Examination of Witnesses (Questions 160
- 166)
TUESDAY 20 OCTOBER 2009
MR STEVE
ROLLES AND
PROFESSOR NEIL
MCKEGANEY
Q160 Tom Brake: Professor you said
that you were worried that if the government got into regulating
the cocaine trade, for instance, that you would see illegal suppliers
coming in and undercutting the government supply or the official
supply. Would you expect that to have happened in relation to
other products such as alcohol that the government does regulate,
because as far as I am aware there is not, and is it because the
profit is not as large? What is the answer?
Professor McKeganey: I would slightly
differ. I think that there is an enormous counterfeit market in
relation to tobacco, for example. I think that you find precisely
there a good example of what I fear. You have cigarettes being
sold legally and you have an enormous counterfeit cigarette market.
Q161 Tom Brake: But not in relation
to alcohol?
Professor McKeganey: No, I think
in relation to alcohol it is not evident.
Q162 Mr Clappison: Just a very general
question and very briefly on the point that you make about drug
barons—and we all want to tackle the problems that they
cause—how effective do you think we are in stamping down
on drug barons and tackling them through the criminal justice
agencies?
Professor McKeganey: I do not
think that we succeed to anywhere near the degree that we need
to. I will use a Scottish example but I suspect it has relevance
here too. My colleagues and I recently calculated the total amount
of heroin seized in Scotland in a year represents less than 1%
of the heroin that is consumed. In relation to cocaine, calculations
that we have carried out suggest that that figure may be higher
but less than 10%. So we are, I think, failing to tackle this
problem as successfully as we need to. I think that it presents
enormous difficulties how one accumulates the necessary evidence
of criminality on the part of individuals who sit many layers
removed from the act of producing, transporting and selling drugs.
I think that presents us with an enormous conundrum as to how
one does that and there are a small number of individuals who
sit with a degree of immunity, I believe, because we seek to accumulate
the necessary evidence of their criminality, and they are extremely
adept at maintaining a considerable distance from any overt criminality;
and yet they orchestrate a trade which I think presents a threat
greater than almost any other that we face in our society.
Mr Rolles: I think that history
shows with crystal clarity that an enforcement response cannot
get rid of the illicit drug trade. It has not happened here; it
has not happened anywhere; it has not happened anywhere ever.
It is clearly impossible, not because of a failure of enforcement,
not because it is not being implemented and not being done right,
but it is a fundamental reality of the economic dynamics of unregulated
illegal markets where demand is huge; and, as I have said, the
opportunity is created and criminal entrepreneurs will always
exploit that opportunity. And if you catch one all you do is create
an opportunity for another one, and we demonstrate that again
and again at all scales. Every dealer or trafficker you arrest
another one immediately fills the void. There is nothing we can
do about it; the only way to put these people out of business
is to take control of the market back within the ambit of the
law and control it by the state. You cannot police your way out
of this problem and 100 years of history shows that with absolute
clarity.
Q163 Mr Clappison: Can I ask Professor
McKeganey, from your research with recovered and recovering addicts
what do you consider to be the most effective ways of treating
dependent drug use? In particular, do you know of any prescribed
medication options to aid recovery from non-opiate drugs?
Professor McKeganey: Prescribing
alternatives to opiates, principally methadone, has become the
default medical treatment for heroin addiction in the UK; so we
have well over 100,000 addicts now on methadone. When we have
looked to find what proportion of those individuals had become
drug free, had recovered from their drug dependency and ceased
to use illegal drugs the percentage becomes miniscule—around
about 3%. When we look at the experience of those addicts who
have had residential rehabilitation—participation in a drug-free
programme for a number of months—the proportion who attain
a drug-free status rises to nearly 30%. So I do not feel that
we can easily prescribe our way out of drug dependency. Prescribing
runs a very real risk in the circumstances with this client group
of accentuating their dependency. The evidence as far as I understand
it is that, nevertheless, where they participate in a drug-free
programme and they are committed themselves to becoming drug-free,
that is the most beneficial combination of factors. Prescribing
methadone very, very rarely allows them to become drug-free.
Q164 Chairman: The final two questions
from me. First of all, the effectiveness of the Government's advertising
campaign with Pablo the dog; how effective do you think the preventative
work is that the Government is doing? Does this advertising campaign
make any difference to young people in particular taking up drugs
like cocaine? Mr Rolles?
Mr Rolles: One of the problems
with questions like that is that it is very difficult to effectively
evaluate these things. It is easy to get process measures; you
can say how many people viewed it or how many people clicked on
a website and so on, but it is very difficult to do a controlled
trial or somehow track whether there has been an impact on levels
of use, specifically on levels of problematic use. The evidence
would seem to suggest that these things are not particularly effective
or are not effective at all. Public health education certainly
can be effective when it is done properly but I think often with
mass media government campaigns they are much more about being
seen to do something rather than following best practice in education
and prevention. One of the problems historically, not just with
education but with the drug policy more generally, is that it
is driven by this very emotive, often tabloid fuelled law and
order populist agenda and it is not driven by objective rational
assessment of what the best evidence is.
Professor McKeganey: We would
not have one of the highest levels of illegal drug use amongst
young people anywhere in Europe if our drug prevention methods
were successful. I think it is a record largely of failure. We
have had policy which is misguided drug prevention for many years
and it does not have the standing within the curriculum that I
believe it needs to have if we are to substantially reduce the
levels of drug use amongst young people in the UK.
Q165 Chairman: What about the celebrity
drugs culture; does this have an effect on young people taking
it up?
Professor McKeganey: I think that
is an unfortunate but nevertheless perhaps predictable occurrence.
It certainly does not help matters. However, I do not think it
has a substantial influence on the choices young people make in
relation to illegal drugs. I think a greater impact is the somewhat
pro-drug culture which has penetrated much of our thinking on
this issue. I think that that actually has unfortunately furthered
a culture of acceptability around illegal drugs, of which the
celebrity instances are just a manifestation of those.
Mr Rolles: I think the celebrity
thing—as the speaker from Drugscope said—is a red
herring; I think it reflects politicians' concerns with tabloid
obsessions more than anything. There are an awful lot of very
important issues to do with civil wars in Columbia and the criminal
trade and the drug barons. What Amy Winehouse does at the weekends
is entirely irrelevant and I think we need to move on and not
get bogged down with all that. I suppose my overriding comment
is that before I came here I had a look back at the 2002 report,
which covered an awful lot of this ground and an awful lot of
detail and I do hope that this inquiry report builds on some of
that groundbreaking work and does not default back to some of
that tabloid law and order populist drug war grandstanding rhetoric,
which has had the unfortunate consequence of leading us to the
appalling situation we are with drug policy today. So let us move
forward and not look backwards.
Q166 Chairman: Thank you very much
for your recommendation, Mr Rolles.
Mr Rolles: There is more in my
written submission.
Chairman: Professor McKeganey and Mr
Rolles, thank you very much for your evidence today. If there
is anything further that you wish to put to the Committee that
you have not been able to get across to us today, please do not
hesitate to write to us. We are closing the inquiry in December
of this year, so we will be very glad to receive any further thoughts.
Thank you very much.
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