It's been more than a year since I have felt like re-examining my travels through the world of blood cancer and I make no apologies to you dear reader for this, it's hard indeed at times overpowering.
Let me take you back to October 2015 I was awaiting my result of the second CT Scan of my pancreas. The result was in there was some scarring to the pancreas but it was healing and that it should resolve itself given time. It did the pain subsided and I was soon back on the transplant express. I had a meeting with my consultant and complained of severe headaches when I bent over, he said to me in a conspiratorial way ' look you've already missed one transplant date, for you the window is closing you need to go now or your chance will be gone' I forgot instantly about those headaches and have never had one since. I call it the 'transplant express' because you agree to the procedure then it takes off like an express train and there is no getting off. Date confirmed for 7th November 2015, admitted week before and administered increasingly stronger types of chemo and other fiendishly human unfriendly drugs to wipe out my immune system. Imagine my joy when my hair began to fall out in lumps, I felt like a real cancer patient then. I had the badge of honour that I had failed to achieve with my earlier chemo bombardments. The Anthony Nolan Organisation had found me the near perfect match, a 25 year old young man from England. I was ready, the donors cells arrived and from a small bag of pinkish fluid my only chance at life was dripped slowly into my blood stream via the Hickman line in my chest. Maria was the name of the Nurse who sat with me, my wife and daughter who was extremely emotional and cried through the twenty minutes or so it took for the stem cells to drip into my body. I received a birthday card from Anthony Nolan to celebrate my transplant date. That was it I felt rather deflated such a big build up, then it was over with no real fanfare or marching bands just a return to a waiting game to see how fast I could recover my 'counts' to see when I could get home. I expected a long stay in hospital however I was pleasantly surprised when three weeks later my consultant informed me I could go home.
Home for Christmas a dream come true I was still very weak, everyone in the family had to get the flu jab to keep me safe, avoiding busy public places for fear of infection, walks in Balloch Park with Lyn small distances, fresh winter air then back home, exhausted but rosy cheeked. Christmas spent with my children, wife and Sister and brother in law so enjoyable family time had never felt so sweet and precious. Even the crazy winter sweaters we all had to wear failed to diminish my enjoyment of just being there with them, my family.
I was still consuming large quantities of prescribed drugs, morning and night but slowly as the new year moved from Winter to Spring the drugs were slowly withdrawn and I recognised a long lost friend stirring inside of me...it was me, appearing from the shadows of the drug induced, toxin imposed stupor that had enveloped me. Spring became Summer, outings became more a normality, restaurants, cafe's, car trips, shopping and imbibing in a few real ales. Seeing my Daughter receive her LLB at Strathclyde University again reinforced how those pinkish cells had allowed me to be part of her memories and allowed me to feel so proud and honoured to have her as a Daughter. Travel by aircraft was out of the question so First Class rail travel become the norm. A trip to York was an enjoyable and memorable experience, we promised each other we would return again it was so good. My twice weekly visits to the clinic had been reduced to once every three weeks they were monitoring my chimerism in effect the donor cell and my cell balance, unfortunately mine were in the ascendency and his were falling. I therefore needed a 'Donor Lymphocyte Infusion' a top up from my donor which was arranged for the 14 June 2016. A quick visit to the Beatson and 10 minutes later the infusion was done. A brief warning from the Consultant that in about 5 weeks I might get some 'Graft Versus Host Disease' symptoms maybe a skin rash or upset stomach nothing to worry about though.
So of to the British F1 Grand Prix we went First Class travel picked up hire car, great weekend my god I had my life back, we had our life back, amazing, the darkness would finally leave us. Back home life was great, really great feeling more and more like myself doing things the couples do, even falling out.
Small rash appeared on my arm, called Beatson asked to come up next day, duly attended and saw Consultant who prescribed some steroid cream apply three times a day, sorted. Well not really... and for that dear reader you will have to wait for my next instalment.
Tuesday, 13 December 2016
Monday, 19 October 2015
...and the world stopped turning.
Well it's been a while and I really have no excuse for the past 4 years other than being wary of my employers professional standards types finding some obscure reason to find fault in my ramblings so I'll stick to that excuse meantime.
However I can be excused from the 14th May 2015 the day I received a telephone call from my Doctor who informed me without fanfare or due warning that I was suffering from leukaemia and that I was to attend at the Beatson Cancer Hospital the next day at 1000 to Ward B7 for immediate admission. The world stopped turning, the words fell from the page and all that was left was blankness. She assured that they were talking about a total cure and that all the signs were positive, early detection. age etc.etc. My wife and I duly attend the next day (Friday) met with my consultant who informed me that this was a completely random event there being nothing that I had done or didn't do to cause the disease which he confirmed as Adult Acute Lymphoblastic Leukaemia. Yes I'd be allowed home for the weekend as my blood counts were still normal and admitted on Monday to start me treatment regime. Yes they were working toward a total cure, age, early diagnoses, fitness, no underlying health issues all pointed toward a positive outcome. No you couldn't go on holiday, so the trip to New England with your sister and her husband in September would have to be cancelled. Yes you will be off work for a considerable amount of time here is a six month sick note for your employer.
I cannot now sit and go through the time I've spent in hospital and the effect the chemo has had on me and my body, suffice to say that within 5 weeks I was in remission and out of hospital, able to visit Perth and family. The out-patient cycle turned into an in-patient cycle, chemo side effects, then repeated lumber punctures led to hydromas being caused on my brain and severe headaches, sickness, nausea, more chemo, ever more chemo, blood tests, more blood tests, more chemo. A visit to the stem cell transplant team at the colloquially know 'Death Star' as the new Queen Elizabeth University Hospital is called or as folk call it still 'the Southern' as it in the South side of Glasgow, left us both in a state of shock. Being confronted with your own mortality is a very scary and mind altering event, well it was for me, we sat in the car in the car park for 45 mins afterwards wondering if any one ever survived transplants. Date set for the transplant, donor in place, near perfect match apart from the blood group so all good. Back in-patient, more chemo, then home, then pain like I have never felt in my life luckily just as I attended at the day hospital, a quick 10mg of morphine and back in Ward B7 for the weekend sorted the main pain out but still the effects shot through me. Varying diagnoses, it's your duodenum, its damage to stomach due to the retching, nothing to worry about, do you suffer from irritable bowel? All and any of the above it could have been. After a CT Scan it was revealed that it was indeed pancreatitis ( a known but rare side effect from one of the chemo drugs) and that it was now resolving itself. Unfortunately the transplant team decided that the risk was too great to proceed and my transplant would have to be delayed 2-4weeks. So back home, out-patient, slowly the pancreas did resolve, slowly... and after second CT Scan I now await the result and a consult with my Doctor as to where we are going next. Did I mention the dentist? No, well I'll keep that for the next post.
