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Crisis and Opportunity in Drug Policy: Changing the Direction of British Drug Services in the 1980s

Published online by Cambridge University Press:  27 April 2009

Alex Mold  and
Virginia Berridge
Alex Mold
Affiliation:
London School of Hygiene and Tropical Medicine University of London
Virginia Berridge
Affiliation:
London School of Hygiene and Tropical Medicine University of London
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Extract

During the 1980s illegal drug use in Britain appeared to be increasing at an alarming rate and spreading across the country on an unprecedented scale. An apparent growth in the use of heroin caused particular concern: the number of known heroin addicts rose from just over two thousand in 1977 to more than ten thousand by 1987. Moreover, heroin use was being reported in urban areas throughout the country. This was in contrast to previous decades, when it was thought that drug use was largely confined to London. By 1985 the Conservative government was able to assert that “the misuse of drugs is one of the most worrying problems facing our society today.” Growing fears about drug use prompted a flurry of activity from both central and local government, from law enforcement bodies, voluntary organizations, and health professionals.

Type
Articles
Information
Journal of Policy History , Volume 19 , Issue 1: Special Issue: New Perspectives on Public Health Policy , January 2007 , pp. 29 - 48
Copyright
Copyright © The Pennsylvania State University, University Park, PA. 2007

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References

Notes

1. Precise figures are 1977, 2, 016; 1987, 10, 389. Home Office, Statistics of Drug Addicts Notified to the Home Office, 1988 (London, 1989).Google ScholarPubMed

2. Advisory Council on the Misuse of Drugs (ACMD), Treatment and Rehabilitation (London, 1982), 25.Google ScholarPubMed

3. Ministry of Health, Drug Addiction: Report of the Second Interdepartmental Committee (London, 1964), 8.Google ScholarPubMed

4. Home Office, Tackling Drug Misuse: A Summary of the Government's Strategy (London, 1985), foreword.Google Scholar

5. Berridge, V., “The ‘British System’ and Its History: Myth and Reality,” in Strang, J. and Gossop, M., eds., Heroin Addiction and the British System. Volume 1, Origins and Evolution (London, 2005), 7–16.Google Scholar

6. Finlayson, G., Citizen, State, and Social Welfare in Britain, 1830–1990 (Oxford, 1994), 357–360.Google Scholar

7. Deakin, N., “The Perils of Partnership: The Voluntary Sector and the State, 1945–1992,” in Smith, J. Davis, Rochester, C., and Hedley, R., eds., An Introduction to the Voluntary Sector (London, 1995), 40–65Google Scholar; 54–62; Kendall, J. and J., and Knapp, M., The Voluntary Sector in the United Kingdom (Manchester, 1996), 201–5Google Scholar; Lewis, J., “Developing the Mixed Economy of Care: Emerging Issues for Voluntary Organisations,” Journal of Social Policy 22, no. 2 (1993): 173–192.Google Scholar

8. For an overview of welfare policy under Thatcher, see Lowe, R., The Welfare State in Britain Since 1945, 3d ed. (Basingstoke, 2005), 317–327, 350–57.CrossRefGoogle Scholar

9. MacGregor, S. and Pimlott, B., “Action and Inaction in the Cities,” in MacGregor, S. and Pimlott, B., Tackling the Inner Cities: The 1980s Reviewed, Prospects for the 1990s (Oxford, 1990), 9Google Scholar. Although of course state funding of the voluntary sector was nothing new, see Berridge, V., “New Social Movement or Government-funded Voluntary Sector? ASH (Action on Smoking and Health) Science and Anti-tobacco Activism in the 1970s,” in Pelling, M. and Mandelbrote, S., eds., The Practice of Reform in Health, Medicine, and Science, 1500–2000: Essays for Charles Webster (London, 2005), 333–348.Google Scholar

10. Spear, H. B., Heroin Addiction Care and Control: The British System, 1916–1984 (London, 2002), 41–42.Google Scholar

11. Home Office, Statistics of Drug Addicts Notified to the Home Office, United Kingdom, 1988 (London, 1989).Google Scholar

