| Overview: health risks and the law
|
| | |
| 1. | Cocaine, even before it is cut, frequently with other noxious substances, and even if only taken occasionally or in small amounts is not a 'safe' drug. A significant number of sudden deaths are associated with cocaine: 235 in the UK in 2008 alone—a whole third of the number of deaths from heroin/morphine the same year. As a recent study in the European Medical Journal concluded, "the notion that recreational cocaine use is 'safe' should be dispelled, since even small amounts may have catastrophic consequences, including sudden death". Medical understanding of the precise nature of harms associated with regular cocaine powder use is still developing: but a body of evidence is emerging about the links to heart disease, the long-term erosion of cognitive brain function, and of disturbing toxic effects when combined with alcohol, when it forms a third substance, more dangerous than either of the two ingredients. As Professor Nutt told us, it rightly deserves its 'A' classification. (Paragraph 23)
|
| | |
| 2. | We were very interested to learn that a Government review completed in 2007—the publication of which the Home Office had fought for three years—concluded that the effectiveness and value for money of the Government's drugs spending could not be evaluated. It is at best careless that the Government nevertheless pressed ahead and published its Drugs Strategy in February 2008 without publishing a proper value-for-money analysis of where resources would be most effectively targeted. We therefore support calls for an full and independent value-for-money assessment of the Misuse of Drugs Act 1971 and related legislation and policy. This assessment must also address the concerns about inadequate data collection raised in the 2007 review. (Paragraph 24)
|
| | |
| Who uses cocaine? |
| | |
| 3. | We heard varying assessments of the addictive nature of cocaine. Although cocaine powder had a lower severity dependency score (4.22) than crack cocaine (6.10) and heroin (9.09), there was no disputing that users typically developed a very strong psychological or habitual addiction to the drug. (Paragraph 27)
|
| | |
| 4. | Crack cocaine users are more regularly those with chaotic lifestyles, with a high likelihood of concurrent heroin abuse, and are over-represented in the treatment and criminal justice systems. In this context we understand the use of the term 'recreational' applied to cocaine powder as a shorthand for links between its use and the social context in which it is taken, often characterised by weekend use, and associated with pub and club culture. However, to term cocaine powder users as 'recreational' and their drug use, by contrast with crack users, un-problematic, is inappropriate, misleading and downright dangerous, since it contributes to the misconception that cocaine powder is a relatively non-addictive, 'safe' party drug. We recommend that the Government stop using the term 'recreational' in relation to cocaine. (Paragraph 31)
|
| | |
| 5. | Whilst crack cocaine and cocaine powder continue to have different user profiles, the characteristics of those using cocaine powder has broadened from the 'rich and famous' to a far wider cross-section of society. The broadening of its appeal seems to be related to the emergence of a two- or even three- tier market for cocaine powder, with cheaper, less pure cocaine available at a lower price, and purer cocaine at a higher price. (Paragraph 51)
|
| | |
| 6. | Cocaine powder is increasingly being taken simultaneously with alcohol. The two drugs combine to form a highly toxic third substance, cocaethylene, which a recent medical study reported to be associated with a 25-fold increase in sudden deaths. (Paragraph 52)
|
| | |
| Trends in cocaine use |
| | |
| 7. | The UK has the second highest number of cocaine users in Europe, second only to Spain. The number of adults reporting use of cocaine powder within the past year quintupled from 0.6% in 1996 to 3.0% in 2008/09, as did the number of young people. This increase in cocaine use bucks the overall trend in illicit drug use in the UK, which fell over the same period. Almost half of those who used cocaine in the last year were aged 16-24 years. The number of crack cocaine users seems to have remained relatively stable, although those with the most chaotic lives are not necessarily captured in surveys. (Paragraph 63)
|
| | |
| 8. | Figures from the National Treatment Agency show that the number of individuals receiving treatment for primary cocaine powder addiction increased from 10,770 in 2006/07 to 12,592 in 2007/08. (Paragraph 64)
|
| | |