However I can be excused from the 14th May 2015 the day I received a telephone call from my Doctor who informed me without fanfare or due warning that I was suffering from leukaemia and that I was to attend at the Beatson Cancer Hospital the next day at 1000 to Ward B7 for immediate admission. The world stopped turning, the words fell from the page and all that was left was blankness. She assured that they were talking about a total cure and that all the signs were positive, early detection. age etc.etc. My wife and I duly attend the next day (Friday) met with my consultant who informed me that this was a completely random event there being nothing that I had done or didn't do to cause the disease which he confirmed as Adult Acute Lymphoblastic Leukaemia. Yes I'd be allowed home for the weekend as my blood counts were still normal and admitted on Monday to start me treatment regime. Yes they were working toward a total cure, age, early diagnoses, fitness, no underlying health issues all pointed toward a positive outcome. No you couldn't go on holiday, so the trip to New England with your sister and her husband in September would have to be cancelled. Yes you will be off work for a considerable amount of time here is a six month sick note for your employer.
I cannot now sit and go through the time I've spent in hospital and the effect the chemo has had on me and my body, suffice to say that within 5 weeks I was in remission and out of hospital, able to visit Perth and family. The out-patient cycle turned into an in-patient cycle, chemo side effects, then repeated lumber punctures led to hydromas being caused on my brain and severe headaches, sickness, nausea, more chemo, ever more chemo, blood tests, more blood tests, more chemo. A visit to the stem cell transplant team at the colloquially know 'Death Star' as the new Queen Elizabeth University Hospital is called or as folk call it still 'the Southern' as it in the South side of Glasgow, left us both in a state of shock. Being confronted with your own mortality is a very scary and mind altering event, well it was for me, we sat in the car in the car park for 45 mins afterwards wondering if any one ever survived transplants. Date set for the transplant, donor in place, near perfect match apart from the blood group so all good. Back in-patient, more chemo, then home, then pain like I have never felt in my life luckily just as I attended at the day hospital, a quick 10mg of morphine and back in Ward B7 for the weekend sorted the main pain out but still the effects shot through me. Varying diagnoses, it's your duodenum, its damage to stomach due to the retching, nothing to worry about, do you suffer from irritable bowel? All and any of the above it could have been. After a CT Scan it was revealed that it was indeed pancreatitis ( a known but rare side effect from one of the chemo drugs) and that it was now resolving itself. Unfortunately the transplant team decided that the risk was too great to proceed and my transplant would have to be delayed 2-4weeks. So back home, out-patient, slowly the pancreas did resolve, slowly... and after second CT Scan I now await the result and a consult with my Doctor as to where we are going next. Did I mention the dentist? No, well I'll keep that for the next post.
Saturday, 8 October 2011
LEGAL AND ILLEGAL DRUG USE AND CONTROL
INTRODUCTION
This essay will seek to evaluate the long-term effects that the legal and illegal use, classification and control of drugs has had on modern society. Using examples from both the local and global levels it will assess drug policies from the United Kingdom and United States whilst drawing on the work of criminological theorists, such as Blagg (2008a), whose work will be used to draw parallels between the incarceration of the indigenous Aboriginal population in Australasia and racialized patterns of incarceration in the USA and U.K. Citing Mooney (2008), it will seek to establish a causal link between the identification of problem populations, legal and illegal drug control and drawing from the works of Tonry (1995), Wacquant (2005), Smith & Hattery (2010) the mass incarceration policies being implemented by the United States and, drawing from Webster (2007) more recently the United Kingdom.
This essay will seek to evaluate the long-term effects that the legal and illegal use, classification and control of drugs has had on modern society. Using examples from both the local and global levels it will assess drug policies from the United Kingdom and United States whilst drawing on the work of criminological theorists, such as Blagg (2008a), whose work will be used to draw parallels between the incarceration of the indigenous Aboriginal population in Australasia and racialized patterns of incarceration in the USA and U.K. Citing Mooney (2008), it will seek to establish a causal link between the identification of problem populations, legal and illegal drug control and drawing from the works of Tonry (1995), Wacquant (2005), Smith & Hattery (2010) the mass incarceration policies being implemented by the United States and, drawing from Webster (2007) more recently the United Kingdom.
It will investigate how the controls imposed by those in power have led to many medical professionals being unable and/or unwilling to prescribe the relevant opioid pain control medication to their patients through over zealous legal controls or limitations on the quantities and types of drugs dispensed. Conversely however, the lack of strict regulation and control of the pharmaceutical companies has, it will be argued, engendered a system where abuse of power has led to the miss-selling drug products which has resulted in the deaths of thousands of customers. Whilst no company employees were found criminally liable the justice was seen to be administered through regulatory legal responses.
The essay will critically review the control of drugs, and will demonstrate how the policy responses and alternatives offered by leading medical practitioners, academics and policy research groups have been paid scant attention by criminal justice policy makers. To facilitate this critical review the essay will access and reference a number of literary sources. Drawing from the works of Jeffrey Reiman (2007) who directs our attention to the inbuilt failings of state controlled criminal justice with his ‘pyrrhic defeat’ theory, Lois Wacquant (2005) who exposes the racial bias in the American penal system, and Jane C. Ballantyne (2009), who identifies the conflicts implicit in the prescription of opiate medication by practitioners.
