Home Affairs Committee - Drugs: Breaking the CycleWritten evidence submitted by Professor Jake Chapman, Demos Associate (DP136)

Executive Summary

The issues involved in drug policy are complex and not amenable to simple “solutions”. Current policy generates many unintended consequences, some of which could be avoided by a more nuanced system of regulation that recognises the differences between groups of users. The author has gathered evidence of drug experiences that have influenced professional people’s lives for the better; this negates the view that drug experiences are always either illusory or negative. One objective of drug policy is to protect vulnerable groups, including those prone to mental illness and young people. Recent research suggests that persistent addiction is strongly associated with mental illness which has implications for treatment. The young people most at risk to drugs are also at risk to other activities, such as sex, crime, and drinking. This group will be best helped by an integrated approach that addresses their risky behaviour. It is currently impossible to devise a drug policy to protect other young people since so little is known about their motivation and the factors that have produced past trends in drug use. Addressing the complexity of drug use is difficult but as a minimum requires different policies targeted at different user groups.

About the Author

1. I was trained as a physicist at Cambridge (1963–70), was appointed a lecturer at the Open University in 1970 and gained a personal chair in Energy and Systems in 1978. I moved to the Systems department in 1980 and since then have taught systems thinking to adults both at the OU and more recently in the Metropolitan Police Leadership Academy and on the National School of Government’s Top Management Programme (TMP). I retired from the University in 2001, worked in the Performance and Innovation Unit in the Cabinet Office for a year and gave technical advice to the Economic Development Committee in the Welsh Assembly. From 2006 to 2008 I served as an external member of the Metropolitan Police Modernisation Board.

2. Since 2002 I have been an Associate at the think tank Demos where I have published several pamphlets documenting how systems thinking can be applied to “wicked problems” in the public sector. For the last three years I have researched the application of systems ideas and procedures in the domain of drug policy. My last Demos publication, in 2011 in collaboration with the UKDPC, was Taking Drugs Seriously. This explored the issues associated with “legal highs” and used systems workshops to explore options for protecting young people and developing a more robust approach to the regulation of new compounds.

3. I am currently writing a book that applies systems thinking to drug policy, this will be published before the end of 2012. I am also writing a pamphlet, to be published by Demos before 10 March, summarising the key results for policy that have emerged from the research. The points made in this submission are explained in more detail, with supporting material and further references, in that pamphlet which will be made available to all members of the committee once published.

Complexity

4. The participants on TMP are largely senior civil servants and other public sector leaders, such as chief constables. I teach them systems thinking as a way of addressing complexity, and this is supported by a live challenge around a current complex problem. It is clear from this experience that people find it hard to face the uncertainty, ambiguity and different views of what is happening in complex situations; which is why it is included in the programme. The dominance of radio and TV reporting of issues has caused a focus on “sound bites”. As Andrew Marr has noted “what is lost is the lengthy building up of an argument which, boiled down, might seem nonsensical. And so fresh thinking is rarely heard. It can take time to marshal the facts, explain unfamiliar thoughts and lead the listener towards unexpected conclusions.”1 The most common ways of avoiding complexity are to presume simple causation of the issue (when in fact there are multiple interacting causes), to adopt an ideological position or to make use of stereotypes that evoke prejudices used in justifying a simplistic “solution”. However it is achieved, the consequences are, that a policy or intervention that ignores complexity will generate a plethora of unintended consequences. These arise because the simple causation or solutions presumed by the advocate do not match the reality of what is occurring in the real world.

I recommend that the committee be deeply sceptical of approaches that seek to avoid the complexity of drug issues, by for example proposing simple “catch-all solutions” such as legalisation or tougher enforcement.

Unintended Consequences

5. Misuse of Drugs Act 1971 (MDA) has not been significantly altered, even though the world in which it is applied has changed radically and become far more complex. As a result there are many unintended consequences, some obvious, others more subtle. The most obvious are:

Providing criminal organisations with a very large source of funds, both at international, national and local levels.

Making the illicit drugs available to users less pure and hence increasing the chances of overdose or other negative health outcomes.

Criminalising large numbers of young people.

The more subtle ones include:

Making it much harder to carry out research on drug use.

Bringing the law into disrepute.

