain, methadone distribution has become an entitlement for certain segments of the population.

    Cold turkey has got me on the run.

  • Mike||

    I'm a heroin/cocaine addict of 15 years. I got off of it. I've been clean for 2 years now. How I did it was with Suboxone. They should be giving these people Suboxone and mental treatment to go with it. Then eventually (within a year or two) taper them down and rehabilitate them!
    Pressing The Issue

  • BakedPenguin||

    insomuch as you can totally kick a heroin addiction, of course...

    Huh? You can quit a heroin addiction. It happens when addicts stop doing heroin. Armin, you might want to speak with Jacob Sullum (or someone else who hasn't bought into drug war propaganda) before writing drug columns.

    FWIW, cigarettes are considered (by some) as more addictive than heroin. I am a former nicotine addict. I haven't smoked in 15 years. How'd I do it? I stopped putting cigarettes in my mouth and lighting them.

  • ||

    fwiw, not only can you stop a heroin addiction, but UNLIKE alcohol addiction it may FEEL like you are going to die, but people almost never DO die from heroin withdrawal (contrast with alcohol. fwiw, i have never heard of a single case of somebody dying, i just just "almost never" because i am not omniscient)...

    generally speaking, it takes about 2-3 days to break the physical addiction. granted, they will be a very long 2-3 days.

  • BakedPenguin||

    The Empress of China was a morphine addict. She died during morphine withdrawal, but only because she wasn't given water, as opiate withdrawal causes diarrhea. The other potential risk is high blood pressure, which increases somewhat during withdrawal, but can be controlled with medication.

    Alcohol and benzodiazepam withdrawal can be, as you correctly stated, very dangerous.

    A person I know sees withdrawal on a regular basis. He says that the junkies are no problem. They lie in bed (when not on the toilet) and don't want to be bothered. The alcohol withdrawals go insane. Furthermore, they have about a 30% chance of dying, unless they are given large amounts of benzodiazepams.

  • ||

    A guy i work with had a very nasty lod shooting and had many months on relatively high dose opioids. opioid withdrawal is opioid withdrawal, although obviously dose and duration dependant (as well as mode of administration, to some extent). he said it SUCKED e.g. some nausea, etc.

    i had about 4 months of that stuff after surgery (oxycodone instant release, oxycodone continuous release (oxycontin), etc.).

    withdrawal was not particularly fun. i can imagine for a hardcore addict it would be geometrically worse. my surgeon had me on a simple taper regimen and it worked pretty well. i'm used to physical discomfort of a similar sort since i have to frequently make weight for sports competitions - so, nausea, restlessness, aching, etc. are not unfamiliar.

  • IceTrey||

    I'd opt for the quick method. They knock you out and pump you full of Narcan. When you wake up 24 hours later the physical symptoms are over.

  • johnl||

    Why should it cost a lot of money to supply people with methadone?

  • Alan Kellogg||

    The actual methadone doesn't cost so much, what brings up the price is the cost of administering the program; the cost of the paperwork and the people who fill out the paperwork and perform other administrative work.

  • ||

    right. like for example, they have to personally dispense the methadone to each person AND the person has to consume the methadone on premises in front of them. at least that's how it works in the methadone clinic i saw.

  • Hacha Cha||

    If you aren't going to legalize drugs and end government health care and entitlements, then you might as well keep them on methadone, its cheaper over a lifetime than keeping them in the courts and in jail.

  • ||

    A few decades back, the UK government /did/ dispense actual heroin to addicts. It swapped to methadone. Why? Why not swap back?

  • Brett L||

    Why not make them pay for their own fucking highs?

  • Mike||

    I'm a heroin/cocaine addict of 15 years. I got off of it. I've been clean for 2 years now. How I did it was with Suboxone. They should be giving these people Suboxone and mental treatment to go with it. Then eventually (within a year or two) taper them down and rehabilitate them!
    Pressing The Issue

  • Hacha Cha||

    Suboxone doesn't work for everyone. I can't stand the shit.

  • ||

    Breaking the PHYSICAL addiction is nothing--addicts do it all the time, by force, by inavailability of the drug, or by choice. The problem is, they cannot STAY clean. This is often due to permanent changes in the brain chemistry that occur in long term opioid users--changes that involve the brain's ability to produce natural opiates (endorphins).

    When endorphins are not produced the patient suffers from severe depression, inability to feel pleasure, irritability, anxiety, physical exhaustion. THIS is what leads to repeated relapses as the desperate patient attempts to self medicate this ongoing misery.

    In many cases, this impairment is NOT reversible--no amount of abstinence will cure it. Counseling and therapy cannot cure it. It must be addressed medically, just as most other diseases of the brain chemistry (schizophrenia, depression, bipolar, etc).

    Methadone serves to normalize the brain chemistry without causing a high or euphoria, in the same way that a diabetic requires insulin because the pancreas is no longer making it. Most MMT patients will require long term replacement therapy, so a goal of complete abstinence from methadone is unrealistic.

    As for Suboxone--it is intended primarily for those with light habits of short duration. Due to it's ceiling effect, it is not usually strong enough to control the symptoms of heavy users--the two medications are not interchangeable. And even those for whom it does work often need long term therapy as well.

    If we haven't learned by now that just detoxing someone does not solve their addiction problem, that is a sad sad thing.

    Lastly, the primary reason the UK has so many MMT patients who continue to use opiates is that they grossly underdose patients. The average needed dose is 80-120 mgs, but the UK avg dose is 30-40 mgs---less than half the usual minimum required dose.

    Doses of over 80 mgs block the effects of other opiates--therefore, addicts on a blocking dose would have no incentive to use opiates as they would feel nothing at all from them. Yet, this minimum dose is almost never reached in the UK. Is it any surprise then that patients who are being thrown into withdrawals each evening as their inadequate dose wears off would try to stave off the misery by continuing to use?

    If we give a 300 pound man with an infection a dose of antibiotic meant for an infant, and he does not get well, do we blame the drug? Or do we blame the inadequate dose?

    Given correctly, MMT is the most effective treatment available for opioid addiction, by FAR. Here in the USA where almost everyone is shipped off to residential rehab at the first sign of trouble, the success rate of abstinence based rehabs in treating opioid addiction is ABYSMAL. WHy not learn from this example? MMT was not created because abstinence treatment was working well, you know.

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