In this occasional series in conjunction with the SSA’s journal Addiction, we record the views and personal experiences of people who have especially contributed to the evolution of ideas in the journal’s field of interest. In this episode Harry Shapiro talks about his time working in addiction. From the Institute for the Study of Drug Dependence (ISDD) in 1979 to DrugScope and DrugWise. Harry also talks about how addiction treatment and policies have changed over that time. He also comments on the future of addiction treatment and his recent work on e-cigarettes.
Harry has also provided an annotated bibliography of his work, available here.
This episode was recorded online on 15 October 2020. The transcript below was lightly edited by Virginia Berridge and Harry Shapiro.
Addiction (A): Well tell us how you first got involved in the …?
Harry Shapiro (HS): How did I get into drugs! (Laughs.) Okay well I was a qualified librarian and after qualification I had a job at a firm of architects and engineers in London and it was pretty boring I have to say. I mean I was cataloguing the trade literature and it was fairly grim, I decided I needed to find something else to do outside of work, because this was driving me crazy. And so I decided I wanted to try and write and I thought, ‘well what do you know to write about’? The answer was music and I just researched around for some musical thing to write about and I came across an entry in one of these rock encyclopaedias about a British R&B blues musician from the sixties called Graham Bond, who was quite influential. He had some big names in his band like Ginger Baker, Jack Bruce and John McLaughlin when few had heard of them and it looked really interesting as a story. This guy, I found out from reading a couple of articles, had a heroin problem and I knew absolutely nothing about heroin addiction at all. I did some research, read up on it, started writing the book, talking to people etc. In the meantime, and this would have been around the summer of ‘79, there was an advert in The Guardian for an Information Officer at the Institute for the Study of Drug Dependence, which was out in West Hampstead. I just looked at this and I thought,’ okay well I know a little bit about the subject now’, so I applied for it and I found out later that they had about 70 applicants for this job, and I got it. So, the beginning of September 1979 I started working for the Institute for the Study of Drug Dependence, initially as a cataloguer, indexer and looking out for new materials to add to the library. There were four of us doing this job. There was myself and Philip Defriez who were what they called ‘input’, in other words getting stuff into the library and John Witton and Mike Ashton, who were dubbed as ‘output’ – producing current awareness bulletins, reading lists and Druglink magazine. That’s how it was divvied up and that’s how I started out.
A: So was this the early days of ISDD, had it been going long then?
HS: It had been going for about a decade. In 1968, Frank Logan, a former Home Office and UN Narcotics Division official had just retired from the Royal Institute for International Affairs, and was searching in vain for sound, objective information about drugs for an article he planned to write. This was at a time when there was a lot of media and political interest in drugs, but Frank couldn’t find what he was looking for. He decided to set up an institution to solve this problem. On 1 April 1968, ISDD opened for business from the attic of the Royal Society of Medicine premises near Covent Garden with a library you could fit into a cupboard. He employed Jasper Woodcock, who was a pharmacology researcher and Jasper became the first director. There was no government funding then, but funds came from the US Drug Abuse Council. In the early seventies ISDD moved to larger premises in West Hampstead and started a research unit headed up by Nicholas Dorn.
The library was growing quite considerably at that point, because the collection policy was pretty much anything in the English language, whether it was books, articles, grey literature, ephemera, you name it. It was focused on non-medical or illegal drugs. So non-medical drug use would have included misuse or overuse of barbiturates, tranquilisers and prescribed opioid drugs. The remit excluded alcohol and tobacco, not because they thought they weren’t drugs, but there were other organisations like ASH for instance dealing with that side of substance use issues. They didn’t collect any foreign language material and stopped collecting chemistry studies as well, where you fill a rat with THC, it falls over and you write a paper about it. I think there was a lot of that going on and probably still does, you know what it’s like in academia everybody needs to publish, publish, publish. Very few people could really understand any of it, so it seemed pointless to clog up the library with loads of articles that no one was ever going to read.
HS: The library just grew apace really. They appointed Mike Ashton I think in the mid-seventies and then John Witton and Phil DeFriez and it was building up until it took up most of the ground floor of this two-storey building. By which time I think they’d begun to get some money from what was then the DHSS, the Department of Health and Social Security along with the Drug Abuse Council funds which might have been running out by then.
A: Well, the Drug Abuse Council funded by first research.
HS: By the time I arrived, there were more people working in the research unit as well. Important too, was that we shared premises with the Standing Conference on Drug Abuse, SCODA.
A: In Blackburn Road.
HS: In Blackburn Road. SCODA I think came into being around 1970. It was essentially an umbrella organisation for lots of little NGOs, what we now call third sector drug agencies, outside the NHS, who really had no way of communicating with each other and no voice to central government and so SCODA was formed to be that voice, to be that kind of intermediary between a whole group of small, poorly funded disparate organisations and central government. And also to help new agencies to start a new service. That was SCODA, so they were on the top floor of Blackburn Road and that was the set up when I got there in September ‘79.
A: So what sort of people were you dealing with in your job, who was using it?
HS: Who was using it? Well, (laughs), literally everyone. I mean the whole rationale that Jasper established was that the information we should provide should be topical, non-judgemental and a term, before anyone thought of using it, evidence based. Eventually I dubbed it, in the war against drugs, ISDD and later DrugScope, as the demilitarised zone. We were that space in between all the polarised views and opinions and myths and prejudices and whatever you want to say about drugs, and we were this. You might argue with the concept of objective truth, but the point being that we were in that middle zone I suppose. My best example of that is one day in the library, because we had limited space for visitors, people could come to use the library, but there wasn’t much space. I distinctly remember one day we had the legalise cannabis campaign at one end of this trestle table looking at stuff and the Metropolitan Police Drug Squad at the other end, also looking at some articles. And that kind of encapsulated the mission statement, again I don’t think anybody used ‘mission statements’ back in those days, but that encapsulated what ISDD really was all about. And we had, you know government officials, we had students, we had parents, we had thousands of enquiries from schoolkids who wanted information about drugs. So literally anyone who had an interest in the subject from whatever discipline or level of complexity – there were no exclusions.
