UN Office on Drugs and Crime admits it is at war with itself

News release

24th June 2009

The World Drug Report 2009, the flagship annual publication of the United Nations Office on Drugs and Crime (UNODC), will be launched in Washington DC on 24 June. Launched in the run up to World Drug Day on 26th June, the report provides detailed descriptions of trends in world drug markets. The report is likely to repeat the fact that the drug control system creates huge unintended consequences.

Transform, an NGO with special consultative status with the UN, argues that it is the regime of global prohibition that has created and compounded what is generally thought of as the ‘drug problem’, and that the UNODC is in agreement about the problem, if not the solution. Transform argues that the war on drugs must be ended to enable legally regulated drug markets to be established .

Even the UNODC website admits:

“Global drug control efforts have had a dramatic unintended consequence: a criminal black market of staggering proportions. Organized crime is a threat to security. Criminal organizations have the power to destabilize society and Governments. The illicit drug business is worth billions of dollars a year, part of which is used to corrupt government officials and to poison economies.

Drug cartels are spreading violence in Central America, Mexico and the Caribbean. West Africa is under attack from narco-trafficking. Collusion between insurgents and criminal groups threatens the stability of West Asia, the Andes and parts of Africa, fuelling the trade in smuggled weapons, the plunder of natural resources and piracy.”

The World Drug Report has long been criticised as attempting to dress up the long-term systemic failure of the international drug control system as success, and for ignoring some of the system’s most catastrophic failings. Despite the ongoing attempts to put a positive spin on the data there is no hiding from the reality that the era of global drug prohibition, enshrined in the three UN drug conventions (1961, 1971 and 1988), has witnessed a consistent escalation in harms associated with illicit drug production, supply and use.

Not only has the international drug control infrastructure – by its own measures – consistently delivered the opposite of its stated aims (the creation of ‘a drug free world’ being further away than ever) but, as Antonio Costa (UNODC executive director) has repeatedly stated, it has created a series of disastrous ‘unintended consequences’. Costa describes how the drug control system that his office oversees has created the ‘huge criminal black market’ that turns over in excess of £160 billion a year that has devastated producer and transit countries, has displaced policy ‘from public health to enforcement’ and caused the ‘balloon effect’ in which the problem is not eliminated but merely moved from one region to another.

Indeed the UN drug agencies are increasingly isolated from the UN family and at odds with the principles and practices of other UN agencies, whose work is built upon the pillars of human security, human development and human rights. Illustrating the point, a World Health Organisation report stated only last week that:

“The first two [drug] conventions predate the HIV/AIDS epidemic, while the third one predates the explosive global growth of injection drug use. Hence, while they benefit from considerable international support, these conventions my need to be revised today because some of their provisions affect the control of the HIV epidemic.”

Danny Kushlick, Head of Policy at Transform said:

“UNODC is officially at war with itself. The Executive Director has admitted repeatedly that the UNODC oversees the very system that gifts the vast illegal drug market to violent criminal profiteers, with disastrous consequences. The UNODC is effectively creating the problem it is claiming to eliminate. Mr Costa has identified five major ‘unintended consequences’ of the drug control system. Is there a time limit on how long a consequence remains ‘unintended’? Aren’t they now just ‘consequences’?”

“On the supply side fragile states like Afghanistan, Colombia and Guinea Bissau are drawn deeper into the illegal market where their profound underlying social and economic problems are compounded. Whilst for the rich consumer countries, like the US and UK, the illicit nature of trade is a catalyst for drug dealing and turf war violence, with the collateral damage inflicted on their more vulnerable neighbours, such as Mexico.”

He concluded:

“Only by ending our politically driven war on drugs can we hope to address the underlying sickness of producer, transit and consumer countries alike. In the short term, the UN and its member states should be obliged to conduct transparent impact assessments of their continued commitment to the Conventions with a view to acting on the evidence that they garner. In the longer term, the conventions need to be adapted, specifically allowing the flexibility for states, should they democratically decide, to explore legal regulation of drug production and supply. Until then the conventions will continue to undermine development, security and human rights.”

ENDS

Contact:

• Danny Kushlick, Head of Policy and Communications 07970 174747
• Steve Rolles, Head of Research 07980 213943

Notes for Editors:

• Transform is an NGO with UN ECOSOC special consultative status
• The WHO report quoted above is the 2009 Asia Pacific Report: ’Assessment of compulsory treatment of people who use drugs in Cambodia, China, Malaysia and Viet Nam: An application of selected human rights principles’
• The Costa quotes about unintended consequences come from the UNODC report "Making drug control 'fit for purpose': Building on the UNGASS decade

Updates 25.06.09:

17.00
Transform quoted in the Guardian coverage: UN report shows fall in opium and cocaine production

The Guardian: legalisation is a no-go area

This short response to today's UKDPC report appears in the Guardian's Comment is free section. Comments can be posted on the Guardian site for the next three days. The online copy is an edited version of the submitted text and the title and subheading are by the copy editors.

Legalisation is a no-go area

A report on drug policy, like so many before it, fails to recognise the simple fact that prohibition is actually part of the problem

Steve Rolles. Wednesday July 30 2008

The publication today by the UK Drug Policy Commission (UKDPC) of its thorough review of existing literature on the failure of efforts to tackle the supply of illegal drugs, whilst welcome, is yet another example of a report that fails to notice the elephant in the room. Prohibition and its enforcement not only fails to restrict the availability of drugs but is itself the root cause of many of the most significant drug-related harms.

For the UK's lawmakers and enforcers it will make yet more grim reading, telling a familiar story of the systemic failure of UK supply-side drug enforcement to have any positive impact, with drugs becoming progressively cheaper, more available and more widely used over the past four decades. Whilst usefully restated, this critique is nothing new, following in the footsteps of numerous other reports including those from the Police Foundation (2000), the Number 10 strategy unit (2003) and the RSA (2007).

All of these reports, however, suffer from the same conceptual flaw: they begin their analysis with the assumption that prohibition is a given rather than a policy option. It is not just that enforcement of prohibitions on drug production and supply are merely expensive and ineffective, or even that they often have disastrous unintended consequences, but rather that their enforcement actually creates the problem in the first instance. Failing to acknowledge the primary role prohibition has in creating the problems of illegal markets dooms any policy recommendations that follow.

The UKDPC report, for example, highlights how more strategic enforcement may be able to reduce the negative social impacts of drug dealing by shifting it geographically or changing dealing behaviors (from open street markets to less bothersome closed markets). Whilst these changes, if they can be achieved (and the report cautions that even here the evidence is flimsy), would be beneficial, there is something self-defeating and illogical about trying to minimise the harm caused by enforcement inside a framework that works to maximise it. It is effectively a policy at war with itself.

It is disappointing that when the UKDPC report does touch on the policy alternatives to absolute prohibition it does so only very briefly, with a mention of the legalisation debate tucked away in its final paragraph. When the report's most optimistic conclusion is that better enforcement may be able to "at least ameliorate the harms associated with visible drug markets", it's a shame that an opportunity to explore alternatives – legal regulation and control of drug production and supply that would largely eliminate these socially corrosive illegal markets – was missed.

The broader calls for a greater focus on public health and better evaluation of the outcomes of enforcement policy are obviously sensible, but if we are to have any progress beyond "marginally less disastrous" thinking about policy, we have to look further than prohibition. The contemporary reality that certain drugs can only be purchased from unregulated, untaxed and uncontrolled criminals is the result of policy choices. By treating the debate on alternatives to maintaining organised crime's monopoly as a no-go area, this report helps entrench the view that the basic tenets of prohibition cannot be challenged. In doing so it actually helps perpetuate the policy whose failure it describes so eloquently.

