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March 18, 2008

It is right to imprison drug addicts - argues Theodore Dalrymple

Posted by Theodore Dalrymple

Theodore Dalrymple - the author of Junk Medicine: Doctors, Lies and the Addiction Bureaucracy and for many years a prsion doctor - explains why he believes it is right to imprison drug addicts.

An item in this week's Observer caught my eye. It was a report that the UK Drug Policy Commission had concluded that:

convicted drug users should not be sent to prison because it does more harm than good.
But to whom or to what does it do more harm to send them to prison? The way the Observer puts it, one is reminded of the lady in Dickens who thinks there is a pain in the room but cannot positively assert that she has it. Just as a pain cannot exist without a subject to feel it, so a harm must be done to someone or to something in which someone has an interest. So who is harmed by drug users being sent to prison?

There seem to be two main possibilities here: the first is the prisoners themselves, and second is everyone else in society.

Let us take the possibilities in order. Does going to prison harm drug takers?

Contrary to alarmist reports about the number of prisoners taking drugs, the answer is no, indeed the suggestion is the very reverse of the truth. The condition of heroin addicts is frequently pitiable when they arrive in prison: they are frequently malnourished, covered in sores and possessed with abscesses where they have injected themselves. Within two or three months of imprisonment, they look the picture of health.

Unfortunately, it is truth that they often a few months later are back in the condition in which they arrived the time before. I told many prisoners that they would make excellent extras in a film about concentration camps, and they all knew exactly what I meant. It is also the case that some prisoners, having lost their tolerance to heroin while in prison (a testimony to the fact that the easy availability of heroin in prison is exaggerated), sometimes take a celebratory dose of heroin on their release that kills them, though it would not have killed them before their imprisonment.

In other words, it is the totally inhumane and callous policy of the swift release of drug addicts from prison that is harmful to them, not their imprisonment in the first place. The humane as well as the morally correct thing to do would be to treat drug addiction as an aggravating circumstance of criminal activity and give an automatic sentence of five or ten year in addition to any sentence that the crime committed would ordinarily have attracted.

In any case, the assumption that the imprisonment of drug addicts would have been shown to be wrong if it were the case that imprisonment did them harm is itself mistaken, because it supposes that the primary purpose of prison is therapeutic, a form of medical treatment of those imprisoned. But this is nonsense.

What harm can sending drug addicts to prison do to the rest of us when they have committed crimes? In the first place, it costs us money that we would rather spend in some other way, preferably by means of a reduction in our taxation. But it is also argued that imprisoning drug addicts who have committed crimes fails to deal with the cause of their criminal activity, and that if they were treated for their addiction, things would be much better.

This argument relies on two assumptions, both false: first, that drug addicts commit crimes because they are addicts, and second that addiction is a bona fide medical condition for which a reliable medical cure exists.

Insofar as a causative connection between drug addiction and criminality exists, it is that criminality inclines to addiction and not the other way round. I think it is probably best to put it like this: that mass criminality and mass addiction such as we have now arise from the same socio-cultural roots. Most heroin addicts who end up in prison have long histories of criminality before they ever took heroin; therefore their addiction is only marginal to their criminality.

Further, if in fact it is the case that no medical "treatment" of addicts, to heroin or to other drugs, works in a reliable fashion (and this is the case), and furthermore it is argued that addicts cannot help their criminal activity because of their addiction, the case for locking up addicts for much longer is greatly strengthened. Failure to lock them up, and thereby to separate them from the rest of society, is to invite them to commit more crimes; therefore the imprisonment of drug addicts who have committed crimes cannot possibly be said to do harm to society, unlike setting them free.

So locking up drug addicts who commit crimes does harm neither to them, nor to the rest of society. Failure to do so does very definite harm, both to them as individuals and to society.

But there is something more. The harm that is done to society by failure to lock them up for a suitably long time is unequally distributed among the various classes of society. If there were any justice in the world, it would be the readers of the Observer whose houses would be burgled by criminal drug addicts left at liberty by the criminal justice system; but there is not justice in the world.

In fact, it is the relatively poor, the working class, that suffers the brunt of the criminal activity of criminal drug addicts, as the slightest acquaintance with British social reality makes abundantly obvious. (This explains why the Observer, in its Olympian way, is able to call burglary "a less serious crime" - without, of course, saying what it would consider a serious crime. Moreover, burglary is far more serious in its effects for the poor than the rich.)