A: No, there wasn’t really anything else at that time presumably.
HS: No there wasn’t and there still isn’t and there never was. I mean ISDD was unique and what was fascinating about that was that although we were a charity in receipt of government money, whenever we got visitors from overseas and most of the visitors from overseas tended to be from enforcement agencies of one sort or another – who came to look around to see how Britain was dealing with its drug problem and go off and see the Home Office and whichever national police agency was around at the time – they could not understand how we could operate entirely independently of government and government views and still get government money. They could just not get their heads around that idea, they automatically assumed that we were a government front agency or that we were going to be anti-drug, because the government obviously was and we were in receipt of funds. Some people over time accused us of sitting on the fence when it came to issues like drug law reform and so on and my response was that I quite like the view from up here. (Laughs.) So you know it was a helicopter view and it paid off, it paid dividends, because to be honest at that time there was a reluctance to engage with the media. There was a sense that if you engage with the media on drug issues they will simply misquote you, quote you out of context or in some way or another screw you over. And moving on in time, it was still ISDD, but I began to encourage a change of policy around that, saying it’s no good if a journalist phones up and says, ‘what do you think of this latest government initiative to do this?’ and then you say, ‘well we’ll get back to you next week’. You can’t do that. If you are going to do it, you have got to realise what you’re dealing with – that they have deadlines and all the rest of it. So over time we got more and more journalists contacting us as well, because if they wanted people who were anti-drug they could find those, or if they wanted pro-legalisation organisations, there was Release and other organisations like that. But if they wanted something a little bit more in the middle, some sort of helicopter view of whatever the issue was, they came to us. Now, we all had our own personal views about where things were going. I think it would be fair to say that we were all pretty left liberal you know, I think it stands to reason we probably would be that – regular Guardian readers and all the rest of it. But nevertheless, we stuck to that principle of the evidence. And then certain issues became very central to what we were doing, primarily harm reduction, when HIV and AIDS took off, that very much became the focus of what we would support and speak in favour of. So we weren’t trying to do a BBC balancing act where you talk about this, but you say on the other hand some people think harm reduction encourages people to shoot up heroin, I mean we didn’t do that. Because we were focused on the evidence base and the evidence base was pretty clear on this point that people can’t recover if they’re dead, that you have to do what you can to keep people alive, while accepting that you aren’t necessarily going to change their behaviour.
A: Yes. how did the work develop in other directions?
HS: Well what happened was, as I was saying, we were getting lots and lots of enquiries, the same enquiries, like what’s the effect of heroin and how do you know if someone is using drugs and why do people use drugs? The same questions kept going round and round. And we spent a lot of time photocopying articles and sending those out, but it became clear that what we really needed to do was produce our own materials and not just photocopy little bunches of articles and send them out for private study. So from there we developed a publications unit and that’s when I moved away from classic library work. I moved across to developing and heading up that publications unit and then I also began to write for Druglink as well.
A: When did the publications unit develop was it during HIV?
HS: I think it probably was, because the research unit was putting out publications of its own. In the early eighties it began to develop some pioneering work around drug education in a harm reduction context. In fact, it was the research unit that produced a controversial leaflet called, ‘Teaching about a Volatile Situation,’ around 1980/81, because the big topic before the heroin epidemic kicked in, was glue sniffing. That was the big media story at the time and the leaflet that Nicolas Dorn and those research workers produced, may well have been the very first piece of harm reduction, drug-related literature in the UK, which was essentially saying that mainly kids were dying by shoving large paper bags over their head and sniffing glue and suffocating. So if kids are going to do this and there is no way you can really stop them, they should be using small crisp packets. And if you see a kid sniffing glue by the river, don’t start chasing them around all over the place, because volatile solvents might trigger a heart attack, or a seizure if someone is running around. Now that caused a massive stink, as you can imagine, in the press, you know ‘glue sniffers charter’ from charity. There were some worried calls from the Department of Health, and I think it actually got raised in the House of Commons at some point. But all of that eventually went away. But it was the beginning of publications from ISDD and over that time we started producing some standard titles, like the Drug Abuse Briefing which went into about 20 different editions over time. We did drug education materials, we did HIV-AIDS based materials, teaching packs, teaching packs for youth workers. So we did a lot of that stuff, but we also produced what I would call, ‘here is your starter for ten,’ type drug information. So basic questions were answered, and it became quite a money spinner. By the time things began to change, which we can talk about, but by the time things began to change in the late nineties, we were up to a turnover of something like a quarter of a million pounds, which was pretty sizeable for a small unit like this.
A: Because you were one of the few places putting out that sort of material weren’t you. It became much more widespread later.
HS: Well, it did, but even then, there were places like TACADE up in Manchester, which was basically health education, another organisation called, Health Wise, they were based in Liverpool. And Release, the Blenheim Project, there were a number of agencies who were putting out information that was particularly related to their sphere of operations. So Release would put out information about drugs and the law and things like that. We used to stock other people’s literature, so it wasn’t just our material. We became a kind of hub really. It became quite an operation in the end.
A: And you’d moved by that stage too, hadn’t you?
HS: We moved into larger premises in Hatton Garden, which was sometime in the mid to late nineties, because the library was growing and the number of staff we had was also growing. So the library was getting bigger, there were more people working in the library and then we did another move, this was in the late nineties to premises in Loman Street, near Borough tube station, which is probably the biggest area that we actually occupied. We bought the building on a Department of Health mortgage and throughout all those moves, SCODA came with us. So we were always kind of sort of joined at the hip, which was a little bit of everyone’s undoing in the end, but I can tell you about that in a minute. There was also Adfam was in the building and Alcohol Concern and Victim Support. So that building in Loman Street became a much bigger enterprise. More research was going on, we were doing research overseas, I think we were doing drug education advice overseas as well, Pakistan and various places.
