2013-06-19T10:34:52-04:00 Luke Dale-Harris http://www.huffingtonpost.co.uk/author/index.php?author=luke-daleharris Copyright 2008, HuffingtonPost.com, Inc. HuffingtonPost Blogger Feed for Luke Dale-Harris Good old fashioned elbow grease. tag:www.huffingtonpost.com,2013:/theblog//3.3177308 2013-04-29T08:35:00-04:00 2013-04-30T07:52:37-04:00

Luke Dale-Harris http://www.huffingtonpost.com/luke-daleharris/
But this never stopped it being fought. In fact, as failure became ever more apparent, each successive Republican government approached the war on drugs with renewed vigour. Why? Not because they thought it could be won, that much was clear, but because no one knew how it could be lost. If this is war and drugs are the enemy, defeat can only mean one thing- drugs win. This is, of course, a form of madness, a spiral of rhetoric that has drawn out its enemy from an abstraction and cast it as real, only for it to become so. As drugs have become further and further polarized from the state, they have agglomerated a world of crime, picking up the marginalized, the addicted, the greedy and the plain psychotic and pitching them directly against the rest of us. In calling for war, America has created an enemy. Everyone, from the tax payer to the addict, is paying the price.

Luckily there is an escape route, and the US government seems to be waking up to it. It involves not admitting failure- they have been doing that for decades- but shaking free of the madness; calling out the whole war as bogus and starting again. This is the essence of America's new Drug Policy Reform 101, the details of which were released this week. It doesn't call for drug legalization- there is enough evidence to show that that is not the answer. Instead it demands something that sounds obvious but, in terms of policy, could be genuinely radical; 'drug policy reform should be rooted in nueroscience, not political science. It should be a public health issue, not just a criminal justice issue.'

The methods outlined to achieve this are simple. The approach to drugs will be bought down to a local medical level. GPs will be trained to screen for addiction through a series of questions. If necessary they will perform what is termed a 'brief intervention', a procedure much less sinister than its name suggests, in which the doctor works with the addict to try and change their way of thinking in regards to their substance use. Finally, if necessary, the doctor will provide the addict with a series of treatment options. This, coupled with a justice system that recognises that you 'can't arrest [your] way out of the drug problem' and treats drug use as a health issue rather than a criminal offence, promises to help an extra 32 million Americans out of drug addiction by 2020.

At the root of the reform is a logic Britain would do well to learn from. Drug addiction needs to be tackled from the bottom upwards, rather than the top down. For this to happen, our view of drug addiction must be grounded in the reality that it is a brain disease, not a moral weakness or the manifestation of a criminal mindset. Then, critically, our general health practitioners must be trained up to recognise and understand addiction, and the appropriate treatment facilities put in place for them to refer patients too.

The spokespeople for the NHS seem to be aware of this. Dame Sally Davis, the Chief Medical Officer of the NHS, recently reported that research showed how a focus on criminalisation 'was deterring drug users from seeking medical help'. This year's British Medical Association report 'Drugs of Dependence' supported her findings and argued that GPs must 'confront patients they suspect of drug addiction and offer them treatment without fear of prosecution.'

But these ideas are still a long way away from the reality. Most heroin and crack addicts find their way into treatment either through accident and emergency or the criminal justice system- the stops towards the end of the line- by which time the damage, physical or social, has often been done. Those who do go to their GP are often met with inexperience- only 3% of British GPs have been properly trained in drug addiction and alcoholism, the rest receiving just 1/2 a day training over the course of their medical studies. At our addiction helpline, every day brings calls from addicts at their wits end, who have either tried to go through their local health services only to find suitable help unavailable, or have been too afraid to make the visit to their GP.

