Examination of Witnesses (Questions 204
- 219)
TUESDAY 20 OCTOBER 2009
JOHN MANN
MP, DR EVAN
HARRIS MP AND
LORD MANCROFT
Q204 Chairman: Thank you very much
for coming. I will not explain the format of select committees;
I am sure you are very familiar with them, to all three colleagues.
Each one of you is here because you are regarded as being an expert
on drugs policies as far as the political parties that you represent
are concerned, and what we will try and do is direct the questions
to all of you, and in some cases specifically if anyone would
like to chip in they are more than welcome to do so. Can I ask
each one of you, starting with you, Dr Harris, what you think
the focus of public policy should be as far as cocaine use is
concerned?
Dr Harris: Thank you for having
me here, firstly. I think that the key thing for public policy
makers is to consider evidence-based policy. We have an opportunity,
particularly in the scrutiny function that you perform, to look
at what works, as the slogan goes, and to identify good quality
research that gives an indication of what might be the best way
forward. Part of that I think is recognising what does not work
and I think that, whatever side of the argument you come from
on drug policy, it is very hard to find many independent people
who would argue that the current approach is working. The thing
that is desperately needed, as has been said by David Nutt who
chairs the ACMD, is space in politics and in the media to have
an open and honest debate about all possibilities—you have
that, obviously, in the select committee structure in a well-constructed
inquiry—and not to have the crowding out by insult and headline
of those people arguing that there may be and is likely to be
a better way. The second thing I would argue is that we should
be calling at every opportunity for more good quality research
funded by the Government because the potential savings from finding
successful effective policy would reward hundreds of times over
the investment in research, and we lack that because sometimes
we do not want to know the answer that we think that might provide.
Q205 Chairman: Thank you. John Mann?
John Mann: I have brought you
a pamphlet which outlines what I think should happen with drugs
policy specifically on cocaine. Number one, you should recognise
that drugs are different and how cocaine is dealt with should
be totally different from how other drugs such as heroin are dealt
with. There is no crossover in similarity in how they should be
dealt with. Secondly, you should rely on the evidence base. There
is no evidence anywhere in the world on successful treatment of
cocaine addiction. Indeed, questions of whether it is addictive
or not are up for grabs in terms of the literature. Thirdly, where
there is a clear evidence base is that cocaine is price sensitive
and it is more price sensitive than other illicit drugs, and therefore
the concentration of British policy making should be to disrupt
the supply and force up the price of cocaine, which will do two
things: one is that there will be less use and, secondly, there
will be less motive and reason to turn cocaine into crack, which
itself is far more dangerous health-wise and criminality-wise.
Q206 Chairman: Lord Mancroft?
Lord Mancroft: Thank you, Chairman,
and thank you for inviting me. I think I should say to start with
that I hope you have not just invited me as a Tory because I do
not think that my party always agree with everything I say on
this rather complex subject. I agree very much with much of what
Dr Harris said. I am afraid I do not agree with Mr Mann says.
There are differences between the drugs but fundamentally if you
are addicted you are addicted. I know a lot of people who have
been addicted to cocaine who have recovered from it and continue
to recover from it. Treatment is not a mystery in this day and
age. Treatment works really well and it works all over the world.
It used not to work very well here but it is increasingly doing
so and there are a lot of treatment facilities. You asked the
previous people who gave evidence for names. I can give you a
long list of treatment facilities providing really first-class
treatment across the board for all drugs. We live now in the age
of poly-addicts, not people who are heroin addicts or alcoholics
or cocaine addicts or marijuana addicts but people who jump from
one drug to another. They usually have a favourite. Most cocaine
addicts, because cocaine is an upper, take a downer such as heroin
or those sorts of drugs to come down on. Addicts swap drugs, and
it is not the drug you treat; it is the addict. We are quite capable
of doing that in Britain. We have been doing it very badly because
the Government's rolling treatment has been wrong. This takes
me back to the central tenet of your question, which is, what
should policy be doing? For the last 30 or 40 years in this country
policy has been focused on the criminal justice system, on the
crime side of drugs, and it should not be. The problem with drugs
is a health problem. You do not solve health and social problems
using the criminal justice system. We currently stick about £12
billion, I believe, into the criminal justice system and have
done for many years. It has shown no results, as Dr Harris said.