In policy terms the essay will draw on a number of resources from which the failure of the current drug control policies will be clearly evidenced; The Report of the RSA Commission on Illegal Drugs, Communities and Public Policy (2007) highlights a number of failings in the current drug policy, whilst The United Kingdom Drug Policy Commission - A Response to Drugs: Our Community, Your Say Consultation Paper (2007) questions the ‘zero tolerance’ approach of drug policy by highlighting the lack of evidence that street level enforcement activity works. An Analysis of UK Drug Policy A Monograph Prepared for the UK Drug Policy Commission (Reuter and Stevens 2007) exposes the clear lack of research study into the benefits or otherwise of drug enforcement and evidences the need to expand capacity in the treatment and harm reduction fields. To bring balance to the discourse a response to the aforementioned reviews by Neil McKeganey (2007) who questions the approach proffered by the RSA & UKDPC and highlights the failings of their analyses.
This essay broadly endorses the view that the control of legal and illegal drugs has been and continues to be at the behest of the powerful, who perpetrate harms and violence on communities through mass incarceration and a failed criminal justice policy at both the global and local level.
DEFINING LITERATURE
Whilst drug control legislation is seen by the majority as a means of protecting society from itself, closer examination of the field reveals that there are a number of hidden harms resulting from it. Drug control legislation by its very nature targets and identifies drug users and suppliers; it in effect creates a problem population. As shown by Mooney (2008) populations of this nature once defined are open to the discrimination and stigmatization of society and policymakers. This social devaluation allows for them to be viewed as surplus to the needs of society but at the same time through the politicization of crime they remain the subject of central debate and policy decisions. Smith and Hattery (2010) continue this theme in the devaluation of problem populations when they question if the ‘War on Drugs’ in the USA whilst appearing on face value to deter the use and supply of controlled substances has a hidden intended consequence of removing a problem population ( in this case, African American males) from society. Whilst highlighting the harm caused to African American communities by their mass racialized incarceration (Wacquant 2005) as a result of the ‘Rockefeller Drug laws’, Smith and Hattery (2010) indentify the harms caused to the community by the loss of capital in human, financial, social and political terms to the Prison Industrial Complex of the United States. Wright (1997) suggests that the capitalist US state views African American males as surplus to the requirements of the capitalist machine and having no skills to offer are, as shown earlier by Mooney (2008) open to discrimination, devaluation and stigmatization, they are easily contained by those in power within the Prison Industrial Complex or the ghetto. Continuing in the racialized theme Tonry (1995) argues that those in power were fully aware that in 1970’s America drug use in general was declining, but was not doing so in the problem areas; those areas of high inner city deprivation and by the problem populations residing there; the African American and Hispanic communities. Thus the powerful elite knew that the ‘war on drugs’ would be a waged against the young from the African American and Hispanic communities with both Tonry (1995) and Wacquant (2005) providing clear examples, as shown above, to this effect, as Quinney (1977) theorized; it is through the enactment and application of laws that the powerful are able to preserve their social and economic order and maintain the status quo to their own benefit.
The racial bias inherent in the US is mirrored by Webster (2007) who finds that Afro- Caribbean youths in the UK are subject to greater stop and arrests and to higher than average prosecutions as opposed to cautions by police. Once entered into the justice system they are subject of greater indictable proceedings and remands, whilst if convicted have a higher than average chance of facing a custodial sentence than white offenders. What is clear is the subjective approach by society enacting laws that are made by the rich and powerful white male to protect society from any breach of normal white masculine behaviours, Hudson (2006). Blagg (2008a) adds to the work of Hudson (2006) when he reveals the high rate of incarceration of the indigenous Australian Aboriginals within the Australian penal establishment, whilst making up just two percent of the population they account for forty two percent of the prison population. This strongly parallels the USA with African American males making up seven percent of the population but over fifty percent of the incarcerated population. (Drake, Muncie, Westmarland, 2010) What Blagg clearly reveals is the subjective approach by Australia’s white political masters to the ‘problem population’ of the Aboriginal community who like the African American population in the US are disproportionally represented in drug and alcohol abuse.
In more general terms illegal and legal drug control, whilst central to crime policy provides a clear example of what Quinney (1977) although writing from a Marxist perspective argued was the function of criminal justice systems; that it is through law that the powerful ruling class maintain the social order to promote their own social and economic interests. By setting the agenda and tailoring crime control and justice to identify and suppress the problem any threat to power can be neutralized by apparently legitimate means. As argued by Box (1987) this arrangement places certain groups identified as a problem or threat more prone to arrest not because they commit more crime but because they are perceived by society to be unsafe. Although not commenting directly on illegal and legal drug control policy one could be forgiven for so concluding that Reiman (2007) had the subject in mind when he argues that the aim of criminal justice is to create and maintain a constant perceived threat to society. This is achieved by defining a problem population and ensuring that their criminality is amplified to show that the system is failing to control them. Once identified the focus of criminal justice can be brought to bear on them whilst the crimes of the rich and powerful go unchallenged.This Reiman theorises is a ‘pyrrhic defeat’ in which the system serves the powerful notby its success but by its inbuilt failures.
The racial bias inherent in the US is mirrored by Webster (2007) who finds that Afro- Caribbean youths in the UK are subject to greater stop and arrests and to higher than average prosecutions as opposed to cautions by police. Once entered into the justice system they are subject of greater indictable proceedings and remands, whilst if convicted have a higher than average chance of facing a custodial sentence than white offenders. What is clear is the subjective approach by society enacting laws that are made by the rich and powerful white male to protect society from any breach of normal white masculine behaviours, Hudson (2006). Blagg (2008a) adds to the work of Hudson (2006) when he reveals the high rate of incarceration of the indigenous Australian Aboriginals within the Australian penal establishment, whilst making up just two percent of the population they account for forty two percent of the prison population. This strongly parallels the USA with African American males making up seven percent of the population but over fifty percent of the incarcerated population. (Drake, Muncie, Westmarland, 2010) What Blagg clearly reveals is the subjective approach by Australia’s white political masters to the ‘problem population’ of the Aboriginal community who like the African American population in the US are disproportionally represented in drug and alcohol abuse.
