Home Affairs Committee - Drugs: Breaking the CycleWritten evidence submitted by Dr Sue Pryce (DP053)

Summary of my Main Points

After years of study and the experience of living with an addict I have become a reluctant legaliser. The Government should legalise and redistribute the costs of enforcement into drug therapies and rehabilitation.

The drug problem cannot be solved—it can only be managed.

Prohibition of recreational drugs is wrong in principle and in a democracy, unworkable in practice.

Decriminalisation is fundamentally inconsistent and at best would only be a temporary half-measure.

Below I have addressed my comments to the inquiry’s terms of reference. My book provides a detailed analysis of these matters, and although it is not available until 24 February I could provide the committee with an early copy on request.

Introductory Comments

Having studied the Home Affairs Committee 3rd Report “The Government’s Drug Policy: is it working 2002?”, I was struck by the fact that most of the arguments and evidence remain the same and relevant. Drug policy has moved in the direction of harm reduction, as recommended by the report. As the parent of an addict I know that the sources of help and treatment have increased in the last 10 years. Substitute prescribing, both outside and inside prison have become the norm. Since 2010 “recovery” has become the new mantra, which is a worthy aspiration, but in reality seems to be another “one cure fits all” or nothing. The real change over the last 10 years has been in the climate of opinion. As drugs have come out of the ghetto and the sons (to a lesser extent the daughters) of the middle class and opinion formers have been exposed to drugs and the effect of the drug laws, the argument for prohibition has become less self-evident (ref the letter to the PM “Taking Drugs Seriously” from Demos and the UKDPC, and recommendations of many former politicians in the GCDP). Useful comparisons can be drawn with changes in the law relating to capital punishment, abortion, homosexuality, the time for change, and a willingness to accept it, seems to have come.

1. The criteria used by Government to measure the efficacy of its policies

The problem with drug policy is that the success of outcomes that did not occur cannot be measure. It is impossible to measure the extent to which prohibition acts as a deterrent to use. It seems reasonable to suppose that some people who might try drugs do not do so because of the legal implications. But it is also reasonable to assume that many non-users would remain non-users even if drugs were legal.

Measuring the efficacy of policies becomes measuring what is measurable eg. the quantities of drugs seized. But if seizures go up it does not tell us if the police/customs have become more efficient or whether they are simply interdicting the same percentage of an increased volume of drugs.

Likewise, increasing the number of people in treatment tells us nothing about outcomes—does treatment lead to drug free lives? Evaluating treatment outcomes is notoriously difficult because of the lack of transparency and heavy reliance of self-reporting from interested parties. Treatment providers have a vested interest in the “treatment works” slogan. Addicts who have achieved a drugs free life may wish to advertise their success and provide feedback to researchers, or they may wish to distance themselves from their old drug lifestyle and ignore invitations to participate in surveys and research. Those for whom treatment has not been a success will be difficult to trace if they have returned to drug using. Many users “in treatment” use both substitutes and street drugs.

How can the success of drugs education be measure? People who do not use drugs may not do so because of drugs education but there may be a range of other explanations such as peer group, sport, etc.

2. The independence and quality expert advice given to the Government

Once again this is something that can’t be measured. Drugs evoke strong responses some of which are based on a belief that drugs are wicked and should be prohibited whatever the practical outcomes. The best hope is that the Govt. listens to lots of different kinds of advice. If however it gives more attention to “insider groups”, some of which receive tax money to perform their advisory role, it raises questions about the independence of what they have to say. Providers of drug services develop a vested interest in the continuation of policies from which they benefit. Prohibition has become a massive job creation scheme for the “prohibition-industrial complex”: providers of prisons, security, legal services and treatment services. Bureaucracies both public and private develop vested interests in the perpetuation of the current regime. See for instance Cindy Fazey (2003) “Commission on Narcotic Drugs and the UN’s Int Drugs Control Prog: politics, policies and prospects for change” Int Journal of Drug Policy 14.

3. How effective are different policies to reduce drug usage?

This is partly answered in (1) above, for example, how can the effectiveness of drugs education and drugs information services such as FRANK be measured? Research is unlikely to be able to prove effectiveness. The best the Government can do is try lots of different policies combining education, honest information, offer a real range of treatments not one type fits all, listen to drug users and families.

