Drugs and alcohol - the Truth
Article for Christian Medical
Fellowship by Dr Patrick Dixon
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8% of all international trade is illegal drugs |
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80% of all large US companies test workers for drugs |
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8% of all men dependent on alcohol or drugs, 2% of women
(UK) |
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14% of 15-16 year old boys took drugs last week, 11% of
girls |
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10% of older US pupils take drugs every day |
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Updates from 100,000 daily publications + many good links |
Drug testing takes off in workplace
On current trends within two years it will be almost
impossible for recreational drug users to get a job with larger
companies. drug testing at work is probably the single most effective
weapon we have against adult substance abuse. It is a proven,
low cost strategy which identifies those needing help, reduces
demand, cuts accidents and sick leave, improves attendance and
increases productivity.
Yet testing is (or rather was) highly controversial:
it penalises users with positive tests that can bear little or
no relation to work performance, encourages knee-jerk dismissal
and discrimination at interview. It costs money, invades privacy
and smacks of authoritarianism.
Despite all this, almost overnight it has become
fashionable to talk of testing millions of people at work for
both alcohol and drugs. Just over six months ago the idea seemed
so extreme that the government cut it out of the White Paper altogether
- with small concessions for prisons and roadside.
Huge policy shift
In a dramatic policy shift, drugs czar Keith Halliwell
and government Ministers have started encouraging drug testing
by employers. They are following a quiet revolution, largely unreported
because firms have been scared of bad publicity.
The government's own Forensic Science Agency alone
carried out over a million workplace tests last year, with a rush
of interest from transport, construction, manufacturing and financial
services industries. Last month the International Petroleum Exchange
joined London Transport and many others in random testing.
This stampede to test follows spectacular success
in America when many had declared the mega-war against drugs all
but lost. The drugs industry accounts for 8% of all international
trade according to the UN. Education, customs, police, crop destruction
and prison sentences have failed to deliver so testing has become
highly attractive, even at the cost of civil liberties.
80% of all large companies already spend over £200m
a year testing for drugs at work, affecting 40% of the US work
force. By 2005 up to 80% of all workers will be covered.
But Britain also has a significant and growing problem
with addiction. 8% of men and 2% of women in Britain abuse drugs
or alcohol, costing at least £3bn a year in accidents and absence
alone.
Every office, factory, train operator, airline,
construction company and hospital is affected with serious risks
to public health and profitability. Workplace testing in America
is being forced on employers for economic and safety reasons.
Drug companies that don't test will go bust. Their insurance premiums
will go through the roof.
Read
The Truth about Drugs book NOW - all text online for free
Drug and alcohol abuse cripples
society
US studies show that substance abusers (including
alcohol) are 33% less productive, three times as likely to be
late, four times as likely to hurt others at work or themselves,
five times as likely to sue for compensation, and ten times as
likely to miss work.
When the State of Ohio introduced random testing
they found absenteeism dropped 91%, there were 88% less problems
with supervisors and 97% decrease in on-the-job injuries. These
results are so striking that many companies are now screening
job applicants.
One plastics company realised many workers were
taking amphetamines to keep awake after they lengthened shifts
to twelve hours. Staff found tell-tale powder residues and scratch
marks on equipment. They estimated that 20% of the workforce were
taking drugs. After random testing was introduced drug-taking
fell to negligible levels.
A Wisconsin cardboard factory was contacted recently
by their insurers who were worried about high levels of injuries.
Random testing was introduced and accidents fell 72% the following
year, with an 80% decrease in days lost as a result.
Doped doctors kill patients
Health and safety will be the driving force at first
in the UK. Take doctors: a recent report in the Lancet revealed
that 37% of male junior doctors were using cannabis and 14% cocaine,
amphetamines, barbiturates, LSD, ecstasy, magic mushrooms or other
substances. The figure for women was 12%. But that's just the
ones willing to admit it.
The BMA's own figures suggest around 8% of all doctors
may abuse either alcohol or illegal drugs, including cocaine,
crack and heroin. However that is based on self-reports in surveys
and they are hardly likely to overstate the problem. On the contrary,
my own view is that the true figure is likely to be around 10%.
That's almost 10,000 doctors, treating perhaps 200,000 patients
every day. Do you, your relatives or your own patients want to
be operated on by a surgeon who is suffering from withdrawal?
