The Intolerability of Freedom? Don’t Set the People Free: “Theodore Dalrymple says that many poor souls need institutions, but the ideologues and cost-cutters insist on giving them autonomy…

Spare a thought, then, for those poor souls this Christmas who will try desperately to insinuate themselves into hospital, in order that they should not be alone during the festive period; upon whom our society places a burden that they cannot bear, for lack of real charity and in the name of a crude ideology. Our giant apparatus of welfare, to which we devote an ever increasing proportion of our income, is — to adapt, slightly, a well-known phrase from an official report — institutionalised callousness.” Spectator

Related (?) ‘The Rehab Don’t Work‘: Dr. Michael Fitzpatrick, my favorite medical iconoclast from the UK, reflects:

The key shift signalled by the promotion of ‘detox and rehab’ is away from a ‘law and order’ approach to the drug problem towards a new therapeutic strategy, emphasising education, treatment and support. (It is not surprising that Keith Hellawell, the drug tsar, had to go: New Labour’s crusade against drugs needs a social worker or a counsellor, not a policeman, as its symbolic head.) ‘Detox and rehab’ now go together like ‘rum and coke’, but what do they mean?

(…) ‘Many people who oppose the ‘war on drugs’ say that the ‘solution’ to the ‘problem’ is ‘treatment’. This is baloney. Addiction treatment is a scam.’ (11)

The phrase ‘treatment works’ is repeated like a mantra in the government’s ‘Updated Drug Strategy’. Everybody in the world of drug policy is desperate to believe that it is true. Indeed it is supported by evidence from research that is either carried out directly by government agencies (such as the National Treatment Outcomes Research Study) or commissioned by them. But are such studies reliable? Here the British authorities might learn from the (vast) experience of the USA in this field.

Research on the efficacy of treatment programmes for problems of addiction in the USA follows a now-familiar pattern. This begins when promoters of a new scheme or programme claim dramatic successes (often accompanied by media and celebrity endorsements). Early studies, often influenced by the enthusiasm of the promoters and the zeal of those they have cured, tend to confirm impressive results. Later, when the publicity had died down and independent researchers take a more dispassionate view of the outcomes of treatment over a longer period, the extravagant claims cannot be sustained. sp!ked