Home Affairs Committee - Drugs: Breaking the CycleWritten evidence submitted by The Beckley Foundation (DP142)

The Beckley Foundation was instituted in 1998 with the aim of making drug policies more effective by promoting evidence-based, health-oriented, harm reducing cost-effective policies that respect human rights. It promotes objective and open debate on drug policies at national and international levels. It is a UK-based drug-policy think-tank with ECOSOC special consultative status at the United Nations. It has commissioned over 35 drug-policy books, reports, briefing papers and proceedings documents, and organised nine international drug-policy seminars, mainly held at the House of Lords. In 2006 it convened the Global Cannabis Commission Report, later co-published with Oxford University Press as Cannabis Policy: Moving Beyond Stalemate, which for the first time gave an overview of global cannabis policies, and put forward recommendations for reform.

The Beckley Foundation warmly welcomes the Select Committee’s inquiry into drug policy and its invitation to present submissions. Improving drug policy is one of the key policy challenges of our time. The Beckley Foundation’s submission argues:

that scientific evidence is essential in constructing rational and effective drug policies;

that drug policies should be aimed at reducing the harms caused not only by drugs themselves but also by the policies controlling them;

that evidence shows that about 10% of drug-users become “problematic users”, usually arising from dependence on addictive compounds (cocaine, heroin, amphetamines). This group causes great harms and costs to both themselves and society; however, 90% of users of controlled drugs do not cause themselves or society significant harms;

that drug policy should clearly distinguish between different substances and different patterns of use;

that the classification of drugs should accurately reflect the scientific evidence of the harms and benefits of different drugs. This is important not only for informing policy but also for education;

that drug policies should not focus scarce resources on the 90% of “harmless” users, and should instead focus attention and resources on treatment and rehabilitation of the 10% of “problem” users;

that drug dependency should be treated as a health and social problem, not a criminal one;

that the decriminalisation of the use and possession of small quantities of drugs for personal use does not increase prevalence, and has multiple beneficial effects—this (ie, decriminalisation) is the single most important step the government could now take to make its drug policies more effective, both in minimising harms and saving money;

that new policies should be developed to control the growing phenomenon of so-called “legal highs”, largely manufactured abroad and distributed through the internet;

that an all-party debate on the costs and benefits of a legal, regulated market for cannabis (and possibly other drugs) should be initiated;1

that in order to allow experimentation with a legal, regulated market for cannabis or other drugs, the 1961 UN Single Convention on Narcotic Drugs (and the UN Conventions of 1971 and 1988) will need to be amended to allow individual countries greater freedom to develop internal policies tailored to their individual needs; and2

that scientific research should be encouraged into the underlying properties of controlled substances, in order to both inform policy and to investigate possible health benefits arising from their medical use.

1. Scientific Evidence

A major factor in the failure of global and national drug policy over the last 50 years has been that these policies have too often been driven by ideological and emotional imperatives rather than by the rational, scientific assessment of the practical consequences of any given policy. Political decisions have generally been taken with a view to avoiding media criticism. There has therefore been an absence of careful analysis of these complex problems and an unwillingness to consider alternative approaches. It has become clear that we cannot, as originally hoped, eradicate drug markets and drug use, so we must instead find ways of minimising the harms they cause to the health, security and welfare of citizens. In the last 15 years, a growing body of evidence has accumulated indicating the benefits and harms of different policy options. Governments should seek to base their policies on this scientific evidence. In the past, the success of policies has been judged by the size of drug seizures and the numbers of those arrested. Policies should instead be judged by their outcomes, in terms of the improved health, security and social well-being of citizens. It is time to openly debate and analyse alternative approaches.

2. The Aim of Drug Policies

The stated aim of the United Nations’ global drug policies pursued since 1961 has been “to protect the health of welfare of citizens by eradicating drug production, trafficking and use”.

These policies have failed in their principal objective (as drugs are more available than ever before), and have generated unintended and devastating consequences worldwide. In many respects, enforcement of the drug policies has caused more harm than the drugs themselves. The failure of the prohibitionist approach has become yearly more apparent, and evidence from countries such as Portugal and the Czech Republic indicates that a health-oriented approach can be more effective.

