Dr. Peter Kelly:

I agree with everything Professor Comiskey said. It is implemented inconsistently. To give a good example, I worked on the drugs policy Tackling Drugs to Build a Better Britain in the early 2000s. There was a lot more urine testing when I worked in clinics in the UK. People were punished if they used drugs on top of their dosage. It was not a direct punishment; it was under the guise of safety that people would be moved on to more regular collection of methadone.

When the orange guidelines came out, it completely changed. I had been there for the first set of guidelines, went away and came back to work ten years later. It completely changed the dynamic between me and the service user. People would come in and say they had used on top of their dosage or that they had a slip last week. The response was to say "Alright" and ask what we can do about that, whereas before we were being lied to because the person was in fear of being punished. It was a massive change and the noticeable thing for me was how it changed the dynamic. It was a lot more open and honest. Urine screening has to be done for safety reasons, and maybe it is done once or twice a year for safety. People understand that. If drugs are found in the urine, the results state that drugs are in the urine.