The Drug Policies Don't Work

Heroin addiction and the social problems associated with it are at their worst ever level in Dublin. Far from improving things, the high-profile busts of heroin and other drug dealers have merely exacerbated the situation, at once contributing to a misguided official view that the problem is being tackled, and adding to the range of woes inflicted on addicts.

This is the view of Sean Cassin, one of the most experienced, knowledgeable and thoughtful experts on the subject in Ireland. Cassin is director of the Merchant s Quay Project, a hands-on social work organisation set up in 1989 to try to help the people of Dublin s inner city, that patch of land between two canals, north and south, which has a higher incidence of drug use, HIV and AIDS, crime, homelessness and prisons than anywhere else in the country.

The levels of drug-use are increasing, and the number of different age-groups of those taking drugs are increasing. We have very disturbing figures coming in at the moment in relation to younger injecting, says Cassin, citing an official EU report. Ireland has the youngest injectors of heroin in the EU.

Cassin s analysis challenges the emerging consensus that at long last the heroin situation in Dublin is being successfully tackled. Evidence of a deterioration rather than an amelioration in the drug problem glares at anyone who walks through Dublin with open eyes, Cassin asserts. There are an alarming number of young people sleeping on cardboard in Dublin s doorways; there are chronic levels of theft in the city, including syringe muggings; and, tragically, there is an influx of very young teenage girls into the red-light districts.

These are visible signs of the social problems commonly associated with heroin use, and they are becoming more and more apparent in Ireland s capital city.

Meanwhile the police, courts and prisons busily punish a non-stop stream of heroin addicts in a manner which is not just futile but is also inhumane. This is the system entrusted to deal with the escalating heroin problem and its associated calamities social calamities which are, by extension, having negative effects on us all.

In the stark light of reality, it is clear that the punitive system has radically failed to provide a genuine solution. Yet the current, mainstream ideology, with its stereotyped ideas and shallow interpretation of the social dynamic behind drug use, is obscuring the truth of the situation. It s as though both the authorities and the non-heroin-using population view the problem through a distorted lens.

We ve inherited the American myth about the drugs problem, observes Sean Cassin, and I don t know why we re continuing to buy it hook, line and sinker. For 25 years here we operated a kind of prohibitionist approach to drug-use. We took on the notion from the States that if you say, Stop Drugs, Drugs Out, and like Bush did put billions into customs and excise and armies, that it ll work. But in fact the incidence of drug-use was increasing on a daily basis despite the billions of pounds Bush spent on prohibiting drugs.

So prohibition doesn t work and it hasn t worked. That s the first thing to say. The other thing is that there s a myth about the drug-pushers.

PUSHERS

This is probably the most challenging aspect of Sean Cassin s thinking. It is the one that directly confronts the entire basis for current Department of Justice policies on drugs.

There is this facile view that pushers are the problem, says Cassin. The second line that they trot out relentlessly is that the drug-user is a poor victim of the pusher and of society. But the reality is that heroin, for the past 25 years, in every major city in Europe as well as in Ireland, in England and the States is the drug of preference for a growing number of people. That s a fact. And it is the demand for this drug, from these people, that is creating the supply. Now the real question is, or should be: how do we cope with that fact? How do we cope with the reality that today, at least 7,000 people injected heroin in Dublin either once, or sometimes twice, or maybe three times within that given 24-hour period.

Most of those are people who have no intention of giving up drugs or of stopping using drugs, in the next month or six months or six years, maybe. So we re saying that we d better start finding a way of coping with these and working with these people, and making sure that they re alive in ten years time when they choose to give up drugs. And also to make sure that they re not a source of infection, of HIV or hepatitis, to themselves or to the rest of society.

Subverting the more widely-held view, Cassin believes that instead of prohibiting drugs, the focus of policy and resources needs to be on reducing the demand for drugs, since this, and not the pusher, is the real problem.

What creates the demand across all the European cities and the Americas is clear, Cassin reflects. In the vast majority of cases, there is a direct correlation between destitution, poverty and heroin use. By and large there is a significant relationship between these.

By this logic, the only thing that will ever eradicate heroin use is a permanent healing of poverty and social injustice. But meanwhile, life must go on . . .

We ve coined the term here social pain , expands Cassin. Heroin, since about 3,000 BC when it was discovered by the Sumerians, is the best-known pain-killer that civilisation has ever invented. Of all our other medicines, there isn t a more effective or powerful pain-killer. We don t think that it s just about dulling physical pain, but that there s a kind of a social pain which exists in people who live in these areas, that, if you like, is being self-medicated for.

