Addiction: the policy framework

Abstract

Addiction psychiatry operates within a policy framework. For most of the 20th century, the 'British system' of drug treatment operated with a small number of drug users being treated by doctors. By the 1960s formal policy set up the first drug treatment services and passed the 1971 Misuse of Drugs Act, which sorted illicit drugs into classes A to C according to the degree of harm they cause. Cannabis was later downgraded from Class B to C despite concerns about its effect on mental health in vulnerable groups. Further legislation in 1985 defined the classes of person authorized to posses controlled drugs. Alcohol supply is controlled by licensing laws first introduced in 1916. In 2003 these laws were revised in an attempt to reduce antisocial behaviour, despite having the effect of increasing opening hours. In 1995 Tackling Drugs Together was the first strategic response to drug misuse, published with cross-party support. In 1998 the drug strategy was published that clearly defined four strands of work on prevention, reducing supply, access to treatment and crime reduction. In 2001 the National Treatment Agency was set up, with the objective of doubling the number of clients in substance misuse treatment and monitoring that objective in local areas. The alcohol harm reduction policy published in 2004 focused on reducing antisocial behaviour, with little discussion of treatment. Policy is defined by structures including the Advisory Council on the Misuse of Drugs, the Department of Health and the Home Office. It is influenced by public health, criminal justice, the desire to reduce antisocial behaviour and the research evidence base. © 2006 Elsevier Ltd. All rights reserved.