In more general terms illegal and legal drug control, whilst central to crime policy provides a clear example of what Quinney (1977) although writing from a Marxist perspective argued was the function of criminal justice systems; that it is through law that the powerful ruling class maintain the social order to promote their own social and economic interests. By setting the agenda and tailoring crime control and justice to identify and suppress the problem any threat to power can be neutralized by apparently legitimate means. As argued by Box (1987) this arrangement places certain groups identified as a problem or threat more prone to arrest not because they commit more crime but because they are perceived by society to be unsafe. Although not commenting directly on illegal and legal drug control policy one could be forgiven for so concluding that Reiman (2007) had the subject in mind when he argues that the aim of criminal justice is to create and maintain a constant perceived threat to society. This is achieved by defining a problem population and ensuring that their criminality is amplified to show that the system is failing to control them. Once identified the focus of criminal justice can be brought to bear on them whilst the crimes of the rich and powerful go unchallenged.This Reiman theorises is a ‘pyrrhic defeat’ in which the system serves the powerful notby its success but by its inbuilt failures.
Whilst the control of illegal drugs produces harms on communities at both a local and global level, the controls on legal drugs have a similar effect. The community in question are the prescribing clinicians and their patients who suffer from ill-judged and overzealous prescription controls to the miss-selling by powerful pharmaceutical companies who appear to be immune from criminal prosecution. The control of legal drugs pose a different threat through the ease of abuse and potential for onward supply to non-medical users. Whilst this is one aspect of the supply of legal drugs that ensure strict controls are placed on clinicians it also has an adverse affect on the care of patients who require pain control. In the US doctors face ‘loss of medical license, criminal prosecution, and imprisonment’ (Ballantyne, p.811, 2007) if they are found guilty of over or wrongly prescribing, this has engendered a fear culture which result in harm being caused to patients who do not receive sufficient pain control. These restraints placed on clinicians by the authorities can become strained when pharmaceutical companies knowingly mislead them. In 1996 Purdue Pharma introduced Oxycontin, a sustained-release oxycodone preparation. This was highly marketed and promoted to the medical profession and patients who were told
‘…in much of its promotional campaign — in literature and audiotapes for physicians, brochures and videotapes for patients, and its "Partners AgainstPain" Web site-Purdue claimed that the risk of addiction from OxyContin was extremely small’ (Van Zee, p.223, 2009)
‘…in much of its promotional campaign — in literature and audiotapes for physicians, brochures and videotapes for patients, and its "Partners AgainstPain" Web site-Purdue claimed that the risk of addiction from OxyContin was extremely small’ (Van Zee, p.223, 2009)
In 2002 the US Drug Enforcement Agency reported that 464 deaths were attributable to Oxycontin overdose, (Brown University 2002). Whilst the harm caused by Oxycontin became known the company continued to promote it in an aggressive manner, in 2001 alone the company spent $200 million on marketing (Van Zee 2009). They began targeting the non-malign pain control segment where the benefits of opioid pain control are less well documented. Whilst the Federal Drug and Food Administration looked on, opioid pain control drugs became the illicit drug of choice being more popular than heroin and cocaine. Unsurprisingly then that in 2002
‘unintentional overdose deaths from prescription opioids surpassed those from heroin and cocaine nationwide’ (Van Zee, p.224, 2009)
In 2007 the growing number of deaths led to Purdue Pharma being indicted, which resulted in the company receiving a $600 million fine. Whilst this is a large sum, compared to the $2.8 billion in revenue OxyContin produced it does not seem such a heavy fine. No executives were incarcerated and no criminal records were created. On such evidence one would find it hard to argue against the theorists such as Reiman, Box, Quinney et al, that justice operates to protect the rich and powerful, whilst the lesser crimes of the poor are prioritised.
POLICY TERMS
Drug policy within the UK has remained clearly set to prioritise the criminal justice agenda with harm reduction a secondary objective. Drugs policy is based on the enforcement of The Misuse of Drugs Act 1971 and the categories of drugs therein classified as controlled substances. As noted earlier this essay takes a critical view in respect of the policy and has so far argued by evidencing the work of theorists that the ‘war on drugs’ and indeed drug policy in general is being used a crutch to maintain the social order for the ruling elite, and in so doing has caused more harm to society and communities both locally and globally than the use of the drugs themselves. To progress this viewpoint and underline the inadequacy of the approach a similar critical view will be taken through the evidence provided by a number of policy responses. The Royal Society for the encouragement of Arts, Manufactures & Commerce in its report ‘Drugs - facing facts: The Report of the RSA Commission on Illegal Drugs,
Communities and Public Policy’ (2007), is categorical in its dislike of the approach taken by current UK Drug policy. It argues that the implementation of policy is clearly biased toward a criminal justice outcome which neglects responses towards health and social care. Recognising that the system is centered on criminal justice and crime it seeks for policymakers to take a wider more holistic view and realize that a totally prohibitionist approach is one that will lead to failure. It states quite unequivocally, ‘Drugs policy in its present form has largely been a failure. We know it has substantially failed because in the nearly four decades since the Misuse of Drugs Act came into force the number of addicts and others dependent on drugs has soared and the social problems associated with substance abuse have worsened dramatically. (RSA, 2007, p. 21)
The mixed messages promoted by the policy are called into question explaining that on one hand the policy publicly demonstrates a strictly prohibitionist rhetoric, whilst on the other it takes a more measured approach in reducing harms. These mixed messages it argues condemns the policy to be perceived as confusing and contradictory. The report concludes by arguing for policy to be refocused on the need to reduce harm and become harm reduction centered rather than simply a criminal justice tool. In their ‘Analysis of UK Drug Policy’ Reuter & Steven (2007) clearly evidence that drug use increased in the last quarter of the 20th century with a stabalisation after the millennium at record high numbers. This increase in drug use appears to have occurred when according to The Home Office there has been an increase in seizures which they have hailed as a ‘key achievement’. The Prime Ministers Strategy Unit conclude however that drug seizures do not impact on the reduction of harms. With international drug studies showing that drug seizures do not reduce users numbers. Citing Degenhardt et al (2006) the authors show that whilst drug seizures in Australia increased between 1996 and 2004 the price of drugs between 1997 and 2004 decreased. Whilst showing the inadequacies of drug policy through seizures, harm reduction strategies clearly evidence that needle exchanges and methadone treatment reduce the harm to the installed user base. Whilst enforcement has been the dominant theme of drug policy they argue that if successful then the price should have increased instead of the noted decrease and availability should have reduced which does not appear to be the case due to the steady increase in users. The limits of drug policy are examined by the authors who find that
‘The most fundamental point to understand about drug policy is that there is little evidence that it can influence the number of drug users or the share of users who are dependent.’ (Reuter and Stevens, p. 81, 2007) The authors can find no evidence to support the claim that stricter enforcement sends a message that results in less drug use. In research terms the report concludes that there is a limited pool from which to draw and that which there is, is weighted towards harm reduction studies. One strong criticism is that there is little research on the effect of enforcement; this is also a finding of the UK Drug Policy Commission whose work is reviewed later in this essay. In conclusion Reuter and Stevens (2007) find that Government drug policy has little effect on rates of drug use, it does however have a large effect on the amount of drug related harm incurred by users and communities.
