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Should we support calls to decriminalise drug use?


The UK has one of the highest rates of recorded illegal drug misuse in the western world despite a rapid expansion over the past 10 years of drug treatment.

Although new posts such as “substance misuse nurse” or “addiction nurse” show a change in the culture of care for addiction, many nurses still loathe and fear substance misusers, describing giving care to them as the most unrewarding and unpleasant experiences of their clinical careers.

This response is hardly surprising given that criminalisation is a powerful stigma, and as a result nurses are bound to find it difficult to provide appropriate and compassionate care to those that society generally regards as criminals.  Faced with this reality should nurses support recent calls for the decriminalisation of drug use?    

The question comes at a time when health specialists and journalists are looking at Portugal, where drug use has been decriminalised, (not legalised - an important distinction) for the last decade with dramatic results. Users are treated as having a health and social problem. Giving up addiction as a result of legal sanction or coercion is accepted as unrealistic, and resources are put towards mitigating risk for individuals and the wider population by harm reduction, treatment and reintegration. The move has not resulted in higher rates of drug use or turned Portugal into a magnet for drug tourists. In fact there have been recorded reductions in HIV diagnoses, overdose deaths, petty crime and drug experimentation among young people. 

Our country’s attitude to drug use is riddled with hypocrisy. Those drugs that have the greatest potential to harm are not necessarily those that are controlled by law. Use of alcohol, tobacco and prescribed tranquillisers are not prohibited, though tens of thousands die prematurely each year from their adverse affects. Conversely, prohibited drugs are used far less and cause fewer fatalities, yet carry massive stigma and the threat of criminalisation.  

Nurses may often experience a conflict between personal views on drug use and professional responsibilities towards drug users. A punitive attitude to drug users among some healthcare professionals is a logical outcome of classing a health problem as a crime. Such stigmatisation must hamper effective care and result in inappropriate and judgemental treatment.  Negative attitudes may also compromise the rehabilitation of drug users by hindering a professional’s ability to deliver primary health care and health promotion messages with the sincerity required for success.

As a district nurse, I regularly come into contact with this client group and have experienced some of the negative attitudes towards drug users, not only from nurses but also medical staff.

It seems the condemnatory notion that they have ‘brought it upon themselves’ is often applied to drug users, but rarely to those with illnesses associated with smoking, obesity or those over-indulging in prescribed and non-prescribed medication.

Stephen Riddell is a district nurse working in Dumfries and Galloway


Readers' comments (11)

  • The present course of action has failed and continues to fail.
    I think patients might also be more honest with disclosing such information if they were not afraid of being stgmatised and possible legal consequences.
    I also think we have a poor approach to 'pain' relief and have had complaints from patients who feel they are being treated as 'druggies' when all they want is pain relief and not the assumption that they want to get high.

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  • Great Article Stephen.
    I work as a substance misuse specialist with a nursing background and agree with your view of the situation.

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  • I agree, very good article. Well spoken

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  • No we should never support calls to decriminalise drugs! For crying out loud, we are MEDICAL and HEALTH professionals, and these drugs abused in this way are the antithesis of health! And before anyone gets started, yes I hold the same views on tobacco!

    I agree that there is a certain amount of hypocrisy in this country in that tobacco is legal but many other substances are not, but that in my mind means tobacco should be criminalised too, not the other way around!

    I have to disagree with the closing statement here too, illnesses associated with smoking, obesity, etc ARE quite often the persons own fault, and I think people should start to take more reponsibility for their own health.

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  • some of these people may need help but it should be outside the remit of the taxpayers health services

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  • Mr/Miss/Mrs/Ms anonymous on 23rd January is obviously one of those practitioners who find it.....lets say challenging, working with drug misusers and forget unconditional positive regard?

    I am currently working within the substance misuse field and find it the most rewarding and challenging nursing role I have worked within. OK, so our specialities are 'horses for courses' but please remember, drug users are HUMAN and have the fundamental right to health care just like any other citizen. We are not here to judge, we are here to provide the best, ALL OF US!

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  • I HATE the word 'druggie'- it belongs in the same place as those other words for people that you can't say in public. Offensive, judgemental and unfortunately I hear it too often.

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  • Anonymous | 24-Jan-2011 9:22 am

    Mr/Miss/Mrs/Ms anonymous on 23rd January is obviously one of those practitioners who find it.....lets say challenging, working with drug misusers and forget unconditional positive regard?

    'We are not here to judge,'

    then practice what you preach and do not judge or preach morality to others you know nothing about. in this case judgment applies to everybody not just patients
    and everybody here is entitled to express their opinion.

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  • the past and current political leaders have not got the courage to address this openly with an open debate based on fact and clinical evidence they are more concerned with popularity image and media

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  • As an experienced ICU nurse who in a past life was an IVDU for over 10 years the attitude of many of my colleagues frankly stinks.

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