MEMORANDUM 32
Submitted by the Independent Drug Monitoring
Unit (IDMU)
FOREWORD
1. The issues raised by the Committee are
complex, and cannot adequately be addressed within a limit of
1,000 words. We have however endeavoured to keep the length of
this document to a minimum, whilst addressing all the major issues
raised by the Committee, and questions arising therefrom.
2. IDMU is a small independent research
consultancy specialising in the study of illegal drug consumption
patterns, prices and effects. We are funded wholly via professional
fees earned in providing expert evidence for the criminal and
civil courts, with experience of over 900 criminal cases since
1991. The evidence mainly covers personal consumption and drug
valuations, but includes yields of cannabis cultivation systems,
effects of drugs (re criminal intent, driving impairment etc),
and a range of other aspects, most notably therapeutic uses of
cannabis. Our mission is to provide accurate, up to date and impartial
information on drugs to all parties to the debate over drugs policy.
Other than legal casework, we have provided consultancy for GW
Pharmaceuticals, the House of Lords inquiry, the Home Office,
Transport Research Laboratory and Northamptonshire Police.
EXECUTIVE SUMMARY
1. Existing drug policy is clearly not working,
for reasons outlined herein.
2. Decriminalisation is a vague term which
requires clarification.
3. The effect of law reform on availability
of and demand for drugs would depend upon the policies adopted.
Alternative methods of control could reduce the availability of
drugs, particularly to young people, who view legislation as a
challenge rather than a deterrent.
4. The effect of law reform on drug-related
deaths would depend on the drug and upon the policies adopted.
Pragmatic reforms could cut the number of drug-related deaths
significantly.
5. The effect on crime would depend upon
the policies adopted. Options are outlined which could lead to
a substantial fall in acquisitive crime.
6. Decriminalisation (permitting possession
but not supply) could have advantages and disadvantages. The main
disadvantage would be to leave the supply of drugs in criminal
hands.
7. There are a number of practical alternatives
outlined. A system of regulated and licensed supply could avoid
many problems currently experienced, and raise substantial revenues
(£1 to £5 billion per year) for the Exchequer from a
combination of excise duties, greater productivity and reduced
law enforcement costs.
8. The following appendices are provided
with the report
A Medicinal Use of Cannabis
C Drug Trends (IDMU survey research data
1984-2000)
D How IDMU can contribute to policy development
1. DOES EXISTING
DRUGS POLICY
WORK?
1.1 The question raises several issues:
(a) What are the goals of current drugs policy?
(b) By what criteria can existing policy
be judged?
(c) How is current policy performing against
such criteria, what are the successes and failures?
(d) To what extent are current successes
adequate, and failures acceptable?
1.2 The goals of drugs policy can range
from the absolutist achievement of a "drug free society",
to the pragmatic "harm minimisation" approach. For the
absolutists, being seen to "fight the fight" at all
costs, is more important than achieving practical results. Those
favouring the pragmatic approach would seek to minimise the harm
caused by drugs, both to the individual and to society.
1.3 A range of criteria can be used to evaluate
the effectiveness of drug policy—these can include:
(a) Prevalence—all drugs and/or more
dangerous/addictive drugs
(ii) Current/recent drug use
(iii) Problem drug use (treatment episodes)
(v) Teen drug use (age of first use)
(iv) Deaths from health problems caused
by chronic drug use
(iii) Drug-related violence
(d) Market trends—all drugs and/or
more dangerous/addictive drugs
1.4 Taking a global view, there is overwhelming
evidence that current drug policies do not work.
(a) Prevalence, particularly of Class "A"
drugs is increasing.
(b) Lifetime prevalence will continue to
increase for the next couple of decades irrespective of drug policies,
until more users/ex-users start to die out through old age or
ill health than new teenagers initiate drug use—evening
out the demographic bulge.
(c) The key policy objective should be to
minimise the number of people initiating or continuing to use
Class "A" drugs.