12. Ibid.

13. Stimson, G., “British Drug Policies in the 1980s: A Preliminary Analysis and Suggestions for Research,” in Berridge, V., ed., Drugs Research and Policy in Britain: A Review of the 1980s (Aldershot, 1990), 260–281Google Scholar; and Mott, J., “Notification and the Home Office,” in Strang, and Gossop, , ed., Heroin Addiction and Drug Policy, 271–291; 287.Google Scholar

14. MacGregor, S., “The Public Debate in the 1980s,” in MacGregor, S., ed., Drugs and British Society: Responses to a Social Problem in the 1980s (London, 1989), 1–19; 3.Google Scholar

15. The Hansard Journal of Parliamentary Debates: Lords, 30 October 1979, 355.

16. For a breakdown in regional notifications, see ACMD, Treatment and Rehabilitation, 121–27.

17. Parker, H., Newcombe, R., and Bakx, K., “The New Heroin Users: Prevalence and Characteristics in Wirral, Merseyside,” British Journal of Addiction (1987): 82, 147–157; 147.CrossRefGoogle ScholarPubMed

18. Davenport-Hines, R., The Pursuit of Oblivion: A Global History of Narcotics, 1500–2000 (London, 2001), 364Google Scholar; Power, R., “Drug Trends since 1968,” in Strang, and Gossop, , eds., Heroin Addiction and Drug Policy, 27–41; 34–35.Google Scholar

19. ACMD, Treatment and Rehabilitation, 130.

20. Griffiths, P., Gossop, M., and Strang, J., “Chasing the Dragon: The Development of Heroin Smoking in the United Kingdom,” in Strang, and Gossop, , eds., Heroin Addiction and Drug Policy, 121–133; 124.Google Scholar

21. Stimson, G., “The War on Heroin: British Policy and the International Trade in Illicit Drugs,” in Dorn, N. and South, N., eds., A Land Fit for Heroin? Drug Policies, Prevention, and Practice (Basingstoke, 1987), 35–61; 39–41CrossRefGoogle Scholar; R. Lewis, “Flexible Hierarchies and Dynamic Disorder: The Trading and Distribution of Illicit Heroin in Britain and Europe, 1970–1990,” in Strang and Gossop, Heroin Addiction and Drug Policy, 42–65; Spear, Heroin Addiction Care and Control, 255–74.

22. MacGregor, “The Public Debate in the 1980s,” 3. The key contemporary paper detailing the link with unemployment was Peck, D. F. and Plant, M. A., “Unemployment and Illegal Drug Use: Concordant Evidence from a Prospective Study and National Trends,” British Medical Journal 293 (11 10 1986).CrossRefGoogle ScholarPubMed

23. Hansard Journal of Political Debates: House of Commons, vol. 91 (1985–86), p. 296, col. 568.

24. Lowe, The Welfare State in Britain, 325; Harris, J., “Tradition and Transformation: Society and Civil Society in Britain, 1945–2000,” in Burk, K., ed., The British Isles Since 1945 (Oxford, 2003), 91–125; 112.Google Scholar

25. For an overview of the debate on deprivation and drug use, see Pearson, G. and Gilman, M., “Drug Epidemics in Space and Time: Local Diversity, Subcultures, and Social Exclusion,” in Strang and Gossop, Heroin Addiction and the British System, 1:109–114.Google Scholar

26. Kohn, M., Narcomania: On Heroin (London, 1987), 114.Google Scholar

27. Mold, A., “The ‘British System’ of Heroin Addiction Treatment and the Opening of the Drug Dependence Units, 1965–1970,” Social History of Medicine 17, no. 3 (2004): 501–517.CrossRefGoogle Scholar

28. On treatment methods, see Mold, A., “Dynamic Dualities: The British System of Heroin Addiction Treatment, 1965–1987” (Ph.D. thesis, University of Birmingham, 2004).Google Scholar

29. Dorn, N. and South, N., Helping Drug Users (London, 1985)Google Scholar; Mold, A., “The Welfare Branch of the Alternative Society? The Work of Drug Voluntary Organisation Release, 1967–1978,” Twentieth Century British History 17, no. 1 (2006): 50–73.Google Scholar

30. MacGregor, S., Ettorre, B., Coomber, R., Crosier, A., and Lodge, H., Drug Services in England and the Impact of the Central Funding Initiative (London, 1991), 6, 28.Google Scholar

31. Interview conducted by authors with a Sheffield-based psychiatrist, 2 May 2006.

32. House of Commons Social Services Committee, Misuse of Drugs, liii; Love, J. and Gossop, M., “The Processes of Referral and Disposal within a London Drug Dependence Clinic,” British Journal of Addiction 80 (1985): 435–440; 438.CrossRefGoogle ScholarPubMed

33. Mold, “The ‘British System,’” 506, 509.

34. ACMD, Treatment and Rehabilitation, 120.

35. “Drug addiction: British System failing,” Lancet (9 January 1982): 83–84; 83.

