Drugs and Health Alliance editorial in the Guardian

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Increment of Harm

Government obsession with drug crime has overshadowed the needs of the truly marginalised

Danny Kushlick
Wednesday May 16, 2007
The Guardian

UK drug policy is unique. In no other area of social policy do we criminalise at one stroke both recreation and disadvantage. In no other area have we seen so much evidence of the counterproductive effects of a predominantly criminal justice response to a public health problem. And we have seen almost no genuine debate or evidence-based scrutiny from ministers. The last 10 years of this parliament's tacit and active support for a policy based on moral panic has finally broken the camel's back. As the Home Office reviews its last 10-year strategy - results are expected next month - the Drugs and Health Alliance has been formed to bring together organisations committed to bringing about a public health-led approach for the next decade.

In the mid-80s the Conservative government, in the face of a potential HIV/Aids epidemic, initiated a proactive harm reduction strategy that led to the UK having one of the world's lowest rates of HIV. It was based exclusively on a pragmatic public health and harm reduction approach to dealing with unsafe sex and injecting. No one suggested that we should ramp up penalties for injecting drugs or make unsafe sex illegal. How times have changed. Twenty years later there are significant political taboos among senior policymakers who dare question the prevailing tough criminal justice line on drugs. The result has been that most of the drugs initiatives in the last decade have had draconian law-making at their core.

Our current policy is completely at odds with social and legislative norms, a strategy based on criminalising drugs in order to reduce social harm. Yet, as the PM's strategy unit drugs report of 2003 showed, it is the very illegality of the supply and use of drugs that causes harm. Despite our commitment to harm reduction, drug use exists within a political and legal framework that is harm maximising; hepatitis C remains at 80% among injecting drug-users and HIV, while still very low, is on the increase.

Throughout the last decade government has shown a pathological unwillingness to debate the efficacy of the current approach. Witness the lack of genuine engagement with the Police Foundation drugs report of 2000, the Home Affairs Select Committee report of 2002, the Science and Technology Committee report on drug classification of 2006 and the recent RSA report, as well as the announced and then withdrawn public consultation on the drug classification system and the lack of consultation or parliamentary scrutiny of the Drugs Act 2005. The list is endless. One concern is that the upcoming consultation on the future of the UK drug strategy will end up looking strikingly similar to the last one.

The frustration of many working in the drugs field is that the obsession with crime reduction has overshadowed the need for improvement of individual and public health. We are demonising some of the most marginalised people in the UK rather than offering them effective treatment. For commissioners of services, this ought to look perverse and bizarre: enforce the drug laws in such a way as to increase the offending of problematic users of the most dangerous drugs, "identify" them through the criminal justice system and finally spend money on "treatment", as ordered by the court, as a way of reducing their offending. The £13bn to £16bn in crime costs associated with the current drug policy should suggest an urgent reallocation of the billions spent on counterproductive heavyhanded enforcement, toward education, dealing with underlying social problems and treatment in a primary care setting.

Ultimately, we need a new paradigm for drug policy development, one based around health and wellbeing rather than macho posturing and knee-jerk, short-term responses to the failures of the current criminal justice-based policy. The UK sits atop the rankings for levels of problematic heroin and cocaine use. The Dutch, Spanish, Swiss, Portuguese and numerous other nations have all adopted a more public health-focused approach. The average age of heroin users in the Netherlands is 40. They have half the rate of cannabis use compared to the UK. Isn't it time that we joined them?

The consultation on the new strategy offers a window of opportunity for change that will close again soon. This is our chance to let government know that tough enforcement does not reduce harm, it creates it. We should grab the chance with both hands.

Danny Kushlick is spokesperson for the Drugs and Health Alliance
Drugshealthalliance.net
dannykushlick@yahoo.co.uk

Note: Danny Kushlick is also director of Transform Drug Policy Foundation