Transform in the Guardian's Comment is Free

The following article from Transform director Danny Kushlick was published in the Guardian's online comment is free section yesterday evening. There is an active discussion forum below it to which you can contribute for the next three days (after which it closes - this blog forum remains open of course). Note: The slightly odd title to the piece is the work of the Guardian copy editors BTW, not Danny.

A drug on the market

Today's report, revealing the extraordinary scale of the UK's drug trade, admits only one conclusion: the policy of prohibition has failed

A Home Office report published today estimates the size of the UK illicit drugs trade at over £7bn. Using phrases like "market dynamics" and "enterprise structures", the report reads rather like a large business's annual report to shareholders. Except that this trade is entirely illegal and therefore totally beyond the reach of HM Treasury and the Department for Business, Enterprise and Regulatory Reform. It is the ultimate in deregulated markets, with absolutely no red tape for traffickers, suppliers and dealers.

To quote from the report (pdf): "There were very large mark-ups along the supply chain, from production to street level, for cocaine (circa 15,800%) and heroin (circa 16,800%)". Yes, you read it correctly, that's 16,000% mark-ups, unheard of in any other commodity market. The reason, pure and simple, is global prohibition. Is this a surprise to anyone in government? No.

The PM's Strategy Unit produced a report (pdf) in 2003 demonstrating in detail how this happens: it explained that "over the past 10-15 years, despite interventions at every point in the supply chain, cocaine and heroin consumption has been rising, prices falling and drugs have continued to reach users. Government interventions against the drug business are a cost of business, rather than a substantive threat to the industry's viability." (p94)

What the Downing Street report shows is that prohibition cannot prevent drug production, cannot prevent drug-trafficking, cannot prevent drug use, but that it does create huge volumes of acquisitive crime. But worse than all this, prohibition actually creates the vast unregulated market and all the misery and degradation that goes along with it from Afghanistan and Colombia to New York, Moscow and London.

These illicit profits are one of the single greatest corrupting economic forces in operation globally today. It is a policy of mass destruction, with dodgy dossiers to support its continuation and a group of senior politicians the world over which proclaims its success, despite its all-too-obvious horrors.

Now, however, there is an increasingly influential group of individuals and institutions demonstrating their opposition to the status quo. Given this growing opposition and sustained critique, one wonders why the Home Office continues to draw attention to prohibition's shocking failings. But, to the extent that they do, it gives us all the opportunity to see the reality of prohibition's impacts for what they are - and to let government know that the "war on drugs" is not being fought in our name.

Drugs prohibition is a 'policy of mass destruction' and the consultation document is a 'dodgy dossier'

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Drugs prohibition is a “policy of mass destruction” and the consultation document is a “dodgy dossier”

News release
No Embargo
Date: Monday 22 October 2007

The Government's consultation on the last ten years of its drug strategy and its future, finished last week (Friday 19 October). As part of its submission Transform uses correspondence from officials, previously not in the public domain, to illustrate the Government's knowledge that its support for drugs prohibition creates significant harms. The submission can be read here (pdf)

The submission demonstrates how the Government:

• manipulated the entire consultation to close down genuine debate on drug policy
• set the framework in such a way as to have determined the outcome before the consultation had even finished
• ignored ten years of constant criticism of its drug policy
• hid internal reports critical of prohibition
• treats criticism of drug policy with disdain and contempt
• refuses to evaluate prohibition
• is a hostage to US inspired geopolitical forces
• uses drug policy for electioneering

This is despite the fact that the Government admits that prohibition itself is a significant cause of harm. In a letter to Transform's Director Danny Kushlick in Oct 2005, Foreign Office Minister of State the Rt Dr Hon Kim Howells MP wrote:

“Prohibition of course gives rise to illicit trafficking and use and a range of problems associated with those.”

And in a letter to Dr John Marks from the Home Office Direct Communications Unit in September 2007, they admitted that:

“…it is likely that there would be a reduction in acquisitive crime, if drugs were legalised…”

The implication of which is that the Government admits that prohibition creates acquisitive crime. Home Office estimates suggest that crime costs associated with prohibited drugs are about £15 billion a year.

The letter to Dr Marks goes on to say:

“The Government is aware of the arguments for legalising controlled drugs in a regulated way and has concluded that the disadvantages would outweigh the benefits.”

These deliberations on cost benefit analysis have never been made public and, suggest that “arguments” have taken precedence over evidence.

Transform's submission concludes that political parties will not engage in genuine debate and that it is up to individuals from every walk of life to challenge drug policy spin and debate the issue in their workplaces, professional bodies and social circles to avoid another ten years of self inflicted disaster.

Danny Kushlick, Transform Director, said:

“The consultation should have been a thoroughgoing review of the policy making process and the impact that policy has in the everyday world. In the event, it turned out to be a sham. The consultation document is another dodgy dossier. It contained no proposals, breaking one of the fundamental rules for consultations. The document was the most blatant propaganda we have yet seen to support ten more years of prohibition. During the process Gordon Brown announced that cannabis law would be changed and that drugs will never be decriminalised. Lastly, the Government targets were announced, predetermining that the entire framework for future policy development would be unchanged.

“We have an enormous amount of evidence now to show that the Government is in full possession of the facts that the policy of prohibition of currently illegal drugs is the significant driver for harms associated with their production, supply and use. Prohibition is a policy of mass destruction, from Afghanistan and Colombia to London and Liverpool. Transform's submission contains extracts from previously unreleased correspondence from the Foreign Office and the Home Office demonstrating that both departments admit that prohibition causes great harms but that neither are willing to contemplate change. This intransigence is despicable, given the level of chaos and misery associated with the illegal drug market. The correspondence quoted above demonstrates that Government drug policy is explicitly based upon claims to have won an “argument”, rather than evidence. Whilst Government uses primary school debating society rhetoric to decide its drug policy, huge swathes of the global population die or live in misery and degradation as a result.

“In the absence of political parties' willingness to enter into genuine debate, it falls to institutions and individuals outside of government to throw down the gauntlet. Significantly the press has played an enormously valuable role in raising a debate where Westminster has obstinately refused. We believe that this will remain the case for the foreseeable future, until the counterproductive forces of prohibition bring the criminal justice system to its knees and the general public is in possession of the facts and analysis to see through the propaganda that the Government uses to support the status quo.”

Ends

Notes for Editors

Transform's submission to the consultation

The letter from the Rt Hon Kim Howells MP can be seen here

The letter to Dr John Marks can be seen here

Transform launches our latest publication ‘After the war on drugs – Tools for the debate' at Portcullis House on Wednesday 24 October. For an invite please email jane@tdpf.org.uk or call 0117 941 5810

‘Drug Policy Unspun: Overwhelming failure' is a briefing produced by Transform to counter the propaganda in the Government's consultation document. It can be seen here

Observer: Drugs strategy debate 'is a sham'

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There was an interesting piece in yesterdays Observer newspaper, in which Transform loomed large. The item drew together three separate but related stories; The publication of the report by the Chief Constable of North Wales calling for the legalisation and regulation of drugs; the ending of the drug strategy consultation period and Transform's criticisms of the consultation and review process; and Transform's new publication 'After the War on Drugs, Tools for the Debate' which has its official launch at a Parliamentary reception later this week.

