Memorandum submitted by DrugScope
DrugScope is the UK's leading independent centre
of expertise on drugs and the national membership organisation
for the drugs field.
DrugScope's objectives are:
— to support drug services and promote
good practice;
— to improve public understanding of drugs
and drug policy.
All DrugScope's policy work is shaped by our
core values and beliefs.
DrugScope believes in drug policy that:
— minimises drug-related harms;
— promotes health, well-being, inclusion
and integration;
— recognises and protects individual rights;
— recognises and respects diversity.
DrugScope is committed to:
— promoting rational drug policy debate
that is informed by evidence;
— involving our membership in all our policy
work;
— ensuring our policy interventions are
informed by front-line experience;
— speaking independently, and free from
any sectoral interests;
— highlighting the unique contribution
of the voluntary and community sector.
1. COCAINE BEYOND
OUR BORDERS
1.1 Cocaine hydrocholoride is a white powder
produced from the coca leaf plant, which traditionally is grown
in remote areas of Bolivia and Peru. The coca plant is not native
to Colombia and was only introduced in the 1980s.[33]
However, most of the region's coca is now grown in Colombia where
most of the processing of coca leaf to cocaine also takes place.
The UN Office on Drugs and Crime (UNODC) report for 2008 estimates
that about 180,000 hectares of land are devoted to cocaine growing
across the three countries.[34]
Just two hectares of land can yield six harvests of coca a year,
producing 1.250 pounds of coca leaf which in turn results in 2.5
kilos of pure cocaine.[35]
1.2 The USA remains the key market for consumption,
but since the late 1990s, cocaine has been shipped to Europe and
the UK in ever-increasing quantities. Cocaine arrives in the UK
via different routes; directly from South America by sea in bulk
to the UK or smaller quantities via airports in Spain and Holland;
through ports of entry in west Africa and then to Europe and the
UK, and also via Central America and the Caribbean.
1.3 The current levels of cocaine use have
their roots back in the 1980s. Until then, most serious organised
crime in Britain concentrated on armed robbery of bank vaults
or bullion trucks, for example. As the UK police grew more successful
in apprehending these criminals, many fled to Spain. There, they
met criminals linked to the cocaine cartels of South America and
began to realise that drug trafficking (including heroin and cannabis)
was much more profitable than armed robbery and carried much less
risk. This began the flow of cocaine into Europe, so that even
by the early 90s, more cocaine was being seized by British customs
than heroin.
1.4 In 1993, Pablo Escobar, then the world's
most notorious cocaine trafficker, was killed by Colombian security
services. Subsequently, the two main cocaine cartels in South
America, the Medellin and the Cali, broke up. The impact of these
victories in the "war on drugs" was unexpected; the
supply of cocaine to Europe actually increased. Far from crippling
production and supply, the amount of cocaine coming out of the
region increased, with many more middle-levels traffickers needing
to expand their trade beyond the ever more crowded US market.[36]
2. THE CURRENT
UK MARKET FOR
COCAINE
2.1 The latest estimated value of the UK
market in illegal drugs is around £5.3 billion, just under
half of which is accounted for by sales of powder cocaine and
crack cocaine. This easily makes cocaine the most profitable sector
of the UK drug scene.[37]
2.2 The two forms of the drug, powder cocaine
and crack cocaine, are different in the intensity of their effect
and consequently tend to attract different types of user. However,
if you consider powder cocaine and crack cocaine together, the
drug is now the most widely used illegal substance in the UK after
cannabis.[38]
2.3 In terms of seizures, the number of
seizures by police in the UK is probably a more reliable indicator
of trends than the weight of cocaine seized by Customs. This is
because a single large seizure of cocaine (or any drug) can distort
the figures for that year. So for example, in 1992, Customs seized
2,224 kilos of cocaine and hardly any more in 2006, but almost
double that figure in 2003. Police seizures in England and Wales
of relatively small amounts on the other hand have shown an inexorable
rise over the same 1992-2006 period from 1,160 in 1992 to nearly
15,000 in 2006-07 while the number of convictions for cocaine
offences has trebled between 2000-2006.[39]
2.4 Similarly, Customs or police bulk seizures
on their own cannot be taken as indicators of the overall success
or failure of enforcement activities. More drugs seized in any
one year does not necessarily indicate greater use on the streets;
nor do some of the very large seizures result in anything other
than a blip in supply and the removal of one criminal network,
which is rapidly replaced by another.