In an operating theatre with two anaesthetists, a consultant and
two junior doctors there is a 50% risk that one of the team is
a substance abuser.
I am appalled at the stance of the BMA, who have
long been opposed to random testing of doctors. They say we are
sensible enough to come forward for help, and those that don't
are informed upon. Both these claims are complete fiction, judging
by the vast gap between numbers with dependency and the few who
have been identified. The BMA's resistance to random testing will
be over-ruled soon. We know that it is very difficult in practice
for - say - a GP to inform on a senior partner because it is immediately
obvious who's done it. Likewise, what chance would a junior doctor
have after informing on a Consultant, especially without hard
proof - which requires a test, and in the case of alcohol a test
at the right time? And very few doctors volunteer for help.
We will never know how many have died under the
knife of an intoxicated surgeon or as a result of a physician's
drug-clouded mind. Doctors don't like admitting errors, even in
court long after the event, by which time evidence of substance
abuse has vanished.
If you're too drunk or doped to drive, or drive
a train, you shouldn't be operating - nor working a crane or cement
mixer for that matter. Nor should you be defending someone in
court nor making huge financial decisions on which other people's
future will depend.
Testing is cheap. Breathalysers cost £40 with virtually
no running costs while £30 urine tests for drugs only have to
be carried out on a few to be effective. For example, London Transport
tests just 5% of drivers a year.
That means each worker is checked on average once
every twenty years. Hardly a mass invasion of privacy, yet more
than enough to be a powerful deterrent. In America positive test
rates have fallen from 13.6% to 4.9% in a decade. This is a method
that works.
Drug testing can be barbaric
However random testing is barbaric unless introduced
sensitively as part of a comprehensive package of education and
access to confidential treatment. The primary aim should not be
to sack, but to discourage abuse, offer help, to treat. The most
effective programmes are those where the workforce approves a
humane, compassionate and fair anti-drugs policy. However those
who place others lives at serious risk must expect to face the
consequences.
There are many unresolved problems with testing:
for example cannabis tests are almost useless with positive tests
weeks after use. What blood levels are acceptable for illegal
drugs? Who should be tested? How often and what action should
be taken?
Some argue for tests only where performance is poor.
But by then a fellow worker may have lost an arm, a leg, an eye
or a hand - a patient her own life. The aim of testing is to prevent
mistakes, not to allocate blame after the event.
One thing is clear: drug and alcohol testing will
continue to spread fast regardless of government support, as the
most practical and cost effective way to strengthen existing drugs
and alcohol policies at work. It will be introduced well or very
badly. Either we take hold of the issue now or the issue will
take hold of us.
Drugs crisis in schools
Schools are facing a new drugs epidemic this Autumn
- 1.5 million pupils in the UK have already taken drugs - 300,000
will try them this year. Over 700,000 starting High School this
week will find ready access to every illegal drug - from friends.
More than 10% will have tried them by the Summer.
Every High School has a drugs problem. Every classroom
is affected whether teachers realise it or not. Some pupils are
suffering after effects of drug-taking almost every day. Drug-dealing
leads to violence: pupils are scared to inform teachers, afraid
of being beaten up, knifed or killed. The "pusher at the
gate" is a myth. Pupils usually get drugs from friends.
The good news is that most pupils are non-users
- however drug-users make them feel minority freaks for abstaining.
That's a terrible thing: it means the drug-using minority are
making everyone else feel they are just about the only abstainers
in the world - and media overkill doesn't help. Non-users need
urgent help to create their own, powerful anti-drugs culture at
school, so they feel good about saying "no". Too many
schools lessons on drugs actually encourage use because they give
facts in a moral vacuum.
Christian mission at forefront
of tackling addiction
In Britain and many other nations Christians have
been at the cutting edge of developing new care services and in
prevention. It is well known that strong faith is linked to lower
addiction levels and that a profound conversion experience is
often followed by successful rehabilitation. Centres like Yeldall
manor have set a national standard for professionalism in a non-judgmental
environment, with Christian values shaping the organisation but
not rammed down people's throats. There is a grave shortage of
decent rehab facilities in Britain today. Rehab works. There is
life after heroin and crack.
The trouble is that until the church sorts out its
position on tobacco, it has little to say to the cannabis user.
