Hidden army of addicts is ignored

OUTBREAKS OF heroin use are spreading rapidly across Britain. We have clusters of new, often very young, users in areas with no heroin history, few services and, vitally, no expertise in managing the dire consequences.

From where I stand, undertaking frontline research into drug problems, official responses seem slow. We already know where the outbreaks are, and we know broadly the profiles of the new users.

We know they are relatively naive about heroin's initially subtle addictiveness. We are seeing, through the rapidly rising death rate, that varying purity levels and toxic drug cocktails are catching them out. The classic transfer from smoking to injecting is under way. We are realising teenage users are trying to come off but lack the useful know-how.

Yet aside from an insightful anti-heroin television campaign in Scotland there is nothing really happening to reduce the damage to health. The Government is dedicating more than pounds 200m of extra resources in the next three years to expand treatment, mostly to provide treatment and testing orders within the criminal justice system.

This is a double-edged sword. It will almost certainly reduce drug-related crime in this population but will also strip an already shaky treatment industry of spare capacity. The biggest deficit will be in appropriate treatment for a largely hidden group, aged 14 to 30, of users of heroin and other drugs in the community.

With waiting lists of six months even before this enormous burden, it is difficult to see how we will be able to develop programmes geared to waves of younger users, given the enormous skills required.

The real danger is that we will abandon attempts to challenge dependency and so get young people "clean" in favour of dispensing methadone not as a detoxification/stabilising tool in a structured programme but as a long-term chemical cosh to subdue another generation of socially excluded youth.

All these problems are beginning to be discussed in government but they will take several years to resolve.

After a decade of relative neglect under the Tories the UK (Anti) Drugs Strategy is undergoing a post-election overhaul. There are three elements: a new co-ordination structure with the appointment of a drugs tsar and deputy, a new 10-year plan and the extra resources.

To implement government strategy locally we have more than 100 drug action teams, with co-ordinators, chairs, representatives and advisers, but no one to provide strategic leadership or even kick ass. And we do not have the safeguards of external scrutiny and independent inspection.

This is a handicap for a new strategy that has many strengths. But it inherits a decade of under-investment and just as it is "running in" we see a serious deterioration in problematic heroin use. It is difficult to see how it can deliver all that is promised.

We cannot be sure how far this heroin cycle will penetrate but we can be sure it will run for several years, with all the unwanted social consequences. That we still have a drugs interventions industry which is insufficiently professional and lacks resources to contain this outbreak is something we must live with for now.

The challenge for this sector and its political masters in hiding, who have devolved responsibility to the drugs tsars, is to ensure its weaknesses do not remain hidden in corporate rhetoric. There are a lot of young heroin users out there who are messing up big style. We have not protected them from heroin availability, we have not given them the drug wisdom to protect themselves. Failure to have decent services in place as they present themselves over the next few years would be unforgivable.

Professor Howard Parker is Director of SPARC, a drugs research centre at Manchester University, and has carried out research on heroin for the Home Office.

Leading article,

Review, page 3