2.5 In the 10-year period since 1998, Class
A drug use has stabilised or even slightly declined; the only
exception has been the use of powder cocaine. Over that period,
self-reported use in the previous 12 months among those aged 16-24
rose from an estimated 0.1% to 6%, although that figure has decreased
to 5% in the most recent statistics from the British Crime Survey
(Home Office).
2.6 The net consequence of this has been
a significant fall in the price of cocaine in the UK from around
£80 a gram (UK national average) 10 years ago, to nearer
£40 in 2009. Due to its clandestine nature, no analysis of
the illegal drug market is ever straightforward. In 2008, DrugScope
reported an emerging two-tier market in cocaine (the equivalent
of supermarket "economy" and "premium" branded
goods) whereby dealers were selling two types of the drug—allegedly
"good" quality cocaine (around £50 or £60
a gram) and basic quality cocaine (between £30 and £40
a gram).[40]
No purity tests have been done to compare samples from different
price brackets, so this could just be a marketing ploy to trade
on the "aspirational" aspect of cocaine use.
2.7 The average purity of powder cocaine
seized by police has fallen sharply in recent years from an average
of 50% down to 30%.[41]
Historically, the weight of the product sold has been made up
with other white powders, usually harmless sugars such as lactose.
However, recent trends suggest that cutting agents have changed.
"Cocaine" is being bulked up with other drugs such as
the minor anaesthetic substances, benzocaine and phenacetin. As
its name suggests, benzocaine is in the same general family of
drugs as cocaine, but is a much milder analogue. Benzocaine will
deliver the same numbing sensation as cocaine would to the tongue
if tasted as well as to the nostrils if snorted, so a naive user
may well be fooled into thinking they have bought high purity
cocaine. Phenacetin is a painkiller which has been banned in the
UK after proving carcinogenic in animal studies.
2.8 These changes in cutting agents has,
it is believed, either led to (or masked) a reduction in the actual
amount of cocaine in UK seizure samples. The drug is now being
bulked out with substances that more readily fool the user.[42]
Evidence of the significance of this trend can be seen in the
development of a whole new industry that has grown up supplying
these new bulking agents to drug traffickers and wholesalers.[43]
To some, this might appear at odds with the assertion that the
UK is being flooded with ever-cheaper cocaine and might suggest
instead that there is a shortage of wholesale quality (pure) cocaine
entering the UK. It is true that the Serious Organised Crime Agency
(SOCA) have reported a rise in the wholesale price of cocaine,
which SOCA ascribe to some interdiction successes as well as the
falling value of the pound overseas.[44]
It is equally possible, however, that the change in the nature
of cocaine adulteration is just another innovative way for dealers
to maximise their profits from the drug trade.
3. "COCAINE
CULTURE" AND
PUBLIC PERCEPTIONS
OF THE
DRUG
3.1 In the 1980s, the use of powder cocaine
was very much associated with the conspicuous consumption of celebrities
and the new affluence of the City of London. While the "champagne"
image of powder cocaine persists to this day, the dramatic fall
in price has made use of powder cocaine an unremarkable aspect
of leisure time for an increasingly broad cross-section of British
society.
3.2 Powder cocaine is readily available
and frequently used in many pubs and clubs on many high streets
across Britain. The nature of the drug—a powerful stimulant
that "revs up" the user—it has also become popular
among workers in certain industries, such as security and construction.[45]
3.3 Although the distinction between "hard"
and "soft" drugs has no basis either in law or pharmacology,
the concept has traction in public perception to distinguish the
most dangerous drugs from others, usually on the basis of propensity
to cause addiction. Twenty years ago, all types of cocaine would
have been perceived in the "hard" category and there
is some evidence of this in the evaluation of Heroin Screws
You Up, the very first UK government anti-drug campaign, back
in the 1980s.
