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Opinion It's time to get real about heroin addiction. It's time to decriminalise this drug

Dr Austin O’Carroll says decriminalisation would be a way of taking responsibility for the vicious effects of inequality.

I CAN SAY without a shred of doubt that the most stigmatised people in our society are those who use illicit drugs.

‘Junkies’, ‘dopeheads’ and ‘crackheads’ are some of the words that capture the general public’s loathing for this group.

Sadly, it has been demonstrated that this antipathy to illicit drug users exists in spades among the public services, including the health service.

The public attitudes focus on blaming the drug user for their fecklessness and lack of character. This is ironic considering that the evidence demonstrates that the precursors to drug use are childhood trauma and poverty.

A class issue

I often ask classes from middle-class schools and colleges for everyone who knows a heroin user to identify themselves -  a small number of people might put their hands up. I then ask how many know someone who has died from heroin use. Occasionally one or two will raise their hands.

If I ask the same questions in an inner-city primary school almost all the class will have their arms in the air.

Blaming individuals for the results of societal ills is surely one of the gravest injustices.

There is an overdose of moralising about addiction. I believe there is nothing wrong with addiction in and of itself. All the problems lie with the consequences of addiction.

Addiction itself is a complex human experience and although rarely a positive one, it can impact the person’s quality of life in a multitude of ways. If I were addicted to exercise, for example, the consequences would not be seen as particularly destructive. But the everyday effects of heroin addiction are horrific.

More people die from drug-related deaths – in terms of overdose and death from HIV or hepatitis – than road-traffic accidents or suicide.

The deleterious effects of heroin use on physical health, which include the spread of HIV/hepatitis, abscesses, leg and lung clots, loss of limbs due to blood vessel complications and heart infections are myriad.

The mental health consequences are equally severe with extremely high rates of depression, anxiety and psychosis associated with drug addiction.

The impact of drug addiction on society can be devastating including unemployment, family breakdown, loss of contact with friends and community, involvement in thievery and crime, homelessness, begging and social rejection.

Let’s talk legalisation

Challengingly, many of these consequences would be diminished or disappear if heroin was legalised. One could sell heroin in the corner shop either in smoking or injection form with clean needles and in regulated amounts. 

This would reduce the risk of overdose, which in turn could be further reduced by including a naloxone opioid blocking injection in the pack. Users would use it together socially so they could watch out for each other. HIV and hepatitis infection would more or less disappear.

As commercial heroin would be cheaper than illicit versions, addicts would not have to turn to crime. As it would be socially acceptable, one could maintain contact with the family, hold down a job and avoid homelessness and street begging or injecting.

Lastly, drug-associated crime would disappear. Al Capone and the Chicago gangs made their money because alcohol was illicit. When it was legalised such crime evaporated.

The downside would that be like when alcohol was legalised, while many of the negative effects disappeared, more people became addicted to alcohol as it was freely available.

This is why I am against legalisation but I am pro-decriminalisation.

Decriminalisation does not mean illicit drugs would suddenly be legally sold; it would mean that those found in possession for personal use would not be criminalised but would be offered health and social supports to help them escape their addiction and find a path to a socially fulfilling life.

The evidence from Portugal is clear that decriminalisation does get rid of many of the negative elements of illicit drug use while preventing the widespread use of drugs that full legalisation would produce.

Since Portugal adopted this policy, the number of new illicit drug users, drug-related overdoses, cases of HIV/hepatitis spread via dirty needles and drug-related crime have all reduced significantly.

As an example, the rate of new cases of HIV-related infection dropped from 104.2 per million in 2000 to 4.2 per million in 2015 post decriminalisation.

The evidence is clear that drug decriminalisation is a no brainer. Any other response to drug addiction has to be soaked in morality and blame to ignore the blatant facts supporting decriminalisation.

The Irish public has led the way in de-criminalising and de-stigmatising homosexuality almost 30 years ago. Let us display the same humanity to those addicted to illicit drugs.

In doing such, in truth, we would be accepting responsibility for the vicious effects of inequality and poverty.

Dr Austin O Carroll is an inner-city GP. He is founder of Safetynet and the North Dublin City GP training scheme and co-founder of GMQ Medical Services for Homeless People and GPCareForAll. 

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41 Comments
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    Mute Ailís McKernan
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    Mar 1st 2012, 12:08 PM

    a farce, thats all it is.

    62
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    Mute Keith Twamley
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    Mar 1st 2012, 12:33 PM

    €19,100 a month, think Europe needs to tighten it’s own bloody belt.

