Heroin injection
The solution to Britain's heroin problem is anything but easy [Wikicommons].

Every so often, up pops a half-briefed politician or occasionally a senior police officer, who has the instant answer to heroin addiction. Those of us who have thought about this for a lifetime are all fools, the answer is obvious!

This week it was Ron Hogg, the Police & Crime Commissioner for the English county of Durham. Mr Hogg, who has the almost unique qualification of being both a politician and an ex-deputy chief constable, has supported Durham's current chief constable's call for drug legalisation.

It seems politicians and senior police officers want simple answers which more sensible folk know do not exist. P&CC Hogg has called for drug "consumption rooms" where addicts are provided with prescribed heroin on the UK's National Health Service. The BBC picked it up and ran with it. I was interviewed for BBC Scotland. It was difficult because the interviewer was understandably confused.

Like P&CC Hogg, the BBC has, I suggest, managed to conflate two distinct issues and confused more than illuminated. Unsurprisingly perhaps, both concepts, because they "normalise" drugs use, are promoted vigorously by the world-wide drug legalisation lobby.

"Drug consumption rooms" or "shooting galleries", are generally taken to be publicly or charitably provided, supervised "clean rooms" where addicts can take "street drugs" and inject, away from the street. Usually they need specific exemption from local law. The best known is probably "INSITE" in Vancouver but there are others in Europe.

Evaluation is tricky. The independent review of "INSITE" by Canadian, Professor Colin Mangham said:

"the published evaluations and especially reports in the popular media overstate findings, downplay or ignore negative findings, report meaningless findings and overall, give an impression the facility is successful when in fact the research clearly shows a lack of program impact and success.......reveal little or no reductions in transmission of blood-borne disease or public disorder, no impact on overdose deaths in Vancouver, very sporadic individual use of the facility by individual clients, a failure to reach persons earlier in their injecting careers and very little movement of drug users into long-term treatment and recovery".

What's more, in the UK they are illegal. They amount to "allowing premises to be used" under the 1971 Misuse of Drugs Act. Despite policy being repeatedly revisited over more than 12 years, no UK Government has sought to create these places.

But let me be fair to P&CC Hogg: he apparently wants heroin prescribed on the National Health Service. The UK has more experience of prescribing heroin to some addicts, over 80 years, than any other country in the world; we largely abandoned it in 1968 after diversion of legal supplies into the illegal market and contrary to some suggestions it had not stopped that illegal market - in fact it failed entirely to cope with drug use as a lifestyle choice.

Those doctors who have special licences to prescribe heroin show no great enthusiasm. A UK academic expert queried if it was really "treatment" at all and described it as "social problem prescribing", in other words, parking addicts who should be treated and rehabilitated.

So P&CC Hogg means well but has forgotten the history and ignored the huge costs. The costs of prescribing heroin have been massively understated. The cost is not just the cost of the drug.

Heroin, because of its short acting nature, ties an addict to his or her clinic, in a way that longer-lasting oral methadone does not. Heroin, through injection, preserves undesirable and risky injecting behaviour. Each small town needs its own clinic with at least two staff plus security for 365 days a year. Larger towns and cities need more than one. London for example, would need many.

Opening hours would need to be early morning to late evening. On this basis the costs and resources mount alarmingly and we know, from the 1960s, the illegal market does not disappear.

Could this be sold politically when there are so many conflicting demands on NHS resources? I suggest not. It is a bear trap for the politician naive enough to try.

David Raynes is a director of the National Drug Prevention Alliance and a member of the International Task Force on Strategic Drug Policy.

He has provided insight for the BBC and several international media outlets on current drug issues.