3.4 It appears that over recent years, the
popular perception of powder cocaine has changed. In 2006, as
part of its wide-ranging Commission on Illegal Drugs, Communities
and Public Policy report, the Royal Society of Arts commissioned
a YouGov poll on public attitudes and experience of drugs, dividing
the sample between those who used drugs and those who didn't.
Of the users, over half said they were using "hard"
drugs, knew others were using "hard" drugs and believed
you could use "hard" drugs in moderation without much
harm to yourself or others. However, only 1% said they had tried
crack cocaine and nobody admitted to using heroin. The only drug
they could have been referring to was powder cocaine.
4. COCAINE AND
CELEBRITIES
4.1 Media revelations about celebrity drug
use are invariably accompanied by attacks from politicians, campaigners
and commentators, who appear convinced that young people are influenced
in their decisions about drugs by the behaviour of those regarded
as cultural heroes—such as pop stars, fashion models and
footballers
4.2 In March 2008, two United Nations drug
agencies—the International Narcotics Control Board (INCB)
in its annual report[46]
and the UN Office of Drugs and Crime (UNODC) through an article
in The Observer[47]
criticised celebrities for allegedly glamorising drug use. In
the article, UNODC chief Antonio Maria Costa argued that young
westerners who use cocaine, and who might otherwise have concerns
about fair trade, third world debt, and the environment, conveniently
forget the violence and corruption caused by their increasing
demands for the drug. It was a point underlined by the Vice-President
of Columbia in launching the Shared Responsibility campaign
who similarly attacked celebrity drug use.
4.3 So how valid is the charge that the
"pied pipers" of celebrity are leading our young people
by the nose—and how do young people themselves respond?
A group of young people who work with a drug education and prevention
charity, Mentor UK were asked this very question by MPs at the
March 2008 meeting of the All Party Parliamentary Drugs Misuse
Group. A similar question was put to listeners of the youth-oriented
radio station 1Xtra. Collectively, their response was, in effect,
"we're not that stupid." It is symptomatic of our patronising
attitudes towards young people that we should think them so gullible.
In fact, fans of pop stars with drug problems generally feel sorry
for them and wish they could get their lives back together again.
4.4 In 2006, the National Collaborating
Centre on Drug Prevention based at Liverpool John Moores University
published a literature review on the effects of celebrity drug
use on use by young people and could find no evidence of the causal
link that the criticisms imply.[48]
This was underlined by a survey conducted by The Observer
about Britain's drug habits including the question about why people
first took drugs. Only 2% replied "desire to emulate heroes".
Eighteen per cent named "peer pressure", but an overwhelming
80% simply cited "curiosity".[49]
There are thousands of young people who dream of getting a record
contract and making a career in music. They aspire to becoming
entertainers, not role models. But for the very few who get there,
they can quickly become entrapped by the media obsession with
celebrity, snapped not only by paparazzi, but anybody these days
with a camera in their mobile phone. The tabloids fall over themselves
to get front-page candid shots. One could reasonably ask, who
is doing the glamourising?
4.5 Our general view is that there is no
evidence that celebrity drug use plays much part in the decision
to use drugs. Moreover, while such public figures may in many
respects indulge in reckless behaviour, there is no evidence that
they are actively involved in the promotion of drugs and may instead
simply represent an easy target in the context of a seemingly
intractable global problem.
5 PREVENTION STRATEGIES
5.1 What evidence is there about "what
works" in preventing young people from trying cocaine or
any other illegal drug? The two main approaches thus far have
been the provision of drug education in schools and the delivery
of wider public awareness campaigns by successive UK governments.