It is infuriating to have America, whose mad war on drugs helped dig this hole in the first place, come up with the first sensible solution in years. But The Drug Reform Policy 101 is undoubtedly a move in the right direction. We need to follow their example- train up our GPs in addiction, remove the threat of persecution for those seeking help and, like we do with other diseases, try and catch it early rather than waiting till it may be too late. The war on drugs has built stigma, fear and a certain glamour around drug use. The 21st century approach must strip these illusions away and reveal addiction as the disease science has shown it to be. This way we'll have not an enemy, but a health problem that can be tackled.]]> tag:www.huffingtonpost.com,2013:/theblog//3.2848654 2013-03-11T19:00:00-04:00 2013-05-11T05:12:01-04:00

Luke Dale-Harris http://www.huffingtonpost.com/luke-daleharris/ Prime Suspect, she fought crime. Later on she fought her own addiction to alcohol. Now, at 61 and with many years of prison counselling and an MA in addiction treatment behind her, she fights the two together.

But while there are endless studies, research groups and counsellors looking at the interrelation between addiction and crime, Malton takes a different approach. For her, addiction isn't just a force that leads people into crime as a means to finance their habit. For many, she believes, crime itself is the addiction, committed first and foremost to satisfy a need to do so within the criminal.

She arrived at the idea after leaving the police force in the late 1990s and starting a MA in storytelling. "I have always thought that there is a strong link between police work, storytelling and addiction", she says, "and that the storyteller's sense of narrative is key in understanding why people do the things they do".

As she studied, she started to make sense of her experiences as a detective, both what she saw and what she felt. The difference between the two seemed smaller than expected; the characteristics she had seen in herself when on a case she also saw in the criminals she had been chasing. "Being a detective is seductive, its obsessional", she says. "For me it was also about proving myself, on the understanding that I wasn't enough. These are also all motives for many criminals. And they are all motives for addicts".

Years later, after starting a new career both writing and working in prisons, Malton decided to go back to study- this time an MSc in addiction psychology. Her central thesis was on crime as an addiction, a section of which she recently published in Addiction Today.

Her case is strong, and though it isn't widely talked about, she's not alone in making it. Since the 1980s, a few addiction specialists have been noting the similarities between the way in which criminals describe the experience of committing a crime, and the way alcoholics, drug users and gamblers talk about the experience of indulging in their own vices. To both criminals and addicts, the feeling of power, control and self esteem are often central to their experience, while the increasing difficulty of achieving this state as time goes on plagues each alike. Perhaps more tellingly, certain criminals were said to exhibit all the characteristics commonly associated with addiction; increased tolerance, withdrawals, craving, salience, conflict and relapse to name a few.

But Malton wasn't satisfied with this which, with limited actual evidence to go on, amounted to mere speculation in the eyes of the authorities. She set out to conduct a series of in depth interviews with 10 prison inmates in the hope of finding further links between the mindset of an addict and that of a criminal.

What she found strongly reinforced her thesis. Nine out of 10 of the inmates interviewed talk of "a powerful emotional reaction... ranging from nervousness and fear to buzz. Verbs used included: super-human feelings, intense, control, adrenaline, buzz, scared, nervous", she writes. Seven of the interviewees described obsessive planning or fantasizing over their crimes, with "all of life, thinking, feeling and behaviour dominated by and organized around the next opportunity to offend". A further seven described what Malton calls "positive feedback loops", addiction jargon to describe an escalating need for higher and higher levels of stimulation, characterized by increased tolerance, withdrawal and feelings of guilt.

Taken together, the study suggests that at least 70% of those interviewed displayed all the major hallmarks of addiction; a very high rate by any standards. I put the concept to addiction specialist Daniel Gerrard at addictionhelper.com. "I don't know why the link (between crime and addiction) hasn't been considered more strongly before", he says. "Like gambling, crime can offer an intense emotional experience. Combined with the right social and personal context, this can lead to addiction".

If Malton is right and crime could, for some, become an addiction, then some serious moral considerations could come into play. In the current medical understanding, addiction is a brain disease where, after regular use of a substance or engagement in a potentially addictive activity (i.e. gambling, shopping, sex etc), the functioning of the brain changes and the patient becomes reliant on the stimulant, leading to all the characteristics mentioned above. It is understood to be a non-recoverable and relapsing disorder.