Making young people suspicious of any “official” advice on drugs.

Making data on drug use and numbers of users inherently unreliable.

I recommend the Committee to give weight to unintended consequences in its recommendations.

Data Reliability

6. Virtually all the data on drug use and numbers of users is derived from self-reporting surveys, for example the British Crime Survey (BCS). It is known that this under-reports drug use since (a) people are generally unwilling to admit participating in illegal acts and (b) surveys do not include excluded groups who are known to have higher rates of drug use. Where checks have been made the level of under-reporting of drug use is often very high.2

Number of Users

7. Table 1 below3 indicates that by age 30 more than half of all adults in the UK will have tried illicit drugs. This is consistent with the view that drug use has largely become normalised and is one of the reasons for the growing belief that the “war on drugs” has failed.

Table 1

FIGURES FOR THE PROPORTION OF 16- TO 59-YEAR-OLDS REPORTING HAVING USED DRUGS IN THEIR LIFETIME BY AGE GROUP, 2005–06 BCS (ENGLAND AND WALES)

Age group

16–19
(%)

20–24
(%)

25–29
(%)

30–34
(%)

35–44
(%)

45–54
(%)

55–59
(%)

All ages

2009–10
All ages

Cannabis

35.1

44.4

46.7

40.1

28.5

18.8

11.1

29.8

30.6

Amphetamines

7.5

14.5

23.8

20.5

11.8

5.6

2.8

11.5

11.7

Any cocaine

6.5

14.5

15.2

10.4

6.4

2.4

1.1

7.3

8.8

Ecstasy

5.8

14.4

18.2

14.0

5.7

0.9

0.2

7.2

8.3

Opiates

0.4

1.1

1.9

1.2

0.9

0.5

0.3

0.9

0.9

Any drug

40.4

49.0

51.6

45.8

34.2

23.4

15.4

34.9

36.4

8. Drug experiences. It is widely presumed that whilst drug use may enhance fun and socialising, the experiences achieved under the influence of drugs are unreal, illusory and of no lasting value. Before widespread prohibition there were several research programmes that challenged this presumption.4 More recently a double blind trial using psilocybin5 has demonstrated that it fosters long-term openness in subjects. I have carried out a small scale investigation by asking professional colleagues to report any drug experiences that have, in their view, enhanced their lives. The sample I have used are all aged between 30 and 65, are successful and usually married: I am aware that this may be an atypical sample. They report significant improvements to their relationships, to their personal awareness and in some cases to solving difficult technical or business problems. Although the sample have experienced many different illicit drugs, the positive experiences they report arise from the use of cannabis, ecstasy, LSD, psilocybin and ayahuasca: there are no reports of positive outcomes from cocaine, amphetamines, heroin or other drugs.

I propose that this evidence counters the widely held view that drug use cannot contribute positively to users’ lives.

Drug Use and Morals

9. Prohibitionists assert that drug use is immoral and no matter what the cost it must be outlawed. This attitude is largely based on the presumption that all drug users are addicts and liable to irresponsible behaviour. Using laws to support contested moral arguments does not have a good history. The moral case against drug use is similar in tone to the attitudes toward homosexuality until the 1950–60s. Up to then homosexuals were regarded as immoral, suffering from a disease and that they should be criminalised. The process of changing those attitudes is still not complete, similarly changes in drug policy may also take time.

I recommend the committee be sceptical of the value of enforcing contested moral arguments using the law.

Drug Addiction

10. A recent study of drug use and addiction in the USA6 based on very large sample surveys (generally well in excess of 30,000) has come to a number of striking and important conclusions. It utilises the American Psychiatric Association definition of substance dependence to identify addiction. The key conclusions are:

More than 45% of the samples had used illicit drugs, only 5% of these became dependent users.

The percentage of users who became addicted to cannabis was about 2%, to cocaine about 6%, to heroin 20% and to alcohol 15%.

Most drug users and dependent behaviour is started between 18 and 25; by the time users are aged 30–44 70% have remitted, mostly without treatment.

The people who become stuck in addiction over long periods are generally those who also have a mental disorder.