The idea that social, economic and environmental deprivation leads to drug addiction is not new. However, looking at heroin use as a form of self-medication for unbearable social pain is a radical departure from the normal perspective. It is one that imbues us with the awareness necessary if we are to truly get to grips with what s happening that addicts are generally ordinary intelligent people dealing with problems in a certain, easily accessible way, and not a pack of unthinking fools who deserve what they get.

INTOLERANT

After years of direct experience, Sean Cassin has many crucial insights into that whole web of interconnected social ills which are herded together under the catchphrase, the drug problem .

Another thing that we re finding is that, by and large, unlike alcohol which is a far more lethal drug than heroin by the way the time-span of somebody on heroin tends to be about 15 years. Now you have some older ones who go at it long-term, but most of our clients after 15 years will have given up heroin, because of some kind of major event in their lives. It needn t always be a negative event it could be the birth of a child, and because of this they actually stop using heroin.

This puts, or should put, a very different kind of emphasis on the way you handle it, and the way you respond to it. There s a huge need for us to re-address the thing of keeping people alive for those 15 years.

Fourteen and 15-year-old heroin-users regularly turn up at the Contact clinic in the Merchant s Quay Project. This presents Cassin and his colleagues with an ethical conundrum.

Really we ought to be saying to those 15-year-olds, Go home and get your mother , because they re children. But at the same time they re going out into the backstreets, they re borrowing syringes, they re using infected spoons, injecting Hepatitis C and possibly HIV into themselves. So we re caught in the dilemma: do you give a kid of that age needles and exchange them when you establish that they are injecting, or don t you? That s a huge issue at the minute. There aren t any guidelines on it. And that s very worrying.

Homelessness is another key factor in the vicious circle of heroin addiction, and the number of young, homeless heroin addicts in the city centre is growing steadily. Cassin relates this to the attempt in particular areas to drive the pushers out . The result is that young people move into the city centre for their drugs. Last year, a Merchant s Quay Project study on homelessness among heroin-users in Dublin found that almost a third were sleeping rough, unable to get room in the hostels.

In a lot of the suburbs where communities are becoming active, someone who s using drugs becomes afraid that the family is going to be targeted by the local residents group or whatever, says Cassin. And so they get out before that happens. Others have been directly targeted.

Here s my concern about community activists, he adds, addressing the Concerned Parents issue. Some of them are at such an early stage of development in their thinking on the issue, that they are intolerant of current drug-users. And that is contributing to the problem. They re pushing them into the no-man s land of O Connell Street and Grafton Street and Thomas Street. Fundamentally that has to do with local communities not coping with the drugs problem, not coping with the current user in the community.

Cassin makes the point that there were many evictions in Dublin in 1997 seventy squatters were evicted from Ballymun alone. Was that because that was assumed that they were dealers?

Cassin refuses to accept the mythical distinction between drug-users and pushers. Every drug-user is a pusher. Every user sells drugs to other people in order to provide their own habit, he argues. There is a distinction with the supplier who is a big-time crook. There was none of them evicted from flats in Ballymun.

RISK

The 1966 Housing Act in which families can be evicted for repeated non-payment of rent and the more recent Miscellaneous Housing Act of 1997, also compound the homelessness problem.

My worry is that we re going to be looking at an American scenario, where people who can t pay their way or who are maladjusted are filling up our streets and wandering around homeless, because there s no statutory obligation to care for them while they re declared anti-social . The language incorporated into the act literally lets the statutory agencies off the hook, in relation to the most vulnerable people in society.

The group where all of that comes together the maladjustment, the anti-social behaviour, the inability to pay rent, the unemployment and all the rest of it is among drug-users. They sum it up. They have all of that in double portions, so they are the ones who are increasingly becoming homeless. And we re very concerned about that. There is no strategy in place to deal with homeless drug-users.

All the hostels are packed to the teeth. I do a night s duty here in the friary [Sean Cassin is a Franciscan friar] and the number of people that you have to try and ring up the emergency helpline for, and the hostels are full, and the numbers who are sleeping in squats . . .

Summing up the current heroin situation in Dublin, Cassin says: What you re looking at in terms of drug use is a re-emergence of increased levels of risk practices, especially in terms of HIV infection. We re going to have to go back to the 80s and early 90s in terms of campaigns to create awareness among drug-users. Also, more and more drug-users are becoming homeless, which leads to more crime and more drug-use.

Some of the work of the Department of Health in the last five years has been innovative they ve incorporated a whole range of harm-reduction approaches. But if we continue to pursue policies of prohibition and more prison and that, we re really just worsening the problem. n