It's a baffling conclusion, especially as there seem to be some obvious common-sense approaches that work well in other areas of life. For example, it seems reasonable that more drug education would help reduce drug use. If we honestly explain the risks to children, it seems self-evident that less of them would go on to use drugs. Now I'm convinced that having honest information on drugs is essential for everyone, but in terms of actually reducing drug use, education has been a disaster. The research suggests that, in schools or elsewhere, drug education has no significant beneficial effect on drug use at all. In fact in a few cases it has been counter-productive. The UK 'Heroin Screws You Up' campaign in the late eighties showed showing pictures of sickly thin heroin addicts defiantly arguing that they didn't have a problem, just a “touch of 'flu”. Some young people who saw themselves as outsiders found this quite an attractive image, and promptly started using. In America a $1.2 billion dollar education campaign was abandoned after research found the only measurable effect was a slight increase in cannabis use.  

Other approaches also seem like common-sense. For example, it seems logical that tougher penalties for drugs would reduce the number of users. If we could combine harsh penalties for use with a realistic chance of getting caught, it seems self-evident that less people would take the risk, and drug use would decline. Again, the evidence shows that this approach, tried for decades throughout the world, simply doesn't work. In America a study of 94,000 school children found no significant difference between rates of drug use whatever penalty and testing regime were used. Even random testing didn't stop users, though it did prompt a slight switch away from cannabis, which is relatively easy to detect, and towards other drugs such as cocaine which leave the body much quicker. Certainly at home and abroad, widespread increases in the number and length of prison sentences have failed to stop huge increases in drug use.

So what can a drug strategy actually do? Well, I think it's essential to look at dependent and non-dependent users separately, and see what it's realistically possible to achieve. The vast majority of recreational users stop by the time they reach thirty.  Though the headline figure is that 35% of the population have tried drugs, less than 10% have done so in the past year, and only around 0.6% go on to become dependant on them. Most users seem to grow out of it without suffering any ill effects, and since as they are predominately young men, the risks involved might well be part of the attraction. There is no evidence that legislative change will make any difference, but it does carry considerable political risk. More liberal laws open the Government up to accusations of being “soft on crime”; more draconian laws risk accusations of “pandering to the right”, ignoring evidence, and wasting time and money. Unless attitudes in society change, the best government may be able to do is present an honest message that drug taking is a dangerous thing to do and is not recommended, but if people decide to do it anyway, outline the risks, and be clear about what to do if things go wrong.

The problem of dependent drug-users seems on the surface to be equally baffling. Some addicts commit huge amounts of crime, and many suffer dreadful physical and mental health problems, but may return to drugs again and again even after long periods of abstinence. Some addicts continue using after losing their home, family, and even their limbs. Many continue for years after the drugs have stopped giving them any pleasant effects at all, and resist all efforts to help. Tragically, over 1,500 addicts die every year, yet most can recover completely if they commit to a treatment programme. So why do so few addicts ask for help, and of those that do, why do so few take it? Well, happily I'm in a position to tell you, because I've been there.

Many addicts think that mood-altering chemicals affect them in a different way to normal people. Certainly when I first discovered alcohol, and later cocaine,  the effect was almost religious in intensity, and all my problems seemed to melt away.  It was as if I had found something I had been looking for my whole life. I didn't start using regularly until the nineties, but as my tolerance increased, I used more and more. However, my experience of life when not taking drink or drugs got progressively worse. The world seemed to become an increasingly hostile place, relationships got more and more difficult, and an all-encompassing sense of dread and paranoia set in. At the same time, the drink or drugs became progressively less able to soothe those feelings. At some point, the drugs stopped working completely, but life without them had become impossible. It was a dreadful catch-22 situation, where it was impossible to live without alcohol or drugs, but impossible to continue using. I managed to get help before it destroyed my life and these days I'm very active in the recovery community, working with other people who have found themselves in the same place.  The key point here, is that all the way along I thought my behaviour was perfectly normal, and it was the  rest of the world had gone mad. I had no idea my experience of alcohol or drugs was different to anyone else's because I had nothing to measure it against. Friends were baffled as to why I was doing it. I was baffled as to why they weren't.

So if my experience is typical, and I think it probably is, many addicts aren't interested in treatment, because they don't believe there's anything wrong with them. As with other kinds of mental illness, it's very difficult to make much progress without the co-operation of the patient. So while it is vital to provide treatment facilities for addicts who want them, it is equally vital to find ways of reducing the harm that addiction does to those who don't, as well as to society as a whole. Some of these facilities, such as needle exchanges, are already quite common, and have proved effective in limiting the spread of HIV amongst injecting users. More controversial are trials of prescribing heroin to dependant users for use under medical supervision. A similar Swiss experiment proved so successful in cutting health risks and crime that it is now an established part of the healthcare system. Unexpectedly, the Swiss found there was a slow drift from the prescription programme into abstinence-based treatment. The British trials are due to start reporting next year.

So what I'm hoping for in 2008 is a strategy based on research, education, and harm reduction. Some evidence suggests that the proportion of people who have the kind of unusual reaction to alcohol and drugs that I do, and so may be at serious risk of becoming dependant, may be as high as 1 in 6. If so, taking drugs is really like playing Russian roulette. Most people will get away scot-free, but for some it will mean their death. And just like Russian roulette, you won't know which group you're in until it's too late.