Select Committee on Home Affairs Third Report


THE GOVERNMENT'S DRUGS POLICY: IS IT WORKING?

ILLEGAL DRUGS
The main drugs in Classes A, B, and C

  
Class A
Includes cannabinol and cannabinol derivatives, cocaine (including 'crack'), ecstasy and related compounds, heroin, LSD, magic mushrooms, methadone, morphine, and opium.
  
Class B
Includes amphetamines, barbiturates, cannabis (herbal and resin), and codeine.
  
Class C
Includes anabolic steroids, benzodiazepines, and bupronorphine.

PREVALENCE OF USE OF DRUGS

14.  The primary tool for measuring the extent of illegal drug use in the population is the British Crime Survey, which is a household survey based on a representative random sample across England and Wales. The main survey addresses questions of victimisation and other crime-related topics, and the drugs component is a self-completed section tacked on at the end. In 2000, 98% of the sample of 13,300 respondents completed the drugs section (13,021 in total).[14] The 2000 survey reached the following conclusions on prevalence of drug use (in brief):[15]

  • Around a third of those aged 16-59 had tried drugs in their lifetime. However, only 11% had used drugs in the last year and 6% in the last month.

  • In the 16-29 group, 50% had tried drugs in their lifetime, 25% in the last year and 16% in the last month. This means that, of the nine and a half million young people aged 16-29 in England and Wales, at least 2.3 million would have used an illicit drug in the last year.

  • Cannabis was the most commonly used drug: over a fifth of young people aged 16-29 reported using it within the last year, whereas only around 1% of 16-29 year olds had used heroin in the last year, 5% of 16-29 year olds had used cocaine in the last year and around 5% of 16-29 year olds had used ecstasy in the last year.

  • In total around a fifth of young people have used Class A drugs in their lifetime, although only 8% reported use in the last year and 4% in the last month.

15.  The Survey also revealed some lifestyle patterns of drug users:

  • There were considerable regional variations in prevalence for particular drugs. London had consistently higher rates than other regions for Class A drugs, cocaine and ecstasy.

  • There were uniformly higher levels of drug use among 16-29 year olds living in affluent urban areas, for cocaine and other Class A drugs.

  • For most drug types, use did not vary significantly between income groups, but for heroin, the rate was notably higher in the poorest income group (3% compared with 0.5% in the intermediate and richest groups).

  • Single people, those living in rented accommodation, and those who visited pubs and clubs and drank alcohol more frequently, were found to be more likely to have taken drugs.[16]

16.  Over the four sweeps of the Survey in 1994, 1996, 1998 and 2000, some trends in drug use may be observed. The main trends were continued (but possibly decelerating) growth in cocaine use across all age ranges, including 16-19 year olds, and a drop by almost a half in use of amphetamine among 16-29 year olds since 1996-8. Among 16-19 year olds, use of "any drug" in the last year fell from 34% in 1994 to 27% in 2000.

17.  In comparison with other European countries, the UK has high prevalence rates. Mr Mike Trace told us that in terms of overall numbers of people who have ever used drugs, and numbers who used drugs last month:

    "the UK comes top of the European league. There may be six or seven other countries which are the same sort of level as us in overall prevalence, countries such as France, Spain, Portugal, Denmark and Holland, but three or four per cent below on most of these indicators".[17]

AVAILABILITY OF ILLEGAL DRUGS IN SOCIETY

18.  Illegal drugs are easily available in Britain, despite the large amounts of public money pumped into attempts to stem the supply of illegal drugs. The Home Office told us that the Government is forecast to spend £376m in 2002-3 and £380m in 2003-4 on the Reducing Availability strand of the strategy. Mr Terry Byrne, Director of Law Enforcement, HM Customs and Excise, told the Committee:

19.  The Home Office Minister, Mr Bob Ainsworth, told the Committee that there was some room for optimism, however: "there is evidence that the wholesale price of drugs is higher than it has been for some time now".[19] Mr Byrne concurred that that policy seemed to be containing, if not reducing, the problem:

    "there is a very clear indication that law enforcement is having an impact on the level of supply. What it is not doing at the moment is reducing the level of supply. What we do not know is what the level of supply would be were we to take the brakes off completely".[20]

LEVEL OF DRUG RELATED HARM: PROBLEMATIC AND NON-PROBLEMATIC USE

20.  While around four million people use illicit drugs each year, most of those people do not appear to experience harm from their drug use, nor do they cause harm to others as a result of their habit. Mr Ainsworth acknowledged that "there are people who manage, over fairly long periods of time (when they can slip into problematic drug use) to use drugs in a recreational fashion without becoming problematic drug users".[21]

