Addiction

Three articles on addiction in the Guardian in one day. Strange serendipity.

By far the most interesting is by Antonio Maria Costa (Wikipedia entry), the executive director of the UN Office on Drugs and Crime. An Italian by birth but a life-long UN bureaucrat, he holds degrees in Pol Sci from Turin, in Mathematical Economics from Moscow State (!) and a Ph.D. in economics from Berkeley. He also, clearly, has people on his staff who can work language very skillfully.

"Legalise drugs and a worldwide epidemic of addiction will follow" is Costa's title, and he lays out his stall in the first two paragraphs. He argues that the dispute between prohibition and legalisation should be focused on the "appropriate degree of regulation" for all addictive substances, including alcohol and tobacco.

Current international agreements are hard to change. All nations, with no exception, agree that illicit drugs are a threat to health and that their production, trade and use should be regulated. In fact, adherence to the UN's drug conventions is virtually universal and no statutory changes are possible unless the majority of states agree – quite unlikely, in the foreseeable future. Yet important improvements to today's system are needed and achievable, especially in areas where current controls have produced serious collateral damage.

Neat little verbal trick there. He uses "illicit" instead of the accurate "illegal" to blur the line, because of course addictive drugs are not "regulated" - they are banned. Costa creates the straw man of a totally free market in dope to undermine, very subtly, the opposing case for outright prohibition. It has to be subtle, because the biggest donors to Costa's office have made it very plain to him that he can kiss his funding goodbye if he even thinks about supporting harm reduction policies such as needle exchanges and diamorphine substitution (that is to say, regulated addiction).

All in all, as neat a piece of high-grade polemical sleight of hand as you are likely to read. Most people think French bureaucrats are the masters of indirection, but the Italians taught them all they know - but not all the Italians know. Not for nothing is the Roman Curia the most successful international bureaucracy in history.

Sadly, the two articles on alcoholism, much the greatest public health issue in Britain, are brutally unsubtle, betraying the usual British refusal to think things through, for fear of reaching an unpalatable conclusion. It is a society in denial on a number of fronts, but I suspect the refusal to accept the prevalence of the genetic predisposition to alcoholism (in common with other northern European societies) may be the most adamant.  

"Britain is on an almighty bender and only by raising drink prices can we lower consumption", says Luisa Dillner. "We have desocialised drinking and taken it into the privacy and unregulated arena of our homes", she says, because booze is so much cheaper at supermarkets. She does not argue that pubs should receive a special dispensation from the general price increase she advocates, so all a further price rise will achieve is to kill off the pubs for once and for all, while increasing the profits from smuggling.

"Only when you tackle the alienation of people living in extreme deprivation will you begin to tackle the problems with alcohol", says Kevin McKenna. No, you stupid lefty. Quite a lot of people living in "extreme deprivation" are there because they were born predisposed to substance dependency. Unadmitted and indulged, it is the most assured means of social demotion to living squalor and early death; and it is hereditary, so the children of addicted parents are doubly handicapped.

The most startling thing about the insolently intrusive British nanny state is that it frigs around at the margins, seeking to reduce risks without a thought of cost-effectiveness, while leaving by far the biggest cause of crime, accidents, domestic strife, preventable illness and lingering death unaddressed.

There are no programmes to educate the population about this lurking danger, and not even the justice system finds it appropriate to impose compulsory Antabuse treatment as a condition of probation for individuals convicted of offences while under the influence of alcohol.

There is a simple metabolic test to establish whether someone is predisposed to alcoholism. If administered in the context of a no-nonsense public awareness programme alongside sex education in schools, it would at least equip the predisposed with the necessary information to manage their condition.

Many would choose not to do so, just as many choose to fuck without protecting themselves or their partners from STDs and pregnancy. But in terms of cost-effectiveness such a programme must surely have an order of magnitude better claim to public money than 'elf 'n' safety wheezes like bumping gravestones to see which ones, if climbed upon by thoughtless youths, might collapse and hurt the little dears.