36. Mars, S., “Peer Pressure and Imposed Consensus: The Making of the 1984 Guidelines of Good Clinical Practice in the Treatment of Drug Misuse,” in Berridge, V., ed., Making Health Policy: Networks in Research and Policy after 1945 (Amsterdam, 2005), 149–182.CrossRefGoogle Scholar

37. Berridge, V., “AIDS and British Drug Policy: Continuity or Change?” in Berridge, V. and Strong, P., eds., AIDS and Contemporary History (Cambridge, 1993), 135–156; 141.CrossRefGoogle ScholarPubMed

38. Interview conducted by authors with David Turner, former director of SCODA, 25 February 2005.

39. DrugScope Library, London (hereafter DL), record no. 30658, SCODA Annual Report, 1977–78, 2–3.

40. DL 32718, SCODA Annual Report, 1978–79, 12.

41. DL 36959, SCODA Annual Report, 1980–81, 6.

42. ACMD, Treatment and Rehabilitation, 3. For a membership list, see ibid., 87–88.

43. The National Archives, Kew (hereafter TNA), MH 154/1149, letter to Minister for Health from Sir Robert Bradshaw, chairman of the ACMD, 25 June 1977.

44. TNA MH 154/1148, Minutes from M. E. G. Fogden to Mrs. Pearson, 28 February 1977.

45. TNA MH 154/1151, Minutes of the 27th meeting of the ACMD Treatment and Rehabilitation Working Group, 28 June 1979.

46. Ibid.

47. ACMD, Treatment and Rehabilitation, 79.

48. Interview conducted by authors with key social science researcher, 10 February 2005.

49. Interview conducted by authors with Dr. Dorothy Black, 2 May 2006.

50. Interview conducted by authors and key civil servant, 2 May 2006.

51. Berridge, “AIDS and British Drug Policy,” 141; interview between authors and Professor Gerry Stimson, 17 May 2006.

52. Hansard Journal of Parliamentary Debates: House of Commons, vol. 33 (1982–83), p. 704, col. 212.

53. DL 42638, SCODA Annual Report, 1983–84, 4.

54. MacGregor et al., Drug Services in England.

55. Interview conducted by authors with Dr. Dorothy Black, 2 May 2006.

56. MacGregor and Ettorre, “From Treatment to Rehabilitation,” 145.

57. DOHA (Department of Health Archive, Nelson, Lancashire: papers released under the Freedom of Information Act, 2000), OCG/1/1/3, letter from DHSS to all Regional Health Authorities regarding Treatment and Rehabilitation report of the Advisory Council on the Misuse of Drugs (ACMD); Central Funding Initiative (HN (83) 13 LASSAL (83) 1), 25 April 1983, ii.

58. Interview conducted by authors with Dr. Dorothy Black, 2 May 2006.

59. Hansard Journal of Parliamentary Debates: House of Commons, vol. 41 (1982–83), p. 806, col. 397.

60. Interview between authors and senior civil servant.

61. House of Commons Social Services Committee report, DHSS evidence, 13 March 1985, 171.

62. MacGregor et al., Drug Services in England; House of Commons Social Services Committee report, DHSS evidence, 13 March 1985, 174.

63. MacGregor et al., Drug Services in England, 70.

64. Ibid., 28.

65. To some extent DDUs did combine social and medical approaches by aiming to treat and control the drug problem. See Mold, “The ‘British System.’”

66. See, for example, Stimson, “British Drug Policies in the 1980s.”

67. For an analysis of this, see ibid. For the reports, see Ministry of Health, Drug Addiction, and ACMD, Treatment and Rehabilitation.

