ANGRY AS HELL!

I hope I will be forgiven for titling my new opening essay for this site in that intemperate manner but that is how I feel now after almost thirty years in the drug policy field. I considered other titles but rejected them. This was a calm, deliberate, cold sober choice on a beautiful September afternoon. In fact, I believe that any sensible person ought to be angry as hell, along with me, about the disastrous impact of our drug laws and policies.

But why, you ask, am I, in particular, so angry? And why now?

It is a long story, but I will attempt to give you the short version. The first reason is my recent foray back in time and into the future when I revisited the horrors of Straight, Inc. and its many bastard cousins and descendants. These ill-conceived facilities claim to help young people in trouble with drugs and other problems, but in fact help very few of them and seriously harm a great many. As is described more fully later in this site, one result of my renewed involvement was the conference held in July -- and another was an outpouring of messages from people all over the country who had been harmed in Straight or in another one of these alleged treatment gulags. No sane person, I contend, can read these stories without being angry with the leaders of our allegedly civilized society who allow these practices to exist.

It is worse than that. The destruction of our youth in closed institutions like Straight is well known. That destruction has been documented in the public media and in books and magazines for years. Yet, these tactics are endorsed by social and political and medical leaders as being necessary to save our youth from destruction by drugs and other threats. Choose your destruction. Our leaders choose institutionalized tough love as the harsh but necessary remedy. Many members of the press apparently agree with them. Despite an extensive publicity campaign, we are not aware of any major press coverage of the July conference. The major media players seem unconcerned that multitudes of our youth have been harmed more by government-sanctioned programs than by drugs themselves. Thankfully, DRCNet did give these events extensive and excellent coverage.

There is also the salient fact that our save-the-children project and conference has been forcing leaders to face up to the reality that the field of drug and mental health treatment is confused and riddled with doctrinal conflict. Thus the slogan "treatment not jail" is a kind advance but is without clear definition. Most alleged drug treatment has no scientific foundation, and much of it is downright harmful.

Second, another reason for my current anger is to be found across the pond in the United Kingdom where the immediate issues are quite different but where the main point is proven once again – there is no definitive science of addiction treatment, certainly not within the field of medicine as many might well have thought. I have just finished yet another stint in London serving as an expert witness in a case involving an English doctor accused of irresponsible prescribing of drugs to addicts. Because the case is still in the process of a possible direct appeal, I will not now reveal the name of the doctor, although it is a matter of public record. Of course, the British are light years ahead of the Americans when it comes to dealing with addicts, especially in terms of trusting doctors to choose the drug and the dosage for maintenance as well as for gradual reduction. For years I have described that institutionalized trust as the core of the wonderful British System. (See for example The Heroin Solution, Yale University Press, (1982) and ‘The Trusted Doctor in a Humane Drug Control System" Journal of Psychoactive Drugs, 1984.)

That institutionalized condition of trust still exists for most doctors in the United Kingdom, especially for those who are among the medical addiction elite. Sadly, starting almost twenty years ago that medical elite – members of what I have termed the London-American School of addiction treatment – started a campaign to destroy the professional status of those doctors who seemed to be members of what might be called the Liverpool-British School. The rules of this destructive game are not clear. That is, after decades of study and involvement I cannot define the bright line that ought to distinguish responsible prescribing from irresponsible prescribing to addicts within the laws and guidelines of the United Kingdom.

In all three cases where I served as an expert witness, the doctors in the dock were not part of the medical elite and were what might be termed medical dissenters. The first case involved Dr. Ann Dally who was forced to face disciplinary hearings during the 1980s before the General Medical Council, the supreme governing body of the unitary medical profession in the country. The second involves Dr. Patrick Hickey, whose case has been heard by the GMC and also by the Royal Courts of Justice. I have been retained by Dr. Hickey for over four years and appeared as an expert witness in a defamation case in the High Court in London in May 1999. My work with him continues as the case is now going to the European Court on Human Rights. My involvement in the third case just took place starting in May and I testified before the Professional Conduct Committee of the GMC in London on July 26.

In my opinion, all three doctors were competent, compassionate professionals who helped a great many patients, including addicts. Yet all three have seen their professional reputations destroyed and have been in one way or another pushed out of the medical profession because of their prescribing practices. I just learned that the third doctor had his name "erased" from the Medical Register by the GMC almost immediately at the conclusion of the hearing. Also, I know of a number of other British doctors who have been erased or face the imminent possibility of erasure very soon. Erasure means the total loss of one’s license to practice medicine.

Thus here again I see irrationality dominating the field of addiction treatment in a country whose system was a model of practical rationality for the world, including the United States. Thankfully much of the British System still exists but I am angry at the fact that in front of my very eyes, as it were, and despite my best efforts, I have directly observed that humane system unraveling at the edges and perhaps at pieces of the core. Scores of addicts and many doctors, as well as the general public, have been harmed in the unraveling process.

My third and final reason for being angry now is William Bennett and all he represents. Bennett served as the first drug czar under the President Bush the elder, and has often been considered presidential material by Republican leaders. Despite all of the progress that is being made in building public opinion against the drug war, this articulate and intellectual opinion-leader just came out with a well-written editorial in The Washington Post arguing that the drug war was a war worth fighting and that all this doubting rhetoric was harming a noble effort. He also claimed that real progress was made during the first Bush administration that there was retrograde movement under Clinton, and now the wonderful war was moving forward again. Most of his well-articulated arguments lack any factual foundation, not least the unhappy fact that more people were imprisoned on drug charges during Clinton’s watch than at any time in our history. Bennett also conveniently ignored that fact that he was a deserter in the drug war. He left his post for no good reason while the elder Bush was still in the White House. The allegedly tough warrior could have stayed and led the fight, but he cut and ran.

My anger here comes from the fact that despite all of his shortcomings, Bill Bennett and his views represent the majority opinion in both major political parties and in the country. There is no sign of any leading national political figure willing to contradict Bennett on his basic posture – that the drug war is a war worth fighting. The only question worth asking on the national political scene is which politician is tougher on drugs.

With attitudes like that dominating American drug policy, which in turn tends to dominate policies in much of the world, there seems little likelihood of any real progress being made soon in dealing with the myriad horrors created by our polices. That includes dealing realistically with all of the bad practices that abound in the treatment field, here and abroad. I may be wrong to be this angry, but perhaps if many others had the equivalent of that feeling it might spur more passionate and energetic efforts on a wide front for improvement.