Home Affairs Committee - Drugs: Breaking the CycleWritten evidence submitted by The Maranatha Community (DP166)

This submission has been prepared in response to the House of Commons, Home Office Select Committee’s announcement that it will undertake a comprehensive review of the drugs policy, examining the effectiveness of the Government’s 2010 drugs strategy and the UK Government’s contribution to global efforts to reduce the supply and demand of illicit drugs.

The Maranatha Community

The Maranatha Community is a Christian movement with many thousands of members throughout the country, active in all the main churches. Its membership includes a substantial number of people involved in the health and caring professions and in a wide range of voluntary work. It has been deeply engaged on a direct personal level with those experiencing drug problems together with their families. It has been in direct contact with research projects, academic studies and help agencies in many parts of the world. It has carried out extensive research into every aspect of the problem of drug addiction and has established charities which, over many years, have been dealing with addiction problems. It has produced a broad range of reports on the subject, both in Parliament and at international conferences. Since its formation 30 years ago, it has been deeply involved in work amongst children and young people, people with drug and alcohol problems, the disabled and disadvantaged. It has taken the initiative in a broad range of projects directly contributing to the health of the nation and it also has extensive international experience.

1. Introduction

1.1 The illegal drug trade in the United Kingdom is an integral part of a huge, highly organised and ruthless international criminal network involved in a range of violent crime, prostitution and human trafficking. Warnings, largely unheeded, were made many years ago about the potential danger of illegal drugs particularly for children and young people. A drug culture emerged, to some extent promoted by the entertainment industry, and a highly efficient system of distribution was established across the country embracing thousands of schools, public houses and other meeting places. Today, it constitutes a grave and continuing threat to the wellbeing of our nation, and particularly our young people.

1.2 Contrary to the original suppositions. so called “soft” drugs have proved to be a gateway to so called “hard” drugs. The aim of the distributors always was to introduce innocent children to a “recreational” drug as a first step to the creation of a substantial market of young people who became dependent upon or addicted to “hard” drugs. Society now faces a huge problem with enormous numbers of young people who are in need of help.

1.3 Concern is currently being expressed about the doubtful cost effectiveness and efficacy of many rehabilitation systems, particularly those operated under public sectors. There is a need for a thorough review of alternative rehabilitation systems which are proving successful both in this country and overseas.1 There needs to be a far greater recognition of the dangers to children in our society.2

1.4 Concern is being expressed about the quality and independence of advice given to Government and there is clearly a need for far closer links with those immediately engaged in helping addicts on a day to day basis rather than those running campaigning pressure groups.

1.5 The expensive Methadone regime which is currently in operation is in very urgent need of review. It is known that those on methadone frequently continue to abuse other drugs. Methadone itself is more highly addictive than heroin and so increases the unlikelihood of a person attaining a drug-free existence. Methadone is not an answer to the drug problem; it is a sign of capitulation.

2. Executive Summary

2.1 Those who advocate a “harm reduction” strategy base their arguments on false premises: that there has been a wholehearted war on drugs; that this war has failed and is in any event unwinnable; and that in consequence all that remains is to teach people to use drugs as safely as possible.

2.2 In fact, there has been no concerted war on drugs: mixed messages abound and there has been no proper attempt to mobilise officialdom and the public at large to create a drug-free society.

2.3 Further, harm reduction is a flawed concept: there is no safe way to take harmful substances. Far from mitigating the harmful consequences of substance abuse, harm reduction leads to increased drug use, with all its attendant negative social and health effects.

2.4 These effects are experienced disproportionately by those who are most vulnerable: the young, the poor and those whose lives are troubled—the very people whom Government has the greatest obligation to protect.

2.5 The cost to society of increased drug use will be massive: already some reckon that up to one third of NHS capacity is deployed in dealing with so-called lifestyle diseases, of which those attributable to drugs use form a significant part.

2.6 Additional costs will result from the need for state support of those who cannot lead productive lives by reason of their addiction. The costs will far outweigh any additional revenue that may derive from taxing drugs.

2.7 It is a fallacy to imagine that legalisation of drugs will bring an end to problems associated with the involvement of criminal gangs in drug-related activity, or the crime caused by those who need to feed addictions.

