ISSUES
: Drugs
Chapter 2: UK drug laws
26
Detox or lose your benefits: new welfare
proposals are based on bad evidence
and worse ethics
An article from
The Conversation
.
By Ian Hamilton, Lecturer in Mental Health, University of York
W
hen is a choice not really
a choice? It could be argued
that the latest proposal from
the Government aimed at people who
have problems with drugs and alcohol
is not a choice but an ultimatum –
accept help for your problem or lose
your right to welfare benefits.
This proposal raises some very
serious issues. Treating any condition
is based on consent – the person
shouldbewilling tohave the treatment.
In this case, people have little choice
and therefore they would probably
be consenting to treatment to avoid
losing money. This also passes on
an ethical dilemma to treatment staff,
who would need to decide if they
are willing to participate in state-
sponsored coercion.
The consultation on these issues, led
byCarol Black,will have its supporters.
The Government has pledged to
reduce the country’s deficit. When
tax-payers’ money is given to people
who will inevitably spend some of it
on the substances they are reliant
on, many people despair. The idea
of sanctioning addicts will resonate
broadly with the public who often view
drug and alcohol problems as self-
inflicted in the first place. But that is
not the full story – and to cut through
these emotionally charged arguments
we need to consider the context.
The first thing to consider is howmany
people who have drug and alcohol
problems claim welfare benefits –
something that, unfortunately, we
don’t know. Even the Government’s
own recently published calculations
of those in treatment and claiming
benefit are three years out of date.
It is clear that the results of the
consultation will inform the Treasury
spending reviewwhich is due to report
inNovember. But if we don’t howmany
people are claiming benefits and are
not in contact
with
treatment
services, it is
difficult to see
how this review
will be based on
anything
other
than guesswork.
This is not the
finest hour for
the new era of
evidence-based policy.
Compounding this missing data is
the lack of proof supporting such
an initiative. There is already good
evidence from other parts of the
world that coercive treatment does
not produce the desired benefits
It would be naïve to assume that
people only have problems with
drugs and alcohol. Most will have a
range of complex and interrelated
issues in which their physical and
mental health is also compromised.
This complexity is not matched by a
sophisticated system of treatment.
Services have become increasingly
specialised and resistant to
accepting people who don’t meet
their strict criteria. Navigating such
complex pathways into and around
treatment would challenge the most
cognitively able.
Treatment can take time and, for
most people, will require more
than one attempt to recover from
addiction. So if drug treatment
becomes compulsory, the capacity
of treatment services will need
attention. Particularly if funding for
drug treatment continues to be cut,
then the capacity of these services
to accept the increasing number of
referrals will be compromised. This
initiative could also make it more
difficult for those who are ready
for treatment to access services.
Increasing demand without resources
tomatch will delay entry into treatment
for many.
If the moral arguments for treatment
fail to seducepoliticians and taxpayers
perhaps the clear economic case
might be persuasive. For every £1
invested there is a conservative
estimate that £9 is saved by reducing
crime and other health costs.
In economically austere times, led
by a government that believes it has
a mandate to cut public costs, we
need to be realistic about what form
drug and alcohol support takes,
ask whether there’s evidence to
justify it and think carefully about the
unintended consequences.
These are challenging times for
people who have problems with
addiction, and those who wish to help
them. We must speak up quickly and
with one voice. Not only to challenge
the ideology of this review but to offer
some fresh views of our own.
3 August 2015
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The above information is reprinted
with kind permission from
The
Conversation
. Please visit www.
theconversation.com for further
information.
© 2010–2016, The
Conversation Trust (UK)
