Examination of Witnesses: (Questions 100
- 119)
TUESDAY 30 OCTOBER 2001
SUE KILLEN,
VIC HOGG,
ROSEMARY JENKINS
PAUL HAYES
AND KEITH
HELLAWELL
100. Describe to me what happened in 1970. I
am sure somebody can.
(Rosemary Jenkins) There is no ban on the prescription
of heroin at all.
101. That I understand.
(Rosemary Jenkins) I cannot comment on legal matters.
(Keith Hellawell) A certain weight of medical opinion
was that methadone was a better drug than heroin and that diamorphine
would be used, but used in certain controlled circumstances and
it has continued to be used in those circumstances.
102. Has the number of heroin addicts increased
or decreased since 1970?
(Keith Hellawell) I would suspect it has increased
since 1970.
103. On what kind of scale?
(Keith Hellawell) It is difficult to assess. We are
dealing with imprecision as to how many people there are out there.
104. I appreciate that there may be other reasons
why it might have increased but the point I am making is that
if by any chance it has increased massively since 1970, might
that not have something to do with the change which was made in
the law at that time?
(Sue Killen) That is assuming 1970 is the point at
which it increased. I am sure Vic can come up with the figures
better than I can. One thing I do know, going round and looking
at communities which are affected by drugs, is that when I went
out with Tower Hamlets police and was looking at an area which
was an area I used to live in, which they now say is riven with
drugs, I asked them when the drugs problem seriously started in
the area, when they started to find most of the people they arrested
were linked to drugs. The date they gave me, and I have no scientific
evidence for this, was 1985; the mid-1980s onwards they really
began to find that drugs were an issue in terms of damaging communities
and that sort of link between poor neighbourhoods and grosser
drug use and issues like that. It is all terribly intertwined,
it is very complex why people start to take drugs and why neighbourhoods
get embedded with them. I would be surprised if the 1970 law change
was the thing which had started it.
105. The independent drug monitoring unit said
that health risks associated with clean opiates are relatively
low. Would you agree with that?
(Sue Killen) Not in terms of experience of injecting
and sharing and overdosing.
106. And that the major cause of death is unsafe
practices. If you take away the unsafe practices, the drug itself
is not the key problem. Do you agree with that?
(Rosemary Jenkins) My medical adviser is advising
that clean heroin is not in itself particularly dangerous except
of course for the area we all know about which is that it is highly
addictive and produces dependence. However, what we have to look
at are the practices which really are dangerous. The things which
lead to people dying are overdose, injecting, sharing; something
like 98 per cent of people who die of an overdose have injected
that drug rather than taken it through another route, polydrug
use, that is mixing drugs and drugs and alcohol together. In a
sense it is those behaviours which we have to look at and we have
to deal with.
107. Just coming back to the points made by
Nick Davies who put them very forcibly, he said that the core
point is that the death and sickness and moral collapse which
are associated with class A drugs are in truth generally the result
not of the drugs themselves but of the black market on which they
are sold as a result of our strategy of prohibition. Does anybody
agree with that?
(Keith Hellawell) I would put a different slant on
it and I want to make another point.
108. I want you to address that one first because
that is the core point in this massive series of articles which
appeared in July.
(Keith Hellawell) I spent about six hours with him
and clearly I had no impact on the film or his articles at all.
He decided what he was going to say and he said it. The access
to drugs is the key issue when you are addicted. Many people are
doing drugs casually, they are doing them to give them good feelings,
they are not into the game of what type of drugs, or use, or availability
or treatment. People are dying because of the bad practices they
are involved in, because they are not presenting themselves for
treatment. The type of treatment they should receive, in my mind
should be determined by the drugs treatment workers and the doctors.
Therefore I think we are arguing around a little bit of an obtuse
point. Uniquely in the world we have the facilities to provide
heroin in this country. Because that heroin is little used, his
article is suggesting that it is government policy and some sort
of political nuances have prevented that. You will find at the
root of that that it is medical opinion which has said that the
best form of treatment is this. The key is not what treatment
they receive: the key is to get them into treatment as soon as
we possibly can. As far as I am concerned, and I told Nick this,
if the doctor says you will be much better on diamorphine, fine.
I have no objection to that and I have not met a Minister yet
who has any objection to that. It is an argument without a sound
basis frankly. The issue is getting people in treatment.
109. His argument is that it is prohibition
and the black market which is created as a result leads to the
proliferation of crime and also to the adulteration of much that
is sold on our streets which leads in turn to very bad health
effects and in many cases death. Is that right or wrong?