It is a welcome plug for the report and will add pressure on the Government to undertake a more meaningful review of the evidence of the last ten years than the rather preposterous piece of window dressing that we were given in the consultation document. Also look out at the end for a new entry in the all-time top ten stupid Home Office comments on drug policy, wherein we learn that legalisation of drugs can't proceed because it would be against the law. Doh!

Observer: Drugs strategy debate 'is a sham'

Think-tank says prohibition has failed and wants talks on legalisation as Home Office defends ban

Jamie Doward, home affairs editor
Sunday October 21, 2007
The Observer


The government's consultation on a new 10-year drugs strategy is a 'sham', according to one of Britain's leading think-tanks on narcotics, which warns that the current policy is fuelling a crime epidemic.

The Transform Drug Policy Foundation, the only UK organisation of its kind to advise the United Nations on such issues, will this week publish a new report claiming the current strategy has failed. The report, 'After the War on Drugs: Tools for the Debate', claims there is an urgent need for full consultation on allowing the controlled supply of illegal drugs. 'It is clear our drug policy cannot continue down the same failed path forever,' the report states. 'Prohibition's failure is now widely understood and acknowledged among key stakeholders in the debate... the political benefits of pursuing prohibition are now waning and the political costs of its continuation are becoming unsustainable.'

The report claims that drug prohibition has allowed organised crime to control the market and criminalised millions of users, putting a huge strain on the justice system. The Home Office estimates that half of all property crime is linked to fundraising to buy illegal drugs. The police claim that drug markets are the main driver of the UK's burgeoning gun culture. Official figures released last week showed that drug offences recorded by police had risen 14 per cent in April to June of this year, compared with the same period in 2006.

Politicians claim tough anti-drugs laws send clear signals to society. But Transform points to a Home Office survey, commissioned in 2000, which showed the social and economic costs of heroin and cocaine use were between £10.1 and £17.4 billion - the bulk of which were costs to the victims of drug-related crime.

'Over the course of 10 years, a series of different inquiry reports into UK drugs policy all say the same thing: the policy is malfunctioning,' said Steve Rolles, the report's author. 'They've all been blithely ignored by the government, which insists it is making progess.'

Last week, North Wales Police chief constable Richard Brunstrom said he would 'campaign hard' for drugs such as heroin to be legalised. Previously he has said that drugs laws are out of date and that the Misuse of Drugs Act 1971 should be replaced by a new 'Substance Misuse Act'.

Transform claims the consultation process, which finished on Friday, was designed to stifle debate on drugs policy. 'The consultation process has been a sham,' Rolles said. 'It hasn't highlighted any policies to consult on. It's becoming very clear the next 10-year strategy is going to be identical to the last one. The whole idea that there is going to be a radical change is just not the case.'

The think-tank has taken the unusual step of writing to the Better Regulation Executive, set up to ensure government runs smoothly, to complain that the Prime Minister, Gordon Brown, is already making policy before the consultation process had finished.

The Prime Minister signalled earlier this year that the government would reclassify cannabis. He also recently insisted the government would never decriminalise drugs, something Transform argues makes a mockery of the consultation process.

A spokeswoman for the Home Office said: 'We have undertaken an open consultation and we welcome constructive ideas and views on how we can continue to reduce drug harm. However, the government is emphatically opposed to the legalisation of drugs which would increase drug-related harm and break both international and domestic law.'

North Wales Police Authority endorse call for the legalisation and regulation of drugs

Transform Drug Policy Foundation news release
13.30
15th October 07
no Embargo

North Wales Police Authority endorse call for the legalisation and regulation of drugs

North Wales Police Authority have endorsed a report from the North Wales Chief Constable that calls for the repeal of drugs prohibition and its replacement with an effective system of legal regulation and control for all drugs.

The report, which argues that the current system is ‘unworkable and immoral’, has had its three first recommendations endorsed by the Police Authority today:

2.1 That the Authority submits a response to the current Home Office consultation on drugs strategy.

2.2 That the Authority submits a response to the forthcoming Welsh Assembly Government consultation on the all Wales substance misuse strategy.

2.3 That the Authority urges the repeal of the Misuse of Drugs Act 1971 and its replacement with a Misuse of Substances Act, based upon a new ‘hierarchy of harm’ that includes alcohol and nicotine.

The fourth recommendation; for the Police Authority to affiliate to Transform, is pending discussions between the Authority and Transform:

2.4 That the Authority seeks affiliation to Transform Drug Policy Foundation which campaigns for the repeal for prohibition and its replacement with a legal system of regulation and control.

Transform director Danny Kushlick said

“It is hugely significant that the call for a legal regulation and control of drugs has now been publicly supported by the North Wales police authority, and they are to be congratulated in taking a bold stand in this urgent and vital debate. There are many high profile individuals who support this position but this sort of institutional support really puts the debate centre stage. We hope to see other police authorities following their lead and we look forward to the Police Authority affiliating to Transform in the near future.

“The Government have tried their best to avoid this debate in the current drug strategy consultation and review process, not engaging with any policy alternatives despite the obvious failings of the current approach that the North Wales police highlight so clearly. The call from the North Wales Police Authority makes the continued evasion from meaningful debate impossible: the Government must now engage with the significant and growing body of mainstream opinion calling for pragmatic moves away from prohibition towards evidence based regulatory alternatives.£

Ends

Notes to editors

Read the full report from North Wales Chief constable Richard Brunstrom here

Transform Drug Policy Foundation

More critiques of the Tory Social Justice Policy Group on Addiction report

I went to the launch event for the Tory Social Justice Policy Group on Addictions report (full report, exec summary) yesterday and discussed some of its contents with the working group and its authors. Interesting stuff indeed, and I have been diligently poring over the detail of the report. There is a lot to talk about; it covers an awful lot of ground at 428 pages and it is certainly a heavyweight document, literally, if not always intellectually. I hope to discuss some of its recurring themes over the coming weeks on the blog as I feel it will be a useful exercise to highlight many of the problems and confusions within contemporary drug policy thinking and debate.

In the mean time here are a three of the critical responses that emerged for yesterdays official launch:

Firstly from the International Harm Reduction Association:

Evidence, not ideology, must drive public policy on drug use

Commenting on the launch of the Conservative Party’s new drug policy proposals, the International Harm Reduction Association (IHRA) has called for UK drug and public health policy to be based upon evidence, not politics.

IHRA is the leading organisation in promoting evidence-based harm reduction policies and practices on a global basis for all psychoactive substances, including illicit drugs, tobacco and alcohol.

“Iain Duncan Smith say he wants a ‘clean break’ from harm reduction programmes such as needle exchanges,” said Prof Gerry Stimson, IHRA Executive Director. “These programmes were in fact introduced by the Conservative Government in 1987, and they have helped keep HIV infection among injecting drug users extremely low by international standards. The Tories also expanded our methadone programmes.”

“The Conservative’s new drug policy suggests there is insufficient research to support harm reduction interventions. In fact nothing could be further from the truth, as the controversial nature of these programmes means they are among the most rigorously monitored and evaluated of all drug programmes. The scientific research from around the world shows clearly that needle exchange and methadone save lives, and for this reason these interventions are supported by the World Health Organization and the United Nations, among many others.”

“Interestingly, the detailed research on harm reduction produced by the WHO and the UN is conspicuously absent from the new Tory policy, suggesting that the authors have cherry-picked their ‘evidence’ to fit pre-determined, ideologically driven outcomes,” said Prof Stimson.

