Home Affairs Committee - Drugs: Breaking the CycleWritten evidence submitted by Mat Southwell (DP174)

1. Executive Summary

1.1 Drug policy is an area that creates polarised dialogue and wide-ranging debate. This submission is narrow in its focus limiting itself to what is possible within the constraints of existing UN Drug Control Conventions. The 7 Pillars for Reforming UK Drug Policy and Practice are all drawn from practical examples either from the UK or other partners operating within the UN Drug Control Conventions.

2. Introduction to Mat Southwell

2.1 Mat Southwell brings a wide ranging of perspectives to the drug policy debate. He joined the drugs field in the early HIV era and was responsible for running an innovative community harm reduction service before going onto be professional head of service and general manager from NHS drug services in East London. In 1999 Mat Southwell came out publicly as a drug user and has since worked to bridge the gap between the drug using community, the professional drugs field and policy makers.

2.2 For the last three years Mat Southwell has been involved in the development of the International Network of People who Use Drugs (INPUD), he sits on the governing body of the UN’s Joint AIDS programme as a civil society representative and has twice been a Non-Governmental Organisation (NGO) representative on the UK delegation to the UN’s Commission on Narcotic Drugs.

3. Seven Pillars for Reforming UK Drugs Policy and Practice within the Current UN Drug Control Conventions

3.1 The 7 Pillars set out below come together to a comprehensive model of drug policy and practice. Each component part is tried and tested and has been shown to be effective. The UK has a very high level of underlying drug prevalence and this ensures that bad drug policy and practice has a disproportionate affect on us as a nation. Too much drug policy is driven by ideology and this clouds the debate in this complex and rapidly changing area. This model for reform starts with the simple premise of what do we know works.

3.2 Day-to-Day Management of Drug Policy Devolved to the Advisory Council on Misuse of Drugs (ACMD)

The Government should set overarching outcome indicators but otherwise remove drugs policy from the rough and tumble of party politics. The ACMD would be held accountable through Parliamentary Committees as happens with the Bank of England. People directly affected by drug policy and practice should be invited to join the ACMD to allow a 360 degree strategic view of our policy and practice. It is critical to take drug policy out of the rough and tumble of party politics so a more objective, science-based policy can be shaped.

3.3 Portuguese-style De-criminalisation of Drug Possession

We should be very proud of our Police Service. They have transformed their approach to engaging with the drug using community and with different policing priorities they could follow through on this forward momentum. Taking the individual person who uses drugs out of the criminal justice system would save police and court time, increase treatment uptake far more effectively than coercive strategies, reduce the risk of HIV transmission, and decrease the pressure on the drug using community.

3.4 Removing Pressure from the Illicit Drug Supply Networks

The UK should change policing priorities and only target drug suppliers who cause a public nuisance. Criteria should be set forbidding drug supply in areas close to schools or other sensitive public spaces. Special police units should be developed that would crack down quickly and firmly on drug suppliers who step out of line. However, if everyone is comfortable and safe then the police would not actively seek out drug suppliers. This policing strategy, coupled with customer preference for good quality, fair price, and good service, will drive the gangster dealers out of the market and take income and influence away from street gangs. Substantial police and court resources would be freed up. Advice could be sought from the Dutch who have successfully deployed this strategy.

3.5 Improving and Normalising Drug Treatment

Drug services spend too much time policing and “treating” people seeking support around their drug use. Providing proven technologies like opioid substitution therapies, advice, and psycho-social support allows people to get back on their feet and flourish. The current recovery focus of UK drug services is reintroducing the culture of harassment and dishonesty which so hampered drug services in the 1980s and 1970s. The scale up of drug services is too often hindered by ideological baggage of some parts of the drug treatment system, which leads to costly blanket regulation and restrictions that reflects the pathologisation of people who use drugs. Expert patient programmes should be deployed in drug treatment settings fostering self-reliance and an honest dialogue with healthcare workers. The majority of drug treatment should be provided through primary care ensuring discreet access to holistic, cost effective and normalised services.

3.6 Extending and Enriching Harm Reduction Services

Despite the bureaucratic and deadening leadership of the National Treatment Agency, the UK continues to have dynamic harm reduction sector that is aided by vibrant social enterprises, private training and practice development businesses, and innovative peer-based responses. Expanding the range and reach of harm reduction services will lower the threshold to all drug services and be an effective public health measure. This is key to quickly accessing those who can no longer afford to fund their drug use through legal means. Importantly the recent period reinforces once again that response to active drug users cannot remain static. They have to be flexible and adaptive responding to rapidly changing drug scenes and the ever-growing array of substance now available to young people in the UK.

3.7 Tackling Short-Term Drug Related Offending

Tackling short term offending is key to creating a drug policy environment that minimises the negative consequences of drug related offending on the general population. The key is to secure a responsive, high capacity and accessible drug treatment system that does not incentivise offending as a way to access restricted treatment places. Multi-agency responses, involving the police, probation and court system, have been shown to be effective in managing prolific offenders but cessation of offending rather than drug abstinence would be the priority of this multi-agency response. The latest resettlement and social reintegration programmes would address the reasons drug-related prisoners often return to offending on release.

3.8 Fostering Healthy Drug Community Norms and Systems

Drug user organisations have been shown to be of huge value in fostering healthy cultural norms, mediating relationships with drug services and providing peer education programmes to the majority of people who use drugs who are not engaged with services. However, the NTA forced an agenda of service user involvement on the drug users movement suffocating these organic community networks and sabotaging a key innovative funding programme set up by Comic Relief. This has undermined the positive effect that the active drug users movement can have in sharing peer education, distributing harm reduction equipment and fostering healthy cultural norms. When engaged active drug user groups have shown themselves to be committed and effective partners in promoting health and managing problem situations.

4. Recommendations to Committee

4.1 UK drug policy should be driven by what works. This is rarely ever perfect and normally requires ongoing development and adjustment given the changing and complex nature of drug scenes. The 7 Pillars model provides a practical and pragmatic approach to reforming drug services based on tested and validated approaches. The UK should aspire to recover its leading position as a pioneer on drugs policy and look to what can be achieved without needing to renegotiate UN Drug Control Conventions.

5. Conclusion

5.1 Poor drugs policy and practice compounds other social problems like crime, poverty, unemployment, urban decline, mental illness and gang culture. However, the vast majority of people integrate drug use into their lives and establish self-regulated relationships with drugs. Many age out of drug use as they enter the employment market, start families and even become politicians.

5.2 The majority of us who experience problems with drugs at some point in our lives secure change without professional help. Lowering the threshold, improving the quality and reducing the moralism in drug services would make them more accessible, effective and efficient.

5.3 The British System is rightly commended around the world and the UK hosts many of the leading international NGOs that are advising other governments on how to reform their drug policies and address HIV crises among people who inject drugs. As such, I am arguing for a reconnection of our domestic and international development policies on drugs.

5.4 Most importantly in a time of economic crisis these policies would have clear cost saving benefits as well as releasing pressure and demand across the UK’s hard pressed criminal justice system.

I would welcome the opportunity to give oral evidence.

February 2012

Prepared 8th December 2012