When Mollie Craven wrote her plea in the Guardian 40 years ago - "we parents of addicts are a neglected and ignored group. We want to be able to help our pathetic children, even while they cause us suffering which tears us apart. We can help each other. I would like to appeal to everyone interested in this agonising problem to form an association" - she could not have imagined that the group set up in response to her entreaty would become the largest drug and alcohol charity in Britain today.
This evolution from a small, self-help and pressure group, called the Association of Parents of Addicts (APA), to Addaction, a charity with a £25m annual budget that helps more than 25,000 people a year, is a striking illustration of society's changing relationship with drugs.
In 1967, when Craven made her appeal in a poignant article on this newspaper's woman's pages, Britain had fewer than 1,000 known heroin addicts. Today, the official estimate is that there are 300,000 "problem drug users" - meaning people ranging from those with a clear drug dependency to those whose drug taking has a damaging effect on their family or the community. But the late 60s was the beginning of the growth in drug culture. Mick Jagger and Keith Richards were sentenced to prison for smoking cannabis just a few months after Craven's article appeared and a much publicised "legalise pot" rally was held in Hyde Park. Heroin use was rising and reports of cavalier prescribing of the drug by doctors led the government - realising it was in uncharted territory - to set up an investigative committee chaired by Sir Russell Brain; it concluded that tighter drug restrictions were needed.
Craven's story hit a nerve among middle-class parents like herself who were struggling to cope with children-turned-junkies. "It wasn't something that was talked about back then in the shires," says her youngest son, Quentin Craven. He describes his mother, who died in 2005 at the age of 89, as a "formidable" woman. "She had nowhere to turn for support, so she went off to do a social degree in London."
The response to her Guardian article was swift: soon parents across Britain were setting up local groups under the banner of the APA. In the capital, Craven and a band of volunteers ran a rudimentary national office, and opened a handful of drop-in centres for drug users and their families that were funded by grants and private donations. Quentin remembers being taken to visit an early project in Soho. "It was pretty scary for an 11-year-old down from boarding school to watch people jacking up," he says. "My mother wanted me to see that drug-taking was not glamorous."
Although APA could not save his brother, who died two years after his mother's article appeared, aged 21, the group was influential in shaping the 1971 Misuse of Drugs Act. That law introduced the drug classification system that still underpins British policy today and stopped doctors prescribing heroin, a practice of which Craven was particularly critical in her son's case. After a period in a clinic where "the very dedicated psychiatrist and staff had restored him to a comparatively normal condition," she wrote, "he discharged himself. This is the heartbreaking part about the present regulations. These junkies can walk out as soon as they wish, half-cured, and go back to their GP for heroin."
As one of the first drugs campaigning charities, APA also became a seedbed for other organisations: it helped to found the campaigning Standing Conference on Drug Addiction (Scoda) - now the influential policy and research organisation DrugScope. Its local groups spawned the likes of Drugaid in south Wales and the Surrey-based Cranstoun drug services, leaving APA mainly to train volunteers in how to listen non-judgmentally to drug users and give practical advice on accommodation, healthcare and benefits. The health service, meanwhile, provided some detoxification and rehabilitation facilities, and psychiatrists prescribed methadone instead of heroin.
But, says Peter Martin, a former hardened drug user who became chief executive of APA in 1990, everyone was feeling their way in the early days: "Treatment was a euphemism for anything that might just work." As the numbers of injecting heroin users grew amid a flood of the drug onto Britain's council estates, government began funding needle exchanges to reduce the spread of HIV. Ecstasy - classified as a class A drug in 1977 - became a cornerstone of rave culture, cocaine use was increasing outside of the City and media circles, and crack, a particularly addictive form of smokeable cocaine, was fuelling gang wars in New York. Despite tougher prison sentences for drug trafficking in a futile attempt to cut off supply, and government-funded "Just Say No" campaigns, drugs services were having to expand and diversify to meet a rising tide of problem drug use.
When Martin arrived at APA, it had just four staff, ran two projects in east London and had an annual turnover of £150,000. To survive, it would have to transform itself into a professional national group. He set about bringing in fundraisers, lobbyists and press officers and bidding against other drug charities to win government contracts to run projects to help drug users. By 1997, the charity had become one of the biggest drug agencies in Britain, renaming itself Addaction at a glitzy event attended by royalty and celebrities. Its founder, by then a septuagenarian approved neither of the name change, nor the professionalism, but she had relinquished control of her baby.
The new identity followed a scandal at the charity earlier that year, when the Guardian's Nick Davies exposed the head of APA's crack project in Nottingham as a drugs dealer (he was later jailed for seven years, in a separate case of dealing). At the time, the charity denied the allegations and attacked the newspaper. Martin says, in retrospect, that APA was naive. But in a wider context, the crisis "forced us to look at ourselves, to get quality control and to make the organisations more accountable".
Today, Addaction runs over 70 projects across Britain, from a mother and toddler service in Scotland to an alcohol and drugs agency counselling young people and their families in Cornwall. Drug users can arrive on referral from social services, the courts or GPs. Projects make a detailed assessment of each one, and then tailor a treatment plan aiming to help them understand their drug use, identify the trigger points for cravings, and find practical ways to change their lifestyle to keep drug-free. Martin added alcohol treatment to the charity's portfolio because people are often dependent on both.