Thus, the idea that drug addicts who commit crimes should not be sent to prison is an absolutely typical example of the cruel, heartless and unimaginative indifference of the educated and intellectual middle classes of Britain to the fate of their less fortunate fellow-citizens of the working class. The only possible benefit of not imprisoning such addicts is that it saves the middle class a little tax to pay for the protection of their poorer fellow-citizens: and even that is very doubtful in the long run. But it is easy to be lenient at other people's expense, and call it generosity of mind.

Theodore Dalrymple is a writer and worked for many years as an inner city and prison doctor. He is the author of the author of Junk Medicine: Doctors, Lies and the Addiction Bureaucracy.

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"What harm can sending drug addicts to prison do to the rest of us when they have committed crimes?" Indeed what harm can it do sending a 'drug addict' to prison and lets whack on an extra 5 years on to thier sentence just for falling prey to an addictive substance. Bravo Theodore what an insightful and humane article.
I look forward to the day that your son/daughter falls victim to such a situation.

Posted by: Geoff at April 2, 2008 10:08 AM

Here we have a problem of words. When the Observer says:

convicted drug users should not be sent to prison because it does more harm than good.

Does it mean to imply that a burglar or violent robber should not be sent to prison because they’re on drugs? Or simply that illegal possession of drugs should not be punished by imprisonment?

“Geoff” talks of “whacking on an extra five years”. I do not see that Theodore Dalrymple is suggesting anything of the sort. And what is sarcastic-humane about his article? Five young women in Ipswich probably had not committed any offences, but they would still be alive if they had been “inside”.

Perhaps some basic training in mathematics, and especially the mathematics of logic, might be de rigeur for those who formulate laws and policies. See this paradox.

Talking of prison, what’s happened to Emily Kingham? Has she been “rumbled” by the authorities?

Posted by: Robert H. Olley at April 3, 2008 02:32 PM

Drug courts in the U.S. have had success using drug rehab for non violent drug users. I am not sure you would include drug dealers or people committing crimes in the group of non violent. Prison does cost more than drug rehab and clearly prison sentences haven't helped stem drug use.

Posted by: Nathan Harris at April 6, 2008 09:38 PM

"Prison does cost more than drug rehab and clearly prison sentences haven't helped stem drug use."

Prison sentences haven't helped stem criminal behaviour in general, but that surely has more to do with prison regimes, than with prison per se. Jails are the perfect places for rehabilitation of every kind, but their potential for so doing is seldom realised: offenders are placated, entertained and indulged (thanks to the self-congratulating and indifferent tribe of Left-liberal popinjays which mismanages our penal system). Why on Earth should they not be expected to earn their keep (or at least to contribute substantially towards it), just as their law-abiding victims have to? Why should the latter have to bankroll the undemanding lifestyle of the criminal underclass which makes their lives such misery?

Many inmates have never at any time in their lives known the structure and discipline of the working day. Where better to habituate them to it?

I wish Dr. Daniels would write an article on this...

Posted by: P. Hayman at April 17, 2008 02:53 PM


You obviously have a problem comprehending simple concepts. I think it's because you feel rather than think. Like all silly lefties you just see in sterotypes. So for you every drug addict is a victim oppressed by society. And anyone who objects to criminal drug addicts suffering punishment for their actions is an oppressor.

Let us set out the real argument for you. Letting criminal drug addicts (CDA's) roam the streets causes harm to the poor, because it is amongst the poor that the CDAs operate. It is the poor welfare recipient who is robbed and/or assaulted by CDas eager for thrills and money. So removing CDAs from society by placing them in prison for a very long time is good for the poor. That is true compassion for the downtrodden, you stupid git! Caring about the fate of idiots who are too effing stupid to avoid dangerous drugs is not a sign of compassion so much as a sign of idiocy and moral corruption. It does not even help the CDA, as it offers him no inccentive to cease his stupid habit.

Posted by: Peter at April 24, 2008 04:20 AM

While I agree that problem drug addicts, defined as those who commit crime to fund their addiction shoulod be locked up the best place to do that might be a secure rehabilitation facility, not prison.We also need a way to reduce the prison population and, if many prisoners are in jail because of their addiction then perhaps an alternative solution is needed.

Here is how I see this working once an individual is arrested fpr an offence and is found to be a drug addict (dealers would not get this option and would be sent to jail as now.

