Select Committee on Home Affairs Memoranda


Submitted by the Centre for Addiction Studies

  Report to the House of Commons Home Affairs Committee from;

  Dr Mohammed Abou-Saleh

  Dr Colin Drummond

  Dr Sally Porter

  Mrs Jan Annan

  Ms Alison Keating

  On behalf of the Centre for Addiction Studies, Department of Addictive Behaviour, St George's Hospital Medical School, Hunter Wing, Cranmer Terrace, London, SW17 0RE.

  Dr Andrew Johns, Consultant Forensic Psychiatrist at the South London and Maudsley NHS Trust also contributed to this submission.

  This submission was prepared specifically for this enquiry by the Centre for Addiction Studies, a research, education, training and clinical centre addressing substance misuse.


  1.1  The current drug policy agenda, initiated in 1995 and revised in 1998 places its emphasis on the wider aspects of demand reduction, rather than concentrating solely on availability. The policy has not been fully operationalised, but it is clearly a strategic approach in the right direction. Additionally other existing policies have been broadly successful in limiting the spread of HIV/AIDS in the UK, with prevalence rates amongst the lowest in Europe.

  1.2  The limitations of the strategy include:

    —  It is not complemented by a similar strategy to tackle alcohol misuse

    —  The current practice related with the strategy does not always adhere to the principles underlying the strategy (eg consultation and joint working).

    —  There is a significant human resource deficit with associated recruitment difficulties

    —  There is the need for a strategic approach and broader availability of training in the substance misuse field

    —  Some interventions are based on custom and practice rather than as evidence base (although it is recognised that the strategy is addressing this issue)

    —  The lack of a co-ordinated response between the health and judicial responses to drug-related crime lead to lost opportunities for diversion from custody, lack of treatment for incarcerated drug misusers and poor link between prisons and local drug-treatment facilities


  2.1  Decriminalisation is likely to lead to an increase in the availability of and demand for drugs. Rising demand and availability will be translated into an increase in drug-related deaths and criminal activity. In all other substance specific markets eg alcohol, tobacco, removing sanctions has increased consumption.

  2.2  It should be remembered that for many people the fact that drugs are illegal is a major deterrent. Previous experience also indicates that whenever there have been periods of unrestricted prescribing this has lead to an increase of drugs moving from the licit to the illicit market, an increase in demand and consumption and a corresponding increase in drug related deaths. For example at one stage dipipanone (Diconal) and the barbiturates were widely used as drugs of abuse. Tighter controls on restrictions have led to the abuse problems with these drugs diminishing significantly. Greater availability of state-sanctioned heroin or cocaine could lead to direct deaths through overdose as addicts tend not to be able to limit their own consumption. There is a high mortality rate among heroin addicts on prescribed methadone because they continue to misuse other drugs.

  2.3  Most of the decriminalisation debate has centred on cannabis. Whilst the dependence liability of cannabis is lower than that of some other drugs it is a mistake to consider cannabis a "soft" drug. About 10 per cent of those presenting to drug treatment clinics in the UK are seeking help with their cannabis use1. There is increasing evidence to suggest that cannabis is at least as carcinogenic as tobacco, with the World Health Organisation stating that cannabis is twice as carcinogenic as tobacco2 and it is also problematic for the cardiovascular system3. The likely increase in use created by decriminalisation would therefore lead to an increase in morbidity and mortality. Furthermore for those vulnerable to mental health problems cannabis can give rise to an acute psychotic phenomenon (cannabis psychosis) that can be easily misinterpreted as schizophrenia and it also worsens treatment compliance and prognosis for those with other functional mental illness. The classification of drugs into "soft" and "hard" is not based on rigorous scientific factors, for example a small amount of oral methadone or morphine in a stable person is much "softer" than ten "joints" of cannabis of 20 per cent THC.

  2.4  Another reason that decriminalisation is not desirable is due to the likely effect on offending. Whilst those who support decriminalisation argue that such a strategy would lead to a reduction of offending, even in Holland most drug dealing does not take place through the regulated channels. It is likely that that when cannabis is regulated and taxed it will be more expensive than when sold illegally4 and the illegal market will therefore continue.

  2.5  Whilst acquisitive crime might reduce if drugs were decriminalised, it is known that alcohol consumption is linked to increasing rates of violent and impulsive offending. There is therefore likely to be an increase in impulsive offending driven by stimulants and cannabis misuse for example. This is likely to be most evident amongst those who also have a mental health problem.


    3.1  The evidence presented illustrates that decriminalisation is not desirable due to its adverse effects on public health, increased drug-related morbidity and death, the negative effective on crime and the increased risk of an individual acquiring harmful or addictive patterns of use. To use an analogy, many people break the speed limit, but the speed limit is not increased. Instead greater effort is put into education, preventative measures and catching law-breakers. This is what the national strategy is now working towards.

  3.2  Additional methods of addressing this problem include:

    —  An educational campaign about the true risks of cannabis.

    —  Ensuring that treatment provision is increased and based on best evidence.

    —  Increasing the consistency of interventions and penalties nationally.

    —  Ensuring that penalties imposed by the court are proportionate to the substance misuse related action.

September 2001


  1.  Runciman R, Drugs and the Law: Report of the Independent Inquiry into the Misuse of Drugs Act 1971. London: Police Foundation, 1999.

  2.  World Health Organisation. Programme on Substance Abuse. Cannabis: A Health Perspective and Research Agenda. Geneva: World Health Organisation, 1997.

  3.  Hall W, Solowij N, Lemon J. The Health and Psychological Effects of Cannabis Use. National Drug Strategy Monograph No 25. Canberra: Australian Government Publication Service, 1994.

  4.  Drummond C, (2001) Cannabis should not be legalised: The Pot Smoking Gun. British Medical Journal (in press).

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Prepared 20 December 2001