There is an important battle of ideas going on around Britain's extensive use of methadone in the treatment of heroin addicts. Your interview with Paul Hayes, head of the National Treatment Agency, reports that he was recently "forced to defend his record against criticism that the current strategy of treatment management" - using, for example, methadone for heroin addicts rather than "curing" their addiction - "was failing and wrong-headed" (Keep taking the medicine, June 18). We are told that Hayes apparently dismisses his critics as "a few academics, politicians and 'ideologues' stoked up by the media". He says: "Any notion that investment in treatment programmes has been a failure is wrong."
Britain has pumped huge funding into Hayes' methadone maintenance programme, driven apparently more by the desire to reduce crime figures than meeting addicts' real needs. Barely 3% of addicts leave treatment drug-free. That is a miserable success rate in anybody's book, and if Hayes thinks that this is indicative of an effective drug treatment industry, he needs to tell us how he would define failure.
Does Hayes want increasing open-ended opiate maintenance at public expense? We are told, and Hayes claims it a success, that users in contact with treatment services have more than doubled in the last 10 years, from 85,000 to 195,000. "There are 130% more people in treatment than when we started [in 2001], rather than half the people dropping out because treatment isn't of good quality," Hayes says. But is the system really working if so few become free of addiction? How many will be addicted to methadone, at this rate of success, in another 10 or 20 years?
Genuine harm reduction is not objected to by anyone. But Hayes is in denial if he does not recognise that most addicts want freedom from addiction, that they want hope and help. Drug addiction, to legal or illegal drugs, affects not only the user. It affects the unborn, families and society. With galloping costs for drugs maintenance at public expense we are entitled to ask if there could not be better outcomes for the addict and for society.
Hayes suggests that the opposition he detects to his policy is because of "an element of electioneering and political expediency", and he claims that "there was a political consensus for some time that drug treatment was a good thing and that therefore the more we had of it the better".
This is untrue; there has been widespread concern for years about the rising numbers enslaved by the state in the chemical gulag his treatment represents. The opposition is not primarily politically based. I suggest Hayes needs to listen to his customers: most addicts want to be drug free, and when they complain that they find it hard to get their allowance of methadone gradually cut down (and they do), there is something seriously wrong. Reducing addiction is the best route to reducing the total harm from drug use.
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