Mephedrone and Methadone - keep calm and review the evidence

There is a two pronged drug panic now in full swing, with the media calling for 'someting to be done' about mephedrone and methadone (Always get the journalist to spell it before you start rabbiting on about the wrong drug...)

Mephedrone 

I was up at 5.30am this morning in order to prepare for 5Live news at 6.00am to respond to the media furore regarding the deaths of two young people who had allegedly taken mephedrone. By 7.00 am I'd done eight interviews for local radio stations, warning of the dangers of rushing to make it illegal.

As ever the call is being driven by hysterical media hype (for example Telegraph Daily Mail The Sun and Guardian) about deaths of young people, none of which have unequivocally been linked exclusively to the use of mephedrone.

Leah Betts anyone?

Transform's call is three-fold:

1. Calm down. A knee jerk response to classify may in fact increase harms, rather than reduce them. Mephedrone is not a threat to humanity or even a significant threat to the lives of users (we would have seen far more deaths if that were the case, given the high levels of use). Reduce the threat level to the correct proportions and begin to explore options. Recognise that the media massively over report illegal drug deaths, as opposed to all drug deaths, such as alcohol and tobacco, whose dangers are well known and demonstrably kill many more than mephedrone has (in relative or absolute terms).
   
   
   
   
   
   
   
    
2. All drugs have dangers associated with their use. Put as much harm reduction information out there as we possibly can (knowledge of mephedrone is limited - here is a a decent guide to current knowledge).
   
   
3. Recognise that criminalising drugs causes harms that may significantly outweigh any benefits. Conduct an independent and comprehensive impact assessment to explore all the options: do nothing, criminalise production, supply and posession, legally regulate its production and supply. Until that work is done, we cannot say which is the best option.

However, anecdotal evidence from Guernsey sugggests that the ban on importation there has pushed the price up from £10/gram to £60-80/gram and consequently acquisitive crime is now being committed by heavy users to fund their use/habit. Organised crime has taken over distribution (no guns on Guernsey, so samurai swords are the order of the day for fighting turf wars). This cannot possibly have made things better for the good citizens of Guernsey, and we would hope that (despite the differences between Guernsey and the UK) the Advisory Council take this evidence into account before recommending classification.

Methadone 

I also had a chat with The Times yesterday to try and give some balance to their anti-methadone line. It could have been worse (Leader Here and Feature Here)

What has been forgotten in the drive to turn the rhetoric of 'getting people off drugs' into reality, is  some of the basics.

1. The vast vast majority of problematic users are not ready to stop using. The question then is how do you we manage that fact and reduce the harm that they cause themselves and the wider community.
   
   
2. Methadone is not just for 'getting people off drugs', even if it can help with that goal for some. It is primarily used to reduce the amount of injecting of street heroin. Its purpose is to improve individual and public health by reducing both offending (acquisitive crime or prostitution to support a habit) and prevalence of high risk injecting behaviours, and thereby reduce transmission of blood borne viruses.

Methadone does not stop people becoming drug free. Anyone on methadone who wants to stop should be supported to do so. But whilst the majority of heroin users remain using, we would be foolish to throw away the medicine that has helped the UK keep its HIV rates amongst injectors relatively low, and reduced the collateral damage of making heroin illegal for non-medical use in the first place.

Transform is working with partner organisations to counter this pernicious move to undermine opiate substitute prescribing in the UK.

Thinking outside of the box

Martin's recent post on policy Climate Change is backed up by the publication of a couple of the articles below. Whilst the pieces by serving and former police Tim Hollis (The Times) and Brian Paddick (Mail on Sunday) reveal a singularly stubborn commitment to the war on drugs by completely ignoring the obvious flaws inherent in prohibition, Allan Wall and Silver Donald Cameron present rational positions to suggest that it is the prohibition box itself that is the problem. It is well worth looking at the Hollis and Paddick op-eds to see how supporters of merely tweaking the status quo argue their position by not questioning the overarching regime of criminalisation. It is this unwillingness to think outside of the box that constrains their analysis to effectively rearranging the deck chairs on the Titanic.

• Brian Paddick

Three words that explain why the Rausings (and thousands of others involved in drugs) are getting away with it

"A billion pound fortune buys you many things, it seems, including, as we learned last week, immunity from prosecution for possessing crack, cocaine and heroin."