The UK Drug Policy Commission is an independent charitable body whose remit is to analyse and explore options for drug policy. In response to the UK Governments Drug Strategy Consultation in 2007 the Commission authored a report which highlighted a number of important policy omissions. The reports acknowledges that achievements have been made in the numbers of people receiving treatment during the previous 10 years, however it immediately identifies, ‘There is a scarcity of knowledge about ‘what works’ across many strands of the strategy which cannot be overestimated and should be of serious concern.’ (The UKDPC, p.1, 2007) Identifying this lack of knowledge base the report calls for a dedicated ‘pillar’ of research within a framework of independent evaluation. The report questions the polarised responses by politicians of being either ’soft’ or ‘tough’ on drugs with no real effort in pursuing what works. The success or otherwise of enforcement activity is laid bare it clearly states, ‘…there is no evidence that enforcement activity alone has any significant impact on street level drug market stability.’(The UKDPC, p.15, 2007) In raising the obvious question of why policymakers allow this, one is reminded of the Reiman (2007) and the ‘pyrrhic defeat’ theory put forward by him. The report indentifies enforcement as the largest spend in the policy but in seeking to have research prioritised reveals the clear lack of any. What is evidenced by the report is the harms caused by zealous enforcement, with heightened community tensions mostly it states within the black communities, mirroring the racialized themes put forward by Tonry (1995) and Wacquant (2005). Returning to the research or lack thereof the report questions how an effective policy can be implemented if the cause and nature of the drug problem is not known, and conversely what interventions work. This gap in knowledge was evidenced in the governments 1998 strategy document however no action was taken and many remain. The report raises important questions as to how policy is prioritised in particular why if the majority of spending is targeted toward enforcement, there is no research into how effective enforcement is. The conclusion, if one takes into consideration the work of theorists like Tonry, Wacquant and Quinney et al, is that this is a deliberate omission designed to perpetuate the continuing ‘war on drugs’ which prioritises enforcement and prevention over harm reduction.
McKeganey (2007) considered the impact of a drug policy that would prioritise harm reduction. He finds that such an approach may on the surface be appealing however he argues that current policy allows society to clearly differentiate between behaviour that is acceptable or unacceptable, it clearly send out the message as to what is legal and illegal. He questions the RSA and UKDPC reports recommendations that policy requires to be refocused onto a harm reduction led platform. He argues that in assessing any drug policy one must take into consideration not only the numbers of people using drugs but also the numbers in the entire population who are not using. By turning the figures on their head in this way shows allows current drug policy to be viewed as a success in so much as the majority of the population are not accessing drugs. McKeganey argues that a policy that prioritises the harms caused by drugs would change the focus from the drug use to the effect of that drug use, this he argues would create a moral vacuum in which drug use was neither seen as illegal or legal but accepted as the norm. Whilst McKeganey offers no new evidence within his review he offers an alternate understanding of the issues involved in drug policy.
CONCLUSION
This essay has brought a critical review to the legal and illegal use, classification and control of drugs. It has shown that the policies promoted by the western governments whilst tailored to suite the political landscape of each have in general one overarching theme; enforcement. These policies enacted by the US, UK and Australia are responsible for far greater harms being caused to communities than the scourge of the drug abuse they purport to combat. Following Quinney (1977) the mass racialization of the US prison population as described by Wacquant (2005), and the deliberate targeting of the African American and Hispanic communities as shown by Tonry (1995), clearly shows that the ‘war on drugs’ was used as a means to preserve the economic and social order by the powerful.
Webster (2007) and Blagg (2008a) both evidence that this ‘punitive turn’ was mirrored in the UK with Afro Caribbean youths and in Australia with the Aboriginal population being more prone to imprisonment than their white counter parts. On assessing critical reviews of UK drug policy by the UKDPC (2007) and The RSA (2007) one finds glaring omissions in any true research into the value or success of enforcement led interventions. This is the more confusing when one considers that the greatest spending from drug policy is on enforcement, one would assume that politicians would require to evidence value for money. The fact that 40 years of enforcement has failed to deliver, with drug availability up and cost down, I would fundamentally argue can only lead to the conclusion that Reiman (2007) is correct, that this ‘pyrrhic defeat’ is manufactured at the behest of the powerful.
In comparing the legal use and control of drugs one finds that once again the greater harms caused by the powerful (Purdue Pharma) are resolved not through criminal prosecution or indeed pursued to the same extent as the African America and Hispanic communities torn apart by the ‘war on drugs’ are, the solution is to simply hand out monetary penalty to the guilty. There is overwhelming evidence from theorists, criminologists, and independent policy reviews that clearly and unambiguously point towards the failure of current drug policy at both the local and global levels. The harm and violence perpetrated by the powerful on communities to maintain the status quo in society goes unchallenged whilst the ‘war on drugs’ continues to fail those same communities whom it is espoused to protect.
WORD COUNT 3,680
REFERENCES
‘unintentional overdose deaths from prescription opioids surpassed those from heroin and cocaine nationwide’ (Van Zee, p.224, 2009)
In 2007 the growing number of deaths led to Purdue Pharma being indicted, which resulted in the company receiving a $600 million fine. Whilst this is a large sum, compared to the $2.8 billion in revenue OxyContin produced it does not seem such a heavy fine. No executives were incarcerated and no criminal records were created. On such evidence one would find it hard to argue against the theorists such as Reiman, Box, Quinney et al, that justice operates to protect the rich and powerful, whilst the lesser crimes of the poor are prioritised.