Not only does this model imply that once an addict, the person is no longer entirely responsible for their actions (hence the frequent AA assertion that you are not the problem, alcohol is), it also assumes that relapse is an inevitable part of the process of recovery. For criminals, this amounts to mixed messages. If they are not responsible for their actions, how can they be punished? But if their addiction means they are MORE likely to reoffend, what choice is there but to lock them up?

For Malton, this logic is redundant. "At some level we are all responsible for our actions", she says. More important than deliberating over the moral implications of the addiction model is the way it is considered when approaching rehabilitation and criminal counselling. "People displaying the hallmark characteristics of addiction in relation to crime should get rehabilitation and treatment that looks at their behavioural patterns in the context of addiction", she says.

This approach, rather than applying the fateful logic of the disease model that "once an addict always an addict", looks forward to a more stable future, built on knowledge and understanding. "I know from my own personal experience, as a counsellor and an addict, that people can change", she says.]]> tag:www.huffingtonpost.com,2013:/theblog//3.2714673 2013-02-19T19:00:00-05:00 2013-04-21T05:12:02-04:00

Luke Dale-Harris http://www.huffingtonpost.com/luke-daleharris/ the fattest. But today, for the first time, a campaign has been announced which looks to address the latter of these problems in the same context as the other two; overeating is a problem with its roots in social, cultural and economic causes, and its corollary in habit and addiction.

Unlike the previous, scattershot attempts by the health sector to approach the issue of obesity, this time we have a manifesto, an ultimatum and a series of terrifying statistics to help kick us into action. Already a quarter of British women and a third of under nine's are clinically obese and by 2050 this figure is predicted to have risen to accommodate over half of all British citizens, a reality our NHS could not support. This must be the time when this epidemic starts to be tackled pragmatically; when policy replaces the empty rhetoric and class based condescension that has characterized the debate up until now.

The report released by the Academy of Medical Royal Collages (AMRC) calls for a series of measures to be put into place, "starting right now", that will break the cycle of "generation after generation falling victim to obesity related illnesses and death". These include mandatory food-based standards to be introduced in all UK hospitals, a limit on the number of fast food outlets situated near schools, colleges and other places children gather, and traffic light food labeling to show calorie counts.

It also proposes a series of measures that are familiar from past policies designed to quell our appetite for other harmful substances, notably alcohol and tobacco. A nine o'clock watershed for advertising of foods high in saturated fat, sugar and salt, a tax hike on sugary soft drinks that will increase their price by at least 20%, and increased intervention and advice from GPs to educate people on the dangers of over-eating.

Professor Simon Capewell worked on the report and talks of a need to reverse the obesegenic environment created over the last three decades by the junk food industry. "Unhealthy food has always been associated with healthy living. Advertising tells us that it makes us strong, fit and happy. The reality, that it makes you fat, sick and miserable, is only heard on the periphery."

He talks also of comparisons to the tobacco industry, a similarity referred to throughout the report. "They both shift the blame onto the consumer, in the full knowledge that the product they are selling is seductive, and ultimately addictive."

Dr. Damien Downing, the president of the British Society for Ecological medicine and an addiction treatment specialist, says that overeating must be approached, at least in part, as an addiction. "Often overeating is linked to an addiction to sugar", he says. "This is a physical illness, functioning in a similar way to other addictions. If we are to address the problem, this fact must play a significant part of the approach".

The science supports his theory. A high intake of sugar results in all the defining symptoms of addiction; physical and psychological dependence, increased tolerance, withdrawal symptoms, and changing behavioral patterns.

Dr. Downing explains. "When sugar is consumed your body reacts to it as it would drugs or alcohol, producing an increased amount of certain neurotransmitters, such as dopamine, serotonin and adrenaline. These are the chemicals that make us feel good, whether that is the feeling of relaxation, energy or focus. But this artificial stimulation over time reduces our body's ability to produce the chemicals on its own, meaning we become reliant on the stimulant just to get us feeling normal."