"First there are tip-offs. These bust big shipments and generate wonderful headlines but barely put a dent in supply. Second are operations against street dealers. They take weeks of police time and, within hours of dealers being taken off the street, others have replaced them.
What has been used, and must be used again, is co-ordinated action to take out entire supply chains from import to street dealer.

I’ve seen it succeed in North London in an operation involving the former National Criminal Intelligence Service (NCIS), the security services, the Met’s Drug Squad and local officers.
With the use of intelligence, undercover officers and street coppering, everyone from importer to street dealer can be identified and prosecuted."

• Tim Hollis

Think tank: Fight smart in the war on drugs -A chief constable calls for a fresh strategy

"That’s why I’m in favour of what I call smarter enforcement – involving more intelligence, more research and more dialogue."

Positioning herself somewhere between these two sets of articles is Melanie Reid in the The Times who throws everything but the kitchen sink into the blender and sets it to turbo, without really coming up with a coherent solution, but at least asking some of the right questions:

• Melanie Reid

Blame the rich for feeding the drug industry: The police will never be able to win the war against drugs. It's the culture of tolerance that is the real problem

"At what point do we start to look at legalisation as an exit strategy in a war we cannot win? Is it possible to turn drugs into a health rather than a crime issue? Or should we blame Britain's excess of tolerance for turning it into one of the most drug-blighted countries in Europe? As one leading expert, Neil McKeganey, of Glasgow University, puts it, at what point do we stop regarding illegal drug use as human right, and start seeing drugs as a destructive social cancer?

These are uncomfortable questions for both the Left and the Right but it is time we started asking them. We have to accept that this is no longer an argument about drug availability; this is about the existence of a drug culture that has spread to every corner of society. The poor old police can plug away at reducing supply until they are exhausted, but they cannot begin to address something that undermines them at every turn."

Family Security Matters , (that carries the Allan Wall piece) "is dedicated to men and women who are seeking answers to the most important question of our time: How to keep our families and our country safe and secure. Here you can find the vital information , the understanding and the solutions you need to conquer fear and combat the enemies who threaten our freedom!"

You wouldn't have expected to see this on their website:

• Allan Wall

Exclusive: Searching for Paradigms and Parallels in Mexico’s Cartel War

"Maybe it’s time that our own leaders look the problem squarely in the eye, and ask if drug prohibition is really the right strategy after all.

The issue recalls another historical parallel – the American prohibition of alcohol from 1920-1933. During alcohol prohibition there were powerful gangsters, such as Al Capone and Bugs Moran, who distributed the prohibited substances, and fought with each other and with the U.S. government.

The argument for legalization is that at least it would take the big money out of the drug trade, and drug addicts could be treated as patients and not as criminals.

Legalization is not a perfect solution. The real solution is that people don’t abuse drugs. But whether you have prohibition, legalization, or something in between, it’s likely that there will always be drug abusers. The trick is to stop these addicts from dragging down the rest of our societies with them."

• Silver Donald Cameron

'Dumb drug policies enrich criminals'

"In short, the law has essentially made itself irrelevant. If anything, the law benefits the business. To a large extent, the industry is profitable precisely because it is illegal. All entrepreneurs take risks, but if the risks include jail time, only the boldest entrepreneurs will enter the business — and they’ll demand a premium for the extra risk.

The net result of our irrational drug policies is that we enrich the criminals and criminalize ordinary citizens. We control tobacco and alcohol far more effectively than we control any illegal drugs. If those are the results we want, these policies are perfect."

Signs of The Times

Two comment pieces from the Times this week:

Are our leaders drugged to the eyes? By Daniel Finkelstein

Who'd chuckle about drugs? By Libby Purves

Both articles are revealing about the way that commentators portray drugs in the media. Finkelstein’s piece uses an attention grabbing headline to discuss a wide range of issues, that stem from his reading of Lord Owen’s book In Sickness and in Power: Illness in Heads of Government During the Last 100 Years.

Finkelstein suggests that the press were obliged to report on Charles Kennedy’s drink problem. He fails to say why this was so important, given that Kennedy was hardly the man with his finger on the nuclear button, but he’s clearly very cross about it:

"Now this was a genuine, and shaming, scandal.”

It would appear to have some link with John F Kennedy who, Finkelstein tells us was

“The man who later dealt so capably with the Cuban missile crisis made a total hash of the Bay of Pigs.”