| 9. | There was a large increase in non-fatal hospital admissions for cocaine poisoning in England, from 262 in 2000 /01 to 833 in 2006/07. Over this period the proportion of all poisonings which are attributable to cocaine has risen from 3.5% to 8.5%. (Paragraph 67)
|
| | |
| 10. | There were 235 cocaine-related deaths in England and Wales in 2008, an increase of 20% compared with 2007 and a continuation of an upward trend since 2004. The number of cocaine-related deaths in 2008 accounted for 14% of all drug misuse deaths (1,738) (Paragraph 68)
|
| | |
| 11. | The purity of cocaine seizures at both wholesale and street levels has fallen over the past decade. The most recent forensic analysis found that, in 2008/09, wholesale cocaine averaged 62% purity, whereas street level cocaine averaged 27%, but with some seizures containing as little as 5% cocaine. (Paragraph 72)
|
| | |
| 12. | The street price of cocaine powder has approximately halved over the past ten years, from an average of £80 per gram in 1999 to £40 in 2009. A 'line' of cocaine now costs around between £2 and £8, although the price varies depending on location and purity. However, the wholesale price of cocaine at the UK border has taken the opposite trajectory, increasing from around £22,000 per kilo in 1999 to £45,000 in March 2009. (Paragraph 75)
|
| | |
| Why an increase in use? |
| | |
| 13. | Although it is hard to say conclusively what has driven the increase in number of cocaine users, a corresponding decrease in amphetamine use and the clear emergence of cheaper, more heavily adulterated, cocaine at street level seem to be the most compelling drivers. There is no evidence that celebrity use has made more people turn to cocaine, indeed our witnesses argued strongly against it. However, the seeming propensity of celebrity users to 'get away with' using cocaine does contribute to a general trend of glamorising use, as does the social acceptability and normalisation generated by 'successful' people who appear to function normally, often holding down high-flying careers, whilst using cocaine. These are doubly dangerous as they contribute to the misguided reputation of cocaine as a relatively safe and non-addictive drug. (Paragraph 91)
|
| | |
| Disrupting the supply |
| | |
| 14. | Any public policy which aims to reduce the number of cocaine users and the harms associated with cocaine must encompass both supply and demand. Neither supply-side enforcement nor demand reduction can on its own successfully tackle cocaine use. (Paragraph 95)
|
| | |
| 15. | We recommend that the Government appoint an Independent Drugs Advisor, using as a model the role carried out by Keith Hellawell between 1998 and 2002. The structure of the drugs strategy which Mr Hellawell initiated remains in place. However we consider that the proliferation of different departments involved in drugs policy from supply-side enforcement through to treatment, necessitates an independent co-ordinator to ensure that policy is fully implemented, and in an integrated manner. (Paragraph 100)
|
| | |
| 16. | We were very encouraged by the political will evidenced by the Colombian Government to work with international partners to tackle the cultivation and production of cocaine. The substantial reductions in the last year in Colombia of 18% in cultivation and 28% in production, and a 57% increase in Colombian seizures, are impressive, and point to the implementation of more aggressive anti-cocaine policies. (Paragraph 111)
|
| | |
| 17. | However, the persistence of a high overall area under cultivation in Colombia, at 81,000 ha in 2008, shows that the battle has only just been joined. It seems to us that the key to further success lies as much in alternative development programmes as in crop and laboratory eradication schemes. Given the unenviable position of the UK as one of the largest consumers of cocaine worldwide, the UK has a compelling duty to support Colombia in tackling cocaine production. In this context the £1million a year spent by the UK on anti-cocaine operations in Colombia does not seem very substantial, particularly when compared to the amounts invested by the EU and US. We therefore urge the UK Government to re-examine its development budgets to see whether more could be contributed to Colombian alternative developments schemes. (Paragraph 112)
|
| | |
| 18. | We regret to note that progress in coca crop eradication and cocaine seizures made in Colombia do not appear to have been replicated in Peru and Bolivia, reflecting SOCA's assessment that relations with those countries were "more difficult". The UK should use all diplomatic routes at its disposal to engage with the Bolivian Government on cocaine production, and seek to increase development of alternative crop programmes in Peru and Bolivia. (Paragraph 114)
|
| | |