“Of course we need more and better treatment programmes to rehabilitate people who use drugs. But let’s not fool ourselves, you can’t rehabilitate someone who has died from HIV/AIDS.”

end

Appended to the above press release is the document:

Misrepresentation of the Effectiveness of Harm Reduction: Evidence Ignored in Conservative Party Policy Recommendations

"We certainly know from our experience in the UK that clean needles can dramatically improve the position as far as drug users are concerned. To those who say that free needle exchange is too radical, too liberal a step, I reply that it was introduced here not by some way out administration of the left but by the government of Margaret Thatcher."

Lord Fowler
House of Lords
19th May 2004

World Health Organization Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug users – Evidence for action technical papers (2004) online here

This is the most comprehensive report ever produced reviewing the evidence base for needle/syringe programmes (NSPs), and is based on a review of over 200 scientific studies:

“The studies reviewed in this report present a compelling case that NSPs substantially and cost effectively reduce the spread of HIV among IDUs and do so without evidence of exacerbating injecting drug use at either the individual or societal level.” (p. 30)

World Health Organization, United Nations Office on Drugs and Crime and UNAIDS position paper: Substitution maintenance therapy in the management of opioid dependence and HIV/AIDS prevention (2004)
online here (pdf)

“Substitution maintenance therapy is one of the most effective treatment options for opioid dependence. It can decrease the high cost of opioid dependence to individuals, their families and society at large by reducing heroin use, associated deaths, HIV risk behaviours and criminal activity. Substitution maintenance therapy is a critical component of community-based approaches in the management of opioid dependence and the prevention of HIV infection among injecting drug users (IDUs).” (p.2)

“Methadone maintenance treatment is also an extensively researched treatment modality. There is strong evidence, from research and monitoring of service delivery, that substitution maintenance therapy with methadone (methadone maintenance treatment) is effective in reducing illicit drug use, reducing mortality, reducing the risk of spread of HIV, improving physical and mental health, improving social functioning and reducing criminality.” (p. 14)

“Substitution maintenance treatment is an effective, safe and cost effective modality for the management of opioid dependence. Repeated rigorous evaluation has demonstrated that such treatment is a valuable and critical component of the effective management of opioid dependence and the prevention of HIV among IDUs.” (p. 32)

World Health Organization, UNAIDS, United Nations Office on Drugs and Crime Policy Brief: Provision of Sterile Injecting Equipment to Reduce HIV Transmission (2004)

online here (pdf)

“The provision of access to sterile injection equipment for injecting drug users and the encouragement of its use are essential components of HIV/AIDS prevention programmes, and should be seen as a part of overall comprehensive strategies to reduce the demand for illicit drugs.” (p. 1)

United Nations High-Level Committee on Programme Preventing the transmission of HIV among drug users: A position paper of the United Nations System (2001)
online here (pdf)

“Several reviews of the effectiveness of syringe and needle exchange programmes have shown reductions in needle risk behaviours and HIV transmission and no evidence of increase into injecting drug use or other public health dangers in the communities served. Furthermore, such programmes have shown to serve as points of contact between drug abusers and service providers, including drug abuse treatment programmes” (para 10)

Commonwealth Department of Health and Ageing (Government Of Australia) Return on Investment in Needle & Syringe Programs in Australia: Summary Report (2002) online here

"By the year 2000, approximately 25,000 HIV infections are estimated to have been prevented among injecting drug users since the introduction of NSPs in 1988, and by 2010 approximately 4,500 deaths are projected to have been prevented.” (p.i 10)

“By the year 2000, approximately 21,000 HCV infections are estimated to have been prevented among injecting drug users since the introduction of NSPs in 1988, (of which approximately 16,000 would have developed chronic HCV); while by 2010 approximately 650 fewer injecting drug users are projected to be living with cirrhosis and 90 HCV-related deaths would have been prevented.” (p. 10)

“Overall, total treatment costs avoided over the life of the cases of HIV and HCV avoided by NSPs are approximately $7,808 million.” (p. 13)

“The results demonstrate that NSPs are effective in reducing the incidence of both diseases [HIV and Hepatitis C] and that they represent an effective financial investment by government... The results demonstrate that, across all measures of effect used in the study, NSPs have yielded a significant public health benefit, and that continued investment will result in further financial savings to government and improvements in both the quantity and quality of life of injecting drug users accessing NSPs.” (p. 21)

ends

Before moving on to the next commentary, it is worth pointing out that IHRA, the leading independent centre of expertise on harm reduction, in the world, were not approached for a submission to the working group. Given the reports repeated critique of the approach (as they define it - or in fact fail to define it) this seems like a stunning oversight. IHRA do, however, warrant a brief mention in the online version of the report. The mention comes within the rambling 130 page submission/rant from former headmistress Mary Brett that is included in toto, suggesting they are part of some global drug promoting / legalising conspiracy (which rather disappointingly Transform are not identified as being part of). Of IHRA, Brett says this:

"The IHRA (International Harm Reduction Alliance), of which the UKHRA is an offshoot and The Drug Policy Alliance are to a large extent funded by George Soros"

These 27 words have the dubious achievement of containing an impressive 3 factual errors: They are mistakenly called the International Harm Reduction 'Alliance' (it is 'Association' ), UKHRA is mistakenly described as an offshoot of IHRA (there is no formal link), and IHRA are mistakenly described as being funded 'to a large extent' by George Soros. They currently receive no funding from George Soros (although there are some Soros funded scholarships to attend the annual IHRA conference). In fact they are 'to a large extent' funded by the sinister 'Department for International Development'.

Right then, next:

Secondly, a press release from the UK Drug Policy Consortium, which, as well as making similar assertions to IHRA, is noteworthy because it is the UKDPC's first commentary on an external policy document (they have, up until now, been keen to state that they are collecting evidence rather than making recommendations, or offering commentry on other peoples)

Conservatives risk adopting flawed drug policy

Although the Social Justice Policy Group have spent much time and effort gathering opinions, anecdotes and case studies for their recent weighty report ‘Breakthrough Britain’, they have not taken sufficient account of the scientific evidence of ‘what works’ to tackle the UK’s drug problems.

This has led to some distorted analysis using selected and partial evidence, particularly in two key areas: methadone prescribing and drug treatment.

Despite a cursory acknowledgement that methadone prescribing can have a positive role, overall the report vilifies such programmes (dubbed ‘methadone madness’) and concludes they have “contributed to the growth of the problem rather than lessened it”. In doing so they ignore the robust body of evidence which demonstrates that harm reduction and treatment programmes including methadone prescribing have over many years contributed significantly to reducing deaths and other drug-related harms in the UK.(1)

In looking at drug treatment programmes the Group notes that one size does not fit all, but again contradicts itself by putting far too much reliance on abstinence, claiming: “abstinence is the most effective method of treatment and the only appropriate one for many addicts”. This sidelines some of the best available research. For example, NICE has comprehensively endorsed a range of treatment programmes including substitution drugs such as methadone and buprenorphine as well as residential rehabilitation.(2)

Roger Howard, chief executive, said:

“The UK Drug Policy Commission urges the Conservative Party to look carefully again at the scientific evidence before accepting the proposals outlined in the Social Justice Policy Group’s report. The Addiction’s Working Group which produced the proposals has been selective and partial in its analysis and interpretation of significant research findings across many areas of its work. Consequently, the Conservatives risk adopting flawed drug policy advice.”

(1) As noted in the independent report we commissioned: An Analysis of UK Drug Policy written by Professor Peter Reuter and Alex Stevens, April 2007. The full report and executive summary can be downloaded at the UKDPC website: www.ukdpc.org.uk.