Other studies have pointed out that people with, or liable to, mental illness are likely to use illicit drugs as a form of self-medication.7

Vulnerable Groups

11. Those with, or prone to, mental illness constitute one significant group likely to be harmed by drug use. The other group most at risk is young people, particularly those under 25 when their sense of self is fragile. The vast majority of the 50% of under 25s who have used drugs have done so with no ill effect whatsoever. Only a small fraction have problems, and most of these are at risk for other reasons: principally poverty and exclusion. In the workshop I ran concerned with protecting young people8 those present agreed that the group of young people most at risk would end up in trouble with either sex, or crime, or alcohol or drugs. These activities were not the prime causes; rather it was their low esteem, chaotic home-life and social environment that were more significant and these could be identified early in the child’s life. It was recognised that for this group the most helpful strategy was to enable them to make less risky decisions, including how to avoid harm with whatever they were experimenting.

I recommend the Committee considers an integrated approach to protecting these particularly vulnerable young people.

Protecting Young People

12. There is growing evidence that penalising drug use and users may not be the best way to protect young people.9 There is evidence that decriminalising cannabis use has no effect on the number of users, particularly from adjacent US and Australian states with very different policies.10 For the last decade there has been a steady decline in the use of drugs and alcohol by pupils in UK schools,11 however no one knows why.

Since a major aim of drug policy is to protect young people I recommend the committee asks relevant Departments to commission research to answer the following key questions:

Why did drug use among young people around the world, under very different jurisdictions, increase by 50% between 1992 and 1998?

What are the influences that deter half of young people from trying illicit drugs?

What are the factors that have cause the decline in young people’s use of drugs and alcohol over the last decade?

Why is it that the young people most likely to use drugs are those with the highest IQ?12

13. One size does not fit all: Part of the complexity of drug policy is that it seeks to deal with a spectrum of illicit drugs used by significantly different groups of users. I recommend the Committee consider promoting different policies for different drugs or/and groups of drug users. The policies suited to addressing opiate addicts are quite different from those that might reduce harm for clubbers. Similarly policies that might best protect vulnerable young people are likely to be different from those needed to reduce harm amongst professional drug users. Confronting the complexity of drug use and the variety of drug users will not be easy, but it is the only way that effective policies with minimum unintended consequences can be devised.

January 2011

1 My Trade by Andrew Marr, Macmillan, London, 2004 p 140.

2 The most dramatic result in the literature is a 52 fold under-reporting of cocaine use by US teenagers: see Just say “I don’t”: Lack of concordance between teen report and biological measures of drug use by V Delaney-Black et al. Pediatrics. 126 (5) 2010 887–93.

3 Taken from An Analysis of UK Drug Policy by P. Reuter and A. Stevens, UKDPC 2007 p.20. The data for 2009–11 from Home Office statistical summary of 2010 BCS; this data does not include breakdown by age.

4 For example the work of Grof associated with psychoanalysis: see Realms of the Human Unconscious by S Grof, Viking Press 1975: see also the work with ecstasy based therapy described by Shulgin in Pihkal, Transform Press, 1991.

5 Mystical experiences occasioned by the hallucinogen psilocybin lead to increase in the personality domain of openness by MacLean, K et al J Psychopharmacology 2011: see also: Mystical-type experiences occasioned by psilocybin mediate the attribution of personal meaning and spiritual significance 14 months later by Griffiths R R et al J Psychopharmacology 2008.

6 Addiction a disorder of choice by G M Heyman, Harvard University Press, 2009.

7 See for example Self medication of mental health problems: new evidence from a national survey by Harris K M and Edlund M J Health Services Research (2005) 40 p 117–134.

8 This is reported in Taking Drugs Seriously by J Birdwell, J Chapman and N Singleton. Demos and UKDPC 2011.

9 For a comprehensive review see Children of the Drug War ed D Barrett, Idebate Press, New York 2011.

10 See the review in Drug war Heresies by R MacCoun and P Reuter, Cambridge University Press, 2001 (11th printing 2009) p 358–366.

11 See Smoking, drinking and drug use among young people in England 2010 Ed E Fuller. Publ. NHS Information Centre for Health and Social Care. London 201???

12 From an article in Time magazine reporting a study carried out on 7900 British people born in early April 1970. See http://healthland.time.com/2011/11/15/why-kids-with-high-iq-are-more-likely-to-take-drugs/

Prepared 8th December 2012