Chapter 13: Official Attitudes and Harm Reduction Policies

There are a range of attitudes towards drug use. At one extreme there is the view still widely held in the USA that all drugs (although, inexplicably, alcohol is excluded) cause enormous damage to young people, and must be stamped out by tough use of the law and campaigns such as "Just Say No" rather than genuine education. The view is that drugs are evil in themselves and that no sane person would choose to take any illicit drug unless he or she had a perverse or inadequate personality. Drug dealers are seen as ruthless criminals who have no respect for their customers, and "give the kids free samples, because they know full well that today's young innocent faces will be tomorrow's clientele." These were the satirical words of Tom Lehrer some 40 years ago, but there are some people who still believe in this view, including police in the drug squad.(89)

At the other end is the Dutch government. Although members of the United Nations and therefore signatories to the Convention on Psychotropic Substances(15), the Dutch have decided not to prosecute people found in possession of drugs for their own use, without actually changing the law. Instead of trying to prevent people from taking drugs, the authorities in Holland give drug users help and information so they can choose for themselves. To this end they employ people to buy samples of drugs sold on the street which are then analysed and the results published. Occasionally there are warnings about particular pills that are very strong or are adulterated: in one case 'Ecstasy' that turned out to be Ketamine. Holland also has a "safe house" policy. This means that certain drug agencies have assurances from the police and authorities that visitors will not be raided or stopped on their way in or out. This provides a link between the authorities and the dealers. The pact gives dealers an opportunity to talk about their side of the trade and to have samples of their wares tested, while it provides the authorities with detailed (although anonymous) information about what is going on.

One might say that Britain is in between. My impression is that the Establishment and police favour the official American view, while workers in the field sympathise more with the Dutch. In researching this book, I have come into contact with a number of people who are paid by the government including social workers, teachers, doctors, psychiatrists and researchers in the field of drug use. Many of them cannot afford to say openly what they believe, but off the record have told me they believe that Ecstasy has done more good than harm; several have admitted trying the drug for themselves. At one drug prevention agency I was surprised to hear the staff speak positively about Ecstasy just after their head had told me of the importance of warning users about its dangers. The discrepancy was later explained by the need to raise funds for the organisation.

Current trends

There are signs of attitudes softening. In Britain, the Independent and Economist have launched a crusade to legalise drugs on the grounds that prohibition is the route cause of about half the crime, and that present policies simply do not work - a view also voiced by Commander John Grieve of the Metropolitan Police.(164) In America, the Just Say No campaign is losing credibility and is being challenged by more and more critics including the mayor of San Francisco. In Europe, Holland has been leading the way towards liberalisation but faces pressure from other EC countries to tighten up. A Dutch committee has also recommended that MDMA be reclassified to the same class as cannabis.

Future change in attitudes

In June 1993, a paper called 'X at the Crossroads' predicted that E had a high growth potential in the USA, and that public attitude to the drug will change from its present disinterest to either 'marijuana-like acceptance' or 'LSD-like rejection'. Which way it goes will probably depend on chance rather than common sense, since the public are more influenced by media horror stories than statistics.(151,154)

In Britain, use has been steadily increasing while media coverage has declined. This is partly due to far fewer casualties resulting from successful harm reduction campaigns, but also media burnout. With polls showing that nearly half the population favour decriminalisation of cannabis, and some serious discussion of legalisation of all drugs, it seems likely that attitudes will soften.(151, 164)

On the other hand, there has been concern that "Jobs in traditional leisure industries are being jeopardised by the huge growth in raves which have mushroomed into a #2 billion-a-year industry".(159) The powerful brewery lobby in Britain is likely to put pressure on the government to clamp down on raves.

Harm Reduction

Harm reduction policies(116,117) are based on the idea that it is of greater benefit to society to put effort into reducing the harm caused by drug taking than to prevent drugs being consumed at all. This was first applied to opiate (heroin) users in response to the AIDS scare by supplying free syringes to prevent HIV being spread through sharing needles.