4. To what extent should public health considerations play a leading role in developing drug policy?

It should be the key consideration. Criminalising drugs has not worked. It has filled our prisons, cost a fortune in criminal justice, policing, customs etc. It has undermined public health by the spread of blood borne viruses, the often untreated mental health problems of drug users and their families, and exposing drug users, no matter what kind of drug they use, to the criminals and the risks of consuming drugs of unknown strength and purity. Prohibition has ensured black market profits for criminals and pushed addicts into petty dealing (spreading drug use further), stealing or prostitution (unless they are rich and famous such as city traders, celebrities, sports stars).

5. What of the challenges of “legal highs”?

Once again the Government was seen to panic in reaction to a very few deaths that may have been partly caused by for example methedrone. There was no due consideration, no time for scientific research. The result is that the Home Secretary now has the power to temporarily ban these constantly emerging substances, and then after the ban seek advice from the ACMD. If the ACMD concluded that on balance there was no need to prohibit the new substance, it is difficult to envisage a govt. declassifying a drug having once banned it. The recent farce over cannabis gives little reason for optimism on this matter. It may well be that methedrone is less harmful than other highs that have arrived on the scene since it was banned. In respect of “legal highs” the Government is in a no win situation, as indeed it is with prohibition. No drug is harmless. Drugs have risks but they are insufficient to justify prohibition. The clear double standards with respect to alcohol expose the Government to claims that the real difference between illegal and regulated legal drugs is economic clout of vested interests.

6. What of the links between drugs, organised crime and terrorism?

Organised crime and terrorism will not go away if drugs are legalised. They will simply shift their activities to other things to gain profit or funds for political violence. The problem raised by illegal drugs is that there is no consensus that they are wicked compared to robbing banks, kidnapping hostages, trading in nuclear materials. Many people condone the production of and trafficking of drugs because they see it partly as a western imposed ban prejudiced in favour of our particular menu of drugs (see for instance the continuing argument over the status of coca). Drug users have obvious reasons for colluding in the trade, but many others feel neutral. Therefore the drug market offers reasonably safe rich pickings for criminals and politically motivated violent groups.

7. Should alternative ways be tried for tackling the drugs dilemma?

Yes, the time for radical change has come. It is difficult to think of another policy that has failed so dismally being pursued so relentlessly. Decriminalisation of all types of drug possession seems to be gaining support in Europe and South and Central America. It is defended as a further step along the road of harm minimisation: people caught in possession of illegal drugs would no longer be subject to court proceedings, they would not have a criminal record with its knock on effect on their employment prospects, and the burden on the tax payer in police time and the huge costs in terms of lawyers, prisons etc would be reduced. I would endorse decriminalisation of possession but only as an incremental measure towards full legalisation for the following reasons:

It is fundamentally inconsistent—it involves a kind of public sleight of hand to say you can legally possess these substances but producing and supplying them is illegal. Both Spain and The Netherlands are trying to get round this inconsistency in respect of cannabis by permitting people to grow their own cannabis plants (up to five for personal use in The Netherlands). This measure makes states disingenuous.

How can the police distinguish between an acceptable quantity for personal use and intent to supply. Portugal permits 10 wraps of heroin for example, but this could easily be possessed by a local street dealer who is circumspect enough to only carry the permitted quantity. Users and small time dealers are in any case often one and the same.

Decriminalisation would be unlikely to effect the systemic crime of drug markets (local and global) in which resort to violence is the norm for enforcing contracts and defending turf.

Decriminalisation does nothing to address the health hazards of drug use—the unknown strength and purity (in terms of potentially harmful additives) that cause accidental overdoses, health scares as in the anthrax adulterated heroin in 2011, and septicaemia. Decriminalisation offers some modest improvement over the current position in terms of criminal records and costs, but it still ensures that people who use drugs do so with the maximum risk to their health and exposure to the criminal underworld.

Concluding Comments

Legalisation and regulation will never stop dangerous drugs getting into the wrong hands (minors) as is demonstrated by under-age drinkers and smokers. But nor does prohibition prevent this as per newspaper headlines about children as young as eight using and indeed supplying and trafficking class A drugs.

From a personal point of view, I am ambivalent about arguing in favour of legalising drugs. Drug addiction brings anxiety, heartache and desperation. But prohibition failed to protect us from this. Alcohol brings much the same negative consequences for near ones and dear ones, as well as for alcoholics.

January 2012

Prepared 8th December 2012