See also NICE technology appraisal (2007) Methadone and buprenorphine for the management of opioid dependence.

(2) In draft guidance published by NICE and currently being consulted on, they state: “Opiate misuse is often characterised as a long term, chronic relapsing condition with periods of remission and relapse, so although abstinence may be one of a range of long term goals of treatment, it is not always achieved.” [National Institute for Health and Clinical Excellence – Drug Misuse: Psychosocial management of drug misuse: Draft guidelines January 2007].

NICE has also undertaken rigorous studies of the available evidence, which endorse a variety of treatment approaches.

Thirdly, an excoriating piece from Johann Hari in the Independent titled the very worst policy to combat drugs in which Danny Kushlick, Transform's Director, is quoted: "The report's authors avoid the science and the evidence like the plague". Hari, as ever, takes no prisoners and tears the report apart.

Tory Social Justice Policy Group on Addictions: first thoughts

The Conservative's Social Justice Policy Group report on Addictions is finally published today (full report, exec summary) after a two year gestation. It forms part of the Group's Breakthrough Britain report that, under the guidance of former party leader Iain Duncan Smith, is attempting to update and recast Tory social policy more generally. Whilst it is unclear at this stage how much of the addictions report will make the Tory manifesto, party leader David Cameron has given a strong indication today that he is taking it very seriously. There is a real possibility that Cameron may be forming the next government so we should take it seriously too.

Consequently Transform have made an effort to engage with the development of the document. We made a written submission, gave a presentation to the working group and had meetings with the authors, as well as attending various public discussion events during the document's development. I had a chat with IDS, and he seemed like a reasonable chap.

So, anyway, here it is, all 428 pages of it which I have dutifully ploughed through today so you don't have to. It's all very confused and disappointingly the same as previous Tory policy, with some islands of sensible analysis swimming in an all too predictable sea of misunderstanding, incomprehension, and politically blinkered ideology. Harm reduction, as they define it, comes in for a particular kicking (weirdly, given that the Tories were responsible for introducing it in the UK), as does any treatment intervention that is not resolutely abstinence based from the outset. They are OBSESSED with cannabis classification without any sensible explanation why, and have totally failed to understand the broader critique of prohibition or the inevitable failure of a punitive / enforcement led approach to dealing with the public health and social problems associated with drugs. There's a lot in here which will warrant closer consideration and discussion in the blog, but for now here's some first thoughts and a couple of things to highlight.

A few bits of the report are downright strange. It includes three of the written submissions complete and apparently unedited. There are two on alcohol policy from the Institute for Alcohol Studies, and Alcohol Concern; all sensible stuff about better regulation of alcohol which has clearly informed some of the reports more sensible recommendations about alcohol pricing. But then there is the bizarre inclusion of a rambling, ranting submission from Mary Brett, a former headmistress from the evangelical prevention school of drug policy thinking. Brett's submission, which essentially marks a range of UK drug organisations (and publications) according to their adherence to her particular preoccupations with prevention, abstinence and cannabis (sounding familiar?) totals over 130 pages, yes, that's 130 PAGES, incredibly making up about a third of the bulk of the complete 428 page report.

Whilst I was unable to find a list of submissions that were made, there is one I do know of that didn't warrant inclusion: Ours. So for the record I will be putting it online. It was essentially a series of discussion points to try and make the groups think outside of the narrow confines of more mainstream Tory drug policy thinking (weighing in at a relatively lightweight 5 pages). This they have singly failed to do. They casually dismiss the law reform analysis thus:

"Concern for a stigmatised and untreated population of addicts in the 1970 and 80s – then considered a deviant fringe of society - also resulted in the emergence of a ‘street agency’ voluntary sector. Interlinked with addicts’ equal rights to receive health care alongside other members of the population grew another assertion: the right to use drugs and the right not to be criminalised. From this developed a lobby which today argues for acceptance of the reality of widespread ‘harmless use’ of drugs in the population. The logical corollary of this argument is that it is the prohibition of drugs that is the problem, not drug use itself. They argue that prohibition drives highly profitable and uncontrollable crime thereby exploiting and corrupting socially vulnerable communities, both criminalising individuals and infringing their human rights. (23) In the brave new world of legalised drugs the optimistic scenario projected is one in which ‘harmless’ drug use would go up, while ‘harmful’ drug use would go down – a projection which flies in the face of all that is known about rising parallel trends in alcohol use and harms."

Much of this quote appears as an either ignorant or a willfully confused misrepresentation of the reform position, as anyone who had read our literature would clearly understand. Worse, the reference (23) is given as 'Transform Drug Policy Foundation'. To my knowledge Transform have never used the phrase 'harmless use', in fact in our written submission, which didn't make the report, we say on the first page:

All drugs carry risk and cause harm. However, we need to make very clear distinctions between harms caused by drug use and misuse and harms created or exacerbated by policy - in this case, enforcement of prohibitionist legislation. The principle of policy implementation must be: First do no harm.

The Transform submission does, however, make a distinction between non-problematic or recreational use, and problematic use - suggesting, logically enough given that they are different, that different policy responses are required for each. The SJPG is apparently incapable of engaging with this (really quite low) level of policy sophistication. I understand that the 'harmless use' reference has been mis-attributed to Transform, having been confused with the RSA report (which to note, pointedly stopped shy of recommending legalisation and regulation). For the record we contacted Kathy Gyngell, who apologised for the mistake and offered to make a clarification at Thursday's press conference.

That said, the mostly excellent RSA report itself is also rather grotesquely misunderstood and misrepresented by Duncan Smith and the new report. On the 'harmless use' front, the RSA report actually says this:

The use of illegal drugs is by no means always harmful any more than alcohol use is always harmful. The evidence suggests that a majority of people who use drugs are able to use them without harming themselves or others. They are able, in that sense, to ‘manage’ their drug use. They are breaking the law in possessing illegal drugs, but they are not breaking the law in any other way. The effects that drugs have depend to a large extent on the individuals who use them, the drugs that they use, the ways in which they use them and the social context in which they use them. The harmless use of illegal drugs is thus possible, indeed common. Nevertheless, all illegal drugs, like all other psychoactive substances including alcohol and tobacco, carry risks. Some people die as a result of their misuse of drugs, many more are made ill, some of them very ill, and drug use can compound, as well as be caused by, problems of mental health. Drug use and crime are closely associated. The cumulative costs to society, including in purely monetary terms, are enormous.

I might not have used the term 'harmless use', but in context this RSA comment seems pretty reasonable to me, and is based, as they note, on evidence. The fact that drugs have risks doesn't mean that those risks are realised in every user every time a drug is used. Risk refers to a probability of something happening, and regards drugs and harm that probability is demonstrably not 100%. If you cant get to grip with this, as Duncan Smith seems incapable of doing with his outright condemnation of the RSA report as 'irresponsible', it suggests that you have approached the issue as an idealogue not a scientist, and that your mind was already made up.

A more systematic critique to follow......

Where is the drug policy reform debate up to today?

Below is an edited section from the introduction to the upcoming Transform publication 'After the War on Drug's - tools for the debate' A guide to making the case for drug policy reform. The Transform blog has secured exclusive serialisation rights for an undisclosed 5-figure sum. The guide will be available in print (and as a free pdf download) in July, but the blog will be serialising key sections over the coming weeks.....

Cover Design (an early draft...)

Where are we up to today?