(d) Our surveys suggest that the effect of
an arrest on drugs charges is to increase the probability of that
person progressing to use of Class "A" drugs.
(e) Drug-related death rates in the UK are
much higher than many other countries, most notably the Netherlands
and others with more liberal regimes.
(f) Current policies also fuel crime via
maintaining the cost of addiction at high levels, and providing
high profit margins for drug traffickers.
(g) Availability of drugs is increasing,
drug prices are falling, in some cases dramatically, and purities
are increasing.
(h) The public at large is growing increasingly
tolerant of drug use, notably cannabis, although attitudes among
drug users to different drugs appear relatively stable.
2. WHAT WOULD
BE THE
EFFECT OF
DECRIMINALISATION ON
(a) the availability of and demand for drugs,
(b) drug-related deaths; and
2.1 The term "decriminalisation"
causes much confusion. It may be used broadly to reflect a general
move towards relaxing the current regime, or narrowly to mean
permitting personal possession (eg below a certain limit) but
maintaining criminal controls on drugs supply. By contrast the
term legalisation would normally be taken to mean abolishing legal
controls and permitting a free market in supply of drugs. Regulation
or licensing would introduce a degree of control whilst permitting
a legal supply of drugs—the degree of control could vary
from the off-licence/tobacconist model for the less dangerous
drugs, and/or on-licence such as cannabis pubs or cafes, to prescription
only for the drugs of addiction.
2.2 The key to reducing demand for drugs
is to make drug use "boring" or "uncool",
and reduce the excitement and glamour associated with the drugs
scene. Availability, particularly to minors, could be reduced
if age-limited legal sources were available, reducing the profits
from selling drugs, and if addicts did not need to sell Class
"A" drugs to support their own habits.
2.3 Most drug-related deaths are caused
by drugs of unknown purity, contaminants within illicit preparations,
and unsafe practices associated with drug use.
(i) Illicit heroin powders can range
in purity from under 10 per cent to over 70 per cent—injecting
drug users are therefore at risk if they take a "normal"
dose of high purity powder.
(ii) Heroin addicts who are abstinent
(eg through rehab or prison) lose tolerance to the drug, and are
at risk of overdose if they relapse and inject a "normal"
dose.
(iii) Recent outbreaks of heroin deaths
have been caused by microbial or viral infections, serious health
complications (abscesses, amputations etc) arise from other contaminants
when injected.
(iv) Allowing GPs to prescribe heroin,
in injectable form where appropriate, of pharmaceutical purity
and of known dosages, could dramatically cut the death rate from
overdoses and impurities—the experience in Switzerland and
Australia.
(b) Stimulants (cocaine, amphetamine)
(i) Deaths attributed to cocaine and
amphetamine generally involve cardiovascular effects (strokes,
heart attacks) caused by the drug itself.
(ii) Relaxation of the law is unlikely
to have a significant impact on stimulant-related deaths, unless
this were to result in an increase in stimulant use, and of excessive
binge use in particular.
(iii) Permitting low-dosage or natural
preparations (eg coca tea) may be one way to provide a legal supply
of stimulants. Caffeine use also carries risks.
(c) Ecstasy—Deaths attributed to ecstasy
fall into the following categories:
(i) Dehydration/heat-stroke arising from
the circumstances in which the drug is taken (hot, sweaty atmosphere,
intense and prolonged physical activity),
(ii) Adverse reactions—toxic effects
of the drug often involving liver failure,
(iii) Deaths attributable to impurities
(eg ketamine/ephedrine/procaine combinations),
(iv) Evidence as to the neurotoxic effects
of MDMA is compelling—long-term use of the drug is likely
to result in chronic mental health effects,
(v) If "decriminalisation"
were to result in increased use, deaths could increase. Steps
should therefore be taken to screen all phenethylamine analogues
identified by Shulgin with a view to licensing alternative drugs
which carry more acceptable health risks whilst retaining acceptability
to the users.