There is no evidence that current policies work anywhere in the
world, whereas again and again you can demonstrate that health
policies do work.
Q207 Mr Winnick: Mr Mann, you seem
to be the defender of the status quo. Do you take the view that
prohibition has been a successful policy?
John Mann: Prohibition is the
only option with cocaine. If you provide unlimited cocaine to
people using cocaine they will use more, and with crack cocaine
demonstrably so, and so prohibition will not work.
Q208 Mr Winnick: Sorry—will
work?
John Mann: Prohibition does work.
Q209 Mr Winnick: You are in favour
of prohibition?
John Mann: I am in favour of using
criminal sanctions to try and disrupt the supply as much as possible
with all drugs. It is particularly important in relation to cocaine.
Q210 Mr Winnick: But what evidence
is there, Mr Mann, that such a policy of prohibition, which has
been the position all of the time of successive governments, does
anything to reduce the use of cocaine and at the same time is
it not the position that the drug barons are making a very nice
profit indeed?
John Mann: Lots of people are
making a profit.
Q211 Mr Winnick: Making a profit
from criminality.
John Mann: Or making a profit
from selling a product as well, a combination. If you look at
those countries where there is pretty much free use of cocaine
across South America, the problems of cocaine use and violence
related to excessive cocaine use far outweigh what we have here.
Brazil is a good example of a country that demonstrates that if
there is too much cocaine being used there will be too much violence.
Q212 Mr Winnick: So what you are
saying to us, Mr Mann, and you will correct me if I have misinterpreted
your position, is that the present policy on prohibition, which,
as I say, has been that of successive governments, should continue?
John Mann: It should continue,
and indeed the small successes there have been, such as Operation
Airbridge and Operation Westbridge, which are UK Government operations,
I would recommend that you go and look at because they have been
tremendously under-funded.
Q213 Mr Winnick: And if the drug
barons, Mr Mann, had a vote in Parliament, which way do you think
they would vote? For prohibition or for an alternative policy?
John Mann: There are drug barons
in many parliaments from my experience and they will vote in different
ways depending on the situation. Whether they are running a legal
monopoly or whether they are running a drug cartel, the profitability
will be the same if you have got something that people will take
in increasing amounts if it is readily available.
Q214 Tom Brake: Mr Mann, I just want
to come back on something you said in relation to South America.
You were saying that there are big problems there. When we went
to Spain there seemed to be all-party agreement from the Spanish
politicians that we met that the fact that they do not use the
criminal law to prosecute people for personal possession had not
led to great problems. In fact, it had probably helped them focus
on dealing with the drug dealers. What do you think about that?
John Mann: It is an entirely separate
issue and that in essence has been the policing policy for most
of the last 30 years in this country by default. That is entirely
different from trying to disrupt supply. You have a drug here
in cocaine where the more it is available the cheaper it becomes;
the cheaper it becomes the more people use it. It is the disruption
of supply and large quantities of supply which should be the emphasis
of public policy, not dealing with millions of occasional users.
Q215 Tom Brake: Just to follow up
that point, I thought that you had earlier hinted at the fact
that you thought that some people were suggesting that cocaine
was not addictive, so if the price becomes cheaper then surely
it does not make any difference if it is not addictive, which
is something you hinted at in your earlier remarks.
John Mann: The medical evidence,
and I would recommend you go and read the medical evidence; there
is vast amounts of it, would suggest that addiction and links
to cocaine are not proven. What is proven is that the more available
it is the more it is used.
Q216 Tom Brake: Could I ask the other
witnesses, Dr Harris and then Lord Mancroft, whether they agree
that cocaine may not be addictive?
Dr Harris: Firstly, we have had
illustrated some of the pitfalls of public policy makers. I did
not come here to argue with John Mann. I have huge respect for
the amount of time and effort he has put into this policy focus
that he has, including in his own constituency, but statements
like, "There is no evidence anywhere in the world" can
never be right. There is always evidence and what policy makers
need to do is seek for there to be an independent review of that
evidence to sift out what are high quality research studies, what
are poor research studies, what are statistically random findings
and what has become the accepted consensus which scientists and
researchers are always seeking to challenge. I would urge people
to avoid anyone saying, "There is no evidence to suggest",
or, "All the evidence says", because this is a complex
area. That does not mean it is hopeless because there are clear
conclusions to be drawn from the evidence base and it is very
important that you identify the people best placed to provide
that, and three individuals with a particular interest who are
full-time something else are not the people I would urge you to
rely on, even if it is a point against myself, for summarising
the evidence base. I think it is important to note in respect
of what you just asked that there are different types of addiction.