The cause of drug law reform has been a prolonged struggle that began as soon as drug prohibition in its modern form came into being. Although prohibitions of various drugs stretch back into the 18th century (see Transform’s history of prohibition time line), the modern drug law reform movement began in earnest with the social movements of the 1960s. It was during this decade that the 1961 UN Convention on Drugs enshrined prohibition as a truly global policy, and recreational drug use in the West simultaneously began its dramatic rise toward current levels.

The drugs debate has moved on considerably since that time, with the political, social and cultural landscape shifting and evolving dramatically, both in the UK and in the wider world. All the problems associated with drug prohibition and illegal markets have continued to worsen over the past four decades: the prevalence of illegal drug use has risen steadily despite the many billions spent on enforcing a policy intended to eradicate it. As prohibition’s policy outcomes have deteriorated, the volume of calls for a rethink and serious consideration of alternative policy options has grown. This growth accelerated particularly rapidly during the 1990s as recreational use of illegal drugs became a truly mainstream youth phenomenon, and problematic use (of heroin in particular) ballooned to epidemic proportions. Problematic drug use now causes a level of secondary crime-related harms to wider society that is unprecedented in modern history, and was entirely unanticipated when drugs were prohibited.

It is now clear that our drug policy cannot continue down the same failed path forever. Prohibition’s failure is now widely understood and acknowledged among key stakeholders in the debate. Although politicians have thus far been the primary beneficiaries of the policy (the other beneficiaries being the mafia), the political benefits of pursuing prohibition are now waning and the political costs of its continuation are becoming unsustainable. The intellectual and political consensus supporting a ‘War on Drugs’ is crumbling rapidly, and calls for ‘more of the same’, or ever tougher enforcement responses, no longer go unchallenged. Since the 1990s, a vigorous network of domestic and international NGOs have been making the case for substantive pragmatic reform to drug policy and law.

However, although the failure of the current policy is now widely accepted, even within government, there is less consensus on 'so, where now?'. Those in a state of denial over the failure of the drug war typically argue that policy can be tweaked within the prohibitionist framework to make it more effective. This usually means directing more resources into treatment and harm reduction, and perhaps being more tolerant of low level drug users. There is considerable room for manoeuvre within UK and international law for policies that could improve the current situation and indeed many such changes are already underway. In recent years we have seen cannabis reclassification, the expansion of heroin and methadone prescribing, harm reduction programs such as the needle exchanges and ‘injecting kits’, and increased investment in drug treatment.

Internationally, reforms have gone much further. A number of countries have progressed to de facto decriminalision of personal possession of all drugs, including Russia, Portugal, Spain, Switzerland and Holland. Harm reduction measures have been widely adopted, including maintenance prescribing of heroin (and increasingly of stimulants), supervised drug consumption rooms, and even tolerance of low level ‘grey market’ sales of some drugs, such as the cannabis ‘coffee shop’ system in Holland.

The problem is that, for the most part, these reforms are merely reducing harms created by illegal markets and harshly enforced prohibition in the first place. They never address its fundamental problems: the creation of crime and illegal markets and the injustice of criminalising drug users. Tinkering with domestic policy under strict international prohibition is not a long term solution. It is an attempt to minimise harms within a legal framework that maximises them, and thus its successes will always be marginal ones.

By contrast, the truth that underlies the drug reform movement - that a punitive enforcement approach is actively counter-productive – is far harder to address directly. This prevents it being followed to its obvious logical conclusion: decriminalising consenting adult drug use and moving towards the legal regulation and control of some or all drug production and supply.

Yet this last taboo is now also crumbling, as Transform’s collection of quotes from supporters of reform so resoundingly demonstrates. The Transform quote archive also reveals that there have been strong arguments in favour of drug law reform in media as diverse as the Mirror, the Sun, the Daily Mail, the Telegraph, the Times, the Economist, The New Statesman and many others besides. You really do not have to wait for the reform position to gain mainstream traction – it already has it.

Whilst it remains important to support and encourage the process of incremental change away from harshly enforced prohibition towards a new evidence-based public health approach, there are already many groups dedicated to doing this and much change is already happening in this direction. The specific task of Transform and the movement for longer term reform is to make the case and campaign for a repeal of the absolute drug prohibition currently enshrined in domestic and international law. It is only this fundamental step that will make it possible to end the criminal free-for-all of the illegal drugs market by replacing it with appropriately regulated drug production and supply. That is what will lead to a real transformation of society, both for those who use drugs and those who don’t; and that is what the 'Tools for Debate' guide is all about.

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EVENTS: Westminster Hall debate on drug classification

The Science and Technology Select committee is holding a debate on its report: Drug Classification: Making a hash of it. The Debate is in Westminster Hall this Thursday, from 2.30- 5.30, and is open to the Public. (details below)

The committee's report was highly critical of the A,B,C drug classification system, which it concluded was unscientific, outdated, riddled with anomalies and 'not fit for purpose'. The report made a series of suggestions for ways forward including institutional reforms.

Responses to the report were received from the ACMD (which itself came in for some criticism) and the Government. There has subsequently been a follow up session during which the Committee returned to the issue in light of these written responses, during which they re-interrogated Home Office Minister Vernon Coaker, and the two senior figures in the ACMD.

Thursdays debate will again feature Vernon Coaker defending the Governments position that it 'believes' the classification 'has stood the test of time' and is 'fit for purpose' despite the overwhelming evidence to the contrary as assembled by his fellow MPs on the committee. It promises to provide a showcase for the essential Home Office ministerial skills of spin and defending the indefensible for transparently political reasons. The hopeless written response from the Government was absurdly dismissive of the Committee's detailed analysis and an insulting intellectual response to the Committee's considered conclusions and recommendations. We can expect some fireworks, especially if the Ministerial bluster from the follow up session is any precedent. The Committee are clearly not happy.

Report links:

Transform's written submission to the Inquiry
which, along with Transform's oral evidence, is extensively quoted in the final report, significantly shaping its conclusions and critique.

Drug Classification: making a hash of it?
The Committees final report in pdf (includes oral and written evidence). It is strongest on the science critique, although arguably a bit clumsy in some of the institutional/structural critique.

Governments written response to the report
Defensive to the point of being an embarrassment to all concerned. Fails to engage with all meaningful questions asked about the scientific basis or evidence base for drug policy and classification.

Follow up session on classification with The Committee cross examining the Drugs Minister and ACMD chair (Hansard transcript)
Whilst ACMD are redeemed to some degree, this is worth reading for the absolute astonishing series of exchanges with Coaker in which the Government's belief-based drug policy is laid bare in all its science-free glory. Any pretence that the policy is based on evidence is unashamedly jettisoned.

Previous blogs:

Transform Blog: Classification and Deterrence: Where's the evidence?
discussion of one of the more ludicrous aspects of the Government's response to the Committees assertion that the classification system lacked an evidence base.

Transform Blog: Meth is Class A: we can relax now
revisits some of the themes from the committee report with reference to the reclassification of meth-amphetamine

Transform Blog: The Lancet and drug harms: missing the bigger picture
the ACMD technical experts finally publish their new methodology for assessing drug harms in the Lancet. The Home Office, who appoint the ACMD to advise them on classification issue. Also discusses the Minister's response to this analysis in the world's premier medical journal - needs to be read to be believed.


press release from Select Committee on Science and Technology

No. 39 of Session 2006-07 22 May 2007

DRUG CLASSIFICATION: MAKING A HASH OF IT?
A debate on the Committee’s Report
Thursday 14 June 2007
2.30pm–5.30pm
WESTMINSTER HALL DEBATE

On Thursday 14 June there will be a debate in Westminster Hall on the Committee’s Report Drug classification: making a hash of it?. The debate is open to the public.

