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UK - Dr John Marks talks about controversial Harm Reduction Clinic in Widnes

Discussion in 'Miscellaneous' started by h2uk, Oct 11, 2010.

  1. h2uk

    h2uk Silver Member

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    Dr John Marks talks about the controversial Harm Reduction drug treatment programme in Widnes

    Aug 19 2010 by Mark Smith, Runcorn and Widnes Weekly News

    ASK most people, even those working in the field of drug treatment, and chances are they have never even heard of it.

    But the Chapel Street Clinic in Widnes is known in certain circles from Australia to Canada.

    Pioneering but controversial, the clinic helped to form the blueprint of entire nations’ drug policies, has been the subject of fierce international disputes, extensive educational studies, law enforcement seminars, and even an alleged trans-Atlantic furore involving the American Government and Margaret Thatcher which may have changed the course of Britain’s drug war forever.

    It is known around the world for one reason and one reason only, the Chapel Street Clinic used to give away drugs – not methadone or conventional pharmaceuticals, but legally-prescribed heroin and crack cocaine.


    Up until the mid-1990s, the clinic was run by consultant psychiatrist Dr John Marks, who advocated a form of treating drug addicts which involved giving them the narcotics they craved.

    The theory of ‘harm reduction’ held that while drug-users were kept away from the underworld and from the constant search for money and a ‘fix’, they could live more normal lives – limiting the damage they could do to themselves and society.

    The theory was based on a model used in the UK from the 1920s until the 1960s which became known as the ‘British system’ and the clinic saw remarkable successes.

    Between July 1988 and January 1990, the then-Cheshire Drug Squad began tracking the criminal records of 112 addicts who entered the drug maintenance program.

    It recorded a 93% drop in theft, burglary, and property crimes.

    HIV infection rate among injecting drug users was zero, and the incidence of death among addicts – normally 15% a year - was also zero.

    One side-effect which Dr Marks did not expect though, was a drop in new users.

    The police found that drug dealers simply stayed away from Halton because they knew the local addicts no longer needed their services.

    Word of the clinic’s work quickly spread around the globe, attracting foreign journalists and doctors to Widnes.

    It became the subject of a United Nations study and inspired a more liberal approach to drug-treatment in several European countries..

    Dr Marks – now the clinical director of psychiatry at Gisborne Hospital in New Zealand, told the Weekly News: “The clinic gained the attention of Chief Inspector Bing Spear of the Home Office Drugs Branch in the mid-1980s and he became an enthusiastic supporter.

    “From that beginning, the harm reduction policy was formulated and became an NHS model of good practice.

    “Similar clinics were rolled out throughout the country and there was a lot of foreign interest.

    “Switzerland and Germany modelled their services explicitly on it and eventually there came American attention.”

    It was with the visit of US current affairs programme 60 Minutes in 1990 that America’s Republican administration became aware of the little Widnes clinic, and – Dr Marks alleges – then put pressure on the British Government to close it down for ideological reasons.

    He said: “After it aired I got a sudden phone call from Bing who said: ‘Why didn’t you let us know about 60 Minutes?’.

    “I replied honestly that I’d forgotten all about them among the plethora of other visitors, had no idea that their report had been broadcast nor that the Home Office would be interested in TV programmes about clinics.

    “Bing replied ‘That’s a pity. We’re getting real heat from our embassy in Washington and Maggie’s got her knickers in a twist over the whole issue’.

    “In short order the Halton Health District was dissolved, Bing Spear had resigned and was replaced by a man called Alan MacFarlane – who later described me as ‘dangerous’.”

    Health chiefs at the time said the decision to scrap the programme was due to the prohibitive cost of heroin, citing methadone as a cheaper alternative.

    Dr Marks though remains adamant, he said: “It was in deference to American sensibilities that Margaret Thatcher emasculated the whole harm-reduction programme.”

    The policy at the clinic ran from 1984-1995 and since its end Halton’s addicts have undergone conventional treatment, usually involving the heroin substitute methadone.

    But 15 years later the name Chapel Street is being talked about once again. With funding for police and prison places under threat and with more liberal voices now calling for reform, the traditional approach to drugs is being re-evaluated.

    Ewan Hoyle, founder of the national group Liberal Democrats for Drug Policy Reform, said: “I came across the Chapel Street story early in my investigation of drug policy and it served as a stark demonstration of how both addicts and communities can benefit enormously from heroin dependency being treated with compassion.

    “I hope mine and my colleagues’ current pleas to the coalition Government to reinstate heroin maintenance will not fall on deaf ears.”

    Clinics in Sydney and Vancouver currently follow the Chapel Street model, and in 2009 the German parliament passed a law allowing heroin prescription as a standard treatment for addicts, with two Danish cities set to roll out a similar programme this year.

    Last year 100 addicts in London, Brighton and Darlington took part in trials using prescription heroin which were hailed a success.

    And on Tuesday, Sir Ian Gilmore, outgoing president of the Royal College of Physicians, called on drug use to be treated as a health problem and not a criminal one.

    However, Dr Marks is unsure whether the UK Government will adopt such an approach on a wider scale.

    He said: “I think the (coalition) regime may be more open-minded than New Labour – which is not difficult – but drug policy organisations like Transform are more likely to produce some movement.”

    ----------------------------------------------------------------------
    Transcript From 60 Minutes

    Julian Buchanan on working with Dr John Marks in Liverpool
    see a video discussion about john marks and the widnes clinic here:
     
    Last edited: Oct 11, 2010