POLICY TERMS
Drug policy within the UK has remained clearly set to prioritise the criminal justice agenda with harm reduction a secondary objective. Drugs policy is based on the enforcement of The Misuse of Drugs Act 1971 and the categories of drugs therein classified as controlled substances. As noted earlier this essay takes a critical view in respect of the policy and has so far argued by evidencing the work of theorists that the ‘war on drugs’ and indeed drug policy in general is being used a crutch to maintain the social order for the ruling elite, and in so doing has caused more harm to society and communities both locally and globally than the use of the drugs themselves. To progress this viewpoint and underline the inadequacy of the approach a similar critical view will be taken through the evidence provided by a number of policy responses. The Royal Society for the encouragement of Arts, Manufactures & Commerce in its report ‘Drugs - facing facts: The Report of the RSA Commission on Illegal Drugs,
Communities and Public Policy’ (2007), is categorical in its dislike of the approach taken by current UK Drug policy. It argues that the implementation of policy is clearly biased toward a criminal justice outcome which neglects responses towards health and social care. Recognising that the system is centered on criminal justice and crime it seeks for policymakers to take a wider more holistic view and realize that a totally prohibitionist approach is one that will lead to failure. It states quite unequivocally, ‘Drugs policy in its present form has largely been a failure. We know it has substantially failed because in the nearly four decades since the Misuse of Drugs Act came into force the number of addicts and others dependent on drugs has soared and the social problems associated with substance abuse have worsened dramatically. (RSA, 2007, p. 21)
The mixed messages promoted by the policy are called into question explaining that on one hand the policy publicly demonstrates a strictly prohibitionist rhetoric, whilst on the other it takes a more measured approach in reducing harms. These mixed messages it argues condemns the policy to be perceived as confusing and contradictory. The report concludes by arguing for policy to be refocused on the need to reduce harm and become harm reduction centered rather than simply a criminal justice tool. In their ‘Analysis of UK Drug Policy’ Reuter & Steven (2007) clearly evidence that drug use increased in the last quarter of the 20th century with a stabalisation after the millennium at record high numbers. This increase in drug use appears to have occurred when according to The Home Office there has been an increase in seizures which they have hailed as a ‘key achievement’. The Prime Ministers Strategy Unit conclude however that drug seizures do not impact on the reduction of harms. With international drug studies showing that drug seizures do not reduce users numbers. Citing Degenhardt et al (2006) the authors show that whilst drug seizures in Australia increased between 1996 and 2004 the price of drugs between 1997 and 2004 decreased. Whilst showing the inadequacies of drug policy through seizures, harm reduction strategies clearly evidence that needle exchanges and methadone treatment reduce the harm to the installed user base. Whilst enforcement has been the dominant theme of drug policy they argue that if successful then the price should have increased instead of the noted decrease and availability should have reduced which does not appear to be the case due to the steady increase in users. The limits of drug policy are examined by the authors who find that
‘The most fundamental point to understand about drug policy is that there is little evidence that it can influence the number of drug users or the share of users who are dependent.’ (Reuter and Stevens, p. 81, 2007) The authors can find no evidence to support the claim that stricter enforcement sends a message that results in less drug use. In research terms the report concludes that there is a limited pool from which to draw and that which there is, is weighted towards harm reduction studies. One strong criticism is that there is little research on the effect of enforcement; this is also a finding of the UK Drug Policy Commission whose work is reviewed later in this essay. In conclusion Reuter and Stevens (2007) find that Government drug policy has little effect on rates of drug use, it does however have a large effect on the amount of drug related harm incurred by users and communities.
The UK Drug Policy Commission is an independent charitable body whose remit is to analyse and explore options for drug policy. In response to the UK Governments Drug Strategy Consultation in 2007 the Commission authored a report which highlighted a number of important policy omissions. The reports acknowledges that achievements have been made in the numbers of people receiving treatment during the previous 10 years, however it immediately identifies, ‘There is a scarcity of knowledge about ‘what works’ across many strands of the strategy which cannot be overestimated and should be of serious concern.’ (The UKDPC, p.1, 2007) Identifying this lack of knowledge base the report calls for a dedicated ‘pillar’ of research within a framework of independent evaluation. The report questions the polarised responses by politicians of being either ’soft’ or ‘tough’ on drugs with no real effort in pursuing what works. The success or otherwise of enforcement activity is laid bare it clearly states, ‘…there is no evidence that enforcement activity alone has any significant impact on street level drug market stability.’(The UKDPC, p.15, 2007) In raising the obvious question of why policymakers allow this, one is reminded of the Reiman (2007) and the ‘pyrrhic defeat’ theory put forward by him. The report indentifies enforcement as the largest spend in the policy but in seeking to have research prioritised reveals the clear lack of any. What is evidenced by the report is the harms caused by zealous enforcement, with heightened community tensions mostly it states within the black communities, mirroring the racialized themes put forward by Tonry (1995) and Wacquant (2005). Returning to the research or lack thereof the report questions how an effective policy can be implemented if the cause and nature of the drug problem is not known, and conversely what interventions work. This gap in knowledge was evidenced in the governments 1998 strategy document however no action was taken and many remain. The report raises important questions as to how policy is prioritised in particular why if the majority of spending is targeted toward enforcement, there is no research into how effective enforcement is. The conclusion, if one takes into consideration the work of theorists like Tonry, Wacquant and Quinney et al, is that this is a deliberate omission designed to perpetuate the continuing ‘war on drugs’ which prioritises enforcement and prevention over harm reduction.
McKeganey (2007) considered the impact of a drug policy that would prioritise harm reduction. He finds that such an approach may on the surface be appealing however he argues that current policy allows society to clearly differentiate between behaviour that is acceptable or unacceptable, it clearly send out the message as to what is legal and illegal. He questions the RSA and UKDPC reports recommendations that policy requires to be refocused onto a harm reduction led platform. He argues that in assessing any drug policy one must take into consideration not only the numbers of people using drugs but also the numbers in the entire population who are not using. By turning the figures on their head in this way shows allows current drug policy to be viewed as a success in so much as the majority of the population are not accessing drugs. McKeganey argues that a policy that prioritises the harms caused by drugs would change the focus from the drug use to the effect of that drug use, this he argues would create a moral vacuum in which drug use was neither seen as illegal or legal but accepted as the norm. Whilst McKeganey offers no new evidence within his review he offers an alternate understanding of the issues involved in drug policy.