The debate will focus on the conclusions of the Committee’s Report, the Government’s response as well as the response received from the ACMD, and will also cover relevant recent developments.

The Report to be debated is:

• Fifth Report, Session 2005-06, Drug classification: making a hash of it?, published on 31 July 2006 as HC 1031.

Also relevant is the subsequent Government response to the Committee’s Fifth Report:

• The Government Reply to the Fifth Report from the House of Commons Science and Technology Committee, Session 2005-06, HC 1031, Drug classification: making a hash of it?, published in October 2006 as Cm 6941

The Committee held a follow-up evidence session with the Minister on 22 November 2006. Minutes of Evidence from this session are published as:

• Drug classification: making a hash of it? – follow-up: Oral evidence from Mr Vernon Coaker MP, Parliamentary Under-Secretary of State for Policing, Security and Community Safety, Home Office, Professor Sir Michael Rawlins, Chairman, and Professor David Nutt, Member and Chair, Technical Committee, Advisory Council on the Misuse of Drugs (ACMD), published as HC 65-i on 20 March 2007.

The response received from ACMD is published together with the oral evidence.

For further information please call Ana Ferreira, on 020 7219 2793.

Previous press notices and publications are available on our website

Notes for those wishing to attend the debate in Westminster Hall:

Members of the public wishing to attend should present themselves at St Stephen’s Entrance where they will be directed through security and to Westminster Hall. It is advisable to allow about 15 minutes for this. Please ensure that mobile phones and pagers are turned off before entering Westminster Hall. Under no circumstances should members of the public address Members during the debate. Those attending the debate are asked to remain silent throughout.

Sweden's drug policy: A reality check.

The following article, in a slightly edited form, appears in this month's druglink magazine.

Swedish massage

The perception that low drug use levels in Sweden are a direct result of the country’s tough anti-drugs policy is finding considerable traction in the UK. But, argues Steve Rolles, it is both simplistic and misleading.

Ian Duncan Smith is flagging up the success of Sweden’s drug policy in his new in his role as chairman of the Social Policy Review Group, currently overhauling Tory drug policy in the run up to the next General Election. David Cameron visited the country in February in an attempt to distance himself from his days of cannabis smoking. In the words of the Daily Mail he “praised the tougher approach in Sweden, which does not distinguish between cannabis and harder drugs such as heroin, and practices a zero-tolerance policy.”

In September last year the UN Office of Drugs and Crime produced a report titled 'Sweden's successful drug policy: a review of the evidence'. Launching the document, UNODC Director Antonio Costa repeated his catch phrase that 'societies have the drug problem that they deserve', noting specifically that “in the case of Sweden, the clear association between a restrictive drug policy and low levels of drug use, is striking”.

Sweden's 'successful' policy closely follows, in both letter and spirit, that espoused by the UNODC. Because Sweden has comparatively low European levels of drug use it is perhaps unsurprising that the UN’s drugs office chooses to proclaim the country as a model of good practice, especially given the backdrop of rising drug use globally. Sweden, perhaps not coincidentally, is the UNODC's third largest state funder (nine per cent) after the US (13 per cent) and Italy (11 per cent)*, and has the clearly stated and unambiguous aspiration to a 'drug free society'. This manifests in its tough zero-tolerance approach involving heavy handed policing, the widespread rejection of harm reduction principles, and a focus on coerced abstinence-based treatment.

However, by putting the emphasis so heavily on prevalence success, the UNODC conveniently brushes over some of the less positive aspects of Sweden’s drug policies. According to the country’s nascent user movement, the aversion to harm reduction (shared with the UNODC but notably not the WHO, and UNAIDS) has contributed to Sweden's drug death figures doubling from around 200 to 400 since 1990, placing it high in the Euro rankings. Problematic drug use has also almost doubled since 1980 to a level hovering around the European average.

Furthermore, Costa's suggestion that there is a obvious causal relationship between prevalence and UNODC-style drug control policy appears unsustainable. Various countries have comparable or lower levels of drug use than Sweden but have very different drug policies. Greece, for example, (according to the EMCDDA), has the lowest level of drug use in Europe but spends approximately one-fiftieth on per capita drug-related expenditure that Sweden does. Holland, also has well below the European average drug use, spends more than Sweden per capita, but has a tolerant / harm reduction-led policy that is the polar opposite of the Sweden UNODC model. Conversely, another repressively oriented country - third in the Euro drug-related expenditure tables - is the UK, which sits at the top of most European drug use prevalence tables. We have yet to see a UN report titled 'The UK’s unsuccessful drug policy: a review of the evidence', indeed if the UK Government buys into Costa's analysis they must be wondering what they have done to 'deserve' our high prevalence rates.

The alternative theory, one not based on the UNODC's public relations crisis and overtly political prerogatives, would be that levels of drug use are determined by a complex and highly localised interplay of multiple social, cultural, economic and demographic variables, and that government drug policies, specifically enforcement and prevention efforts, have, at best, only marginal impacts.

Dr Peter Cohen, Director of the Centre for Drugs Research at the University of Amsterdam, has argued that Sweden's low level of drug use and repressive drug policy, rather than being causally linked, are in fact both merely expressions of its historically temperance oriented culture, noting that Sweden also has historically low levels of alcohol, tobacco and prescription drug use. It is also worth pointing out that Sweden has low levels of social inequality, social deprivation, and unemployment, combined with a very high level of health and social welfare spending. There's a lot to admire about Sweden, but even they can play drug-war politics.

* since publication of this article a new UNODC annual report has been published with the UNODC funding rankings shifting slightly (see page 89). Creeping into the number one spot for individual state donors, coincidentally in the year the glowing Sweden report is published, is.....Sweden (9%). The US slips to number two (8%) and straight in at number three is.....The UK, at 7% - a shade under 11 million US dollars. Bargain.

Steve Rolles is information officer for Transform

RSA Drugs Report - so near and yet so far

The RSA published their long awaited drugs report last week to not a little fanfare. The report suggests that the current policy is based on ‘moral panic’, suggests that most drug use is relatively harmless, that tobacco and alcohol should be included in the drug policy making process and that prohibition cannot stop people using drugs – they are here to stay.

It will be seen as a watershed report in raising the level of debate on drugs and drug policy in the years to come. The Commissioners are to be congratulated for producing a groundbreaking report. You can read the press release , the exec summary, or the full volume here and judge for yourself.

In my op-ed for the Guardian online I argue that it is the politics of prohibition that makes it so difficult for politicians to engage with Reports like the RSA's.

And in the Mirror I ask whether we are adult enough to engage in a public debate on the efficacy of repealing prohibition and replacing it with legal regulation

The RSA analysis could easily be the basis for a Phd on the repeal of prohibition and its replacement with a far more effective system of legal regulation and control. But that is not quite where the RSA report takes us. I’ve identified a number of reasons why I think that the report fails to reach what should have been its natural conclusion.

A fundamental mistake: not nailing the problem

My experience of commenting on drug policy issues is that the failure to identify prohibition as the overriding problem leads to convoluted and internally inconsistent solutions. Unfortunately the Report fails to recognise that it is prohibition that is the radical and anomalous response to drugs and that regulation is the policy response that conforms far more closely to social and legislative norms.