A: Yes, talking about overseas, weren’t there a number of different organisations in Europe and the United States that also had a similar kind of library information function?
HS: Up to a point. America had the National Institute of Drug Abuse library in Maryland and there was another outfit somewhere on the west coast, whose name escapes me. There was Trimbos in the Netherlands, a Canadian sister organisation and another one in Australia, the Australian Drug Foundation. So there were other places with library and information capacity, but in terms of just the physical size of what we had, I think we were the biggest as I say outside of the NIDA library in Maryland.
A: You were doing your music writing alongside all of this were you?
HS: I was yes. I wrote this book about Graham Bond and the basic response from publishers was ‘nice book, shame about the subject’, because nobody really knew who the hell he was. And I went on to write more famous ones like Jimi Hendrix and Eric Clapton who were a little bit better known (!). But the work, the day job and the evening job came together in the late eighties when I wrote a book called, ‘Waiting for the Man,’ which is the story of drugs and popular music and it was tracing the link between those two aspects of popular culture from the medicine show days in America in the late nineteenth century, all the way up to the beginning of the rave scene. It went through a few subsequent updates, but it was at that point that, those two bits of my life kind of came together in one book. It is due for re-release in 2021 from the Lemur Press in the USA.
A: Then you said things started to change at ISDD?
HS: They did, they did. I think one of the problems was that ISDD and SCODA did very different things, SCODA was an advocacy campaigning organisation on behalf of non-statutory drug agencies and ISDD was an information and policy and research unit. So they did entirely different things. But I suppose because we kept moving around together, the Department of Health officials, not all of them, some of them knew exactly what was going on and appreciated the work. And I have to do a shout out to Dr Dorothy Black from the department in that context. She was very, very supportive of us, you know whenever things might have got a little bit sticky with central government, which didn’t happen very often, but in terms of securing our funding under what was then called, Section 64, which was a special bit of the Department of Health budget for voluntary agencies like ISDD. Anyway, it came to a point where there was a particular Department of Health official, who actually decided that DH were not prepared any longer to fully fund both ISDD and SCODA.
A: It was late nineties was it?
HS: Late nineties, yeah. This was late nineties and the Department of Health decided that in order to save money and because, they either couldn’t understand the difference between the two organisations, or simply just didn’t want to know. They might have understood, but they wanted to save some money basically, because, if memory serves, there was something like an economic downturn in the early nineties and there was, the ever turning circle of Government cuts and squeezes and all the rest of it. So we were essentially told in no uncertain terms, that the two organisations need to merge or die – was really how it was put. And I remember sitting in a meeting with ISDD and council and senior staff members, of which I was one by then. Civil servants are normally fairly kind of circumspect. They use phrases like, ‘it would be very helpful if,’ or ‘it would be very unhelpful if,’ but this guy just laid it on the line and I think our council was somewhat shocked at his forthrightness. What it meant was that we had to find a way to merge the two organisations. Jasper Woodcock by that time had retired and we had a new director in place, called Anna Bradley, who had come from the Consumers Association. And what happened was that SCODA then got into increasing difficulties with the government who had implemented a new way of funding residential rehab through the Community Care Act and it was going to cause residential rehab quite a lot of problems and SCODA went in to bat. There were no more central grants for rehab, it was all going to have to be handled by local social services, which of course were under huge pressure anyway. So SCODA got quite active in opposing this and on one memorable occasion during European Drug Prevention Week, which was started up, I think in 1992. The very first meeting of the European Drug Prevention Week was in London. ISDD had Princess Diana as its patron, I think it’s worth mentioning at this point and she gave a speech which to her credit ignored what we had written for her. SCODA picketed the conference. It was the beginning of the end at that point and the Department of Health essentially told the SCODA Board that, Dave Turner, who sadly is no longer with us, needed to go. They may well have not put it in quite so blunt terms like that (or maybe they did) but that’s essentially what happened.
By that time there was a feeling in central government, because the drug problem was getting worse, that somehow there needed to be a more joined up local and regional approach to drug issues. There had to be a way of building bridges across regions and from the top down to the regions. They commissioned Roger Howard, who was an independent consultant at that time and he produced a report called, ‘Across the Great Divide’ which eventually set up the whole Drug Action Team structure in England and Wales. He eventually became interim CEO of SCODA after Dave Turner left. It was his job essentially to manage a merger between ISDD and SCODA and that happened on 1st April 2000 which caused a few wry smiles! So the two agencies came together and were one organisation in that building in Loman Street. We had a huge meeting in the basement to decide what this new agency was going to be called and there was one body of opinion that said, ‘we want a name that gives gravitas, like the Institute for the Study of Drug Dependence, it should be some sort of name like that. Other people thought it should be a lot snappier and along the spectrum DrugsRUs, kind of media friendly. I was Director of Communications elect and I hadn’t actually taken over yet, because the agencies hadn’t officially merged. But we had to get all the ducks in a row by April, to launch the new organisation. So I finished up with a huge long list of names that people had come up with and I remember sitting on a train coming home and I thought,’ what about DrugScope?’ and then I thought ‘Come on, somebody must have suggested DrugScope’. There were 133 names on the sheet of paper and I looked all the way down it and DrugScope wasn’t there and I thought,’ okay executive decision required here, because we can’t go round and round in circles forever’. So I came back the next day and said, ‘right I think we should call it DrugScope’, and the only thing I had to do then was check out with SCOPE, which is the cerebral palsy charity, that they didn’t mind us calling ourselves DrugScope. They were fine because we didn’t have high street shops that would compete with SCOPE shops. So it became DrugScope.
A: How did the merger go, what happened?
