Tuesday, 2 August 2011

Why I agree with Mitch Winehouse

Amy Winehouse’s bereaved father yesterday met with senior MPs to urge them to “do more” to combat addiction among young people.

Mitch Winehouse met Keith Vaz (Chairman, Home Affairs Select Committee) and James Brokenshire (crime minister) to discuss drugs policy and the services currently available to those who need support to overcome addiction problems. The BBC website reports that Mr Winehouse “’spoke from his heart’ during the meeting” after which he concluded that “I am convinced that there's a willingness for people to change the way things are going."

On one level, there won’t be a person in the country that doesn’t agree with the thrust of Mr Winehouse’s call. Most of us will recognise that here is a man who lost his daughter after what must have been an arduous struggle with substance abuse not only for Amy but also her family. He simply wants “the system” to work more effectively and, in particular, in the interests of the people it is supposed to serve. Surely no-one can disagree with that?

However, he went further in what he was suggesting and the detail here is vitally important. He focused his energies not merely on criticising the status quo and its inherent failings but by advocating a more progressive and socially responsible alternative. He also wasn’t afraid to bust myths and tell it as it is – most notably in regards the popular misconception that the NHS spends billions providing for rehabilitation that doesn’t work. As Mr Winehouse observed, there was only one NHS rehabilitation centre – in Lincolnshire – and that closed last year. The only adequate rehabilitation services are provided by either charitable or private suppliers and are generally the preserve of those with the financial means to pay for them. Earlier in the year Annabel Goldie intimated that Scotland already had excellent “recovery programmes” but quite honestly those that there are can not be easily accessed, something she clearly failed to appreciate. Mr Winehouse, however, made clear that he feels access to treatment is appalling and while he announced proposals to set up an Amy Winehouse Foundation to help those who can not afford to pay for private treatment he recognised this could only represent a very small part of the solution. What he is actually asking for is for the government and the NHS to get its act together, shape a fit-for-purpose network of support for those with addiction problems (including increased access to residential rehabilitation) and place an emphasis on improved community services with the necessary funding improvements to ensure they are effective.

Mitch Winehouse should be praised for making such a bold and honest intervention. It certainly rattled Keith Vaz into admitting that “it seems, from what he has said today, the level of support is not there and there appears to be an inconsistency of funding”. He’s certainly not the first person to highlight the woefully inadequate current arrangements but he’s probably the most high profile. I genuinely hope his recommendations are listened to and given the respect and consideration they deserve.

I’ve previously discussed the complex issues surrounding drugs policy – It’s time to talk sensibly about drug misuse - and the need to develop a “a strategy on substance abuse that actually works”. Admittedly the focus on that piece was reforming sentencing arrangements in such a way as to facilitate ending the cycle of dependency many young people find themselves trapped in. But fundamentally I have been aware for some time of the truth to which Mr Winehouse refers – the cruel reality that current systems of “support”, “reform” or “rehabilitation” actually combine to create a disempowered underclass, dependent on the state for financial sustenance and leading hopeless lives.

Mr Winehouse didn’t mention it explicitly, but he clearly understands the co-relationship between substance abuse and mental health issues. He also realises that failure to take appropriate action is not only a false economy in financial terms but will carry an inevitable human cost.

I do have some understanding of the complex problems associated with addiction, which Mr Winehouse and his family experienced first hand. I previously worked in a (charity-run) rehabilitation centre and currently work part-time with NHS mental health services in addition to running a business. And what I can say with certainty is this: addiction can often stem from a combination of psycho-social issues rather than merely environmental ones, including self-confidence issues, personal insecurities, depression, mental illness, emotional underdevelopment and social isolation. In fact, only this explanation of drug dependency makes sense when we examine the lives of people like Amy Winehouse, for why else would someone with so much obvious potential and influence, enormous talent and a quite amazing life slowly destroy themselves? It’s not a question of there being a material basis to such people’s addictions, as her father knew too well.

Methodone programmes alone can’t rectify the complex problems that both cause and sustain drug misuse. Neither can a more robust and responsible sentencing system – although that would be a welcome step. And neither can any purely pharmacological or “rehabilitation” approach work – especially those that simply remove the client from a particular environment for a short time – unless they are accompanied by a serious programme for challenging the basis of the problem and supporting people towards productive and meaningful lives.

Actually, I think Amy Winehouse had an incredibly meaningful life. On the day she died, one of my friends wrote on facebook: “what a tragic waste of life”. I disagree. Amy did far more with her life in 27 years than most people do in 100. She touched countless lives and inspired millions. A waste? No. However, it is inescapable statement of fact that Amy was a tragic product of her own self-doubt and self-indulgence, combined with the inevitable pressures of being in the public eye and an unsympathetic media that made her personal problems as much a trademark and an integral part of “Brand Winehouse” as her jazz-inspired tunes. Essentially, this led to her "problem" becoming her identity - something I imagine she must have detested (it's hard to have much in the way of self-esteem when the national media define you by your trademark inebriation). Inevitably, and wrongly, it was an identity she not only struggled with but was unable to escape from.

Mitch Winehouse is right to place the emphasis firmly on improved community services. Because he “gets it” in a way that others don’t. He appreciates that there are psychological and social dimensions to addiction that only such an approach can deal with. He knows, as I do, that people with addiction problems generally drive those closest to them away, leaving themselves with fewer options for support. He also seems to realise that everyone is an individual, with unique pressures and concerns and should be treated as such – yes, even those who abuse drugs. And he knows, from bitter personal experience, that every individual with an addiction is fighting their own personal demons – often alone, struggling to cope with the world and their own role within it. He also understands that most users are self-absorbed – and sometimes so absorbed with their “problem” – that there are obvious benefits to social aspects of community-based rehabilitation.

I firmly agree with Mitch Winehouse’s observations and recommendations. As they stand, they represent a useful starting point for government drug policy? Would it work? Undoubtedly, and the long-term benefits would outweigh the short-term costs. Does the government have the courage to make more than cosmetic changes? Only time will tell.

One final point I would make is that the UK government can and should learn from the Portuguese experience. It is now ten years since Portugal decriminalised drugs and there have been notable benefits including declining rates of cannabis and cocaine use, a fall in deaths attributable to drug use and increased provision for medical support and rehabilitation due to savings being made in no longer pursuing users through criminal courts. Portugal has adopted a more community-based approach, not least in its sentencing policy which is now - while hardly lenient – more therapeutic and less punitive. This otherwise largely politically insignificant country is leading the way when it comes to improving societal health and well-being, recognising that those who imagine a “war on drugs” are not only missing the point but setting themselves up for inevitable defeat. Success in defeating the scourge of addiction problems and the effect they have on society can not be measured by police statistics relating to seizures and arrests.

And what has happened to Portugal in the ten years since it adopted its brave, new drugs policy? Has it become a new haven for organised crime, or overrun by “junkies” as some feared? No. Has the cost to its taxpayers increased? No – although money has been redirected into improved healthcare and additional hospital beds. Far from experiencing the predicted catastrophe Portugal’s drug experiment has proved incredibly successful.

It does therefore seem unfortunate that those responsible for Portugal’s economic policy were not imbued with the same kind of wisdom as those shaping its policies on tackling addiction.

I agree with Mitch Winehouse and heartily support his recommendations. I also commend the progress that has been made in Portugal to date and hold it up as evidence of what can be achieved with the right courage and vision.

Liberal Democrats in government have an opportunity to press for positive change: change that works. I hope our government has a grasp of the nature of the problem and how to deal with it because a failure to do so will simply condemn more young people to lives of hopelessness. And that would be a tragedy on an unimaginable scale.

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