The fact that JFK brought us within hours of nuclear annihilation, Finkelstein finds less worthy of comment. He also finds Kennedy’s case more noteworthy than Blair’s state of mind in the run up to the Iraq war (as quoted in Owen’s book):

“A senior official recalls that when Blair was advised about the difficulties ahead, he would respond: “You are Neville Chamberlain, I am Winston Churchill and Saddam is Hitler.”

What is it about politicians using drugs (including alcohol) that gets columnists so exercised, at the expense of real scandals? In 2005 Transform reminded the press that David Cameron had sat on the Home Affairs Select Committee when it called on the Government to initiate a debate on alternatives to prohibition at the UN. Almost immediately the story had changed as Andrew Rawnsley began asking Cameron if he’d used drugs ‘I may have done him a favour’, thereby replacing the political story with a potentially scurrilous drugs expose. In fact Rawnsley did him a far bigger favour than he realised by taking the attention away from Cameron’s once rational take on drugs.

Finkelstein continues:

“There is one case after another of vital decisions made by sick leaders under the influence of drugs. Often in secret. What can be done? We need regular medical bulletins on heads of government and those seeking to be heads of government.”

Dos this mean a report on JFK’s: “Constant and acute diarrhoea and a recurrence of his urinary tract infection.” Or the fact that someone called Dr Feelgood was overprescribing him amphetamines? Finkelstein’s diagnosis:

“And they need to be independent. They can't be provided by the politician's personal doctor since the duty to tell the truth to the public conflicts with the duty to keep patient information confidential.”

I love the idea of an independent medic getting the PM to succumb to a sobriety test before taking part in significant meetings – closing his eyes and touching his nose with his forefinger whilst whistling Land of Hope and Glory perhaps. Better than that, let’s make him explain to an independent consultant how international drug prohibition is good for planet earth before making statements in parliament talking up the war on drugs. For here is the real scandal: politicians who are not under the influence of drugs are lying to us about the success of the war on drugs, and keeping schtum about the overwhelming human and financial costs of global prohibition.

Transform has always been clear that, outside of certain safety critical positions, drug use per se is not the key issue in the workplace, it is fitness to do the job. We have, in the past, called for competence testing rather than drug testing in the workplace. It is up to all of us to hold the executive to account on the basis of their political competence, rather than their drug use. And support for failed absolutist prohibition is a clear indication of lack of competence.

In the light of the deaths of Natasha Collins and Mark Speight, Libby Purves asks us to condemn drugs: “Damn the drugs, and damn the culture that accepts them with a cheeky wink”. She concludes:

“We know all this (that the cocaine supply chain is dirty and dangerous). Yet we are scared to be “judgmental”. Even I, dull middle-aged trout with a decorous media career, know perfectly well that I have just offended several people I count and value as friends. I am sorry. And intensely sorry, too, for the Speight and Collins families. But it has to be said. Damn the drugs.”

Purves’s anger and frustration comes through very strongly, but you have to ask whether damning drugs is of any use. Damning drugs has the effect of pushing them into some nether world, along with those who use, sell and produce them. It is demonisation in action and it is singularly ineffective, unjust and inhumane. Ultimately it is what led us into our contemporary drugs prohibition in the first place and to a great extent provides the glue that holds it together still. We rarely hear commentators crying out: “Damn the wine”. But we did in the US in the 1920s and, as a result the US suffered for thirteen years from the horrors created by alcohol prohibition.

In the past I have suggested that the process that many go through when talking about drugs, mirrors the oft-quoted process people go through in response to receiving traumatic news – denial, anger, bargaining, depression and acceptance. Purves appears to be oscillating, as she adds: “

I accept many of the arguments for legalising recreational drugs. If you had to queue up at the Tesco pharmacy counter behind coughing pensioners and hand over a chit from your GP with all the other losers, drug crime would abate and drug glamour would tarnish.”

Acceptance of the reality of drug use, the full spectrum of behaviours from beneficial through to problematic (including drug-related death), is key to developing a rounded and rational attitude to both the substances and the policy that surrounds them. I have nothing but respect for anyone who is grappling with the internal contradictions that many experience when they tackle this emotive area, something I wrote about in the Observer in 2002 , ‘Legalising drugs will save lives’.

Lastly, the letters page in today's Times contains three letters under the title: 'Should we ban drugs, or just regulate supply?' . You can submit comments below the letters.