ABSTRACT
Since the Second World War, policy relating to management and treatment of drug abusers has been characterised by sudden upheavals followed by unplanned drifts in direction. Dramatic shifts in policy have resulted from political events, changing social structures and evolving medical philosophies rather than as a consequence of any advance in technology or understanding of the nature of the addictive disorder. Until its closure in 1997 probably the single most important determinant of interest in drug users has been the steady increase in numbers reported to the Home Office Addicts Index (Home Office 1997). Towards the end of 1985, however, events occurred which had probably the most dramatic impact on social policy in the latter half of the twentieth century – the identification of large numbers of known drug users as human immunodeficiency virus (HIV) antibody positive. This sudden discovery was brought about by the introduction of the laboratory test which could indicate the presence of antibodies in blood and, coming in the wake of the clinical epidemic of cases of acquired immune deficiency syndrome (AIDS) in homosexual men in the USA, its impact was tremendous.