HS: Well, there were staff changes, there were staff changes in the run up to the merger, there were people having to reapply for their jobs, mainly in SCODA and people made redundant from ISDD as well. I don’t remember all of it in detail, but there were certain behind the scenes grief going on about it. A number of staff from both organisations had already gone by the time the merger happened, but part of the agreement was that post-merger, nobody would get made redundant. So the staff, when the two agencies came together, was quite big. We occupied the whole of the first floor at Loman Street and our now research and policy units, (SCODA really became a policy unit and we kept our research capacity), took over the whole of the second floor. Most of their work was commissioned by the Department of Health, but that work began to dribble away because of the National Treatment Agency. The National Treatment Agency came on stream in 2001, so a lot of those contracts disappeared because the Department of Health took it all in-house.
A: So the National Treatment Agency, just remind us was?
HS: Roll back to 1997 and the New Labour government. Tony Blair came in on a ticket of breaking the link between drugs and crime. I mean he had ‘education, education, education,’ but he also had ‘break the link between drugs and crime.’ And it was quite clear, going back to Roger Howard’s 1995 report and I have to give a shout out here to Tony Newton, who was the Tory Health Minister, who was very supportive of harm reduction, very supportive of drug treatment and realised that the drug treatment system as it was, was not really fit for purpose, for all sorts of different reasons, mainly waiting times. So because you are going to break the link between drugs and crime, it meant that the treatment system needed substantial investment. The issue then was, how do you guarantee that that investment is going to be used properly, because there were millions going into it. To be honest there was not an awful lot of trust that the NHS would use the money in the way it was intended and that it might via away for other sorts of treatments, because there are no sympathy votes for people with heroin and crack problems. So the NTA didn’t actually hold the purse strings of the central fund, what they called the pool treatment budget, they didn’t actually hold the purse strings, but they were very influential in who got what and even more importantly, which is something we’ve lost, I have to say, in Paul Hayes, who was the CEO, they had somebody who was going to be a champion for treatment, at the centre. Now it was very helpful that it was one of Tony Blair’s top priority areas, because if a Prime Minister designates something as a top priority area, you can bet your boots that there’s going to be some money spent on it and political attention will be given to it. But even so, the other thing about having a champion at the centre, he was also able to demonstrate a level of impact or effectiveness that other areas of the drug strategy couldn’t. It’s very hard to show any effectiveness of drug education, very hard to show any effectiveness of digging up opium poppies in Afghanistan, which Tony Blair had committed the British to do, after the fall of the Taliban. We were going to be the international force that took on stopping the heroin trade and how did that work out? But with treatment at least you had statistics, you could show how many people were in treatment, you could show the fact that the waiting lists were coming down. You could show where people were referred to, so you could at least demonstrate stuff was happening. But in order for the NTA to do that, they needed to conduct an awful lot of research of their own in order to pull all this together. So a lot of the work that had been commissioned out to DrugScope or ISSD/DrugScope and possibly other agencies as well, was all taken in-house. And in a sense that began the decline in DrugScope’s income, which was accelerated by the internet as it meant that people thought they could just produce their own materials by just printing them off and giving them out, because much more material was online. The library began to decline as well, because a lot of journals were available online for academics and students through their own universities who would take out subscriptions for journals.
A: So you didn’t get the people visiting to use the library.
HS: No, visitors to the library fell. The general level of enquiries fell. I mean the immediate enquiries were still up there, because drugs remained a hot topic all the way through the Blair/Brown administration. Over time we lost funding as well. The core grant began to go down and down. Then around 2004/5 Roger left DrugScope, and other members of staff had already gone by then.
A: What about the research unit, did that go, the research unit?
HS: That went quite early on in DrugScope’s life, because there was a view that — how can I put it — we stopped being a research unit and what we were beginning to do was what you really could call market research stuff. It was like – what do DATs need to do to be more effective? It wasn’t the sort of research that we had been doing in the past that was not so much geared to that kind of delivery. I mean I’m not expressing it that well, but the nature of research changed, And Nicholas I think had moved on really from drug research, he’d become more involved in general criminology as well, money laundering and organised crime that kind of thing. So he moved on and the research unit sort of dribbled away.
HS: We didn’t replace it with other research projects. So we lost that, we lost income from the Department of Health publications. We would do a piece of work, produce a publication, which the DH had already paid for, but they allowed us to then go and sell the product. So we were kind of getting double bubble really at that point, which all helped the income stream. That all stopped.
A: Druglink was still very well regarded wasn’t it?
HS: Druglink was going strong. Druglink was our flagship publication really and remained so pretty much to the end of everything. But the grant was going down, the income was going down, we were losing staff and so the bank balance was looking fairly grim and eventually, oh sometime in the mid-noughties, I can’t put a date on this, we sold the building. We sold the building in Loman Street and then all the organisations that were in it just dissipated to other premises. We moved to much smaller premises in Bermondsey. In fact it was the building that was owned by the people who were building The Shard. It must have been about 2007/2008, because of the financial crash, the building of The Shard had come to a stop and so therefore we were able to occupy one of the floors of this building, because they didn’t have anyone working there, because they didn’t need anyone. We took the library with us at that point, it was big enough to house the library. But really the library was fast becoming an archive. There was less and less money to keep it going in all kinds of respects. It wasn’t really being promoted. It was a bit of a lost cause anyway by that point because the same problems were hitting libraries elsewhere.
A: Did you move online at all?
HS: Well, the catalogue was online.
A: You went online did you?
HS: We did, yes. We went online, there was, in fact I’d forgotten that, ISDD had a website, so we were able to do some stuff online and you could do searches online. You could search the catalogue online, so there were various things that you could definitely do online and we kept that going. We kept the current awareness lists and we were able to upload online. But academic researchers and students were really our core business, our core library users and they were going elsewhere, but there were still students using us when they were doing MA’s and things like that, because a lot of their work was historical and we had lots of grey literature that nobody else had. Anyway, eventually The Shard got going again and we had to move out and that was the end of the library, because up to that point we had rented enough floor space, to house the library. But because of the financial crash, you see the assumption was that the income, that the money that we got from selling the building, the interest on that would continue to cover all our rent and all of the essentials for running the thing. But because of the financial crash, the interest rates fell through the floor, so the income that was expected was nowhere near realised. So we moved to much smaller premises in Farringdon Road and then began a very long saga about what happened to the library. Do you want me to go into that one?
