The fourth Okey memorial lecture. AIDS and HIV: the challenge for British drug services.

British drug policies are undergoing a major reassessment and reformulation in response to problems raised by HIV disease and AIDS. The years from 1986 to 1989 are one of the key periods of crisis and transformation in the history of the British response to drug problems, with the emergence in current debate of a new public health paradigm of drug use. Drug policies can be analysed by examining their assumptions about the nature of (a) the problem (b) the drug user and (c) the task facing policy makers and practitioners; and their assumption about (d) the appropriate people to deal with the problem and (e) their relationships with clients. The emergent public health paradigm assumes that (a) the main problem with drug use is the injection of drugs (b) drug injectors are concerned about their health (c) the task is to promote change in health and risk behaviours (d) people dealing with the problem must be broadly skilled 'poly-drug workers' and (e) relationships with clients must be non-judgmental and 'user-friendly'.