| 19. | We were very impressed with the model of the Maritime Analysis and Operations Centre—Narcotics, in Lisbon. It seems to us a fine example of what can be achieved when countries combine to take operational action against smuggling, free from the constraints of national bureaucracy and targets. Its seizure rate of 30 tonnes in its first year of operation is only just under half the amount estimated by the UN Office for Drugs and Crime to have been seized in the whole of the EU in 2008 (76.4 tonnes). (Paragraph 122)
|
| | |
| 20. | MAOC-N also plays a unique and important role in targeting uncanalised routes. We support this. However, we were concerned to hear that UKBA is already reducing operational resources at uncanalised points of entry to the UK. MAOC-N's efforts on uncanalised routes must not be used by UKBA as an excuse for further such reductions. (Paragraph 123)
|
| | |
| 21. | Operations Airbridge and Westbridge have enjoyed conspicuous success in detecting drugs smuggling at key transit points overseas and preventing them from reaching the UK. We urge the Government to build on these effective operations and develop similar projects in other countries, for instance in Nigeria and other west African states. (Paragraph 125)
|
| | |
| 22. | We were impressed by the anti-cocaine operations we observed both at Schiphol airport in the Netherlands and at Heathrow airport. In particular we praise the evident dedication, enthusiasm and expertise of UKBA customs officers at Heathrow. (Paragraph 140)
|
| | |
| 23. | Perhaps contrary to expectation, drugs mules do not tend to be nationals of source countries in South America—in 2008/09, of those arrested by UKBA for smuggling class A drugs, 38% were Northern European. There does not seem to be any grounds for introducing profiling of passengers on the basis of nationality or ethnicity. (Paragraph 141)
|
| | |
| 24. | We do however support the risk-based targeting of passengers entering the UK, using relevant indicators such as previous travel patterns and observed behaviour, as well as intelligence reports. Whilst the Dutch policy of 100% customs checks on certain flights, based on their origin country, has proved fruitful for them, we do not consider it to be a better approach than the current risk-based one taken by UKBA. A risk-based—as opposed to 100% checks—approach is valuable since it keeps traffickers guessing where and in what form they might encounter detection. Therefore we consider the varying of scans and checks based on targeting individuals and flights to be the correct strategic approach. (Paragraph 142)
|
| | |
| 25. | We have some concerns, however, about the extent to which detection equipment is available to UKBA officers. Whilst the scanning equipment we saw at Heathrow was comprehensive, we would be surprised if this was replicated at entry points across the country. We also question whether sufficient emphasis is being placed on the detection of internal concealments at UK airports, in addition to cocaine smuggled in baggage. In the Netherlands we saw comprehensive facilities for the holding of 'swallowers' and large hoardes of cocaine pellets which had been swallowed or internally concealed, but did not observe such seizures at Heathrow airport. (Paragraph 143)
|
| | |
| 26. | When we were able to obtain an up-to-date estimate for the amount of cocaine arriving in the UK each year, it was of 25-30 tonnes. We accept that the estimated amount of cocaine entering the UK each year can only ever be that, an estimate. We also accept that, as discussed below, cocaine seizures do not fully measure the success of supply-side enforcement. Nevertheless we were shocked to discover that, despite the combined efforts of the police, UKBA and SOCA, only 3,489 kgs (3.489 tonnes) of cocaine was seized in the UK last year, whilst 25-30 tonnes is estimated to enter it annually. This means that only a woefully inadequate 12-14% of all cocaine reaching the UK was intercepted. (Paragraph 149)
|
| | |
| 27. | Although there was an overall record number of instances of cocaine seizures in the UK in 2008/09, both the number of seizures and the overall quantity of cocaine seized by UKBA decreased from the previous year. In this context, the UKBA's target to seize 2,400 kg (2.4 tonnes) of cocaine in 2009/10 is both deeply unambitious and perplexing, since it is lower than the amount seized by the agency in both 2007/08 and 2008/09, and only represents between 8 and 9.6% of cocaine estimated to enter the UK each year. We do not understand why a target would be set lower than in both the previous years, and suspect this reflects a culture of complacency within the UKBA regarding the interception of goods as opposed to people. (Paragraph 150)
|
| | |