2.8 Countries that have embraced harm reduction in the past have turned from this strategy as its failures have become glaringly apparent. Sweden and the Netherlands provide prime examples. Sweden has pursued a drug-free society so successfully that it has moved from having one of the highest to one of the lowest rates of drug use in Europe.

2.9 Harm reduction is inconsistent with our international obligations.3

3. An Imaginary War on Drugs

3.1 From time to time Government has spoken about conducting a war on drugs. Yet reality has not matched rhetoric. For example, cannabis has been reclassified from a class B to a class C drug, police forces have increasingly turned a blind eye to possession of cannabis for “personal use” and there have been repeated calls from various quarters for legalisation of all drugs. Media continue to send mixed messages about drug use.

3.2 The incoherence of policy towards the use of harmful substances is illustrated by the efforts that are being made to encourage people to give up smoking. It is of course axiomatic that prevention is better than a cure.

3.3 The contrast with Sweden is instructive. There, every organ of society is actively enlisted to promote the message that drugs are harmful. Sweden aims for a drug-free society. It currently has one of the lowest rates of drug abuse in Europe.

3.4 It is wrong to conclude that a war on drugs has failed when in truth that war has never truly been fought.4 It is likewise false to claim that a war on drugs is unwinnable when Swedish experience proves the opposite.

4. Harm Reduction—A Flawed Concept

4.1 It is no accident that most countries which now adopt strict drug prevention approaches developed these out of the painful experience of drugs being legalised or decriminalised. We should not repeat an historic mistake.

4.2 Laws send a powerful message about what society considers normal, acceptable, safe and good. Legalisation of drugs will inevitably bring about their normalisation and will lead some to claim that they are not only acceptable and safe but even that they are good. Drugs use will inevitably rise in consequence. This has been the experience of the Dutch “coffee shops”.5

4.3 In our own recent past we have seen precisely these results with the introduction of 24-hour drinking. In many quarters this is now seen to have been a disastrous mistake. There are many other examples which illustrate that legalisation of drugs goes hand in hand with increased use and that, correspondingly, robust action can bring significant decreases.6

4.4 Harm reduction will not make the problems associated with drugs go away. It will compound them.

5. Counting the Cost

5.1 Whilst there are many reasons why people take drugs, their vulnerability plays a major part—and especially so in the case of the young. It is generally recognised that someone who suffers trauma, insecurity, lack of confidence, lack of opportunities or deprivation is more likely to be tempted to take drugs.

5.2 Brain development is not complete until the early 20s, which means that the young in particular are at great risk of lasting harm from drug use. By allowing young people to be exposed to drugs, society will compound and exacerbate the vulnerability from which they may already suffer.

5.3 The rights of children and young people to be protected from what is harmful should be paramount. Society should recognise that youngsters may not have the ability, maturity or experience to protect themselves against such things.

5.4 Drugs exact a terrible cost in wrecked lives and unfulfilled potential. They also involve monetary and other costs to society. This is already seen in the impact of life-style diseases on NHS provision. The problem can only get worse if drug use is legalised.7

5.5 Some suggest that to legalise and then to tax currently illicit drugs will benefit the Treasury. Yet data relating to the two most commonly used legal drugs (alcohol and tobacco) do not bear this out. Recent analyses find that the societal, health, criminal justice and other costs of alcohol and tobacco exceed the taxes raised on these products.8

6. Drugs and Criminality

6.1 Legalisation of drugs will not remove opportunities for criminality and neither will separating the markets for soft and hard drugs, as Dutch experience shows.9

6.2 Activity by criminals in other areas such as counterfeiting of goods illustrates the openings that will continue to exist whether or not drugs are legalised. Experience amply demonstrates that the existence of legal alternatives does not get rid of a black market where there is demand.

7. The Portuguese Experience

7.1 Comparatively low rates of drugs use in Portugal lead some to suggest its decriminalisation of drugs as a model. However:

rates of problem drugs use are higher than in Sweden and the Netherlands;

the cost of drugs in Portugal is low (indicating easy availability), whereas in Sweden it is high;

he Portuguese prison population is proportionately higher than the Swedish; and

Portugal has high rates of HIV infection amongst drugs users.

Further, Portugal has followed the path of decriminalisation for about 10 years—too short a span on which to base a judgment. By contrast, the Netherlands (which pursued decriminalisation for about 30 years) has now turned from a liberal approach: see paragraph 4.1 and note 7.