A: Yes, do.
HS: Right. Okay. Now I think there were some views that, ‘ooh let’s find a huge skip and chuck it all in there, because nobody is using it’. There were only two of us left from the original library staff by that time, myself and my colleague Jackie Buckle and I was determined that that wasn’t going to happen as far as possible. The first thing we did was put it all into storage. Something like a few miles worth of storage was rented down in South London called Squirrel Storage. The warehouse was a bit like the last scene in Indiana Jones, where the Ark of the Covenant, you see it go into this huge warehouse and that’s what this was like. The library just got lost in this massive warehouse. Anyway having got it all in there, the next thing was, somebody needs to take this collection and establish the DrugScope library at the ‘University of who knows where?’. I began approaching people, to try and see if they’d take the library. There was enthusiasm from academics and policy people like yourself, but when the librarians of these various institutions found how much there was of it, they turned a whiter shade of pale and said, no. Next, I had to begin whittling it all down and I spent days, weeks and months actually. I started with, the 1500 boxes of material that went into storage and I went through every single one, on my own, in the dust, to try and sort out what we could genuinely get rid of. So, for example, most of the peer review journals went,
A: Because you could access those.
HS: You could access those online. But only up to a certain point. I kept the older ones, the oldest stuff we had, because I knew that wasn’t available online, because online peer review journals at that point had only come up from a certain date, like 1998. If you wanted to look at the British Journal of Addiction from 1953, you couldn’t do it online. Maybe you can now, but you certainly couldn’t back then. I kept all the grey literature, I kept the older journals. The book stock was a whole other story. I had a friend of mine, called Mario Lap, from the Netherlands – we were in an era where drug libraries were closing down. The Trimbos library in the Netherlands was closing down, there was another one I think in Switzerland that was closing down or Germany and Mario had this idea of collecting all these books, from all these different libraries at the time and starting up a whole new place. He came literally in a truck and took a load of books away, which are still in storage in the Netherlands, because he sadly died and that didn’t happen. I finished up with about, in the end, 300/400 boxes of what I would call key documents in one shape or form. Then Swansea University popped up.
A: David Bewley-Taylor.
HS: Thank you. David Bewley-Taylor said he was starting up a new drug policy unit and he’d quite like the stuff. So we shipped it all the way down to Swansea University where it went into another warehouse and at that point the librarian down there said I’m sorry we haven’t got any room for this. Then they were threatening to shut the warehouse. So eventually we got through to the Wellcome Library. One of their people, Elizabeth Graham, came down with me to Swansea and got very excited by this archive. And eventually over a period of time they took it all away and it went up to their warehouse up in Lancashire somewhere and bit by bit it came back down to London, 30 boxes at a time and I went through it all with them and suggested how they might catalogue it and categorise it. So after, I don’t know a decade or so of trying to rescue what was left of the library it is now all in the Wellcome Library.
A: You had a launch not so long ago.
HS: We did, we had a launch for the library. Yep so pretty much most of the British material is there, I focused on particularly British ephemera and government reports and things like that, which you just can’t get anywhere, you can’t get them from the government. I think they’ve got a full set of Druglinks, but then again I’ve got a full set of Druglinks, but you’re not coming round to look at those.
A: It’s a happy end to that story.
HS: Well, there is, yes. It has been preserved and so it’s still there. I mean I’m not sure, the way they’ve done it of course, they couldn’t index and catalogue every single item. So to some extent you’ve got to search the Wellcome Library, so it will say DrugScope, folder number 6, or something like that. So you’ve got to, you know, you’ve got to spend a bit of time trying to find what you want.
A: It’s a DrugScope collection, a separate collection.
HS: I think so. I haven’t actually looked for a while. And I think probably for the purposes of your readers the Wellcome may well be interested in other material of that sort, if they haven’t already got it, you know other people’s papers and books and things of the history of the British drug scene, or addiction, treatment or whatever. I mean obviously their focus is on medical, you know as opposed to law enforcement or something like that. So that was the saga of the library, which started out as a cupboard in Covent Garden and finished up in the bowels of the Wellcome Library.
A: And what was happening to the organisation while it lost its library?
HS: It was going to be death by a thousand cuts, there’s no doubt about that. We moved to Farringdon Street, but you know, we had some money, we were a membership organisation, so we had some income from that, some income from conferences, but we were pretty much by then, totally reliant on a diminishing Department of Health grant. And it became clear over time that the Department of Health, as then constituted, was not really interested in second tier organisations like us — they didn’t think they needed some kind of intermediary or buffer organisations between themselves and organisations and agencies on the ground. And everything was about demonstrating local impact when it came to funding, Section 64 disappeared. And of course, we couldn’t show impact at a local level, because we weren’t running services, you know we weren’t a treatment agency. So in their eyes we became increasingly redundant and then in 2012 when we were expecting yet another percentage cut to the grant, the grant just disappeared altogether. So we were left with no government grant at all and we just had left what was in the bank account at that time. It wasn’t so much death by a thousand cuts, it was death by one really and I think the clock was ticking from that point on. We limped on for another three years.
HS: We came to the end of the road in 2015 and it was fairly sudden and so it would have been back end of March, beginning of April 2015, by which time ironically we had moved back close to Loman Street. By then we were sharing a floor with Phoenix Futures. We had moved, because of CrossRail, the Farringdon area was going very upmarket, so the offices that we were occupying, the rents were going up and up as they refurbished, so we had to move again and we moved to where Phoenix were, opposite Borough tube station and that’s where we finally turned out the lights.
A: So that’s a sad ending. Do you think something like DrugScope is still needed in the field?
HS: Of those second tier agencies I was talking about, the only one left is Adfam. All the other agencies that were a representative body have gone. So what you’ve got now is Collective Voice, which is a group of drug treatment agencies.
A: So like SCODA or not quite?