CONCLUSION
This essay has brought a critical review to the legal and illegal use, classification and control of drugs. It has shown that the policies promoted by the western governments whilst tailored to suite the political landscape of each have in general one overarching theme; enforcement. These policies enacted by the US, UK and Australia are responsible for far greater harms being caused to communities than the scourge of the drug abuse they purport to combat. Following Quinney (1977) the mass racialization of the US prison population as described by Wacquant (2005), and the deliberate targeting of the African American and Hispanic communities as shown by Tonry (1995), clearly shows that the ‘war on drugs’ was used as a means to preserve the economic and social order by the powerful.
Webster (2007) and Blagg (2008a) both evidence that this ‘punitive turn’ was mirrored in the UK with Afro Caribbean youths and in Australia with the Aboriginal population being more prone to imprisonment than their white counter parts. On assessing critical reviews of UK drug policy by the UKDPC (2007) and The RSA (2007) one finds glaring omissions in any true research into the value or success of enforcement led interventions. This is the more confusing when one considers that the greatest spending from drug policy is on enforcement, one would assume that politicians would require to evidence value for money. The fact that 40 years of enforcement has failed to deliver, with drug availability up and cost down, I would fundamentally argue can only lead to the conclusion that Reiman (2007) is correct, that this ‘pyrrhic defeat’ is manufactured at the behest of the powerful.
In comparing the legal use and control of drugs one finds that once again the greater harms caused by the powerful (Purdue Pharma) are resolved not through criminal prosecution or indeed pursued to the same extent as the African America and Hispanic communities torn apart by the ‘war on drugs’ are, the solution is to simply hand out monetary penalty to the guilty. There is overwhelming evidence from theorists, criminologists, and independent policy reviews that clearly and unambiguously point towards the failure of current drug policy at both the local and global levels. The harm and violence perpetrated by the powerful on communities to maintain the status quo in society goes unchallenged whilst the ‘war on drugs’ continues to fail those same communities whom it is espoused to protect.
WORD COUNT 3,680
REFERENCES
Ballantyne, J.C. (2007) ‘Regulation of opioid prescribing: over regulation compromises doctors’ ability to treat pain’, BNJ, 334, (21 April), pp. 811-12.
Brown University (2002) ‘Psychopharmacology Update’ Vol. 13, Issue 6, pp. 5.
Drake, D., Muncie, J., Westmarland, L. (2010) ‘Interrogating criminal justice’, in
Drake, D., Muncie, J., Westmarland, L. (eds) Criminal Justice: Local and Global, London, Willan/TheOpen University
Hudson, B. (2006) ‘Beyond white man’s justice: race, gender and justice in late modernity’, Theoretical Criminolgy, vol. 10, no. 1, pp. 29-47.
Hughes, G. (2008) ‘Community safety and the governance of ’problem populations’, in Mooney, G. and Neal, S. (eds) Community: Welfare, Crime and Society, London, Routledge/The Open University
Mooney, G. (2008) ‘’Problem’ populations, ’problem’ places’ in Newman, J. and Yeates, N. (eds) Social Justice: Welfare, Crime and Society, London, Routledge/The Open University
McKeganey, N. ‘The Challenge to UK Drug Policy’, Drugs: Education. Prevention and Policy 2007;14:559-71.
Reiman, J. (2007) ‘The Rich Get Richer and the Poor Get Prison’ (8th edn), Boston, MA, Pearson/Allyn & Bacon
Reuter, P., Stevens, A. (2007) ‘An Analysis of UK Drug Policy A Monograph Prepared for the UK Drug Policy Commission’ London, UKDPC.
Select Committee on Home Affairs (2002) The Government’s Drugs Policy: Is it Working, London, The Stationery Office.
Smith, E., Hattery, A.J. (2010) ‘African American Men and the Prison Industrial Complex’, The Western Journal of Black Studies, vol. 34, no. 4, pp. 2-4.
The Open University (2009), ‘Production and distribution’ Opium: Cultures, Wars, Markets, Milton Keynes, The Open University [DVD].
The Royal Society for the encouragement of Arts, Manufactures & Commerce (2007) Drugs - facing facts: The Report of the RSA Commission on Illegal Drugs, Communities
and Public Policy, RSA, London.
The United Kingdom Drug Policy Commission (2007) A Response to Drugs: Our
Community, Your Say Consultation Paper, London, UKDPC.
Tonry, M. (1995) ‘Malign Neglect: Race, Crime and Punishment in America’ in Wacquant, L. (2005) ‘The great penal leap backward: incarceration in America from Nixon to Clinton’ in Pratt, J., Brown, D., Brown, M., Hallsworth, S. and Morrison, W. (eds) The new Punitiveness: Trends, Theories, Perspectives, Cullompton, Willan.
Van Zee, A. (2009) ‘The Promotion and Marketing of OxyContin: Commercial Triumph, Public Health Tragedy’ American Journal of Public Health, vol. 99, Issue 2, pp. 22-7.
Wacquant, L. (2005) ‘The great penal leap backward: incarceration in America from Nixon to Clinton’ in Pratt, J., Brown, D., Brown, M., Hallsworth, S. and Morrison, W. (eds) The new Punitiveness: Trends, Theories, Perspectives, Cullompton, Willan.
Wright, E. (1997) ‘Class Counts: Comparative Studies in Class Analysis’ in Smith, E., Hattery, A.J. (2010) ‘African American Men and the Prison Industrial Complex’, The Western Journal of Black Studies, vol. 34, no. 4, pp. 2-4.
Friday, 8 April 2011
Ramblings
I planned to go up the West highland Way, got a green light fro the wife, all arranged, as the day drew nearer I checked the weather forecast....and like any good outsdoorman I put my bergen down and took a rain check.... more to follow when the weather gets better...
Wednesday, 11 August 2010
Overkill....
Is it just me or is the never ending coverage of the doctor who was killed in Afghanistan starting to grind? What makes this female a special case for such coverage? Is it her professional qualifications, her good looks, her middle/upper class background or is it simply that the death of your average everyday squaddie is deemed less important by the news editors and the public? If I hear one more inane comment regarding how 'special' she was I will vomit. How do you think this sort of saturated coverage effects the families of the soldiers killed, why is their son/daughter not as 'special' as this Dr? Answers on a postcard please....