7.2 Statistics show that there has been has been a continuing increase in drug use in Portugal since its legalisation experiment was adopted. In contrast, in other countries there are stable rates of use or—as in the UK—even a decrease in use (albeit from a much higher level).10

7.3 Some of the claims made about Portugal do not stand up to scrutiny. For example, as “proof” of the “success” of drug legalisation, it is claimed by some that the rate of illicit drug usage among 15–19 year-olds fell from 2001 to 2007.11 However, this ignores increased rates in the 15–24 age group and an even greater increase in the 20–24 age group over the same period.

7.4 A recent analysis shows that between 2001 and 2007, lifetime prevalence rates for cannabis, cocaine, amphetamines, ecstasy, and LSD have risen for the Portuguese population at large (ages 15–64) and for the 15–34 age group. Past-month prevalence figures show increases from 2001 to 2007 in cocaine and LSD use in the Portuguese population at large, as well as increases in cannabis, cocaine, and amphetamine use in the 15–34 age group. Drug-induced deaths, which decreased in Portugal from 369 in 1999 to 152 in 2003, climbed to 314 in 2007—a number significantly higher than the 280 deaths recorded when decriminalisation started in 2001.12

7.5 We submit that the UK can learn far more from the much longer established and (probably) also much better researched Swedish drug policy than we could learn from the much shorter Portuguese experiment.

8. The Swedish Model

8.1 Sweden has among the lowest rates of substance misuse in Europe, even lower than Portugal (often touted as a model). Sweden is committed to drug abuse remaining a marginal phenomenon in its society. The overriding task of Swedish drug policy is to prevent abuse.13

8.2 Drug use in Europe has been expanding over the past three decades. More people experiment with drugs and more people become regular users, with all the problems this entails for already strained national health systems. Sweden is a notable exception. Drug use levels among students are lower than in the early 1970s.

8.3 This shows that “the war against drugs” can be won, if there is a societal will and consensus to prevent drug misuse. Sweden’s drug policy is based on the goal to create a drug free society. Drug prevention and education is aimed towards limiting experimental and occasional use. Public opinion strongly supports this approach. Interestingly, Sweden’s drug policy used to be liberal in the 1960s, basically reflecting a harm reduction approach. This led to a significant problem with drug misuse as result of prescription of amphetamines and opiates, so that this “experiment” was reversed. With the 1968 Narcotic Drugs Act Swedish drug legislation became restrictive until the goal of a drug free society was officially adopted in 1978.

8.4 In Sweden all non-medical use of drugs is regarded as drug abuse and no distinction is made between soft and hard drugs. The Swedish drug policy is formulated around the gateway hypothesis, ie cannabis use is associated with “harder” drug use. Efforts are focused on preventing cannabis use since this is frequently the first illicit drug experimented with.

8.5 For a detailed analysis of the Swedish approach please see the publication by the United Nations Office on Drugs and Crime: Sweden’s successful drug policy: A review of the evidence (2007). In the foreword to this publication, Antonio Maria Costa, the then Executive Director of the United Nations Office on Drugs and Crime wrote about Sweden:

“I am personally convinced that the key to the Swedish success is that the Government has taken the drug problem seriously and has pursued policies adequate to address it. Both demand reduction and supply reduction policies play an important role in Sweden. There is a broad consensus that production, trafficking and abuse of drugs must not be tolerated. Thus a clear and unequivocal message is given to the general public, notably to the country’s youth. Last but not least, with its strong economy, Sweden has the wherewithal to devote adequate resources to dealing with the drug problem. Increases in the drug control budgets in recent years went hand in hand with lower levels of drug use.

The achievements of Sweden are further proof that, ultimately, each Government is responsible for the size of the drug problem in its country. Societies often have the drug problem they deserve.”

9. Conclusion

9.1 The International Narcotics Control Board (INCB) has warned “Advocates of drug legalisation are vocal and have access to considerable funds that are used to misinform the public.”14 Over many years drug specialists with first-hand knowledge have been consistently opposed to the legalisation of drugs.15 They have seen it as a totally unmanageable and ungovernable project.