21.  Most harm is caused by and to the group of users commonly classed as "problematic". These are users who are often dependent on crack cocaine and/or heroin and perhaps other drugs, who live extremely chaotic lives with high levels of risk to their health and that of others, and are often involved in crime. The effect on their families of their use can be devastating. Preliminary conclusions from a study of costs of drugs to society, at York University, suggest that problematic users are responsible for 99% of these costs.[22]

22.  We have heard arguments that the harm caused to and by this group are often symptomatic of—rather than caused by—their drug use. Mr Danny Kushlick, Chief Executive of Transform, told us that other problems lie behind their chaotic behaviour:

    "those people who are involved in chronic misuse of drugs are generally damaged and it is the underlying causes we need to look at...most drug misuse is a symptom and not a cause. The same stuff will go on in those people's lives¼abuse, poverty, unresolved bereavements, being in care, drug-dependent parents¼the same stories come out again and again and again, and if you tackle those issues those people will not get into those problems in the first place".[23]

23.  If government policy is to make a positive impact on this group, it must tackle these problems at root, rather than simply trying to target their drug use. Having said this, a number of recent cases has demonstrated that drug abuse can be a problem even among those from relatively affluent and stable backgrounds. In evidence to the Committee, the Home Office estimated the number of problematic drug users as 250,000, of which 200,000 are problematic opiate users.[24]

24.  We believe it is self-evident that by focussing on the relatively small group of problematic drug users, the Government could have a significant impact on the harm caused by drug use.

Harm to the health of the drug user

25.  It is difficult to separate the different kinds of health problem experienced in connection with drug use and it is extremely difficult to provide data which marks clear levels of harm. The Police Foundation Report of the Independent Inquiry into the Misuse of Drugs Act 1971 offered the following factors on which to assess personal harm of drug use:

Acute dangers

26.  The report of the Advisory Council on the Misuse of Drugs, Reducing Drug-related Deaths, offered the following picture of the span of deaths which may be drug-related,

27.  Problems with the way in which data is collected makes it very difficult to put an exact number on drug-related deaths. The Advisory Council found in their report that estimates of immediate accidental deaths as a result of drug use varied three-fold, between 1,076 and 2,922 in 1998, depending which of three approaches was used to calculate this "core statistic".[27]

28.  While the number of illegal drug-related deaths per year does not, in the first instance, appear large compared with those who die from tobacco and alcohol use, the Advisory Council report made clear that, if the age of those dying is taken account of, the true toll of these statistics becomes clear. Perhaps the starkest way to put it is that a young person who injects heroin has about a 14 times higher risk of death than someone who does not.[28] It is also clear that "there has been a profound worsening over the last ten years" in terms of deaths, and that, if drug-related deaths from HIV/AIDS and other blood-borne viruses are taken into account, the figure is very much larger.[29]

Long term harm

29.  The Department of Health statistics submitted to the Committee suggest that during 1999-2000, there were 8,505 hospital admissions with primary diagnoses of mental and behavioural disorders relating to drug misuse, although this may include some patients who were admitted more than once.[30] Long-term harm commonly associated with tobacco smoking, such as cancers and cardio-vascular problems, also attach to smoking of drugs such as cannabis (see paragraph 93 below). There is much we do not know about the long term harm caused by the use of illicit drugs.

Harm due to risky drug-using techniques

30.  The UK has high levels of drug-related harm consequent upon risky using techniques, particularly injecting drug use. Perhaps the most significant are blood-borne viruses, spread by sharing needles. In its memorandum to the Committee, the UK Harm Reduction Alliance commented that:

31.  As Professor Nutt, Professor of Psychopharmacology, Dean of Clinical Medicine and Dentistry, University of Bristol, commented, these infected users "will become a huge burden on the Health Service in the next ten years as their livers slowly decay".[32] The Advisory Council's report suggests that 30% of those infected with blood-borne viruses will die prematurely.[33]

Harm to the health of others

32.  Drugs can cause damage to the health of not only those individuals who use them, but also to the health of their family and friends and of the wider community in which they live. ADFAM, a charity which represents and supports families affected by drug use, told us of "a clear and damaging link between poor physical and mental health and the presence of disruptive drug use in families".[34] Mr Fulton Gillespie, whose son died of a heroin overdose, described to us the effect of his son's habit on other members of the family: "apart from it being a decimating experience for the family, it was particularly hard for his brothers and sisters who had tried very hard to wean him off this and persuade him to take a different direction".[35]

33.  It is clear that drug-related crime also has a malign influence upon the health of victims and communities. The Advisory Council's Report described how drug use might indirectly cause the deaths of others apart from the user:

    "the taking of drugs may lead to violent behaviour which causes the death of others; to the deaths of children through accidental overdose of a drug which has fallen into their hands; and to accidents, notably in road vehicles, killing third parties. Drugs can even contribute towards death without their being taken, when violent rivalry occurs between dealers".[36]