Oddly, prohibition seems to be identified as not being ‘viable’ very early on in the report but the analysis is not developed. This is a quote from the report (p 29) that would lead us to believe that there is only place that the analysis could go:

“As readers of our report will quickly discover, all of our recommendations and suggestions are founded on two core beliefs. One is that drugs and other psychoactive substances are simply not going to go away. People have used them for thousands of years, widespread demand exists, supply is plentiful, and the illegal-drugs industry, not to mention the alcohol, tobacco and legal drugs industries, are among the best organized and most market-oriented in the world. Prohibition is no more a viable policy in Britain today than it proved to be in America during the 1920s and 1930s.With regard to illegal drugs, young people, in particular, are often told ‘Just say no’. That may sometimes be good advice. The only trouble is that there are, and always will be, large numbers of people who, for whatever reason, ignore that advice and choose to say yes. Drugs are a fact and, in our view, need to be accepted as a fact. We believe, as our choice of title suggests, that policy and the administration of policy should be based on a cool appraisal of the facts, not on fantasy and wishful thinking. In the words of Reinhold Niebuhr’s famous prayer:

God, give us the serenity to accept what cannot be changed;

Give us the courage to change what should be changed; and

Give us the wisdom to distinguish one from the other.”

But whilst no one claims it will be easy or happen overnight, history clearly shows that prohibitions can be changed. If drug prohibition is ‘no more a viable policy in Britain today than it proved to be in America during the 1920s and 1930s’ then the logical conclusion is surely that it should be repealed and replaced with something more viable. What it might be replaced with takes us to the next point.

A new Substance Misuse Act?

The failure to identify prohibition as the key problem leads to some confusion about what the legislative framework is for. The Report recommends that all drugs come under one new Misuse Act. Leaving aside the fact that the report suggests that most drugs are used rather than misused, what would be the point of putting all drugs into one piece of legislation if some are prohibited and some are legally regulated? It would end up being nothing more than a list.


Not dealing with supply side

In one of the their discussion documents (produced in the run up to the final report and available here) titled 'The supply of illegal drugs in the UK' , under the 'points to consider' section, the Commission notes:

"1. HM Revenue and Customs estimate that we spend 1 billion + per year trying to control the supply of drugs. Given the difficulties in the path of these efforts, can we really say that our enforcement policies are motivated by practical considerations, or are they moral ones? Are we pursuing a policy of supply reduction because we think it will work, or because we think drug dealing is wrong and should be punished?"

they then ask:

"Is legalisation of the drugs trade the only real way of controlling the supply of drugs? – (e.g. by creating a trade which could be regulated and taxed and could guarantee stable prices and safer drugs, which would not require a smuggling network that can be used for other illicit trades, which would not be surrounded by a gun culture, etc.)"

This question of supply seems to have been lost when it came to writing the final report. What is called for seems deliberately ambiguous, hinting at the obvious but terribly wary of being explicit about it:

"Drugs policy should, like our policy on alcohol and tobacco, seek to regulate use and prevent harm rather than to prohibit use altogether. Illegal drugs should be regulated alongside alcohol, tobacco, prescribed medicines and other legal drugs in a single regulatory framework."

Strangely the Commission opted for regulating use rather than supply. Perhaps it was a case of committee syndrome, where dissent forced a somewhat unsatisfactory and woolly compromise around the prohibition / regulation question? When asked at the launch event last week, Anthony King said the committee felt that it was for ministers and civil servants should be sorting out the specifics for each drug. Perhaps this is fair enough, yet it is at odds with the very specific recommendations in much of the rest of the report.

The committee received various reports from Transform, including our own (referenced by the RSA) aswell as reports from the Health Officers of British Colombia and the King County Bar Association - which provide very clear and detailed analysis of how legal regulation of different drugs would work - from a public health and legal standpoint respectively. This was a missed opportunity to introduce some clarity, nuance and sophistication into the debate about regulatory alternatives to prohibition - and the flirting around the issue without nailing it makes for frustrating reading when the much of the other analysis is so spot on.

Why no recommendation of cost-benefit analysis?

From the report (p 113):

"The most recent version of the strategy is the Updated Drug Strategy 2002. Its overall objective is ‘reducing the harm that drugs cause to society – communities, individuals and their families’. This objective is anchored in a philosophy of prohibition. The opening paragraph of the summary of the strategy states: ‘We have no intention of legalising any illicit drug. All controlled drugs are dangerous and nobody should take them.’ What is missing from all these accounts is a detailed analysis of the cost-effectiveness of the drug strategy itself. Basic calculations have been published of the ratios between the costs of drug interventions and their savings in terms of health and social costs. But Christine Godfrey, co-author of the key study of the economic and social costs of drug use mentioned above, has argued that a really robust and thorough-going cost-benefit analysis should be a priority for government.

Failure to complete this analysis makes it impossible for policy makers to consider alternatives to existing policy by comparing the costs of the current strategy with the estimated future costs of other options, whether these be decriminalization, legalization or zero-tolerance. We agree with Professor Godfrey.

It is dissapointing and inconsistent then that the report did not call for such a cost-benefit analysis (of current policy and alternatives) in its recommendations. Transform called for just such an audit in 2002.

The decision to keep the remit domestic rather than international

There is a significant problem in attempting to review and recommend change from a narrow domestic viewpoint. The UK is committed to international prohibition in the form of the three UN drug conventions to which we are signitories, and it is these that creates the vast globa lillegal drug markets and associated problems. The RSA report shows that the significant price hike in heroin and cocaine occurs between production and domestic wholesale. But calls only for enforcement to be focused on Mr Bigs. (p 13):

"The fight against the supply of illegal drugs should not stop, but it should be refocused so that it concentrates on organized criminal networks rather than on largely futile efforts to interdict supply."

Whilst no one is suggesting enforcement should ignore violent gangsters, unfortunately all the evidence shows that this is futile at interrupting drug supply too, on the basis that the trade is so lucrative that there is always a queue of gangsters waiting to make a killing by moving into the vacuum successful busts will occassionally create. Furthermore it is prohibition that creates the opportunity for gangsters in the first instance - just as it did with non-viable alcohol prohibition. Transform believes that it is impossible to truly understand domestic drug policy unless it is placed in its global context.

Weak analysis of drugs and crime link

The failure to ‘nail’ prohibition as the specific first cause of the link between drugs and crime appears to be a major fator in the Commission's avoidance of calling for its repeal. Although it cites the £16 billion annual crime costs committed by a few hundred thousand heroin and crack users fundraising to support a habit, it fails to identify prohibition as the culprit. The report does call for heroin prescribing (what is that if not legal regulation of a currently illegal drug?) for the usual familiar reasons including reduction in offending - but still fails to make the link explicit. Prohibition directly causes almost all 'drug-related crime' - they really needed to make the point much more clearly.

We are left with what is undoubtedly a thoughtful and throrough report, but also one that walks you to the door but isn't quite willing to suggest you walk through, that does all the hard work and then fails to quite see it through. It doesn't dare go the one step further than the similar reports from the Police Foundation (2000) or the Home Affairs Select Committee (2002), that would have marked it out as historic. Arguably, the HASC went further by at least recommending the Government 'initiate a debate' on 'legalisation and regulation' 'at 'UN level'.

Overall the thrust of the Report has created a significant window of opportunity to scrutinise the failings of current policy. It is now up to those with a vision of prohibition's replacement to use this opportunity to increase the momentum toward a more effective system based upon regulation and control of supply. Despite our criticisms, thanks must go to the RSA for opening up the debate once again.

Media comment on the report:


Alice Miles in the Times suggests that the Commission has been equivocal over its attitude to alcohol

Mark Lawson in the Guardian doesn’t quite get it

Telegraph leader

Guardian leader

Independent leader