9.2 The evidence against a harm reduction approach and in favour of seeking to create a drug free society is compelling. Over many years The Maranatha Community has published factual evidence on the issue of drugs to policy makers and others.16

9.3 There is a rapidly growing awareness of the excellent work of those number of organisations, many Christian in ethos, which are experiencing astounding rates of success with drug rehabilitation programmes. There is a need for legislators to seek evidence from them as to what works, and why.

9.4 There is a substantial amount of evidence pointing to the need for a thorough re-evaluation of drug policies pursued in the United Kingdom over recent years and the total social and economic cost to our nation through drug abuse.17

APPENDIX A

(Data for the Netherlands were not available for 1999 and 1995.)

APPENDIX B

Estimates of prevalence of problem drug use at national level. Rate per 1,000 aged 15–64; as per European Monitoring Centre for Drugs and Drug Addiction (EMCDDA). The EMCDDA defines problem drug use as intravenous drug use (IDU) or long duration/regular drug use of opiates, cocaine and/or amphetamines.

APPENDIX C

February 2012

1 Yeldhall Manor Reading; Giliad Foundation, Devon; Bethany Christian Trust, Edinburgh; Betel, Birmingham & Manchester; Victory Outreach; Victory Outreach, UK; Rema; Teen Challenge; Project Caleb, Harpurhey; Barnabus, Manchester; International Substance Abuse Addiction Coalition (ISAAC); St. Stephen’s Society, Hong Kong.

2 — 42.9% of young people have used illicit drugs. 22% had used one or more illicit drugs in the previous year and 13% in the previous month. (Drugs Misuse Declared—Home Office 2009.)
— 23,528 under 18’s were in specialist substance misuse services in England during 2009–10. 155 were under 13. (National Treatment Agency for Substance Abuse 2010.)
— An NHS survey in 2009 revealed that about 250,000 children had taken drugs (including glue, gas and other volatile substances) in the previous month and 450,000 had taken drugs in the last year. (Information Centre for Health & Social Care, July 2010.)
— Between 1999 and 2009 there has been a 67% increase in the number of children born addicted to drugs. One in five hundred babies have need ed treatment for withdrawal. (British Association Perinatal Medicine, 2009.)
— The lives of more than 350,000 children are being blighted because their parents are drug abusers. (Study “Hidden Harm” for Advisory Council on Misuse of Drugs, June 2003.)
— In 2008–09, 2,284 children (12% of all callers about a parental drug misuse concern) were counselled by ChildLine with concerns about their parents’ drug misuse. This number consisted of 1,639 girls and 645 boys. (NSPCC—ChildLine Casenotes, August 2010.)

3 697 The United Kingdom is a signatory to the United Nations Convention on the Rights of the Child, article 33 of which requires signatories to “… take all appropriate measures, including legislative, administrative, and educational measures to protect children from the illicit use of narcotic drugs and psychotropic substances, … and to prevent the use of children in the illicit production and trafficking of such substances.” (Emphasis added.)

4 Some point to a significant worldwide increase in the total number of cocaine, opiate and cannabis users between 1998 and 2008 as evidence that the war on drugs has failed and is unwinnable. However, this fails to take account of population growth in this period. If this is done, the increase in cocaine and opiate use is significantly less and cannabis use may even have decreased. Based on UN estimates of the number of cocaine and opiate users, the prevalence rates for annual use in the population age 15–64 remained stable at around 0.35% for opiates and 0.36 % for cocaine between 1998 and 2008. (Centre for Policy Studies; press release; 19 September 2011).

5 Cannabis use has increased sharply in the Netherlands since use of cannabis for personal use was decriminalised in 1976. In the age group 18-20 an increase in past year use from 15% in 1984 to 44% in 1996 was observed. The increase in past month use over the same period was from 8.5% to 18.5%. In this same period, use levels were quite flat or declining in cities such as Oslo, Stockholm, Hamburg, and countries such as Denmark, Germany, Canada, Australia and the USA. (MacCoun R and Reuter P. Evaluating alternative cannabis regimes. British Journal of Psychiatry 2001. 178: 123–8.)

6 For example, in the second half of the 19th century, opium and cocaine were essentially legal in the United States, which had around 400,000 opium addicts at the turn of the 20th century. Following the enactment of drug control measures, the number of opium addicts reduced to around 50,000 during the Second World War. In Japan there were some half a million methamphetamine users in the 1950s. As a result of preventative measures (including short prison sentences for about 10% of them), this figure has significantly reduced. Japan now has quite strict anti-drug laws and among the lowest rates of drug misuse in the developed world.