Tuesday, 3 August 2010
Getting more for less or How do you sell a pig in a poke?
The continuing mantra from politicians and senior police officers appears to be 'more services for less money' they espouse this view at every opportunity and no journalist (not even Paxman) has ever called them on it. A simple question like "Can you explain how we get more for less" would suffice because once this thread is pulled the whole idea unravels. No money or less money is just that, it means you cannot do what you could do when you had more money, for example why not try the 'more for less' approach at your local car dealership, that £12,000 loan you were hoping to get is not available and the bank manager has decided that you are only good for £8,000. Although you want the £12,000 car you will have to use £8,000 to purchase it, the car sales man will usher you down to the smaller cars he will not afford you the chance of a 'more for less' deal. You cannot get more for less, more importantly you can't get better public services with less cash. You cannot cut bin men and road sweepers and still expect that your refuse will be collected 2 weekly and your street sweeped. The army of night shift cleansing Dep't personnel who pour onto the streets of our major cities on a Friday and Saturday Night after the clubs close will not be there, the dayshift will start to remove the detrious from the streets leaving shoppers and commuters to trudge through the vomit, condoms and discarded fast food containers on there way to work and whilst shopping. More for less does not work it can't work once again we are being sold a pig in a poke.
Society is going to change for the worse the gap between the haves and have not is going to grow even wider and become more ingrained in our society. The coalition have been left a mess of that there is no doubt, the Big Society is a lot of nonsense as many commentators and Union spokespeople say this is shoring up the cuts in public services through voluntary work. It has disaster written all over it.
A fellow Blogger speaks of how we all have a part to play in the big society of how it is a community failure that a youth becomes criminalised or abuses drugs or alcohol, I disagree with this idea, surely individuals have to take responsibility for their own actions at some point in their life, I believe that society should absolutely provide care and protection and guidance to people but at what stage does the states responsibility end and the individual assume control. The term community can mean any number of different things to different people, what is acceptable in one community may not be acceptable in another. Who decides who is part of a community or who is excluded? it is normally the socially excluded that are identified as needing some form of control or behavioural adjustment. Who am I as a member of my community to impose my beliefs or ideals on another, is this not what social welfare policy is intended to do? One could argue that the punitive measures built into social welfare and child protection allows for the recipient to 'shape up or ship out'.
It seems for to long people who have failed to live in a way in which society expects have been allowed to go on with their lifestyles and the blame is everyone else's, where in the past the welfare agencies were able to re establish contact and offer additional services this will no longer be the case, this is where the major change in our society will come. Watch as the crime rate soars, more people are criminalised and the Gov't tries to put the burden onto 'Big Society', that's our 'Big Society' but not in the leafy lanes of driveways of the Eton Boys who are in charge at the moment, they are talking about us not them. Lloyd George said of the welfare state. " Welfare is the ransom that property must pay in order to ensure it's continued survival"
Society is going to change for the worse the gap between the haves and have not is going to grow even wider and become more ingrained in our society. The coalition have been left a mess of that there is no doubt, the Big Society is a lot of nonsense as many commentators and Union spokespeople say this is shoring up the cuts in public services through voluntary work. It has disaster written all over it.
A fellow Blogger speaks of how we all have a part to play in the big society of how it is a community failure that a youth becomes criminalised or abuses drugs or alcohol, I disagree with this idea, surely individuals have to take responsibility for their own actions at some point in their life, I believe that society should absolutely provide care and protection and guidance to people but at what stage does the states responsibility end and the individual assume control. The term community can mean any number of different things to different people, what is acceptable in one community may not be acceptable in another. Who decides who is part of a community or who is excluded? it is normally the socially excluded that are identified as needing some form of control or behavioural adjustment. Who am I as a member of my community to impose my beliefs or ideals on another, is this not what social welfare policy is intended to do? One could argue that the punitive measures built into social welfare and child protection allows for the recipient to 'shape up or ship out'.
It seems for to long people who have failed to live in a way in which society expects have been allowed to go on with their lifestyles and the blame is everyone else's, where in the past the welfare agencies were able to re establish contact and offer additional services this will no longer be the case, this is where the major change in our society will come. Watch as the crime rate soars, more people are criminalised and the Gov't tries to put the burden onto 'Big Society', that's our 'Big Society' but not in the leafy lanes of driveways of the Eton Boys who are in charge at the moment, they are talking about us not them. Lloyd George said of the welfare state. " Welfare is the ransom that property must pay in order to ensure it's continued survival"
Tuesday, 29 June 2010
Silly Billy's
The recent media reaction to the poor performance and subsequent failure of the English Football Team to make any way in the World Cup has not sat well with me. The media appear now to be lashing out at the FA, Capello ( the manager) and the players. There is a drive in the reporting that borders on the ridiculous which led me to leave this post on relation to an article on The Times on Tuesday 29.06.10.
http://www.thetimes.co.uk/tto/sport/football/international/article2578791.ece
'The only thing that the English players can get the blame for is a poor performance, that's it nothing else. The media seems happy to direct the scorn toward the players not just for the performance ( or lack thereof) but also to the fact that the oh so stupid individuals who through blind faith and ignorance paid out their hard earned cash on this foreign adventure in the arrogant belief that England would come top of the group and easily sail through to the semi finals. The fact that these fans have done so is not the fault of the FA, Capello or the team it is their own fault that they are now left in S.A whilst the under-performers get jetted home in 1st class. The media would be better spent covering real news and not covering for the fact that sports fans are a silly lot.'
http://www.thetimes.co.uk/tto/sport/football/international/article2578791.ece
'The only thing that the English players can get the blame for is a poor performance, that's it nothing else. The media seems happy to direct the scorn toward the players not just for the performance ( or lack thereof) but also to the fact that the oh so stupid individuals who through blind faith and ignorance paid out their hard earned cash on this foreign adventure in the arrogant belief that England would come top of the group and easily sail through to the semi finals. The fact that these fans have done so is not the fault of the FA, Capello or the team it is their own fault that they are now left in S.A whilst the under-performers get jetted home in 1st class. The media would be better spent covering real news and not covering for the fact that sports fans are a silly lot.'
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