3. Percentages of Unproblematic versus Problematic Users

In England and Wales, 20% of 16- to 25-year-olds, and 8.6% of those aged 16 to 59 (or 2.8 million people), were using illicit substances in 2009–10.3 The total number of deaths related to drug misuse in England and Wales was 1,738 in 2008 (Heroin/Morphine, 10%; Methadone, 10%, Cocaine, 30%).4 In comparison, in 2008 in England alone, there were 6,769 deaths directly related to alcohol (an increase of 24% from 2001). Of these alcohol related deaths, the majority (4,400) died from alcoholic liver disease.5 On the other hand, in England alone, in 2009 an estimated 81,400 deaths of adults aged 35 and over were attributable to smoking. This accounts for 18% of all deaths in this age group.6

As already mentioned, approximately 10% of drug-users do significant harm to themselves and to society, falling into addiction,7 with its negative impacts on their health, prosperity and social relationships, or committing crime to finance their habit and ending up in prison. However, the overwhelming majority of drug-users cause little harm to themselves or to society. It is questionable whether the considerable resources applied to the attempt to criminalise their drug-use generate any benefit to society. It has been shown that enforcement policy on possession or use of drugs, whether draconian or liberal, has almost no effect on prevalence of use, and is therefore a waste of public money and effort.8

4. Problem-use Needs to be Treated as a Health and Social Issue, not a Criminal One

Criminalising drug users makes it much more difficult for problem users to access health-care and treatment from the authorities. Some countries, notably Portugal and Switzerland, have experimented with new approaches, which significantly reduce these harms.

Effectively in 2001, the Portuguese government decriminalised all drug use, including the so-called “dangerous drugs” like heroin, methamphetamine and crack cocaine. According to the Institute of Drug and Drug Dependence of Portugal, the number of people arrested for criminal offences related to drugs plummeted from 14,000 (in 2001) to an average of 5,000–5,500 per year (2011), and medical and social assistance is readily available to people with drug dependency.

Portugal’s health-oriented approach has also led to significant reductions in drug harms including HIV transmission and drug-related deaths from overdose, as well as significant reductions in the amount of police and criminal justice system time spent dealing with drug users.

The UK government should consider whether such policies would not be of benefit to problematic users and to society in this country.

5. Differentiation and Classification

The 1971 Misuse of Drugs Act classification of illegal substances has evolved in an unsystematic way, in response to social, political and historical factors, rather than being based on scientific evidence. The Beckley Foundation strongly supports the adoption of a rational, scientific scale of harm for classification of illegal drugs, as recommended by the House of Commons Home Affairs Select Committee Report of 2006. At the 2003 Beckley Foundation Seminar, Prof. Colin Blakemore presented a paper entitled A Scientific Based Scale for all Social Drugs. This was expanded by Prof David Nutt et al’s paper in The Lancet in 2007.

The current classification system is misleading to the young, as the categories in no way reflect their personal experiences. We would recommend a new investigation by an expert committee of how potential harms should be taken into account in classifying psychoactive substances for different degrees of availability or prohibition.

6. Decriminalisation of Personal Possession for All Drugs

Various national and sub-national jurisdictions have experimented with decriminalising the possession of some or all controlled drugs. The widespread concern that this would lead to a dramatic increase in prevalence of drug use and associated harms has proved to be unfounded. Evidence from Portugal indicates that drug use amongst adults has risen no more than in comparable countries such as Italy and Spain over the same period.9 More significantly, usage amongst the more vulnerable 13–18 year old age group has declined for almost all drugs since decriminalisation, including cocaine and heroin, which stands in contrast to rises in drug use in this age group in comparable European countries. Indeed, thanks to their emphasis on education, treatment and harm-reduction services, Portugal now has one of the lowest drug use rates amongst young people in Europe. Improved health and criminal justice outcomes that have been observed in Portugal have also taken place in the Czech Republic, following decriminalisation.10 In the Netherlands, where cannabis use has been de-facto decriminalised for 30 years, heroin use is considered by the youth to be an affliction of old men, and crime rates associated with drugs have dropped dramatically.