The result of this is not only dependence on sugar, but the mental and behavioral symptoms so often associated with obesity. Capewell talks of studies made on children which show that increased consumption of sugar leads to worse behavior in school, while the AMRC report talks of the "depression, anxiety and severe mental illness" that can come from overeating.

Daniel Gerrard is the founder of Addiction Helper, an addiction helpline. He reports that 10% of the 27,000 calls they receive a year are from people looking for help with food addiction. "We treat it in exactly the same way as people with other addictions" he says. "Many patients are referred to residential rehabs, while others receive work through a 12 step program."

While this approach goes further than that mentioned in the AMRC report, they do recognize that "change requires that the emotional and psychological factors (of overeating) be understood and tackled, rather than neglected or minimised". They call upon GPs and local health services to treat obesity as the multifaceted problem it is; to open both their minds and their services.

If the report is acted upon, it will herald a fundamental shift in the way we approach obesity. It is very possible; the economic incentives are there and the public mood for such a change is strong. If the comparison to the social shift against smoking is anything to go by though, it could be a long haul. It took almost fifty years for the tobacco lobby to be overturned after the first government report documented the harm caused by cigarettes in the 1950s. The junk food lobby is equally strong, and their product nearly as addictive. Whether the policies are implemented or not depends on what comes first, our appetite for junk food, or our appetite for change.]]> tag:www.huffingtonpost.com,2013:/theblog//3.2579635 2013-01-30T04:27:05-05:00 2013-03-31T05:12:01-04:00

Luke Dale-Harris http://www.huffingtonpost.com/luke-daleharris/
The answer, for many at least, seems to be not very, and not much. But the argument has become misplaced. In trying to deal with an issue that has come about due to our disregard of the natural world we live in, we have fallen again into an entirely human centric approach, our hands on our wallets and our eyes on our favorite picnic spots. This is, of course, understandable. Money is tight, and the beauty of our countryside important. But, as wind farms will continue to be built, the result is that they are moved to areas where land is cheap, and human habitation scarce. Unfortunately, these tend also to be the areas where biodiversity is rich, and endangered species populous. In trying to keep renewable energy as inconspicuous and inconsequential as possible, we end up blighting the very thing we set out to protect.

A while ago the RSPB released a map showing the areas most sensitive to wind farms in England and Scotland, based on their levels of biodiversity and fragility of their bird populations. Sometime later, the Guardian released a map of all the wind farms, both completed and proposed, across UK. The correlation is obvious; our wind farms are gravitating to the areas where they are most damaging.

Of course there is another element at play here; wind. These same areas, removed from human habitation, are often where the weather is at its most extreme and, across Europe, where wind speeds are consistently highest. But renewable energy companies aren't alone in looking to harness this energy. Migrating birds, especially larger species and birds of prey, choose their routes largely in accordance with wind patterns, using the strong currents found above high and open terrain to propel them forwards in their journeys. When the two meet, there are bloody consequences.

This has been the case at the poorly sited wind farms at Nevarre and Tarifa in Spain and, more famously, at the vast site that spans the Altamont pass in California. In these cases, hundreds of rare and endangered birds, most notably Golden Eagles and Griffon Vultures, are killed each year from collisions with wind turbines. Due to the long life span and low reproductive rates of these species, over time this will have a dramatic impact on their populations and, if the turbines remain in place, could ultimately lead to the extinction of the most fragile species in the regions surrounding the wind farms.

The mistakes made in the sitings of these farms could, at a push, be put down to inexperience, as all three farms were constructed in the early days of wind energy. Now, with the appropriate environmental impact assessments and careful siting, wind farms could be built that would have very little detrimental effect on both migrating birds and biodiversity.

Yet across Europe, wind farms continue to be erected in areas where they cause significant harm. Perhaps most distressing of these are those being thrown up across the migratory corridor that runs through Eastern Romania, along which hundreds of thousands of birds fly each year. With over 5000 turbines in the pipe line, the damage could be on a par with that in Spain and California.