HS: Not quite, because for a long time now, you know the whole divvying up of statutory and non-statutory drug agencies has become redundant as a way of trying to describe the treatment system. There’s all sorts of problems really, you know there is no champion for treatment at the centre anymore. Harm reduction seemed to take something of a back seat in 2010 when the Conservatives came in. A row broke out between abstinence and harm reduction around 2007-ish. There was a lot of backstage lobbying of the Conservative shadow government to essentially turn off the methadone tap. That really was what the push was and also to significantly increase funding for residential rehab. And what happened when the Conservatives got in, they realised that they couldn’t turn off the methadone tap, nor was the money there, as it turned out, to substantially increase funding to residential rehabilitation. So what they had instead was the recovery agenda. Now there is recovery with a small r and recovery with a capital R. Recovery with a small r, lower case r, I don’t think anyone can argue with, because people don’t grow up wanting to be heroin users and pretty much everyone who is a heroin user would rather not be a heroin user and would want to come out the other side and re-establish links with family and get a job and a stable relationship and all the rest of it. Recovery with a big R was much more ideological and it was not anything that most people could really sign up to. It was an abstinence-based vision, which works for some people, but clearly doesn’t work for many, many others, but this was the agenda that the government were pushing.
HS: And you know some treatment agencies bought into it. Harm reduction I think did get side-lined, but I understand it’s made something of a comeback. But you have to bear in mind right now that at least 50% of the people who are dying of drug related deaths are not in treatment and have never ever been anywhere near a treatment service. So you have to ask the question why is that? After DrugScope fell over, I spoke to the liquidators and said, by now we had a website with a substantial amount of information on it and I said you know I just want to take this and carry it on and have a DrugScope legacy website. Now the loss adjuster’s view was – can we sell this to someone, because what loss adjustors do is try to realise as much cash for creditors as possible. So if DrugScope had a whole warehouse full of shoes, they would have said well let’s see if we can sell them, they wanted to try and sell the library and I said no one is going to buy that – someone is going to buy the library? Come on! And nor would anybody really want the intellectual property that was sitting on the website. They might want access to it, they might even fund it, if we did some fundraising, but they certainly weren’t going to buy it. So eventually I claimed the intellectual property rights on all of that. And we started out with something called the DrugScope legacy website, I say we, it was me and the colleague I mentioned earlier, Jackie Buckle. The other thing we carried on was DS Daily. DrugScope had taken that over from another organisation in 2009 and it’s a daily, five day a week curated news site. So it doesn’t create content. Jackie Buckle does an incredible job of scanning god knows how many newsfeeds and every morning pulls together the top stories in the UK and abroad, not just on drugs, but on alcohol, tobacco, gambling, e-cigarettes, vaping, all of that stuff.
A: It’s very useful.
HS: Yeah, it is and we managed to attract funding, which we’ve just about hung onto even five years on, from the major treatment agencies. So we’ve kept that going, but I realised after a while that if I wanted to raise more money just to keep the website going and somehow to pay for a bit of my work that’s not paid for, I couldn’t keep calling it DrugScope as you can’t raise money for an organisation that doesn’t exist. So I literally just cooked up DrugWise, so we are now drugwise.org.uk. There are two of us running it, me from home and Jackie from home and I still do a lot of media work during the course of a week on all sorts of subjects, because I’ve also been involved in the All-Party Parliamentary group on prescribed drug dependence, which is things like opioid painkillers, benzos and antidepressants. But my emphasis has always been on the opioid side, because the people who started that group are mainly people from the psychiatric drug side of things, rather than the painkiller side. So I’ve been working with them and I’m also on the ACMD.
A: Tell us something about that work.
HS: There was an All-Party Parliamentary Group on Drugs, for which DrugScope was the secretariat and helped to organise the meetings. That was chaired by a Labour MP called Brian Iddon, who was really very good, he was a chemist and that committee held a public enquiry into prescribed drug dependence, the problems that people were having with tranquillisers, antidepressants and less emphasis on painkillers at that point. We produced a report in 2009, and we had representations from, you might remember someone called Heather Ashton from Newcastle.
HS: And you know we had patient groups, we had pharmaceuticals, we had the MHRA, it was like a public enquiry really which we held in the House of Commons. We produced the report that essentially said we need dedicated services for people who have got problems with tranquillisers as there is no help for them and in fact then there were literally two very small, underfunded NGO’s in the UK, helping that particular group. The government basically just ignored it and said well we’ve got treatment services, if you look at the treatment statistics only 2% of clients who come forward have got these problems. And we said well yes of course. To put it crudely if you’re a middle-class accountant from Surrey, you are not going to rock up to a traditional drug treatment agency and share a waiting room with heroin users. You are just not going to do that, you know rightly or wrongly, it’s not going to happen, you need dedicated services. So that all kind of went dormant and nothing happened and then new APPG started, the All-Party Parliamentary Group on Inadvertent Tranquilliser Addiction (APGITA), which was very confrontational and basically spent most of its time attacking ministers and the pharmaceutical industry and got nowhere. And then they decided to reconvene, whichever election it was, 2015, I think. And they formed something called the All-Party Parliamentary Group on Prescribed Drug Dependence. Most of the people involved in that were from the benzo- antidepressant side and they wanted someone to take on, or promote, the opioid painkiller issues because things were kicking off in America in terms of the opioid painkiller crisis. One of the chairs of that committee was Kamlesh Patel, who I had known for decades. He had been a drugs worker down in Bradford when I first met him, but he’s now Lord Patel and he asked me to join the secretariat to support that side of the work. So the campaigning effort was for a national helpline and for dedicated services and through the offices of Oliver Letwin, he managed to persuade Duncan Selby, who was then Head of Public Health England, to do some level of enquiry into the evidence base for the problems that people were having. They produced the report, which is great and it’s there, it’s in the public domain, but ultimately it’s all very well advocating and pushing for services and helplines and all the rest of it, but I think the size of the problem is such that the government would rather not know, and I think in an era of Covid it’s going to get worse. People are not getting appointments for pain specialists and GPs, or mental health services, so the actual rate of the use of those drugs is likely to go up, because people can just buy stuff online if they can’t get prescriptions. So I think that’s one of our hidden public health problems.