| 28. | Both the Serious Organised Crime Agency (SOCA) and the UK Border Agency (UKBA) actively export disruption of the cocaine trade overseas, on the rationale that it is better to prevent the drug reaching UK shores than attempt to intercept it once here. We wholeheartedly support this approach in principle, and it should continue to form the basis of UK strategic law enforcement response. (Paragraph 152)
|
| | |
| 29. | Whilst we consider that the quantity and size of seizures are important measurable targets, we also acknowledge that seizures alone do not give an adequate indication of the overall success of 'upstream' disruption of criminal trafficking networks. We therefore recommend that a more nuanced scoring system to measure the impact of SOCA and UKBA anti-cocaine operations overseas should be developed, alongside seizure targets. This scoring system could be along the lines of that used informally by the Maritime Analysis and Operations Centre—Narcotics, in which operations are graded from 1 to 10 on the basis of the impact of an operation. (Paragraph 153)
|
| | |
| 30. | The strategy of seizing cocaine overseas brings with it practical complications in terms of measuring SOCA's input to such operations, particularly when conducted jointly with overseas agencies. We are uncomfortable about the fact that the level of involvement by SOCA in an operation is only recorded in binary terms—whether or not to include the seizure in SOCA figures—and based on the decision of a SOCA officer. Whilst we do not, of course, wish for classified operational information to be made public, we do not see a good reason why SOCA should not publish more detailed criteria upon which the inclusion of seizure statistics are determined. We therefore recommend that (a) the two criteria currently used by SOCA to determine whether a seizure is included in its figures be changed to a more detailed scale which records the level of SOCA's involvement, and (b) that the criteria for measuring that scale be published. (Paragraph 156)
|
| | |
| 31. | We are also concerned that the involvement of UKBA in some overseas operations, and of SOCA in providing intelligence to inform UK operations, runs the risk of double counting between UK agencies. We therefore recommend that a joint target and joint counting be developed to measure all cocaine seizures within the UK. This would include seizures contributed to or made by SOCA, UKBA and the police together as 'UK law enforcement' and would guard against double counting. The target must be set at substantially higher than 12-14% of cocaine estimated to enter the UK each year, which was the percentage seized by all three agencies last year. (Paragraph 157)
|
| | |
| 32. | The doubling in wholesale price of cocaine at the UK border between 1999 and 2009 does indicate that more effective supply-side enforcement may have squeezed the supply of the drug to the UK. However, we do not consider that the substantial fall in purity of cocaine at street level can be attributed to supply-side enforcement. The consistency of purity at the UK border but fluctuating levels found in street-level seizures within the UK—some with as little as 5% purity—suggest to us that the fall in purity is not so much driven by overall squeezing of the cocaine supply to the UK, but rather associated with the emergence of a 'two-tier' market in which there is demand for lower price, more heavily cut cocaine on the street, as well as higher end product by other consumers. The use of more sophisticated cutting agents which themselves mimic the analgesic effect of cocaine may mean that less pure cocaine has gone to some degree unnoticed. And the increase in the number of users may in itself have driven the available cocaine to be more thinly spread, thus reducing purity levels. (Paragraph 162)
|
| | |
| Tackling demand |
| | |
| 33. | Public information campaigns have an important role to play in challenging cocaine use. The Frank campaign on the effects of cocaine use has been successful in generating greater public awareness of the dangers of cocaine, with 63% of young people surveyed saying that the campaign made them less likely to take cocaine in the future. (Paragraph 172)
|
| | |
| 34. | In keeping with some of the more hard-hitting Frank campaign messages—such as those around bleeding and loss of cartilage in the nose, or sudden heart attacks—and similar graphic images used in anti-smoking campaigns, the most powerful public information messages seem to be around the immediate physical impacts of a drug, rather than long-term health damage. The effects of cocaine on executive brain function could be better exploited, especially as cocaine use is more common amongst the professional classes. More could be made also of the immediate risks—from even single use—of heart attack and sudden death, especially when cocaine is combined with alcohol. Similarly the message that up to 95% of what is sold as cocaine actually comprises harmful adulterants may well influence behaviour. (Paragraph 173)