(d) Cannabis/Hallucinogens—few, if
any, deaths are attributed to cannabis or the tryptamine hallucinogens
(LSD, DMT, Magic Mushrooms) although the latter can cause long-term
mental effects in susceptible individuals.
(e) Long-term health risks
(i) Health risks associated with clean
opiates are relatively low, the major cause of ill health is unsafe
practices associated with use (smoking heroin, unsterile injection)
or impurities or adulterants present in illicit preparations.
(ii) Use of stimulants (amphetamines,
cocaine, ecstasy) increases long-term risks, notably of cardiovascular
problems (cocaine/amphet) and serotonin depletion (ecstasy). Increased
use would be expected to increase associated death rates.
(iii) Cannabis—Unlike in the USA,
where herbal cannabis is smoked "neat", in the UK most
cannabis or cannabis resin is smoked mixed with tobacco, which
carries its own risks. Increases in smoking any substance are
likely to increase long-term risks from cancer, pulmonary or cardiovascular
disease. Increased use of alternative forms of administration
(food or drink products, inhalers/sprays etc) in a legal market
could reduce the risks from smoking. The health risks associated
with the use of cannabis have been thoroughly investigated over
the past century, and there is no evidence that increased use
of cannabis would have a significant adverse impact on public
health.
2.4 The effect on crime would depend on
the nature of the policy, and the type of crime involved:
(a) Acquisitive crime—This would include
theft (burglary, robbery, shoplifting), fraud (petty credit-card
fraud, benefits fraud, and larger-scale financial embezzlement).
(i) A substantial proportion of acquisitive
crime is driven by the need to find money to buy the addictive
drugs—heroin and, to a lesser extent, cocaine.
(ii) Any policy which permitted possession
of heroin but did not permit a legitimate supply would be unlikely
to cause a significant reduction in acquisitive crime.
(iii) Prescription of diamorphine preparations,
at nominal cost, or even at cost price where there is the ability
to pay, should result in a dramatic reduction in acquisitive crime.
(iv) Were acquisitive crime to fall dramatically,
and stolen goods no longer need to be replaced by victims (on
insurance or otherwise), there could be an adverse impact on manufacturing
industry from such a reduction in consumer demand.
(b) Trafficking-related violence (turf wars
etc)—the death rates would be broadly linked to the profit
margins available, and risks involved, within the illicit trade.
(i) A policy which permitted personal
possession but left supply of drugs in criminal hands could result
in an increase in violent deaths (assassinations/murders) within
the drugs trade, if such a policy were to increase demand.
(ii) A policy of licensed distribution
of cannabis would only remove the profit incentive if levels of
excise duty were not excessive. Any duty levied in excess of £1.50
per gramme would encourage "bootlegging" on a similar
scale to that currently seen with alcohol and tobacco.
(iii) Prescription of heroin would remove
the profit incentive in the drugs trade, rendering it uneconomic,
abolishing turf wars for drug supply.
(iv) If the consequences of arrest on
trafficking charges were to be less severe, there may be reduced
motive to assassinate suspected informers within trafficking organisations.
(c) Drug-Induced Violence
(i) Stimulants—amphetamine and
cocaine are associated with increased aggression and psychotic
behaviour, particularly when used to excess. The incidence of
such behaviour, and violent deaths arising from stimulant use,
would be expected to increase with a wider increase in use.
(ii) Alcohol—Alcohol is a causal
factor in the majority of violent incidents in society. If policies
were to reduce alcohol consumption, fewer violent deaths might
result.
3. DECRIMINALISATION
AND ALTERNATIVES
3.1 Is decriminalisation desirable?
3.1.1 If decriminalisation involves removing
criminal penalties for possession (eg of less than a designated
amount), but leaving supply of drugs in the hands of criminals,
there would be some benefits, but many problems would remain.
(i) The move would be popular among users
of drugs, reducing the levels of conflict between young people,
police and society
(ii) Removing the threat of a criminal
record (and/or expunging existing criminal records for simple
possession) would reduce the financial impact of an arrest on
the individual and society.
