DRUGS: WHAT THE ENGLISH CAN TEACH US Source: NY Newsday April 11, 1988 [Pat O'Hare is drug coordiator for the Sefton Education Authority. Allan Parry is drugs and AIDS coordinator for the Mersey Regional Health Authority, both in Liverpool England. Newsday Reporter Patricia Cohen interviewed them for this article.] Newday: WHAT DO YOU THINK OF NEW YORK CITY'S PROPOSED CLEAN NEEDLE PROGRAM AS A WAY OF CONTAINING AIDS ? O'HARE: It's not going to work. PARRY: There's a number of things tht have to happen before drug users will come in to use the program. One of them is there has to be a miniumum amount of hoops to jump through. As they get paraniod. From what we've heard about the proposed New York one, it's not ideal. It is a very limited program, which in the final analysis is better than nothing. A lot of people think we make claims that our scheme is stopping the spread of HIV. All we claim is that 2,000 injectors have been tested and there's no seropositivity. That we've found a way of attracting large numbers of drug users into the program and they regularly return equipment. It's different in NY. In Liverpool, the police support us, the church supports us, everybody supports us: the media pomotes it. Here you don't have those things. Newday: HOW DOES YOUR PROGRAM WORK ? PARRY: People come in off the streets and ask for syringes, and what we ask for is evidence that they've been injecting, and they'll show us the track marks. And then we'll lend them 5 syringes. We don't attempt to do any counseling, any treatment the first time unless they ask for it because we don't want to frighten people away. And because their initial experience is positive, they go tell their friends. We've seen 900 in Liverpool since October, 1986. It cost us $50,000. If you work out the cost of keeping someone in detoxifi- cation, a methadone program or a hospital, it's a very cheap service. Newday: YOU SAY THE POLICE COOPERATE WITH YOU. HERE THE LAW ENFORCMENT COMMUNITY IS DEAD SET AGAINST THE NEEDLE EXPERIMENT. PARRY: Police are the key agency. Lets say a syrigne scheme opens up, and a police car parks outside. No one would go in. The police can stop it without even arresting someone. O'HARE: You can see the problem when there was a policeman shot sitting in his care. You can see that the average man on the beat is not going to be too pleased. He might feel that he is backing off people who shot his mate. PARRY: We're not saying we've got the answer and New York should do it. There are a million differences But the differences are in the culture of the people who don't use drugs. Newday: ARE YOU SAYING THAT ALL THE EFFORT THAT WENT INTO GETTING THE NYC PROGRAM IN PLACE IS REALLY A WASTE? PARRY: I thought it was a waste when I heard the caveats being put on it. [But] you've got to try something. Newday: WHAT DO YOU THINK OF THE JOB NEW YORK CITY HEALTH COMMISSIONER STEPHEN JOSEPH IS DOING? PARRY: Because of our National Health Service, there are no politicians directly involved in the implementation of health service. It's really weird listening to someone who's got political considerations first and foremost in the planning of health policy. In our region, when we decide an urgent issue, we don't have to consult politicians, we just do it. Newday: SOME HEALTH OFFICIALS BELIVE AIDS MAY BE THE ENGINE FOR THE ESTABLISHMENT OF NATIONALIZED HEALTH CARE IN THIS COUNTRY. PARRY: That's wishfull thinking by ... the left. People have been saying "Why have you been able to do all these things in England?" Its because our Tory ministers came to America. Norman Fowler, the [social services] minister, two weeks after being back said we're going to fund giving syringes to users because what he saw was so obscene as far as the attitudees are concerned. Secondly, as a good Tory minister tyring to manage social service and health care, he doesn't want to have to fund hospital beds for thousands of people with AIDS. O'HARE: I came here to learn, and I have to say I have learned very little. [I've seen your] public service announcements on drugs. They just lie about drugs. We've heard some absolutely outrageous things about marijuana particularly. PARRY: There's almost a sense [here] that drugs are so bad that even if you have to lie to people to prevent it, that's OK. And I would accept that if people stopped. But that doesn't work. I feel sorry for people doing research on this issue. [They] actually believe taht research determines policy; you produce the results, eople read them and then do something. The research say [teaching kids to abstain] is crap, but the governemnt says "Never mind your research, just say no." Newday: YOUR APPROACH TO DRUGS SOUNDS RADICALLY DIFFERENT FROM THAT OF MOST AMERICANS. O'HARE: You [assume] that drug addiction is a disease, that people who fall to this didease are deficient psychologically, they have a "dependent personality." It allows you to look at them as imbeciles that you can do things to. It's a convenient way to forget the social, economic and political factors. Newday: IS THE LEGALIZATION OF DRUGS THE ANSWER? PARRY: There's two things I don't agree with: one is prohibition, the other is free availability. America has the biggest expenditure on prohibition, and it's got the biggest drug problem. All prohibition does is remove the inefficient dealers from society, allowing the efficient ones to control the market. O'HARE: It's classic capitalism. America go involved in a war in Vietnam and after a few years realized they were not going to get anywhere. But it just seems to be carrying on with this war on drugs, and they're getting absolutely nowhere. PARRY: That's not to say we don't have a big drug problem. But it's dealt with more rationally. Here you've got mass hysteria. The perfect medium for hysteria is the media. It sells newspapers. The media is dictating policy. Newday: ISNT THERE TENSION BETWEEN INFORMING THE PUBLIC ABOUT AIDS AND SPARKING HYSTERIA? PARRY: You can still sell newspapers [and] inform at the same time. The media have got to realize that they have a role to play in the prevention of HIV. Here the one and only rule seems to be "sell newspapers." Newday: DO MOST ADDICTS WANT TO GO INTO TREATMENT ? PARRY: [In Liverpool] we don't call it treatment. We call it free drugs. We give people drugs as a way of giving them a chance to make a choice about their lifestyle. When there's no employment, people don't get depressed and hang themselves. They create an alternative lifestyle. It's ..... robbing, it's ... dealing, it's buying drugs. It's getting stoned -- it fills the 24 hours. That's what they're strung out on; the drug is almost irrelevent. This program interviewed guys from Harlem, and what they were into was the lifestyle. "Taking care of business" they call it. It's a job. because there's no employment, there's no incentives, they don't have anything. O'HARE: In some ways its easy for them to stop. It's getting them to stay stopped that's the problem. What will they fill the void with ? You can't say get off the street and we'll give you a job. The norm for youth unemployment in Liverpool is 30 percent. In some places its about 90 percent. PARRY: You've got people now trying to pretend that they're realy worried about drug use in the minority groups here. I went to the Bronx. Beirut doesn't look like that. Politicians are saying: "We're concerned about about drug use spreading in those communities" What communities? The place is decimated. It's scandalous. O'HARE: I've notice in the whole debate about AIDS and the war on drugs that there is very little discussion about the social, economic conditons in which this activity takes place. Nothing about structural factors. Newday: IS THE WAR ON DRUGS DANGEROUS? PARRY: It is really like a new McCarthyism -- "If you're not for the war on drugs, you're traitors." O'HARE: In a war you can accept victims and you've got an enemy. For some people, that's an effective way of viewing it. PARRY: In the war against drugs, you don't lock heroin up in prison. It's a war on people, so it's a civil war in your own community. If you make drugs illegal, you have to accept certain consequences: that criminals will get involved, that policemen will be shot, that drug users will die of all kinds of infections, that AIDS will wipe them out. They're casualties of war.