7 Some parallels can be drawn from the impact of misuse of alcohol and tobacco. It is estimated that there are at least 10,000 deaths annually due to alcohol and perhaps as many as 100,000 deaths due to cigarette smoking. Over time, there is no reason to suppose that the impact of legalising drugs might not be as great, of which the misuse of prescription drugs gives a foretaste. In a North American context, the International Narcotics Control Board 2006 Annual Report observes: “The high and increasing level of abuse of prescription drugs by both adolescents and adults is a serious cause of concern. The gradual increase in the abuse of sedatives (including barbiturates), tranquillisers and narcotic drugs other than heroin by the general population has resulted in prescription drugs becoming the second most abused class of drugs after cannabis. The abuse of prescription drugs such as fentanyl, oxycodone and hydrocodone has led to a rising number of deaths. Of particular concern to the Board is the noticeable increase in the abuse of fentanyl, a synthetic opioid 80 times as potent as heroin, which is not only diverted from licit distribution channels but also illicitly manufactured in clandestine laboratories.”

8 See the Institute of Alcohol Studies factsheet on economic costs and benefits of alcohol and the Policy Exchange Research Note, March 2010.

9 Dutch drug policy is moving to a much more restrictive approach because the Dutch realise that the liberal policies did not achieve their stated goals, including trying to separate the markets between so-called “soft” and “hard” drugs. For example, the number of Dutch coffee shops has almost halved over past years. In 1997, there were 1,179 coffee shops. In 2009, there were only 666. (Bieleman/Nijkamp. Coffeeshops in Nederland 2009 report) The Van de Donk committee report from July 2009 marked a change in the Dutch drug policy towards a far more restrictive policy. This report stated for example that drug-related “nuisance and drug-related crime place a heavy burden on local authorities, while criminal organisations have found their way to the big money to be made from international drug trafficking.” The Dutch Government expresses its intention that the Dutch drug policy should aim at fighting and reducing drug use. If the current trend continues, we would not be surprised if soon, the Netherlands will have among the strictest drug prevention policies in Europe bar Sweden (Frans Koopmans, personal communication).

10 This is supported by survey data from direct interviews regarding Portuguese attitudes towards drug addiction. 83.7% of respondents indicated that the number of drug users in Portugal has increased in the last four years. 66.8% believe that the accessibility of drugs in their neighbourhoods was easy or very easy and 77.3% stated that crime related to drugs has also increased (Toxicodependências No 3, 2007).

11 Drug Decriminalization in Portugal. Cato Institute, 2009.

12 Office of National Drug Control Policy, Factsheet on Portugal, 2010.

13 The Swedish approach of wanting drugs to be only a marginal phenomenon in society was born out of painful experience of legal opiate and amphetamine use out of control in the 1960s.

14 INCB press release; 28 February 2003.

15 Over many years leading authorities have warned against legalisation and the minimisation of damage caused by drugs.
Dr Clair Rowden, a police doctor for 27 years—“Legalising of cannabis would be an act of unbelievable irresponsibility”.
Mariette Hopman, the Clinical Psychologist—“smoking cannabis is unbelievably dangerous”.
Professor David London, leading physician—“I don’t think anyone should go away with the idea that cannabis is safe. There is evidence that it isn’t”.
Professor Griffith Edwards, of the National Addiction Centre—“There is enough evidence now to make one seriously worried about the possibility of cannabis producing long-term impairment of brain function”.
Judge Keith Matthewman—“Perhaps people who say the drug should be legalised should sit where I do and see the devastation it can cause to other people as well as the defendants”.
Professor C H Ashton of the Department of Psychiatry University of Newcastle upon Tyne—“Cannabis intoxication can precipitate severe psychiatric reactions including paranoia, mania and schizophrenic life states”. “Few, if any doctors, will deny that the symptoms of schizophrenia are made worse by cannabis.”
Dr Norman Imlah former Clinical Director of West Midlands Regional Addiction Unit—“Studies show that benzpyrine, a known carcinogen, is about 10 times more concentrated in cannabis smoke compared to tobacco smoke”.
Phillip Emafo, President of the United Nations International Narcotics Control Board—“Cannabis is not a harmless drug as advocates of its legalisation tend to portray”.
Jan Berry, former Chairman of the Police Federation of England and Wales (the very large majority of whose members oppose the legalisation or decriminalisation of cannabis)—“The siren calls for decriminalisation and legalisation of are not cries for reality, they are the voice of surrender and despair”.
Professor Colin Drummond, St George’s Hospital Medical School—“the harm caused by decriminalisation of cannabis would particularly affect vulnerable groups including adolescents and those with pre-existing mental health problems”.
Dr Ian Oliver, Consultant to the UN Drug Control Programme, pointing to significant medical damage caused to many cannabis users—“it would be perverse of any Government to decriminalise cannabis”.