68. Interview conducted by authors with senior civil servant.

69. For a case study of the different approaches adopted at this time by some regional psychiatrists, see J. Strang, “A Model Service: Turning the Generalist on to Drugs,” in S. MacGregor, ed., Drugs and British Society, 143–69.

70. MacGregor et al., Drug Services in England, 45.

71. Ibid., 8.

72. TNA MH 154/433, letter from Mr. J. C. Eversfield, DHSS to Mr. Platten, Town Clerk London Borough of Enfield, 20 December 1971.

73. For SCODA, see TNA MH 154/1192, “Future Developments of the Standing Conference on Drug Abuse” (SCODA) and SCODA annual reports in DrugScope Library; for ISDD, see TNA FD 23/1949, Institute for the Study of Drug Dependence: proposal to set up the Institute, 1967–76, and ISDD annual reports in DrugScope Library.

74. TNA MH 154/430, “Heroin Addiction: London Boroughs Association”; working party reports on rehabilitation, 1968–74.

75. ACMD, Treatment and Rehabilitation, 77.

76. DOHA (Department of Health Archive, Nelson, Lancashire) OCG/1/1/3, letter from DHSS to all Regional Health Authorities regarding Treatment and Rehabilitation report of the Advisory Council on the Misuse of Drugs (ACMD); Central Funding Initiative, (HN (83) 13 LASSAL (83) 1), 25 April 1983, 1.

77. DHSS evidence of House of Commons Social Services Committee, 170.

78. Interview conducted by authors with senior civil servant.

79. Ibid.

80. MacGregor et al., Drug Services in England, 71–74.

81. House of Commons Social Services Committee, The Misuse of Drugs, liii, xlvii.

82. Interview between authors and Susanne MacGregor.

83. DOHA, JR/01980565/V0001A, paper for discussion at drugs client team meeting on research project on CFI, 31 October 1985.

84. DOHA, JR/01980565/V0001A, letter from Anne Kauder, Office of the Chief Scientist, DHSS to Susanne MacGregor, 17 January 1986.

85. DOHA, JR/01980565/V0001A, paper for discussion at drugs client team meeting on research project on CFI, 31 October 1985.

86. N. Black, “The NHS Research and Development Programme: The First Five Years, 1991–6,” seminar paper at London School of Hygiene and Tropical Medicine, 21 January 1997.

87. On urban initiatives, see MacGregor and Pimlott, “Action and Inaction in the Cities.”

88. DOHA, DAC/0007/V0004, note on Central Initiatives by John H. James, 30 April 1986; DOHA, DAC/0026/V001, memorandum from D. C. Nye to Mr. Alderman, Miss Davies, Mr. Hillier, Mr. Lutterloch, Mr. Pagan, and Mr. Woolley, regarding new initiatives, 14 December 1983.

89. DOHA, DAC/0007/V0004, note on Central Initiatives by John H. James, 30 April 1986.

90. On changes in the welfare state in this period, see Lowe, The Welfare State, 317–27.

91. Ibid., 325–26.

92. Harris, M., Rochester, C., and Halfpenny, P., “Voluntary Organisations and Social Policy: Twenty Years of Change,” in Harris, M. and Rochester, C., eds., Voluntary Organisations and Social Policy in Britain: Perspectives on Change and Choice (Basingstoke, 2001), 3.CrossRefGoogle Scholar

93. Lewis, J., “Developing the Mixed Economy of Care: Emerging Issues for Voluntary Organisations,” Journal of Social Policy 22, no. 2 (1993): 173–192.CrossRefGoogle Scholar

94. Kendall and Knapp, The Voluntary Sector in the UK, 138; Deakin, “The Perils of Partnership,” 54.

95. Lowe, The Welfare State in Britain, 320.

96. Lewis, “Developing the Mixed Economy,” 183–91.

97. MacGregor and Pimlott, “Action and Inaction,” 9.

98. Lowe, The Welfare State in Britain, 325–26.

99. Berridge, V., AIDS in the UK: The Making of Policy, 1981–1994 (Oxford, 1996), 222.CrossRefGoogle Scholar

100. ACMD, AIDS and Drug Misuse, Part One (London, 1988).Google Scholar