Monday, November 13, 2006

Hot Topic: 'Cold Turkey'

From the BBC, Telegraph and many other papers, comes the news that some prisoners have settled out of court after being forced to go 'cold turkey' in prison, which they claimed was 'assualt' and 'a breach of their human rights.'

More than half of all prisoners in England and Wales report a serious drug problem, and on entering the prisons, that figure can be as high as 70-80%. People are on drugs and committing crimes to pay for them, and ending up in prisons, where their treatment and rehabiliatation is inadequate , and where drugs are rife inside.

From the BBC
'According to the editor of the Prisons Handbook, Mark Leech, two-thirds of crime is drug-related and Home Office research has shown that 643 drug addicts were responsible for well over 70,000 offences in one three-month period.
"Prisoners have the right to receive exactly the same type and standard of healthcare in prison as they would receive in the community," he said.
"Yet for the most part drug detoxification in prison is second-rate in standard and woefully short in its duration."

It seems that the prisoners in this case were already recieving treatment to get off drugs after all, which indicates a willingness to get clean, but then the form the treatment took once they got into prison - or the lack of treatment and support recieved- seems to indicate that they were suddenly hauled off the drugs rather than walked off the drugs. I have no doubt that it was a grim experience. But if the outcome was that they were drug-free, rather faster and more brutally than they would like, isn't that still a positive outcome?

We haven't been told what the prisoners think. Did the prisoners manage to stay off drugs after the detox? Or did they just score some more inside the prison walls as soon as they possibly could? If they did, was it because the forced cold turkey experience was so awful? Or because they couldn't function without opiates, and methadone, heroin, whatever would do, and what they resented was being painfully forced to stop in a way that was out of their control?

The drugs trap is not just physical, after all but psychological. Being forced to go 'cold turkey' against your will , with little help or supportive treatment is quite possibly counter-productive. Perhaps the prisoners feared that they would be unable to stop themselves scoring again, after enduring the sudden 'cold turkey' experience, rather than a managed detox, and that was why they fought for the right to have proper drug treatment, and stop slowly, because they wanted a real chance to succeed in getting off drugs. Having your medical treatment suddenly halted, without consultation, is undoubtedly damaging, and inhumane.

I don't especially see why they should get thousands in compensation though. An apology, certainly, if they were given sub-standard medical treatment, after starting a detox course to get clean, and then suddenly having treatment stopped and being forced to go 'cold turkey' with no choice or support in the matter.

Prisoners, like anyone else who is addicted to opiates should be supported and treated to help them get off drugs, criminal behaviour as a result of addiction to drugs being the reason for more than half of prisoners being in jail in the first place . Prisons should be drug-free. They aren't, they are usually places where drugs are easily available.

Maybe it is easier to manage a doped and apathetic prison population, given the huge problems in overcrowded jails, and maybe the Home Office was worried about what would come out in the court case, so they paid up to shut the men up rather than have the facts emerge. Imagine a case where medical treatment to manage coming off drugs was deliberately withheld for sadistic or punitive purposes for example. Or because there wasn't money for treatment and counsellors. That would not make happy headlines, nor would lurid details emerging of just how many drugs are sold and used in many of the U.K's jails.

The key issue isn't really the compensation awarded in this case, though, ( even though it grates a bit). The bigger picture is the whole problem of substance abuse and custodial sentencing trends and prison overcrowding and rehabilitation. And the unpopular notion that prisoners have human rights too, and shouldn't just be stuffed into brutally overcrowded prisons where they will get madder and angrier and more f*cked up and more brutalised because where does that gets us all, in the end? Reoffending rates are going through the roof.

Prisons, which ex-prisoner and Guardian writer Erwin James describes as 'hate factories' I think should be kept for the most violent and serious offenders, with a far greater emphasis placed on rehabiliation, training and education and drug treatment in the community for other offenders. Prisons should not be dumping grounds for the mentally ill, the addicted, the marginalised, brutalised and the desperate.

But all too often they are, and the standards of care in prison are erratic, because the system is so overcrowded. There is help for those who want it, in some prisons, some of the time, and some of the help is excellent. At other times, and other places there isn't the staff or the funding or resources to make a difference and help the offender improve or change.

And the increasingly punitive attitude towards criminals and crime, which does not distinguish between the dangerous and the desperate, and which dehumanises prisoners, and stigmatises them on release, does not help. Some prisoners are truly 'bad', some 'mad', but others know their behaviour is anti-social and want to have the chance to change and become useful members of society. Those that we can help, we should, as much as we could, for all our sakes. Those that cannot or will not stop committing vicious or violent crimes we have no choice but to keep locked up.

Some prisoners' stories

UPDATE: Daniel Finkelstein on the Times links to a prison doctor who writes that cold turkey is 'no worse than 'flu'. A prisoner disagrees.


Anonymous Katherine said...

Just a comment (and in no way a criticism) - this was more about medical negligence than human rights as such. It is rather unfortunate that every major news outlet has focussed on human rights as the nexus of this story, which it isn't, since it gives ammunition to the exaggerated view that the Human Rights Act is helping bad people do bad things. A view that was criticised today by the Joint Committee on Human Rights, who also criticised the government for completely failing to head off this kind of misunderstanding.

November 14, 2006 11:23 am  
Blogger Leighton Cooke said...

This is a topic very close to my heart, with which I was confronted again this week. Luckily my story had a happy ending. Human rights, yes, but this is also a question of medical ethics and scientific principles. "Cold turkey" in prison is in this respect just not an option. This week I had to deal with the consequences of a heroin baby's cold turkey. That was no picnic.

November 18, 2006 12:08 am  

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