A: And is that committee still meeting?
HS: It is still meeting. I mean since that report came out and of course everything now is coronavirus so I’m not sure much attention is really being paid to any other aspect of healthcare at all at the moment. So I’m not really sure what effort could be made, but ultimately it comes down to money, because if you’re going to have these additional services, someone has got to pay for them and, local authorities, however bad a state they were in pre-COVID, it’s got to be getting worse in terms of their income stream. So I don’t know what will happen about that.
A: Well, we are at the stage where DrugScope is at an end and you are moving onto other things, but did you want to look back and think about who has been the greatest influence on you and in what way.
HS: Oh well that’s a very interesting question. I think because this subject is so full of ignorance and prejudice, I’ll just give you one example of the sorts of things that treatment agencies face. In the last couple of years before DrugScope went down, we used to hold these regular summit meetings with Chief Execs and senior staff members from the big agencies and one of them told us that he had had a conversation with a local councillor about local authority funding for his treatment service and what this guy had turned round and said is, ‘why should we be funding a lifestyle choice?’ And that says an awful lot about public perceptions of heroin addiction for example, or crack addiction – it’s all about, you know ‘you choose to do this, it’s your choice, it’s your fault, why should we pay to help you out?’ and I don’t think that’s changed an awful lot in all the years that I’ve been at this – that lack of compassion, lack of humanity and lack of realisation of what these problems actually amount to. And I don’t talk about the people who snort the odd line of coke every now and again, or smoke a spliff, my interest has always really been in the people with the worst problems. I think in terms of people who have that compassion and can write and articulate that, I would put Jasper Woodcock at the top of that list, His vision for what ISDD should be, is very much what I’ve carried on through the last 40 odd years I would also shout out to Mike Ashton as well, who remains a strong voice through Drug and Alcohol Findings magazine, which is absolutely resolute in its commitment to the evidence base. And I think the evidence base, certainly in an era of fake news and all those other sorts of social media nonsense, it’s now more important than ever really. And it gets increasingly hard for people to actually determine what the evidence base is, as we’ve seen with the current pandemic. I think there are other pioneering people I would mention. I would mention Michael Linnell ex-Lifeline, who has got an incredibly dry wit, is an exceptional cartoonist and produced controversial materials that actually appealed to people who use drugs, rather than some of the insanely moronic stuff that governments have put out over the years along the lines, of ‘just say no’ and ‘don’t do drugs guys’ and this is your brain on drugs and all the nonsense that makes ministers feel happy, but actually has absolutely no impact at all. But writing provocative, controversial, rude, whatever, materials that people can actually engage with, I think took a lot of courage. And you know some of the people who have worked in the field, ex-users, people who, or even people who are current users. I mean there are all sorts of people like that. Bill Nelles for instance who was pioneering in the HIV/AID drugs world who now lives in Canada. Gary Sutton who sadly died only very recently. Numbers of people who are intelligent and articulate and like I say show real compassion and understanding for what these problems are. I’d mention David Turner from SCODA who is no longer with us. Roger Lewis, another really fine writer on the subject, again no longer with us. I mean we’ve lost quite a lot of people. I’d mention Rowdy Yates, who used to run the Lifeline project. I do feel like I stand on the shoulder of giants, which is a bit of a cliché I know, but there are lots of people who are very wise and Griff Edwards to be honest as well. I would have to mention Griff because, you wouldn’t necessarily agree with all his views, but a lot of the stuff that he has actually written is very insightful on issues of addiction. I quote him in the book that is due out in 2021 which I might as well mention now, it’s called Fierce Chemistry, 100 Years of UK Drug Wars. And it’s plural, ‘Drug Wars,’ very deliberately, because most people’s idea of what a Drug War is simply cops v robbers, cops v drug dealers, you know Narcos and shoot outs and trafficking. But my perception of drug wars is that there have been so many wars going on in the British addiction scene between harm reductionists and abstinence people, between private prescribers and NHS prescribers. There are political conflicts, differences of political opinion on how we should deal with this problem, clashes within the enforcement agencies themselves. Oh, I’ll tell you somebody else who I think has to go right up there at the top of the list is Bing Spear. Some people ask me why the hell are you still doing it, I ask myself why I’m still doing it and I think for two reasons; one because it never seems to sit still, it’s always evolving and changing. But the second reason is it’s full of interesting characters, it’s full of what I would call outliers in various ways. And although he was a Home Office official for god knows how many years, I’d see Bing Spear as an outlier in many respects. I can’t think of many Home Office officials who would go down to the local café with heroin users and sit down and have a cup of tea and ask them what’s happening on the streets. I can’t actually see a Home Office official these days going down to, even if he was allowed in, going down to Starbucks and saying ‘well what’s going happening on the streets? Bing always said his political views were to the right of Genghis Khan, but on the other hand he had a lot of compassion and sympathy. And on the quiet he was supportive of Ann Dally, he was supportive of John Marks, the people who were controversial prescribers in their own right and who I think were also to some extent victims of a system I describe in the book.
A: I look forward to reading it.
HS: I probably ought to mention something else that’s happened since 2015 as far as I’m concerned. I’ve entered the world of tobacco harm reduction.
A: I was going to ask you about that.