Much of Addaction's phenomenal growth in the past decade is due to the Labour government's 10-year drugs strategy which, since 1998, has ploughed more than £2.6bn into drug treatment in the community. "Around a third of our services are now linked to offenders with drug problems being referred to an Addaction treatment programme as an alternative to prison," says Addaction's chief executive, Deborah Cameron, who joined the organisation last year.
Yet despite the millions pumped into drug treatment, that figure of 300,000 problem drug users persists. Some 98% of prostitutes and 75% of homeless people are hooked on heroin, and at some prisons as many as eight out of 10 men have been found to have class A drugs in their system when they arrive. In addition, 40% of the children who enter care for the first time do so because their parents are misusing drugs or alcohol or both. Martin Barnes, chief executive of DrugScope, says there is still a big gap between drug treatment and practical aftercare: "The penny is finally starting to drop that the reason a person may lapse five or six times from drug treatment is that what they need to start a new life is a flat, education or training to help them get a job and keep them busy."
Although heroin is still the biggest problem for the drug users Addaction sees, crack was the main problem drug for almost one in five who came to the agency in London in 2005-06, while the number identifying cocaine as their primary drug almost doubled. A big new problem, drugs workers say, is crack and heroin mixed - and the combined use of alcohol and crack that produces cocaethanol which, unknown to most users, is highly damaging to the kidneys. According to EU figures, England and Wales have the highest number of drug-related deaths in Europe; 1,427 in 2004.
But with a new government drug strategy expected next year, the funding bonanza for Addaction and other national drug charities is probably going to end. And more of a debate looks likely about what constitutes success when it comes to Britain's drugs projects: should they aim for abstinence or "harm reduction" - that is, an approach that accepts a person's continued drug use but tries to cut the risks to their health (through clean, supervised consumption rooms for heroin and crack, as in some European countries, for instance), and cut the crime associated with feeding their habit? Three pilot studies are under way on prescribing heroin to addicts, an echo from the 1960s. For Addaction, says Cameron, a crucial goal arching over all these debates is to reach more young people through family-based programmes before they repeat what is becoming a generational cycle of addiction.
Mollie Craven would have had mixed feelings about the booming expansion of her organisation, because of the growth of the problem she hoped she would help to end. "Now almost everyone knows someone affected by drugs," says Cameron. Martin adds, "When one looks back, a small problem has turned into a massive one. It sends you into existential despair, but then you have to think about the individuals who have been helped. We can't take responsibility for market forces. That is beyond our control".
This is an edited extract from the appeal by Molly Craven in the Guardian.
Recently I had a telephone call. A doctor asked urgently for the address of the parents of a boy found dying in a London dosshouse from septicaemia; in his pocket was my son's home telephone number. From the description I could recognise the boy, whom I had last met as a happy, apparently uncomplicated student, adored by his parents. Yet here he was dying in a distant hospital.
Then I had another telephone call, which has driven me to writing this article. My son, who had again left home, has been sent to prison for stealing to obtain more money for more heroin. Before Christmas he [had stayed with us] because he was too ill to doss down any longer with his junkie friends. He was emaciated, scarred, ash pale ... constantly injecting himself so that our bathrooms and bedrooms were littered with bloody phials.
I nursed him through this period with the help of a doctor friend who prescribed some palliative alternative drugs, until he was fit to go into a psychiatric hospital. After the very dedicated psychiatrist and staff had restored him to a comparatively normal condition, he discharged himself. This is the heartbreaking part about the present regulations. These junkies can walk out as soon as they wish, half-cured, and go back to their GPs for heroin. The work of the hospital is worthless.
The effect upon the family is appalling. At first my husband and I were driven apart most bitterly: he insisted that the boy should be thrown out; I pleaded passionately that we should keep him, seek treatment ... like any mother animal unwilling to see my own young destroyed. [Yet] helping an addict is extremely difficult, as all normal human relationships are destroyed. There is a constant pressure of guilt and self-reproach. The burden I feel is shame and guilt at somehow failing the child. I am not writing in self-pity, but, I hope, objectively when I say that I personally have altered almost unbelievably within two years. This is bound to show in my personal relationships with my younger children ...
At present we parents of addicts are a neglected group. And we can do nothing to prevent [the addiction of a son or daughter], for doctors can prescribe heroin to a child of 17 and not notify parents. My son was a registered addict before he was 18, having found a doctor who willingly put him on a daily dosage of five grains - and I knew nothing ... Parents must be helped to help.
I would like to appeal to everyone interested in this agonising problem to form an association. I would suggest we call it APA, short for the Association of Parents of Addicts, but also short for Association for Prevention of Addiction, because we should like in our ranks everyone who can help in any way. We still want to be able to help our pathetic children, even while they cause us suffering which tears us apart. We can help each other, we can help with research into the problem and its origin and cure. I am, therefore, asking every interested reader to write to: The APA, c/o The Woman's Editor, the Guardian, 3 Cross Street, Manchester, so that letters can be forwarded to me in the strictest confidence. I will reply to them, and see if our association can emerge strong enough to be a useful force.
