Posted by: Nicholas Swetenham | April 26, 2009

This house would selectively legalise heroin – carried


Bayer brand Heroin, in the old days

That was the topic of the Thursday April 23 main debate at the Cambridge Union Society, Cambridge’s prestigious student debating society. The speakers in Proposition were:

KATE McKENZIE, mother of a girl living with heroin addiction who featured on television.

FRANCIS WILKINSON, former Chief Constable of Gwent Police.

DANNY KUSHLICK, founder of Transform Drug Policy Foundation, a pro-legalisation advocacy group.

The speakers in Opposition were:

PROFESSOR NEIL McKEGANEY, former White House advisor on cannabis.

KATHY GYNGELL, chair of the Prisons and Addiction Forum at the Centre for Policy Studies, a conservative-leaning think tank.

RICHARD LAU, Union debater, ranked 11th in the world for British Parliamentary style debating.

Of course, prescribing heroin must be only one tool in a panoply of the weapons of public health. Support for addicts is even more important. Everyone agreed on that premise. The debate centred on whether it would be a useful addition to add prescription heroin for addicts to those tools. It could be used as part of a long-term treatment scheme to get people off heroin, or used for people who have tried and failed many times to detox despite their best efforts.

The debate was defined by the proposition as centering around prescribing heroin on the NHS (for those readers not familiar, that means giving it for free at the taxpayer’s expense). After the debate, attendees voted on the motion by walking through the appropriate door (Ayes, Noes, Abstentions). The Ayes carried the motion by a large majority. I made a floor speech, which I have (approximately) reconstructed from my notes below:

Nicholas Swetenham, Churchill College.

Ladies and gentleman, I am a medical student. I also have the pleasure of representing our twelve-hundred and fifty medical students at the British Medical Association. I would like to respond to the speakers in opposition.

Doctors prescribe drugs that can cause harm, as most can, if necessary. Doctors have a duty to intervene to protect the public, if necessary. And doctors put aside their prejudices to protect their patients’ health by whatever means necessary.

We are taught to use only those treatments that work. And whatever the good old boys sat around the table at the Royal College may think, I can assure you that a young generation of medical students that is willing to adopt evidence-base practices is coming. Heroin prescription works in all those countries that use it. I urge you to support this motion. Thank you.

The reference to the RCGP is a response to this press release from 2002 which was quoted by Professor McKeganey. I am unconvinced by its arguments: that heroin has a low Therapeutic Index (so does methadone) and that it is more expensive (if we mass-produced it it wouldn’t be). When I talk about countries that use it, I am thinking of Sweden and Switzerland. Switzerland, under its system of direct democracy, they recently approved a referendum to make it permanent:

Final results from the national referendum showed 68% of voters supported the plan.

The scheme, allowing addicts to inject the drug under medical supervision at a clinic, began in Zurich 14 years ago before spreading across the country.

But in another referendum vote, 63% of voters rejected the decriminalisation of cannabis.BBC

This Times of London piece discusses the costs of the scheme vs. the costs of the drug scene in the UK. The scheme still has its opponents but heroin addiction and its human, social and financial cost has dropped dramatically in Switzerland.

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