When did you last hear a sermon on smoking? Yet nicotine is probably
more addictive than heroin, and certainly a greater killer. Nicotine
is also a gateway drug for younger teenagers. An excellent predictor
of future use of cannabis and other drugs is whether or not the
teenager already smokes. The church has moved away from abstention
as an option, with the death of the temperance movement over the
last sixty years. However, expect to see a new rationale for abstention,
based on the fact that little in absolute health terms can be
martialled against cannabis and ecstasy which should not also
be made against alcohol. Example is vital: both in non-use of
tobacco and moderate or non-use of alcohol.
Christian position on drug abuse
The starting point for a believer is that all things
in creation have been made by God and that we are called to "control
and subdue" the earth (Gen 1v21). However components of creation
are not to control and subdue us. We are made in the image of
God and our bodies are temples of the Holy Spirit. (I Cor 6v19).
We are told that the issue is not so much the letter of the law
- for example does the bible ban cannabis? - but the attitude
towards life. "Everything is permissible for me - but not
everything is beneficial" says Paul (I Cor 6v12). Example
should also influence the believer. (2 Tim 3v10-11)
The biggest drug problem in biblical times was alcohol
abuse and the bible is very clear on this, and on the relationship
between addiction and faith - or lack of it. Paul suggests replacing
drunkenness on alcohol with being "drunk" in the Holy
Spirit. "Do not get drunk on wine, which leads to debauchery.
Instead be filled with the Holy Spirit." (Eph 5v18). What
a strange thing to say! He could so easily have stopped at the
end of the first command, as most of our sermons do. Don't get
drunk. Instead he follows on with a further command. The two in
his mind are linked.
He is not talking about an intellectual grasp of
faith that delivers someone from addiction. He is describing an
experience of God's power and grace that is so powerful and overwhelming
that the person is transformed, changing their habits and desires.
Indeed that is the experience of many kicking a drug or alcohol
habit as they have found faith. "Faith in Jesus is the biggest
buzz a man can ever have". Paul's link of two commands reminds
us of an event in history that he knew much about but missed:
the day of Pentecost. On that occasion, disciples filled with
the Holy Spirit were at first indistinguishable in the eyes of
observers from those who were drunk (Acts 2v13). Their psychomotor
apparatus was beginning to fail. The disciples themselves were
struck by the Holy Spirit in an outward, obvious and dramatic
way. Though the outward symptoms would soon fade, their lives
from that moment would never be the same.
Cannabis - harmless medicine
or total ban?
And what of the cannabis debate? Cannabis and other
minor drugs are often portrayed as natural, relatively harmless
things. However new evidence shows long term damage to brain function
in both cannabis and Ecstasy users. Most people accept that legalisation
would bring prices down and lead to increased consumption, which
would be a costly price to pay for the benefit of hitting the
illegal drugs industry. I don't want to live in a world where
cannabis finds it's way around as easily and as legally as packets
of cigarettes in the school playground.
But conventional prevention and control methods
are failing, and if the drugs war is to succeed we land up back
at the door of random testing. That's why a government opposed
to legalisation has come to the reluctant conclusion that random
tests are needed. Expect them not only at work but also at school,
in measures introduced by teachers, parents and governors in conjunction
with pupils themselves, the majority of whom, as we have seen
are not interested in taking them.
Cannabis on prescription?
Many physicians are beginning to recognise that
cannabis seems to help some patients yet the substance is banned.
This is illogical. Doctors have used cocaine in the old Brompton
Mixture for pain until it fell into disfavour. We give heroin
to relieve suffering. Why the hangup about cannabis? My own view
is that medicinal use of cannabis or its derivatives is entirely
consistent with the Christian position. The best way forward would
seem to me to approve cannabis on prescription, but under strict
limits, for example in helping relieve symptoms in the dying.
The Truth about Drugs by Dr Patrick Dixon is published
by Hodder and has generated wide media coverage - TV / radio /
press since launch. For more see Dr Dixon's Web TV site: http://www.globalchange.com
- 350,000 hits in 8 weeks.
The
Truth about Drugs by Dr Patrick Dixon was published by Hodder
September 1998 and deals comprehensively with issues relating
to prevention and treatment - price £7-99. The book has
generated wide media coverage - TV / radio / press since launch,
particularly over drug
testing at work. Latest MEDIA
and PRESS interviews. Search
this site for more on drugs.
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