16 Maranatha Community Parliamentary and other Submissions on Drug Abuse.
2001 “Cannabis—A Warning”: A submission to the Prime Minister, the Home Secretary, the Secretary of State for Health, the leaders of the major political parties, the Archbishop of Canterbury, the Cardinal Archbishop of Westminster and leaders of the Free Churches.
2003 Submission to Home Affairs Committee of the House of Commons on Drugs, prior to the Forty-Sixth Session of the United Nations Commission on Narcotic Drugs.
2004 “Choosing Health?”—A contribution to the Consultation on action to improve people’s health initiated by the Secretary of State for Health (See section 6—Drug Misuse—Prevention rather than just damage limitation and Appendix D Drug Abuse—Prevention) submitted by the Maranatha Community in association with the Council for Health & Wholeness.
2005 “Cannabis Reclassification”—A Submission to the Advisory Council on the Misuse of Drugs.
2006 “Substance Misuse: Public Health Interventions—A submission to The National Institute for Clinical Excellence on the scope of Public Health Interventions.
2007 Consultation Papers: “Drugs: Our community, Your Say” to Ipsos MORI re Drug Strategy Consultation 2008.
2010 Drug Strategy Response form—to the Drug Strategy Unit at the Home Office, Consultation Paper on the new Drug Strategy
Maranatha Community Briefings and Fact Sheets
2002 Cannabis—How Dangerous?—held in Committee Room 21, House of Commons.
2002 Cannabis—A cause for Concern?—The Moses Room, The House of Lords (see the consultation papers “Cannabis—A cause for Concern?” which were presented at this Meeting.
2003 Cannabis—Still a cause for Concern? The Attlee Suite, Portcullis House, Huse of Commons
Maranatha Community Fact Sheets on Cannabis
1997 The Truth about Drugs.
2000 Maranatha Briefing on “Cannabis” (for MPs, social workers and church leaders).
2004 Cannabis—“The Lies and The Truth”.
“Cannabis as a medicine?”
“Decriminalise Cannabis?”
“Negative effects of Cannabis on Mental Health.”
“Learning & Social Behaviour.”
“Random pupil drug testing in Schools.”
“10 facts confirming that Cannabis should NOT be reclassified.”
“10 medical reasons why cannabis should NOT be reclassified: The adverse health effects of cannabis.”
“What about cannabis and driving?”
“What do they mean by harm reduction?”

17 1. The number of people receiving disability benefits because of drug and drink problems have risen by 250% in the past decade. (Department for Work and Pensions.)
2. Drivers high on drugs are getting away because police do not have the training and the equipment to convict them. Just 1.68 drug-divers are persecuted in a year in Britain despite them contributing to at least 56 deaths. (Transport Select Committee). By contrast, in Germany 34,500were prosecuted for drug-driving during the similar period. A report by the Committee states “People assume—quite correctly that they can take drugs and drive a vehicle with little chance of being caught and convicted.”
3. According to the annual report of the European Monitoring Centre for Drugs and Drug Addiction, Britain is now the cocaine capital of Europe, after use among young adults increased by 50% in five years. The prevalence of the Class “A” is higher in England and Wales than anywhere on the continent and use among 15–34 year olds is greater than in the United States.
4. Drug dealing is rife in British jails. A study reveals that 85% of prisoners said they could get drugs if they wanted. (Policy Exchange). An investigation in 2006 found at least 1,000 prison officers—or one in 10—were smuggling drugs. (London Metropolitan Police Investigation.)

Prepared 8th December 2012