34.  Having said this, Commander Brian Paddick of the Metropolitan Police in Lambeth told us:

    "My view is that there are a whole range of people who buy drugs, not just cannabis, but even cocaine and ecstasy, who buy those drugs with money that they have earned legitimately. They use a small amount of these drugs, a lot of them just at weekends. It has no adverse effect on the rest of the people they are with either in terms of the people that they socialise with or the wider community. They go back to work on Monday morning and are unaffected for the rest of the week".[37]

Harm to others—drug-related crime

35.  The relation between drug use and crime is a subject of much debate. To quote Mr Hellawell once again, "all drug takers do not commit crime".[38] However, there seem to be three relevant types of crime which are associated with drugs: organised crime involved with the supply of illicit drugs, acquisitive crime committed by some drug users to fund a habit, and violent crime committed by disinhibited stimulant users.

Drug-related property crime

36.  On some estimates, one third of all property crime in the UK is judged to be drug related.[39] Preliminary data from the Home Office "demonstrate much higher reported levels of acquisitive offending among users of heroin and cocaine/crack than among those arrestees who use other types of drug, or who do not use drugs at all".[40] Overwhelmingly the users involved in crime tend to be the so-called problematic drug users who lead chaotic life styles and who are dependent on highly addictive drugs such as heroin or crack cocaine. These addicts each spend around £16,500 on their drugs a year, of which an average of £13,000 is the proceeds of crime.[41] This group commits very large amounts of shoplifting, burglary and other crime to finance drug purchases. We have been told that, if appropriate drug treatment is given to this group, they reduce their offending levels.[42]

Drug-related violence

37.  We have not been able to assess the contribution of drugs towards violent crime levels although it is a matter of record that the recent upsurge of shooting in London and other major cities is related to drugs—principally crack cocaine. It is also self-evident that the estimated £6.6 billion spent on drugs by users each year represents a lucrative source of revenue to the suppliers—mostly organised crime—and it would be surprising if this did not generate considerable violence amongst drug dealers seeking to extend or protect their territory.[43]

38.  We believe that drugs policy should primarily be addressed to dealing with the 250,000 problematic drug users rather than towards the large numbers whose drug use poses no serious threat either to their own well-being or to that of others. It follows that government policy should be examined in this light, and it is to this that we now turn.


14   Baker Paul, Goulden Chris, Sharp Clare, Sondhi Arun and Ramsay Malcolm, Drug Misuse declared in 2000: results from the British Crime Survey, Research Study 224, Home Office, 2001 (hereafter "Drug Misuse declared in 2000") p. 3. Back

15   Figures for use "ever" are used to estimate the extent of experimental use, figures for use "in the last year" gives an idea of occasional use, while figures for use "in the last month" show the extent of more regular use. Back

16   Drug Misuse Declared in 2000, pp. vi-vii. Back

17   Q. 635. Back

18   Q. 714. Back

19   Q. 1207. Back

20   Q. 715. Back

21   Q. 1250. Back

22   Q. 1322. Back

23   Q. 282. Back

24   Ev 199. Back

25   The Foundation is financially independent of all government agencies and the police service. Financial support comes from a wide variety of corporate, charitable and individual donors, including the Tomkins Foundation, The Zochonis Charitable Trust, the Hobson Charity and the Underwood Trust: Drugs and the Law: Report of the Independent Inquiry into the Misuse of Drugs Act 1971, The Police Foundation, 2000, (hereafter "Drugs and the Law") p. 43. Back

26   Reducing Drug Related Deaths: A Report by the Advisory Council on the Misuse of Drugs, Home Office, 2000, (hereafter "Reducing Drug Related Deaths") p. 3. Back

27   Ibid, p. 59. Back

28   Ibid, p. 1. Back

29   Ibid, p. 51; p.1. Back

30   Ev 200. Back

31   "UKHRA is a campaigning coalition of health and social care workers, drug users, criminal justice workers and educationalists, established in March 2001 as a direct response to inadequacies of the UK national drug strategies", (Ev 188); Ev 189. Back

32   Q. 550. Back

33   Reducing Drug Related Deaths, p. 1. Back

34   Ev 22. Back

35   Q. 1345. Back

36   Reducing Drug Related Deaths, p. 3. Back

37   Q. 398. Back

38   Tackling Drugs to Build a Better Britain, p. 7. Back

39   Drugs and the Law, p. 22. Back

40   Ev 199. Back

41   Bennet Trevor, Drugs and Crime, Research Study 205, Home Office, 2000, cited in Wilkinson Francis, Heroin: The failure of Prohibition and What to do now, Paper No. 24, Centre for Reform, 2001, p. 11. Back

42   DrugScope, Ev 50. Back

43   The Guardian, 22 September 2001. Back


 
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Prepared 22 May 2002