|
| | |
| 35. | The Colombian Government's Shared Responsibility campaign on the environmental costs of the cocaine trade also packs a powerful punch, particularly since it feeds into an increasing public concern about environmental damage. More however could be made of the human effect—for instance child soldiers in Colombia, or the many drug mules locked into a vicious circle of exploitation. More graphic use should also be made of the number and size of internal concealments carried by drug mules who are often exploited, such as the up to 20 pellets swallowed by a single individual, or pellets the size of a pint glass inserted into a body cavity. We found the message that, for every gram of cocaine consumed in the West, 4 square metres of tropical rainforest are destroyed, especially striking. (Paragraph 174)
|
| | |
| 36. | We did not find any substance to the allegation that there are long overall waiting lists to access treatment for cocaine misuse, nor that those in the criminal justice system receive preferential access. It is clear that provision of community-based treatment has vastly improved from a very poor situation in 2002, with waiting times having reduced from three months then to six days in 2008/09. It is perhaps understandable that public perception has not yet caught up with this shift. (Paragraph 192)
|
| | |
| 37. | However, we were perturbed by reports that access to residential rehabilitation was not as readily available as to community programmes. Despite the insistence of the National Treatment Agency that community programmes offer appropriate treatment for the majority of cocaine users, doctors, treatment providers and ex-users expressed the view that addicts in a chaotic environment could benefit from periods of stable, residential treatment. The Government has invested an additional £11.8 million investment in treatment in 2009/10, a quarter of which is earmarked for residential treatment. We recommend that the proportion dedicated to residential treatment be increased. (Paragraph 193)
|
| | |
| 38. | Whilst it was clear from the figures provided by the National Treatment Agency that powder cocaine users were accessing treatment, we were unhappy to learn that the Government's target for getting drug users into treatment only counted opiate and/or crack users, according to its narrow definition of problem drug users. We are worried that this will adversely affect the funding, commissioning and availability of good treatment services for powder cocaine users, which are vital given the increase in users. We therefore recommend that the Government revise the basis on which PSA 25, Indicator 1 is measured, to include powder cocaine users. (Paragraph 194)
|
| | |
| 39. | We note the concern expressed by the Ministry of Justice that custodial sentences are often too short to allow a drug user to complete a treatment programme in prison. We strongly believe that, if custodial sentences are handed down to cocaine users, they should be sufficiently long to ensure that the user can complete a treatment programme in prison. (Paragraph 197)
|
| | |
| 40. | Drug dealers prey on the weaknesses of others. Given that the maximum penalty for cocaine dealing is life imprisonment and an unlimited fine, and yet the average custodial sentence for supply or intent to supply in 2008 was only 47 months, it seems that sentences for dealing may be tending to leniency. (Paragraph 198)
|
| | |
| 41. | We were very impressed with the high-visibility anti-cocaine police operation which we observed in Kent. This kind of proactive approach combines visible, zero-tolerance enforcement in the town centre with treatment through the drugs outreach workers, and medical agencies in the 'SOS' bus. It is an excellent example of how law enforcement and other agencies can work together to tackle supply and demand concurrently, and we urge Chief Constables to consider running more high-visibility operations on the basis of the Kent model. (Paragraph 204)
|
| | |
| 42. | The handheld Ion Track machines are a particularly effective weapon in both deterring and detecting cocaine use in the night-time economy. The capital costs involved are amply recouped by the multiple ways in which one machine can be employed. We urge all Chief Constables to ensure that their forces have one or more hand-held drug trace machines, and recommend that the National Policing Improvement Agency promotes the roll-out of these machines to all forces, as part of its Evidential Drug Identification Testing programme. (Paragraph 205)
|
| | |