In relation to Ecstasy use, harm reduction has recently been adopted as a policy by Manchester City Council(118) in the form of a Safer Dancing campaign. Before this, venues were being closed when the police found illicit drugs, with the result that the clientele moved on to other venues - often unlicensed premises. People suffered from heatstroke as a result of taking Ecstasy in badly ventilated venues where water to the wash basins had been cut off, forcing them to buy drinking water at exorbitant prices. At the illegal raves there are frequently other risks too, such as small or locked exit doors and poor fire access.

Instead of closing clubs where drugs are being used, 'harm reduction' policies accept that people are going to take drugs, and that what is important is to reduce the risk of harm. Dr. Newcombe of Manchester University has been one of the main protagonists of this idea, and the policy is now widely accepted by many people working in the field. Dr. Newcombe offers courses on harm reduction including one related to Ecstasy use(119); under the name The Rave Research Bureau, he offers a consultancy service to club owners who wish to have their premises monitored.(120) Many club owners are becoming more responsible(40) and some even employ people to look after ravers who have problems.(118, 121) However, at one event I attended in 1993 in London the water had been cut off to all the wash basins in the toilets and tap water was being sold at #2.50 a bottle; at another, an illegal rave under a railway arch, there was only one unlocked narrow exit for over a thousand people.

Safer dancing in Manchester

In Manchester, however, evidence of sharp practices on the part of a number of night clubs has triggered the beginnings of a consensus that harm-reduction is the way forward. Tony Cross, press officer for Manchester City Council, said: "We had confidential information that a number of clubs were turning off the cold water supply; charging #1.50p for a glass of water; turning up the heating and switching off the air conditioning. A couple of clubs were doing it every weekend". In neighbouring Bolton, a club called the Pleasure Dome which deliberately switched off its water supply on rave nights achieved notoriety when the local paper reported that "drug crazed" girls had been seen drinking from toilets and was forced to close in 1992.

Local authorities have responsibility under the law for issuing and withdrawing clubs' entertainment licenses and ensuring that their premises are safe. Manchester's response, following advice from Dr. Russell Newcombe, of Manchester University's department of social policy and social work, was to introduce a code of conduct which clubs have to conform to as a condition of retaining their licences. A minimum code of conduct, announced in December 1992 with the launch of the "Safer Dancing Campaign", will be followed in 1993 by more detailed requirements.

The minimum code requires clubs to do the following:

1. monitor air temperature and air quality at regular intervals throughout their premises and improve methods of ventilation if necessary;

2. provide adequate facilities for "chilling out" such as a room with a quieter and cooler atmosphere and comfortable seating;

3. ensure that cold tap water is available in toilets and provide free water at bars;

4. provide customers with up-to-date information about the risk of drug use; how to avoid overheating and where confidential advice and help can be obtained;

5. employ outreach workers to operate on site offering confidential advice, first aid, and a referral service for customers.

There are about seven clubs in Manchester involved in the rave scene and the council is concentrating on these in promoting and following up the new policy. It met with the club owners in March 1993 to discuss the implications of the minimum code and, in conjunction with the non-statutory drug agency Lifeline, it has produced a series of educational posters about E that have been sent to all Manchester nightclubs. By February 1993, one club had been found - by a Lifeline volunteer - to have broken the code by switching off its water. "An enforcement officer will visit that club to review the situation; we will threaten to revoke their entertainment licence and we could then do so," Mr. Cross said. However, Lifeline researchers say that other clubs, notably The Pier in Wigan and The Hacienda in Manchester, have been exemplary in introducing a wider range of safety measures than required by the code. Meanwhile new clubs such as The Parliament in Manchester provide even better facilities than the code demands.

The council is also taking advice from Dr. Newcombe on what to include in the extended code of conduct. He has suggested more stringent steps such as requiring all clubs to cooperate fully with police drug squads and assist with surveillance operations and intelligence; stationing security staff in areas where drug dealing takes place; altering the internal structure of clubs to aid surveillance and keeping a log of all incidents of violence, drug use, drug dealing and other criminal acts.

The policy has aroused great interest from other authorities, private individuals around Britain reporting similar sharp practices and the Institute of Environmental Health Officers. It is likely to become the model for authorities covering other centres of the rave scene.