(iii) The credibility of government messages
among wide sections of society may increase. Our recent survey
showed that the least trusted sources of drugs information were
Government Ministers, the Drugs Czar and the Police.
(iv) Society as a whole could benefit
from a more tolerant climate of individual rights and responsibilities,
with a less authoritarian relationship between the Government
and its citizens.
(i) Leaving civil penalties in place
for possession would not remove the "naughty" or "forbidden
fruit" image of drugs, and would decrease the attractions
of usage.
(ii) Civil fines would be paid by a small
minority of users (those who are caught), and would therefore
represent a very inefficient form of taxation.
(iii) If demand increases, the untaxed
profits of drug traffickers would increase, and with this the
levels of corruption and violence associated with any illegal
trade.
(iv) Decriminalisation would mean users
still having to get their supply from a source. If the "legal"
source of drug (GP, licensing) is inferior in quality to the "illegal"
sources, then the criminal control of the drug trade would not
be halted. To be effective the criminal element that controls
the supply of drugs must be put out of business. This can be achieved
by ensuring the supply of drugs is at least of a standard users
are already accustomed to. In the case of cannabis the easiest
solution would be to allow anyone to grow their own supply for
own personal use only. This would enable relatively law abiding
citizens who only smoke cannabis to avoid visiting criminal suppliers.
(v) The Government would not benefit from
Excise Duty revenues payable on (particularly) cannabis. Our surveys
have indicated that such duties, along with reduced enforcement
costs, could generate between £2 billion and £5 billion
per year for the Exchequer.
3.2 If not, what are the practical alternatives?
3.2.1 Status Quo—No change in legislation.
Public opinion is steadily moving towards support of drug law
reform and some form of liberalisation. Opportunities have been
missed in the past (eg following Wooton Report and 1979 ACMD report)
to reduce the criminal status of cannabis, and those failures
are at least in part responsible for the levels of drug problems
we face today (10 times as many drug users/arrests today as when
the Misuse of Drugs Act was introduced).
3.2.2 Reduce penalties (reschedule cannabis
to Class C, Ecstasy/LSD etc. to Class B)—These proposals
from the Police Foundation in essence echo those of the ACMD in
1979. This would represent tinkering with the system, as the damaging
effects of a criminal record for drugs on the individual and society
would remain.
3.2.3 Regulation/Licensing: In the long
term, some form of regulated supply of cannabis must be considered.
The extent to which licensing could cover existing illicit preparations
would depend on international agreements (ie for cannabis resin
or herbal imported from countries where production remains illegal),
although domestic production could supply the bulk of the UK cannabis
market. The objective of such models would be to satisfy existing
demand without creating additional demand. Different models may
be appropriate for different drugs:
(a) Prescription and dispensation from pharmacy—this
could be appropriate for opiates, but would impact on NHS resources
(GPs' time). Individual use could be regulated.
(b) Individual licences to possess/purchase—Users
could apply for a licence (smartcard?) which would enable them
to buy (eg opiates) in appropriate amounts at or near cost price.
(c) Licences to produce—cannabis growers
could be allowed a "duty free" surface area or lighting
wattage, but could apply for licences to produce larger amounts.
Duty could be levied at quarterly intervals based on the available
surface area, subject to regular inspection.
(i) Outlets such as "coffee shops"
could be licensed to supply cannabis, with appropriate restrictions
on advertising, age restrictions (as with alcohol or tobacco),
and location (eg not within 1/4 mile of a school).
(ii) Alternatives would include a "club"
model whereby licensed clubs could supply cannabis to their members,
who would have to produce a membership card. Reciprocal agreements
could allow cards to be valid in all clubs within an association.
3.2.4 Free Market (Legalisation)—This
would involve drugs being sold in normal retail outlets (eg supermarkets/tobacconists)
without significant controls. Excise duties could be levied on
producers and/or wholesalers as with tobacco or alcohol. This
policy would probably lead to increased usage (particularly among
middle-aged or elderly citizens), although this would also generate
the highest duty revenues for government.
September 2001
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