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    Mute jumpthecat
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    Mar 1st 2012, 12:40 PM

    He’s belt is tight enough by the look of him. Cardiff has the look of somebody after 10 pints after the All Ireland looking for a chipper.

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    Mute Karl Doyle
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    Mar 1st 2012, 12:40 PM

    The UK pays them £50 million per day, they don’t need to tight.

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    Mute Aaron McKenna
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    Mar 1st 2012, 12:09 PM

    That’s our secret plan to write off the debt sorted.

    As the old joke goes, “Well, the strategy is… We’re hoping that the people who lent us the money will forget about it.”

    Seems more plausible with Kevin auditing the books.

    50
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    Mute Sean O'Keeffe
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    Mar 1st 2012, 1:48 PM

    @Aaron.
    I’ve grossly underestimated the genius of our political leaders. How long before Brussels is running like our DoF?
    If the Eurocrats uncover Kenny’s devious plan, he could always threaten them with more civil servants if he doesn’t get concessions!

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    Mute John Murphy
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    Mar 1st 2012, 12:36 PM

    My comments about this chap keep getting deleted so I’m trying a new tack.
    Best of Luck Kevin! We’ll all miss you.

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    Mute Kevin Smyth
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    Mar 1st 2012, 1:35 PM

    Somehow I don’t believe you. But, since I don’t want my comment deleted either, I wish him all the best, He’s a virtuous, honest and devilishly handsome man. I have absolute trust in him. He’s GREAT!

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    Mute Eileen Gabbett
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    Mar 1st 2012, 8:36 PM

    I don’t believe you either John ….
    I hope he works out as well over there as he did here and that
    when he does, the same or similar , he will get his just desserts.
    Best of luck Kevin :)

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    Mute Peter Carroll
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    Mar 1st 2012, 12:04 PM

    Quick, count the stamps.

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    Mute Pat Mc Cormack
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    Mar 1st 2012, 12:51 PM

    He looks like Biffo after a few pints

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    Mute Billygoatmuff
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    Mar 1st 2012, 2:43 PM

    He’s more like Harney after a brief run.

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    Mute LoyalIrish Citizen
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    Mar 1st 2012, 12:52 PM

    I hope he does the same job for them as he did for us.

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    Mute Pat Mc Cormack
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    Mar 1st 2012, 12:47 PM

    This Guy is so Cool….
    I hope he has a Wonderful time in his new job,
    I really wish him all the very best x x x x

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    Mute Gerard Murphy
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    Mar 1st 2012, 1:58 PM

    Good luck Kev, hope the new job works out well, did you get the new (working) calculator I sent you?
    I know it’s a big sacrifice for you going ovef there, what with the poor pay and all that, we’re all rooting for you back home!

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    Mute Innishvilla
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    Mar 1st 2012, 2:53 PM

    Taking up the auditors post is OK. Just don’t let him open it or play with Money and stuff

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    Mute Glyn Carragher
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    Mar 1st 2012, 1:40 PM

    Nice Photo! But I cant make up my mind whether the slogan or the individual is the bigger joke

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    Mute hjGfIgAq
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    Mar 1st 2012, 1:38 PM

    Hey folks,
    Thanks for all the comments on this. I just wanted to note that the only comments that were deleted contained offensive language and were removed as per our comments policy.
    Susan

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    Mute John Murphy
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    Mar 1st 2012, 3:41 PM

    Aww Susan. Ya could let us off once in a while.

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    Mute Rommel Burke
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    Mar 1st 2012, 3:12 PM

    Bunch up on the sofa, Kevin coming!

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    Mute Patricia Gilheany
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    Mar 1st 2012, 4:48 PM

    Cardiff gone to pastures new and leaving one hell of a mess behind him. Just look at what Anglo got away with under his watch,—Maple 10, loan warehousing etc etc etc.

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    Mute Frank2521
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    Mar 1st 2012, 4:48 PM

    For years we sent the cretins to Europe just look at our history Frank Rossi, Pee Flynn, Charlie Mc Creevy, Lucy Cretin and to top it off Our very own Kevin Cardiff. We thought we were just getting them off our TV sets as we were sick of them – now they happen to hold important positions by default. We were caught out. Still we won’t have to see as much of them walking our streets. Lucy takes up the whole footpath in Sandymount.

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    Mute Getard Langslanger
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    Mar 1st 2012, 3:28 PM

    He’s the spit of Benny Hill and a comedy( of errors) genius to boot

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    Mute Shane Farrell
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    Mar 1st 2012, 9:28 PM

    Lets just be glad he is gone!!!!

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