With specific regard to cannabis, research from Australia found no significant difference in the rate of change in cannabis use between states that have decriminalised cannabis possession compared with those that have not.11 Further research from Australia did however show significantly more positive outcomes in terms of adverse employment consequences, further contact with the criminal justice system, relationship problems, and accommodation difficulties for those treated for a cannabis offence under South Australia’s decriminalised enforcement regime, compared with Western Australia’s then criminal one.12 Of further interest in terms of police-community relations is evidence that cannabis users arrested and convicted for the first time in Western Australia were more likely to report negative attitudes to police and the justice system than their South Australian counterparts who received an infringement notice.

Decriminalising possession of drugs for personal use in the UK would, therefore, save considerable police and court time. It would also greatly reduce the number of young people, particularly those from impoverished and minority ethnic backgrounds, whose life chances are adversely affected due to a drug possession conviction; and it would reduce the harm experienced by problematic drug users by facilitating their access to treatment. Adoption of this policy would be one of the most effective steps which the UK government could take to diminish the harms arising from the use of illicit drugs and the present drug control regime, and the Beckley Foundation urges that it be given urgent consideration.

7. The Problem of New “Legal Highs”

The emergence of novel psychoactive substances poses a considerable challenge to drug control strategies everywhere. These new “legal highs” with increasing frequency bypass any poisonous substance or medicines regulations by being marketed as “non-consumable products”. These substances are often of unknown potency and toxicity. They tend to be analogues of other banned substances and on occasion are prohibited substances such as mephedrone, repackaged as a different product. The Demos/UK DPC report, Taking Drugs Seriously (2011), found that the Misuse of Drugs Act is currently unable to keep up with this phenomenon.

An approach that has been proposed by the ACMD in the past is the inclusion of a Class D special holding category, such as the one in New Zealand, whereby drugs are temporarily placed under Class D before they are fully understood. The availability of drugs within this category is restricted to over-18s, the products are quality-controlled and doses are limited to as safe a range as possible. In addition, education messaging is available alongside the product at the point of sale. The Beckley Foundation is supportive of these measures and proposes that the burden of proof –testing toxicity, potency and dose, should fall on the manufacturers; thereby, consumers would be protected in the event of a negative reaction to the substance. This would allow greater control of new substances and improve the ability of medical professionals to rapidly treat those suffering a drug-induced medical emergency. Such a policy would ensure greater accountability for vendors and protect consumers without criminalising them.

8. Open Debate on a Legal, Regulated Market for Cannabis

Evidence shows that cannabis use/misuse causes low to moderate harms. It also dominates the drug market, constituting approximately 80% of illegal drug production, sales, use and arrest. It is the drug most commonly used by the youth. The most common pattern of use is that consumption diminishes or ceases around the age of 30. Partly as a result of criminalisation, most cannabis consumed in Britain is grown under lights in the Home counties (Britain is a net exporter of cannabis), and has been genetically selected to increase the level of THC (the psychoactive component), and to decrease the level of CBD (the anti-anxiolytic component). Were government to regulate cannabis production and distribution by license, it could control and label the contents, prohibit sales to minors, ban advertising, tax, educate, provide more treatment and almost eliminate the illegal market.

The money saved by a policy of regulation would free public resources for better education and treatment where needed. Since there is a substantial margin between the cost of production and the sale-price of cannabis, and since it is undesirable that the sale-price drop much below its present level, there is a good argument for a substantial taxation of cannabis in a regulated market. Estimates of the benefit to the Exchequer of a regulated cannabis market will shortly be available in a report commissioned by the Beckley Foundation. These estimates will include all foreseeable costs, including those associated with informing the public about the harms of cannabis use and any change in demand for medical treatment amongst cannabis users.13

Since illegal drugs are the third most valuable commodity in the world, and cannabis constitutes over two thirds of that value, it is arguable that this revenue would be better in the hands of governments rather than of criminals. In a period when the UK government is desperate for revenue, taxing cannabis would offer a double return to the government, both in terms of revenue and in terms of public health.

The Beckley Foundation would like to suggest that the UK government seriously consider taking the lead in global policy by promoting debate, and possibly initiating an experiment with “strict regulation” of cannabis, which would be carefully monitored and fine-tuned to develop an effective system in which the public could have confidence. Should it be shown not to work, the experiment can be readily reversed. However, the current system is in effect totally unregulated, which gives no protection to the youth. It is also a powerful engine of crime (most inner-city gangs’ main source of funding comes from dealing in cannabis).