1 The individual recognises that they have a problem before being charged and is willing to accept residential treatment for their addiction until such time as they problem has been solved. In this case they could be given a community sentance after drugs rehabilitation or perhaps could avoid a criminal record altogether if this is thier first offence.

2 The individual refuses to recognise their problem or refuses rehabilitation. In this case they would be charged and tried, ideally in a specialist drugs court. In this case the person, assuming they are found guilty would get a criminal record. However, rather than sending them to prison, which probably will not solve their problem and perhaps actually make it worse, that person would be sent to a secure residential rehabilitation facility where they would remain until free of their addiction.

The advantages of this would be that the numbers of people we imprison would be reduced, probably significantly and we would have a better chance of solving more of the drugs problem.

Drug dealers, particularly those who are not themselves addicts would be tried as now in the traditional courts system. In the latter case a longer prison sentance should apply. In the case of addicts who are also dealers might serve part of their sentance in a rehabilitation centre but only after a spell in prison. Likewise, addicts with a more serious criminal record might be sent down this route.

Posted by: Luke Willen at May 8, 2008 02:00 PM

Addiction treatment is a process that needs cooperation from both sides i.e. patient and doctor, for treatment so that the patient gets cured as soon as possible. If the patient doesn’t follow the guidelines then it becomes impossible for a doctor to cure him.

Posted by: Drug Rehabs at May 14, 2008 12:12 PM

My question to Drug Rehabs is what happens when a drug addict refuses to follow the treatment guidelines he or she has been given or refuses to take treatment. It may be that this is because the need to "get a fix" is so great that it overrides anything else including the sense of right and wrong.

Under these conditions the drug addict may well choose criminal means in order to fund their habit thus creating a problem for the rest of society. as Peter points out the effects of this will be greatest in deprived urban areas. Many drug addicts are concentrated in areas like this, not that everyone living in a deproved area is either a criminal or a drug addict. Most are decent ordinary people and they have human rights too.

These human rights include the right to walk the streets without fear of being attacked and robbed by a drug addict wanting to fund his next fix at your expense, the right not to be put at risk of HIV infection because of discarded needlles, the right not to be harrassed by a drug addicted street beggar, the right to live free from thje fear of shootings between rival drug dealers and so on.

If we can be argued that, because of the need for a fix overrding any other factor, drug addiction is similar to a serious mental illness. However, the big difference is that the former has a much more serious effect on society than the latter.

Certainly, offers of voluntary treatment and rehabilitation must be the first and preferred option. However, where these are not taken up and the indivirual drug addict is a clear risk to the community because of the criminal activities in which he/she is involved then I believe that their is a strong case for enforcement of compulsery treatment. While the addict may not want the treatment it is not fair on society or,in the long run, on the drug addict him/herself to allow the situation to contine as is.

In this situation it is better to take the addict out of the environment they are in to a safe, comfortable and secure envronment where their addiction can be dealt with. After this rehabilitation and support must continue in order to allow the former drug addict to reintegrate into society as a productive and effective member.

Posted by: Luke Willen at June 27, 2008 08:57 AM

The idea of imprisoning drug addicts for long periods is entirely inhumane. It may be that they commit crimes but they do not deserve sorer punishment than any other criminal. If an addict murders a pensioner for their purse and 30 quid towards heroin, by all means give him a life sentence with a 18+ year tariff- the same as any other person. But the majority of addicts who break the law in order to fund their habit commit petty thefts, social security frauds, etc. which are aimed not at the lower classes or downtrodden as Dr Daniels suggests but rather large chain businesses and government. We have the right as adults to consume the psychoactive substances we decide are suitable for us, no matter what government says. Law on drugs is a fundamentally immoral sumptuary exercise and disobedience to such law is a justified act as the legislature has far exceeded its moral purview in prohibiting the mere possession of narcotic chemical compounds.

The fact a qualified medical doctor claims addiction is not a compulsion makes me laugh. And coming from this obviously erudite, studious, well-read, well-travelled, classically educated, culturally refined man sounds more like a provocation than a real belief.
I do not need to explain the relationship between dopamine, endorphins, opioids, reward pathways and chemical habituation. Any doctor who cannot fathom such biology should be struck off.

Posted by: M.S.Taylor at March 6, 2010 09:30 PM
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