1st February issue

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 Lives first – always

Public health’s no follower of fashion

The language of recovery can be exciting. It enthuses, it galvanises, it stirs people into action. Most of all it can make us feel we’re doing something very positive to counter the negative energy of addiction. But as the storyon public injecting demonstrates (page 14), many of the challenges of drugs work are much less visible and no less vital for it. The recent anthrax outbreak among Scottish heroin users demonstrates these challenges at their most extreme (cover story, page 6). Why was the public health response so inadequate? Would it have been an entirely different scenario if the sufferers were in danger of infecting the public, rather than contained within the injecting drug user population? Why was the official advice to those at risk so impractical? Any drugs worker knows the impossibility of long-term heroin users being able to stop injecting immediately, let alone to push themselves forward for emergency treatment, so why was this patient group not supported through this crisis as intensely as society’s most vulnerable?Positive initiatives are great for the morale of this field but they should never introduce an either/or option to fundamental treatment rights. We know that – but do our politicians? Never has the tired old harm reduction versus abstinence debate seemed so hollow and we must insist on public health policy that learns from this tragedy. As Andy Stonard points out (page 8), now is the time to lobby from an informed perspective to make sure the politicians of each party understand the policies they are moulding around their voters. Public health is everyone’s business and whichever way the political winds blow over the next few months, we should never forget we’re talking about the right to life and not just how we choose to live it. Talking of debate, there will be some very different views aired at our DDN/Alliance service users conference on Thursday 4 February (still time to book… just) – we hope we’ll have the chance to meet you there!

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