HS: Yes and I was brought into that by Professor Gerry Stimson and Paddy Costall who are drug field colleagues and associates, who at some point realised that the issues around tobacco harm reduction, in other words people taking control of their own health, had direct read across to the early days of drugs harm reduction and HIV harm reduction, where it was, what I termed in the end ‘Geurilla Public Health’ people, users, communities taking it upon themselves to try and improve their health. And very much the same happened with the early days of vaping and e-cigarettes, it wasn’t big companies getting involved, it was people on the ground, word of mouth, obviously internet made a big difference in terms of communication. So since then I’ve become quite heavily involved in report writing, blogging, conference speaking and media interviews in support of tobacco harm reduction. Sadly, which seems to be at complete odds with the WHO, who will not give any wriggle room to this at all and that’s a whole different subject. But it’s not unlike their initial reaction to drug harm reduction, I have to say, where giving out needles and syringes was just encouraging people to use drugs – well, no. And they take a similar negative view, which is of course highly influential across particularly lower and middle income countries.
A: Tobacco harm reduction means e-cigarettes basically.
HS: Not only e-cigarettes, it means e-cigarettes, it means heated tobacco products, but it also means smokeless products like snus, which was invented in Sweden. It’s been around for 200 years, it’s not new, but it’s been shown to dramatically reduce incidences of lung cancer in Sweden. In fact Sweden got the lowest rate of lung cancer amongst men across the whole of Europe, except Europe in its wisdom has banned snus, which actually makes no sense whatsoever. So, there’s lots of work to be done around that and that takes up a good part of my time at the moment and will do for a little while yet I suspect.
As far as the drugs field is concerned, (sighs), the government have made some noises about supporting homeless people and so on, which is probably where most of the problems lie. But in many respects the field has been quite stagnant in terms of developments. When there was lots of money in the field, agencies could afford to be a little bit pioneering, to maybe experiment with things and see how they happen. As far as I can see, for example outreach services appear to be disappearing altogether, so there are so many users who are not in treatment. People talk about users being hard to reach, well they are not hard to reach, they are just poorly served and the money isn’t there it would seem for people to go out there, for drug workers to go out and then try and engage with people on the streets the way they used to.
A: The move into local government has not been so wonderful.
HS: The drug treatment field has collapsed itself into a handful of larger agencies. There have been lots of takeovers and mergers and things like that, which is not necessarily a bad thing, but it may mean that possibly local intelligence and knowledge of what’s going on locally might be somewhat dissipated by that. There is a concern about where the next generation of consultant psychiatrists is coming from in the addictions field, and the same with nurses as well, because voluntary sector agencies are not employing these people, because they’re expensive and increasingly and it was ever thus, local authorities want more and more for less and less. So I wouldn’t say the picture was particularly rosy for the drugs field, for the alcohol field I suspect it’s even worse. It was always a Cinderella service, when there was a lot of money in the drug treatment field, alcohol services were languishing, because it wasn’t politically sexy, it wasn’t up the top of anyone’s agenda and nor is it still. So, you know it’s difficult to be particularly optimistic. I suppose the only thing one can say is there hasn’t as yet been any appreciable new cohort for example of young heroin users. Now there was a big fear that post-financial crash that’s what would happen, it didn’t and there were lots of doom and gloom prophecies about crime rates and addiction and all the rest of it as a result of the crash. But the economy seemed to bounce back fairly quickly. I can’t see the economy bouncing back that quickly as a result of what’s going on at the moment. What we are letting ourselves in for in terms of addiction services and mental health services I’d say doesn’t bear thinking about, but somebody ought to be thinking about it, because it could get pretty serious if we’ve got significant numbers of people that are unemployed and so on, once all the government support schemes come to an end. So the picture from that point of view doesn’t look incredibly rosy I have to say and I can’t see people with serious drug problems coming to the top of anybody’s political agenda.
A: I guess alcohol has become a little bit more central because of the Covid restrictions hasn’t it.
HS: Well, it has, except it still demands a response, it still demands a significant input into alcohol services and you know it’s hard to see where that money is likely to come from.
A: No. Well, I think we’re getting towards the end, but is there anything that you feel we should have asked you that we haven’t?
HS: (Laughs.) The only thing to say is that, just to build on the fact that I said before that people still really don’t have much of an idea about what addiction is all about and I think generally you know the whole sort of stigma attached to people with drug problems, less so with alcohol, but still there. It doesn’t seem to me to have changed one little bit, since I started doing this. The only thing that might have shifted slightly, shifted a bit is I think most people are more relaxed about cannabis than they used to be. But I don’t think that transposes across to anything else, which is I suppose when people say isn’t it inevitable that drugs will be legalised, you know the answer to that is no, it’s certainly not inevitable that drugs will be legalised, certainly not in the foreseeable future. You can make a strong case for easing up on cannabis, in an evolutionary way, you start saying well if you’ve got a few plants in the back garden we are not going to start throwing the book at you. I mean to be honest people haven’t gone to prison for cannabis you know forever really. There were very few people that ever went to prison just because they possessed cannabis. But you’ve still got situations where your foreign travel capacities or abilities or even your job prospects can still be hampered by having a cannabis conviction and even that would require more than one offence. It is probably time to have a look at that. My view on cannabis is that, it goes all the way back to when Jim Callaghan was going up the wall about during the Wootton Report back in ‘68. I think cannabis is a line in the sand. It’s not so much what the drug can do, but it’s what the drug represents, it was then and maybe now as well, you know back then it was we’ve got free love and you know sex and miniskirts and god only knows what and youth rebelling against us, but cannabis is a line in the sand and it might still be a line in the sand. I wouldn’t recommend a referendum, I think we’ve had enough of those. But should there be a referendum on the legalising of cannabis, I don’t think it’s a done deal that it would come back with a resounding yes.
A: Yes. Right so no retirement from the drugs field then, or the harm reduction field.
HS: No, I’ve got to have something to do haven’t I! I mean I’m keeping my music stuff going as well, but no, I suppose as long as I can sort of vaguely keep on top of the subject and answer people’s queries and people draw me in to various little committees and things like that. I’m doing a presentation next week for a Scottish Families group organised by Adfam on drugs in the media. So, I can do my whole spiel about how we got to a point where people were called drug fiends and stuff like that and show them a few fancy slides. So yeah, I’m kind of hanging on in there. I might have to do a YouTube launch though for my book rather than getting lots of people in a room. (Laughs.)
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