Milvus Group, a Romanian ornithological and environmental organization, have been at the forefront of the opposition to the wind farms. Tamas Papp, the director of the group, explains that, when a site is being chosen, 'nature conservation is the last thing to be considered, falling behind the price of the land, proximity to power lines and opposition from locals'.

With no concrete legal standards set by the EU, it is a complicated process to challenge wind farm developments at the European court and, by the time the case is pushed through, they have invariably already been built. As a result, enforceable environmental standards fall generally to the whims of party politics and fluctuations in the economy. If there is anything that could benefit from centralised laws of the European state, it is the birds that move freely across it; but in this case the laws do not exist.

Of course, the impact of wind farms on birds and biodiversity pales in comparison to the predicted devastation that will be bought by rising temperatures, which the RSPB estimates that will commit between 15% and 37% of species to extinction by 2050. But until this move to clean energy is seen as more than just a political tool and a nifty investment, we threaten to lose sight of what it originally set out to achieve.]]> tag:www.huffingtonpost.com,2013:/theblog//3.2424595 2013-01-07T10:00:10-05:00 2013-03-09T05:12:01-05:00

Luke Dale-Harris http://www.huffingtonpost.com/luke-daleharris/
In a small building tucked down an alleyway, the girls at the Lao Cai shelter for Victims of Human Trafficking hold a different perspective. All recently returned from China, they wait for a position to open up in one of Vietnam's more permanent shelters. For many of them, they can't return home and, with a constant influx of new returnees, they can't stay here for long.

The statistics on the human trafficking in Vietnam vary hugely and official information is limited. The Vietnam Ministry of Public Security offer the official figure of 2,935 Vietnamese victims of human trafficking between 2004 and 2009, while Hagar International claim the considerably larger total of over 400,000 victims since 1990.

Madam Thuy, Director of the Human Trafficking department at the Centre for Women's Development, reinforces the general consensus that the phenomenon is on the rise and that it cannot simply be explained by looking to poverty.

"There are many factors that contribute to the growth in trafficking, but most common across all cases is the disintegration of the family structure" says Thuy.

The stories of the girls in the shelters reinforce her point. The vast majority of them where originally sold by either family members or close friends.

Linh is a 25 year old woman who was bought back from China last year and lives now in Hanoi's Peace House Shelter. Born into a family of eight, she grew up working the fields and looking after the chickens in a small mountain village. As she grew up her siblings were allocated different roles, her two brother sent off to university while her older sister was pulled out of school to be married.

'We lived separate lives, even when we were all living together. My brothers treated the rest of us like we were servants to them, and my father didn't care about any of us.'

The Confucian values of authority and filial loyalty hold strong in Vietnam, permeating the language, religion, culture and politics. However, it is under increasing pressure from the younger generations, influenced by western ideals and the divisive nature of incoming money. Thuy suggests it is the conflict this clash brings, between familial tradition and modernization, that is at the root of the problem.

When Linh was taken to Hekou in China by an aunt under the pretext of going on a shopping trip, she was just pleased at the gesture of generosity. 'Looking back now I don't know how I could have been so stupid. She'd never shown any interest in me before' she says.

She was left with two Chinese ladies who took her to market and explained that she was to be sold as a wife. Over the next 5 months she would be sold at 6 different markets, being picked up by 'dealers' each time before being sold on. Finally she was bought and forced into marriage with a 30 year old man.

In contrast to Vietnam, in China it is the demand for an ideal family model that fuels the industry. The one child policy results in a preference for male children and subsequently a shortage of girls available for marriage. Unlike the global trend of trafficking for prostitution and labour, from the north of Vietnam the majority of victims are sold as wives and sons.

Linh's job was to produce a baby. When she refused to sleep with her husband he beat and raped her and, when he wasn't around, his father did the same.

Determined not to become pregnant, Linh seized her chance one rainy night and escaped, running to the local police station. From there she was taken back to Lao Cai where she was given a bed in the shelter. There were fifteen other girls there with her, all with similar stories to tell.

'None of us knew what would happen to us.' Linh says. 'We didn't know whether we were guilty or innocent.'

