Tuesday, July 10, 2007

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......


Anonymous said...

I've always found it quite funny how obsessed the Tories are with reclassifying cannabis to a B. They seem to to be under the impression that it will solve the "drug problem" in the UK.

Steve Rolles said...

It seems to be entirely poltitical. They talk about sending put messages but they are unable to produce any evidence that changes in classification have a meaningful impact on use or misuse amongst key populations. It flies in the face of much recent work on the classification system and relative harms, from ACMD, and various select committees including the home affiars select committee on which cameron was a member. classification is about relative harms (supposedly) and no one is suggesting that class C implies safety, except them.

Anonymous said...

The reality is that the Tory party are happy to appear active by arguing about the reclassification of Canabis, rather than tackle the enormous reality that over 50% of 13 year olds have tried it, and are probably entirely ignorant of its classification or the difference between B and C.