It should be remembered that the 2002 Home Affairs Select Committee Report recommended that “the Government initiate a discussion within the Commission on Narcotic Drugs of alternative ways—including the possibility of legalisation and regulation—to tackle the global drugs dilemma”.

9. Amendments to the UN Drug Conventions to allow for a) Clear Decriminalisation, and b) Regulation

Almost all countries are parties to the international drug control conventions of 1961, 1971 and 1988. These strongly bind parties with respect to their domestic regulation of controlled substances, requiring that possession, growing or use be a criminal offense, and that legal regulated markets in the substances be limited to use only for medical or scientific purposes.

This prohibitionist system was devised half a century ago. Our knowledge of the realities of drug use, drug trafficking and drug control has since then greatly expanded. The conventions form a barrier to national and sub-national experimentation with other approaches to control, such as clear decriminalisation of use, or the regulation of a substance, such as cannabis. The UK government could play a leading role in urging reform of the UN drug conventions to allow countries to experiment with legalising possession and use, and with a regulated domestic market for cannabis or other drugs, without dismantling control of international trade in drugs. Professor Robin Room has led the preparation of a draft for the Beckley Foundation, Rewriting the UN Drug Conventions, which suggests detailed revisions in the treaties to accomplish this. An alternative approach which the UK should consider is to act to make such experimentation possible for itself by withdrawing from the treaties and reacceding with reservations which would allow such new approaches.

10. Need for more Scientific Research

The Beckley Foundation strongly recommends that scientific research should be encouraged into the underlying properties of controlled substances, using the most advanced brain-imaging technologies, in order to inform policy. For example, a better understanding of how THC and CBD (two of the principal components of cannabis) work in the brain, would permit more effective control of the content of cannabis in a regulated cannabis market, thereby minimising the harms arising from the use of the current unregulated illegal product. Through scientific research we can also learn more about any medicinal benefits these illicit substances may hold.

January 2012

1 The Beckley Foundation has commissioned a report by Prof. Steven Pudney, Licensing and regulation of the cannabis market in England and Wales: Towards a cost-benefit analysis. Forthcoming.

2 The Beckley Foundation has commissioned a report by Prof. Robin Room: Rewriting the UN Drug Conventions. Forthcoming.

3 NHS survey, 2011 www.guardian.co.uk/society/2011/jan/27/illegal-drug-use-decline

4 NHS, Statistics on Drug Misuse, England – 2010 Report www.ic.nhs.uk/pubs/drugmisuse10

5 NHS, Statistics on Alcohol, 2010 www.ic.nhs.uk/pubs/alcohol10

6 NHS, Statistics on Tobacco, 2010 www.ic.nhs.uk/pubs/smoking10

7 See UK Focal Point on Drugs’ 2011 Report. They estimate that there were 397,346 problem drug users in the UK in 2010.

8 Robin Room, Benedikt Fischer, Wayne Hall, Simon Lenton and Peter Reuter, The Beckley Foundation Global Cannabis Commission Report, co-published with OUP as Cannabis Policy: Moving Beyond Stalemate.

9 Caitlin Elizabeth Hughes and Alex Stevens (2010), What can we learn from the Portuguese Decriminalisation of Illicit Drugs? Brit J Criminol. 50, 999–1022, Advance Access publication 21 July 2010.

10 Pavel Bem, Former Czech Drug Policy Coordinator, presentation to the Beckley Foundation Conference on Drug Policy Reform, House of Lords, 17 November 2011.

11 Donnelly, N, Hall, W & Christie, P (2000). The effects of the Cannabis Expiation Notice scheme on levels and patterns of cannabis use in South Australia: evidence from National Drug Strategy Household Surveys 1985-95. Drug and Alcohol Review, 19(3): 265–269.

12 Lenton, S & Heale, P (2000a). Arrest, court and social impacts of conviction for a minor cannabis offence under strict prohibition. Contemporary Drug Problems, 27: 805–833.

13 Report being prepared by Prof Pudney et al: Licensing and regulation of the cannabis market in England and Wales: Towards a cost-benefit analysis, soon to be available.

Prepared 8th December 2012