There is physical addiction that is recognised and psychological
addiction—if you are always in one place you generally will
not have fun, you feel, unless you do what the other people are
doing or do that drug, and that is why, in the range of cocaine
users, there are some people who are occasional users, there are
some people who are experimental users, and it makes absolutely
no sense in my view to criminalise them, and then there are problematic
users, some of whom are very regular users who resort to crime
to fund their addiction, but you can call it a habit, something
they do on a regular basis. It is a habit. That is good enough
for me to recognise that that is a problem. I think it is a false
avenue to be drawn down, getting into an argument about the exact
nature of the dependency, and that is what addiction means in
clinical terms. On the question of prices, logically, if you restrict
supply you will increase the price, but you will also restrict
the suppliers in the market to those—you essentially create
a more violent market and there is good evidence for that, and
people who are then facing greater criminal sanction may well
go for a faster buck, and that is, I understand, how crack cocaine
evolved, because you could shift stuff far more effectively in
a way that led you to people who were far more likely to come
back to you for the next fix. You heard from Mr Winehouse. Although
he said he is not advocating decriminalisation of use, everything
he said, from his knowledge of what was happening in Switzerland
and Portugal, suggested that that is something that very much
ought to be looked at because it still allows you to take a prohibition-based
approach against the real villains who are the people who are
peddling the stuff and destroying lives through trying to get
people hooked rather than picking on the people who actually need
treatment.
Q217 Mr Clappison: Could you tell
us a little bit, and I appreciate you are a doctor as well as
an MP, about how you see cocaine use affecting individuals' health?
Can you spell it out for us, particularly those of us who are
not au fait with this whole subject?
Dr Harris: I am not that keen
to do that because the last time I practised medicine was some
time ago and I spend my time arguing against people claiming expertise
in areas where they do not have it, where there are better people
who could do that, and I hope that you will have had at least
written submissions or you can get experts, and I believe you
had in your previous session someone who was both active in the
field and medically qualified. However, do not be intimidated
by the medical side of things because I know people who take cocaine
who hold down a good job and progress in their job, and I do not
recognise the picture for those occasional and social users as
people who are heading down. There are people who do find their
use so problematic that it interferes with their family life and
their career but it is important, I think, to recognise that different
people deal with these things in different ways, the same for
many addictions, actually, and generalisations are dangerous.
Q218 Mr Clappison: What about crack
cocaine and powder cocaine? Have you any comments on those? Is
there a difference between them?
Dr Harris: Clearly there is a
difference.
Q219 Mr Clappison: In the health
effects?
Dr Harris: Yes, clearly there
is in terms of health effects, but, again, it will vary according
to the dose, the frequency. People who are likely to be dependent
are likely to have a pre-disposition to dependency. That is a
factor as well. It is a complex area. All that leads you towards
recognising that you need to have a person-based approach, which
is not well delivered by a criminal justice system that says there
is a minimum sentence for this sort of thing but is delivered
by a well-resourced health service that can provide to a patient,
not a criminal, the treatment that they need. I just want to reinforce
the point that was made by Mr Winehouse, I think, that the amount
of acquisitive crime, even in cocaine use, regular cocaine use,
problematic cocaine use, dwarfs the amount of money it would take
to provide people with alternatives, either proper therapy or
even maintenance. That has been shown very clearly now, increasingly
clearly, in properly conducted trials of heroin maintenance treatment
where simply taking them out of their chaotic, criminal lifestyle
saves money, even if it had no impact on their future addiction,
even if it was not successful in getting them off, it would save
society huge amounts of crime, huge amounts of heartache, save
families that problem, and also save money, and I do not diminish
money; it is very important. It would be a real spend-to-save
policy to do that. Some countries around the world are pioneering
this and I do not think we should be anything other than very
keen to look at this ourselves.
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