After 5 months at the Peace House Shelter in Hanoi, Linh understands clearly that she is the victim, not the offender, in this story. Yet for her family and neighbors back home, this distinction still isn't clear and Linh remains ostracized, unable to return home. With the support of the shelter, she can start a new life in Hanoi. For many others though, such help is not available and, socially outcast, they often fall into crime, most commonly becoming traffickers.

'The industry is growing' says Thuy. 'Until the returnees are seen as victims, it's not going to stop.'
(Linh's name has been changed.)]]> tag:www.huffingtonpost.com,2012:/theblog//3.2323788 2012-12-31T19:00:00-05:00 2013-03-02T05:12:02-05:00

Luke Dale-Harris http://www.huffingtonpost.com/luke-daleharris/
Of course it doesn't really work like that. This is a revenge tragedy, not The Shawshank Redemption. After years of dependency I finally came to terms with the fact that my life partner was trying to kill me, so, like any man with a shred of dignity, I got in there first, sending it under before it could do the same to me. Now, it's gone, and all I can think of are those smoky halcyon days of yonder, the early days of a love doomed to self destruct. This is, of course rubbish, but it seems increasingly hard to remember that.

My first thought after deciding to quit was that I'd take a visit to my GP and get a prescription for every giving up smoking aid there is. Then, armed with my Nicorette patches, gum and inhaler and stoked up on insanity inducing Champex pills, I would settle down to the long, dark night of withdrawal. This, of course, was a ridiculous plan, akin to a man stocking up on hard liquor and porn in preparation for his upcoming divorce. If you premeditate pain, then it will be exactly as bad, or worse, than you expect it to be.

In the end I decided the best course of action was to read Allen Carr's The Only Way to Stop Smoking Permanently. I had been told enough times by glowing ex-smokers how it had singly saved them from the sad fate of nicotine addiction, but I had always remained skeptical. I mean, I had read Jonathon Safron's terrifying Eating Animals and continued to eat battery chickens, so how was this book going to persuade me to give up the one thing I knew it would be impossible to live without?

The answer is, easily. Or relatively easily anyway. Carr's trick is to break down our illusions of smoking, and once the myths that surround cigarettes fall apart, so does our addiction. The result is not a battle of the wills, as both the smoking and non-smoking world would have us believe, but a struggle of faith. What do we believe, the advertised image of cigarettes as a pleasurable vice, or Carr's verdict that nicotine's only pleasure is an illusion, just the relief of the symptoms that it itself creates?

The answer is simple, of course, but coming to actually believe it isn't, at all. As any discerning shrink will tell you, our beliefs are shaped first and foremost by fear, hence the intricate realities carved out by paranoid schizophrenics, or the irrational racism adopted by countries falling into recession. Positive belief, formed by understanding and knowledge, is much harder to come by.

With smoking, the fear of giving up inevitably seems much more real than that of it killing you. I know what giving up will feel like; I go through it every time I'm stuck on a train for more than two hours, and it is rubbish. Dying on the other hand, I'm still getting my head around. When it comes down to it, us smokers are more likely to believe in the entirely irrational benefit of a carcinogenic drug, than the irrefutable certainty of death. That's got to be something to worry about.

Rationalizing with such a warped perspective seems at first like Alice trying to argue her way out of Wonderland; at every corner you meet a ridiculous yet defiant rebuttal. But, just as Alice can finally call out the queen of hearts as nothing but a playing card, and ignore her calls of 'off with her head!', so Carr reasons that, with sufficient understanding we can laugh at our addiction and smile out our cravings. When we stop believing in it, the addiction ceases to exist.

Since starting this article I have walked probably close to a mile in circles around my kitchen, eaten a bag of nuts and decimated the end of a biro. This addiction, when deprived of its need, truly reveals itself as a form of hyperactive madness. They say this is the hard bit, but resisting madness is easy when you can see it for what it is. When the cravings fade and the struggle of faith loses its obvious pointers, that's when things get tricky. Not that I will realise it at the time.

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