(Keith Hellawell) The effect of adulteration is actually
quite limited. What happened in Scotland caused the world to look
at the level of adulteration. The level of adulteration is relatively
low in terms of other harmful products. The whole focus and emphasis
of the strategy is to get people into treatment. I must not move
away from that. If we had a regime that they have in other countries,
and thankfully they are changing it, where there was no treatment,
where the only method of dealing with anyone involved with drugs
was the criminal justice system, then you could say our system
was wrong and I would be the first to admit that it was wrong.
Because the emphasis in our system is not on the criminal justice
system, in some ways you could say we have decriminalised; you
could say it. I have been careful not to say it, but you could
virtually say it. We do not prosecute drug addicts for being drug
addicts, we put them and encourage them into treatment programmes.
We educate our children so that they can understand the consequences
of that. The police performance indicators have changed since
I was involved from arresting people in possession of drugs to
focusing on class A drugs, to focusing on those who are in possession
with intent to supply. We do not have an offence of dealing. The
prosecutions we have are largely in those areas. Because the drugs
are divided and in small quantities it is not easy and sometimes
the magistrates ask the question and we are doing something to
alter that. There is not an emphasis in this country on going
round to arrest someone because they are a heroin addict and putting
them before the court. The emphasis is to put them into treatment.
We are one of the few countries in the world who have been doing
that for a long time and decriminalisation is a red herring; a
red herring.
(Sue Killen) Are we talking about decriminalisation
or legalisation?
110. He is talking, for example, about making
heroin, if I understand him correctly, legally available to addicts
and he says this would collapse the price and all the criminal
activity which goes with it.
(Sue Killen) My answer to the question you have just
asked, about what is described there as the problem, would be
that the problem is addictive behaviour and that is what we have
to deal with. We have to deal with the problems associated with
addiction. It goes back to what I said before. Give people free
heroin and if they are still addicts they will go out there on
the streets and possibly want to buy street drugs on top of that.
They will develop addictions for other things like alcohol. What
you have to do is deal with the behaviour.
111. This is excellent. I have succeeded in
provoking you to address the debate which is going on in the outside
world.
(Sue Killen) We are interested in what is going on
in the outside world and that is why we are focusing on what is
effective and what works. Nick Davies was commenting on what might
work and therefore that is of massive interest to us and when
we consult in the field those are the sorts of things people are
talking about. When it comes to decriminalisation, legalisation,
we come at it tangentially because our main focus is on looking
at how we can be more effective. We are responding to things and
we are looking at whether we should be doing more in terms of
prescribed heroin.
(Keith Hellawell) This is so important.
112. It is important, you are quite right. I
am glad we have got there.
(Keith Hellawell) If I go along to a doctor and say
I have this medical condition and I will have this drug, the doctor
will say that these are the methods of treatment which we provide
and he will decide what method of treatment I have. The fundamental
difference on top of what Sue has said between heroin and methadone
is that heroin is a maintenance programme. I am addicted, yes,
you will control and stabilise my activities, but I shall continue
with my addiction. The basic philosophy of medicine within this
country and within the strategy is that we want the end product
to be for them to lead drug-free lives. In that context methadone
is the drug which is necessary but we are—Belgium might
and it is trying to happen in Switzerland—the only country
in the world which has been doing it for more than 25 years. It
is available.
113. Let me bounce off you another of Mr Davies'
assertions. Prohibition has not merely failed to cut the supply
of illicit drugs, it has actively speared drug use. The easiest
way for new users to fund their habit is to sell drugs and consume
the profit, so they go out and find new users to sell to. Is that
true or false?
(Keith Hellawell) The best way to deal with their
habit would be to go to a treatment centre and have treatment
and that is what we are trying to get them to do. The change in
strategy from back in 1998 to now was a change to try to get them
to do that rather than deny there are large numbers of them and
perhaps use a stronger line in terms of people not willing and
comfortable to do that. Out on the streets now people are clamouring
for treatment, whereas before we were trying to find people for
treatment because they would not admit. They are admitting and
clamouring for treatment because there is now an environment created
by the strategy which is there to help and support. The other
thing I take issue with Nick on is that the choice of whether
heroin is provided to addicts is to my mind a medical one and
is a medical issue. That does not affect decriminalisation in
the terms we would use. Am I allowed, in his presumption, to go
along to the chemist and have some because I want the effects
of heroin in a social gathering? He does not really address that
issue. He actually uses the situation we have reached, the situation
that this strategy is aimed at addressing and beginning to address
as though it were the status quo. I did not know he was
a world authority on drugs quite frankly.