5.2 There is a often an unrealistic expectation
that school-based drug education programmes (or any programmes
come to that) can actually either stop young people from using
drugs or directly influence behaviour away from an unhealthy activity.
There is little evidence of any one programme being able to deliver
such outcomes.[50]
However, from the perspective of a healthy schools environment,
schools can promote a range of healthy outcomes for young people,
which includes tackling attitudes towards substance misuse (including
alcohol and tobacco), bullying, sexual activity, diet and exercise.
Within specific programmes, schools can at least ensure that young
people have accurate, non-judgemental information, have access
to programmes that discuss risk and how to deal with any peer-pressure[51]
and have access to help and support in dealing with a drug or
alcohol problem they might have or which exists in the family.
5.3 The government has invested heavily
in FRANK, which offers 24/7 drug advice and information as well
as being the platform for launching specific campaigns. While
FRANK and the attendant campaigns have high recognition ratings,
there is no evidence that public awareness campaigns of this kind
do prevent or reduce drug use.[52]
At best, the evidence indicates that such campaigns might reinforce
existing negative attitudes towards drugs.
5.4 Occasionally, public awareness campaigns
have unintended consequences. A 2006-07 campaign run in Scotland
specifically targeted at cocaine called Know The Score revealed
in its evaluation that 12% of a sample surveyed actually thought
they would try cocaine as a result of the campaign.
6. HEALTH RISKS
ASSOCIATED WITH
COCAINE USE
6.1 It is the case that many people can
use cocaine on an occasional basis without coming to much harm.
But the risks to the individual of chronic or regular use remain.
The drug has a high potential to cause psychological dependency.
The drug also puts significant strain on the cardiovascular system
and increasing numbers of people are being admitted to hospital
as a result of cocaine poisoning. Between 2000 and 2007, the number
of non-fatal hospital admissions rose from 262 to 833.[53]
Heart attacks, strokes and fits in otherwise healthy young people
are being recognised by doctors as possibly cocaine-related. And
because the way the drug acts on the brain, there is also the
risk of serious psychological problems from generalised anxiety
to paranoia and addiction. While there are no heroin-like physical
withdrawal symptoms for those who stop, there can be a periods
of deep depression, during which some people can be suicidal.
6.2 There is also an association between
cocaine and alcohol consumption. A combination of the two drugs
creates a new drug in the body called coca-ethylene which can
be more toxic than either drug in isolation. There is also some
anecdotal evidence that cocaine can promote excessive drinking
through the simple expedient of keeping people awake longer in
bars and pubs so they drink longer than they might otherwise have
done.[54]
7. TREATMENT
FOR POWDER
COCAINE DEPENDENCY
7.1 The National Treatment Agency for Substance
Misuse (NTA) report increasing numbers of those coming forward
who cite powder cocaine as their primary drug problem. The number
of recorded treatment episodes (rather than individual presentations
to services) rose from around 3,700 in 2003-04 to over 8000 in
2006-07. Although use of cocaine has been growing for a decade,
the upward trend in treatment presentations is more recent.
7.2 There is no specialised treatment for
helping those with powder cocaine problems and (despite many attempts
to find one) no satisfactory drug substitute for either powder
cocaine or crack cocaine—an equivalent to methadone for
heroin users—that might help stabilise users and reduce
cravings while they undergo psychotherapy or counselling.
8. CRACK COCAINE
8.1 Crack cocaine is being considered separately
in this submission as it has a different profile and provenance
from powder cocaine. Crack cocaine is a crystalline version of
powder cocaine. It first appeared on the UK drug scene in the
late 1980s. The devastation caused by the drug in areas of endemic
poverty and deprivation in the USA led to dire predictions of
the impact on UK society.
8.2 Fortunately, the most dire predictions
of the impact of crack cocaine on British society did not materialise.