114. I make no such claims; I do not suppose
he does either. He does make some arguments and his basic argument
is on prohibition versus non-prohibition; a familiar one from
the 1920s to do with alcohol, which is not a new argument. My
point is, and our terms of reference make this clear, that I want
to see it addressed and it was not addressed.
(Keith Hellawell) Prohibition is a very emotive term.
There are many laws. There is a law which stops you stealing.
Would he call it prohibition on theft? To be fair this is the
emotive language people tend to use with drugs. Because you say
you should not burgle a house, do you say there is a prohibition
on burgling houses? It is a nonsense quite frankly, it is semantics
which people use in support of their case. It is an illegal activity
as proscribed by the international community. Each government
decides which way to deal with it. Our philosophy here in this
country is that we want to prevent it through education, we want
the right treatment and support and after-care service for people
who have had it and we want to reduce the damage and harm that
it causes to the communities. That is a strategy which is laudable,
will take time to work and it is working.
Chairman: I do not seek to decry it. What I
do seek is that this inquiry needs to address these arguments
which not only Nick Davies puts but other people, including a
few experts and current chief constables. Mr Hellawell will have
an interest in the credibility of chief constables. We do need
to address those points. What I am going to suggest to you is
that rather than carry on now, the Home Office go away and consider
points two and three in our terms of reference, perhaps take some
of the key assertions made by Mr Davies or anybody else, quote
them and then rebut them, if that is what you want to do. I do
feel we have to do that in order to move on.
Angela Watkinson
115. One key question is whether we can establish
whether decriminalisation would increase usage. There are essentially
two different groups of people we are thinking about here. There
are people who are already addicted and their treatment and the
people who may be tempted into taking drugs and those are the
ones we have to deter in the first place from ever starting. What
would be the impact on them if it were decriminalised?
(Keith Hellawell) Please, this word "decriminalise"
is so key and it is conjuring up different things in all of your
minds. Decriminalisation in terms of those who are addicted to
drugs. If you use the term to mean that they are treated rather
than prosecuted, we have decriminalisation of hard drugs in this
country now. You do not get police officers going into treatment
centres saying people are heroin addicts, they must have got it,
they are going to arrest them and take them in. It does not happen.
It does not happen around the needle exchange programme, it does
not happen. If you use decriminalisation to mean that we are using
treatment rather than the law, it has happened. In terms of using
decriminalisation to mean that anyone can have access to these
drugs for whatever purpose and there is going to be no criminal
penalty attached to that, we do not have decriminalisation. We
believe that we want education to prevent them getting to that
stage, we want to put controls and measures to deter them from
being involved at that stage, but if they do get involved then
we want to provide treatment to support them.
116. Some people would translate decriminalisation
as the Government providing a whole range of drugs for users at
a cheap price to cut out the illegal market and then you have
to look at whether that would be moral for the Government suddenly
to become a supplier.
(Sue Killen) Anything which could possibly increase
the use of harmful drugs is something we would all have real difficulty
with and how drugs are treated within the law does affect whether
or not people feel inclined to consume them. We have looked a
lot at the user but you have to think about the dealer in this
too. One thing I would say about decriminalisation is: will that
necessarily reduce the incentive for the dealer to go out there
and push his product? What we are dealing with here is a market,
a business and it is one which is highly flexible where people
are trying to sell a product. You have to look at what any changes
in law will do to affect that market as well as looking at it
from the users' perspective.
Chairman
117. Mr Davies would argue that it would collapse
the market. He may be right or he may be wrong but that is what
he is arguing.
(Sue Killen) That is why I was asking whether you
were talking about decriminalisation, which is what this debate
was going to be about, or legalisation. Why would it collapse
the market necessarily?
118. Sorry, legalisation.
(Sue Killen) Exactly and that is what I was trying
to clarify because we started this range of questions on decriminalisation.
119. Would it?
(Keith Hellawell) There are many methadone deaths
in this country. Methadone is a legally obtainable substance.
Methadone is widely used illegally. It is widely used illegally
and traded for other substances. Benzodiazepine, some of those
other substances, we had a big peak in Scotland some years ago,
are legally obtainable substances under certain controls, which
is what he is arguing for heroin. We put tighter controls on methadone
but it is still a commodity which is used on the streets illegally.
The fact that you can actually change the status of something
does not mean that there is going to be an actual change in the
culture or the habits of the people on the ground. I feel, as
clearly I would do, that the balance we have in the strategy directly
addresses the issue of decriminalisation as you have described
it and it seems to have come out of the debate at the moment.
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