Instead, it was understood that crack would find a level of use
within the drug using population. It was, however, clear that
the drug would pose serious problems for existing problem drug
users and the areas in which they lived. Latest Home Office estimates
suggest that there are 180,618 problem drug users who use crack
cocaine in England. This is as part of the estimated 328,767 total
number of problem drug users.[55]
8.3 Many crack users actually enter the
treatment system as heroin users, having used the drug to come
down from the effects of crack. Data from the National Treatment
Agency for Substance Misuse (NTA) shows that of the 185,460 adults
in drug treatment in 2007-08, 10,826 cited crack cocaine as their
primary drug of misuse, compared to 122,749 who reported heroin
as their primary drug of misuse. However, 44,360 people sought
drug treatment for their use of both opiates and crack cocaine.[56]
8.4 NTA data demonstrates that over the
last three years there has been a small rise in the number of
people who receive drug treatment for problems with crack cocaine
(alone or with other drugs)—from 7,598 people in 2005-06
to 8,496 in 2007-08. There has also been a rise in the number
of people seeking treatment for problems with both heroin and
crack cocaine—from 32,234 in 2005-06 to 44,360 in 2007-08.[57]
However, these increases come against a backdrop of an overall
rise in the number of people in treatment due to an expansion
of drug treatment services and increased investment over the last
decade.
33 Buxton, J. The political economy of narcotics. Zed
Books, 2006. Back
34
However, US government estimates put the figure much higher. There
are no clear reasons for the discrepancies other than the problems
of estimating the size of growing areas in remote and hidden locations
using satellite surveillance. Back
35
Streatfeild, D. Cocaine. Virgin Books, 2002. Back
36
ibid. Back
37
McSweeney, T et al. Tackling drug markets and distribution
networks in the UK. UKDPC, 2008. Back
38
British Crime Survey 2007-08. Back
39
Department of Health. United Kingdom drug situation 2008: annual
report to EMCDDA, 2009. Back
40
Druglink; Vol 22, 5, September/October, 2007. We say "alleged
good quality" because no purity tests have been done to compare
samples from different price brackets, so this could just be a
simple marketing ploy to raise profits by trading on the "aspirational"
aspect of cocaine use. Back
41
UK drug situation report 2008. Back
42
Some samples recently tested by the Forensic Science Service had
no cocaine at all. Personal communication, SOCA. Back
43
Druglink, Vol 26, 3, May/June, 2009. Back
44
SOCA Annual Report 2008-09. Back
45
Testimony to the increasingly ubiquitous nature of Britain's cocaine
culture can be found in several sources including; Druglink;
vol 22, issue 4, July/August 2009 and The Observer Magazine,
How Britons Get High, 20 July 2008. Back
46
International Narcotics Control Board Annual Report 2007 (can
be accessed here: http://www.incb.org/incb/annual-report-2007.html) Back
47
The Observer: "Coke fashionistas" are ruining
Africa-UN boss (9 March 2007). The article can be accessed here:
http://www.guardian.co.uk/world/2008/mar/09/unitednations.drugstrade Back
48
Witty, K. The effects of drug use by celebrities upon young people's
drug use and perceptions of use. Back
49
The Observer, Inside an addicted nation: Britain's habits
in 2008 (16 November 2008). Articles can be accessed here: http://www.guardian.co.uk/society/series/drugs-uncovered. Back
50
UK Drug Policy Commission. A response to "Drugs: our community,
your say" consultation paper, 2007, p8. Back
51
There is a view that while some young people do feel pressurised
into fitting in with the crowd, there are other who simply choose
to either go with a particular group who are using drugs and indulging
in other risky behaviours or even change their peer group. This
is more akin to peer-preference than peer pressure. Back
52
UKDPC, p 10. Back
53
UK drug situation report 2008. Back
54
Druglink; vol 24, issue 2, March/April 2009. Back
55
Home Office: http://www.homeoffice.gov.uk/rds/pdfs08/horr09.pdf Back
56
NTA: Annual report 2007 / 08 http://www.nta.nhs.uk/areas/facts_and_figures/0708/docs/ndtms_annual_report_2007_08_011008.pdf Back
57
NTA, ibid. Back
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