Home Affairs Committee - Drugs: Breaking the CycleWritten evidence submitted by Adam Corlett (DP 086)

Executive Summary

The efficacy and value-for-money of current policies are poorly monitored, if at all. Core approaches such as “sending out messages” are not evidence-based.

The Committee should accept that ‘prohibition’ has its own harms which must be measured too: some intentional such as financial and opportunity costs, loss of individual freedom, criminal records and convictions; and some unintentional such as making these drugs less safe, organised crime and causing acquisitive crime via high prices. These are often conflated with the harms of the drugs themselves.

Neither the Drug Strategy nor ACMD have analysed the fundamentals, rather than details, of the current approach.

Liberty should be a consideration, even if its valuation is subjective. Responding to unhealthy behaviour with the criminal justice system is at the top of the “intervention ladder” and so it’s necessary to show it’s worthwhile.

The Committee should consider why it is not the Department of Health that has the most control over [illicit] drug policy.

In general, “For far too long, drugs policy has been dictated by what sounds tough, not what works” (David Howarth).

The classification system and the placement of drugs within it are not based in science.

Far too little attention is paid to displacement between drugs (including alcohol which is certainly a “drug”), with each often looked at in isolation.

Prohibition fuels corruption, organised crime and terrorism around the world and almost no illegal financial flows are being intercepted.

There is little evidence that decriminalisation of possession increases harm (often the reverse) and there have many expert calls for change. The Home Office has dismissed rather than engaged with this debate. The onus should be on the Government to show that criminalisation of users is beneficial.

There are good arguments for legalisation (particularly with strict regulation) but the UN Conventions severely limit experimentation. Via treaty reform we should at least allow some countries to cautiously experiment with regulating some drugs.

Given all this, it does not seem at all unreasonable that the over 40-year old fundamentals of UK drug policy should be rigorously compared to alternatives (including a yet more punitive approach) in terms of costs and benefits.

A1. Metrics

1. The aim of drugs policy should be to reduce the harms stemming from drug use and from drug policy too (and maximise any benefits). “Reducing drug usage” is of course part of the solution but like many attempts to measure these harms it is not sufficient and can be misleading in isolation, as I discuss below and in Section D. Strategies on alcohol do not start with the aim of reducing the number of alcohol users.

2. For example, I hope the committee will recognise that drug prohibition brings its own harms and that it’s therefore not sufficient to look just at the harms of drug use. We need to ensure the (presumed) benefits of current policy outweigh the costs. See Section F.

3. For the amount of drugs seized or number of arrests, it is unclear whether an increase is a good or a bad sign, the UKBA having claimed both (http://www.bbc.co.uk/news/uk-15756462). For assessing spending, a more useful figure would be the percentage of such smuggling is stopped. Whilst this is harder to estimate, seizures can be compared to estimated levels of use. Are we intercepting 90% or—in the case of heroin in Scotland1—1%?

4. More importantly still, do these efforts lead to decreased availability or increased price and do these lead to a reduction in use/harm or just to increases in acquisitive crime/prostitution, use of cutting agents or a shift to other drugs?2

5. Evidence of the efficacy or value-for-money of most of the Government’s supply reduction or demand reduction programmes seems sparse. Existing programmes must be compared with each other, and with more radical alternatives, for cost-effectiveness.

A2. Questioning fundamentals

6. Many of the fundamental premises of our drug strategy are even less scrutinised. Does locking up dealers and smugglers reduce use or are they too easily replaced? Are longer sentences a deterrent? Does drug law enforcement decrease drug market violence (the evidence strongly suggests the opposite3)?

7. “Sending a message” is one central idea: that we must punish problematic and non-problematic users not for their own good but to deter others from copying this behaviour. I think this is based on a mistaken assessment of the state’s ability to influence Britain’s culture, rather than on evidence.

8. There seems to be little correlation between the severity of states’ drug laws/rhetoric and levels of drug use. Cannabis use in the USA is far higher than in the Netherlands, for example. Culture and socioeconomic factors are far more important than Ministers’ pronouncements. Within countries, changes in policy do not seem to affect levels of drug use.

9. Non-drug users tend to explain their preference by saying they simply don’t want to or that they know the health risks, rather than “because it’s illegal”. Conversely, a study of mephedrone users4 showed “none of the study participants recalled an initial interest in using mephedrone because it had been legal” or “felt that ‘legal highs’ were safe simply because they were legal” and “21 of the 23 study participants had used mephedrone after the ban”.

10. The Government also seems to want it both ways when it “sends out messages”. “It’s harmful therefore it should be illegal” suggests that alcohol is not harmful. Undeservedly classifying drugs as A or B to “send a message” says that all class C drugs are less harmful than cannabis or ecstasy.

A3. Personal freedom

11. Added need to rigorously assess drugs policy comes from the loss of liberty involved. Some MPs may put little value on personal liberty but if two approaches give the same results, the more liberal one should clearly be favoured. To quote from a Health Committee report, “In its approach to health improvement, the Government makes much of the idea (developed by the Nuffield Council on Bioethics) of a “ladder of intervention”. [...] [I]n dealing with particular lifestyle-related public health issues, a range of policy options, on an escalating scale of intrusiveness, is available. Healthy Lives, Healthy People states that: Where the case for central action is justified, the Government will aim to use the least intrusive approach necessary to achieve the desired effect. We will in particular seek to use approaches that focus on enabling and guiding people’s choices wherever possible. This favoured approach it refers to as “nudging people in the right direction rather than banning or significantly restricting their choices”.

12. In discussions of unhealthy food, alcohol and smoking, the benefits of moving up the “intervention ladder” are indeed “weighted against the erosion of individual freedom” (Nuffield Council). The same should be true for other drugs, even if the intervention is already in place, or especially so given that the benefits can be better judged and that prohibition and criminalisation of users would be at the top of the ladder.

B. Science, health and human rights

13. Despite causing and being caused by problems in other departments, drug use is definitely a physical and mental health problem. The Committee should therefore consider why it is not the Department of Health that has the most control over [illicit] drug policy. I have heard that this is the case in no other EU countries except for Malta and Ireland.

14. Trials such as re naloxone for prisoners on release are a very welcome scientific approach (and I hope more will be done into heroin-assisted treatment). But this has not extended to the fundamentals of drug policy. The Drug Strategy 2010 stated a commitment “to continuing to review new evidence on what works in other countries and what we can learn from it” but dismissed any other approach without reference to any evidence, saying it “does not believe that liberalisation and legalisation are the answer” (my emphasis). In the strategy’s impact assessment, “What policy options have been considered?” was answered with the strategy and an alternative of “Do nothing” only. Its consultation was criticised in EDM 709 (2010) and by NGOs for its brevity and small scope.

15. Classifications are extremely inconsistent and unscientific, not least due to the status of alcohol and tobacco. The Science and Technology Select Committee‘s report “Drug classification: making a hash of it?” and other proposals for more rational scales of harm have apparently been ignored. The effectiveness of the classification system should be considered by this committee as we are now at a point where neither those who want a drug uprated (such as ketamine) or downrated (such as ecstasy) seem to think it worth the effort.

16. However, if classifications and legality are not based scientifically on harms then that is unfair and discriminatory—often a tyranny of the majority. The fact that “black people are six times more likely to be arrested than white people for drug offences and 11 times more likely to be imprisoned” despite “no evidence that black people use or deal drugs more than white people” is even more worrying.

C. Expert advice

17. In practice, the ACMD is significantly constrained. It doesn’t have time to cover all the areas it needs to, whilst what time it has usually goes to priorities set by the Home Office. It seems in no position to rigorously review the fundamentals of drugs policy which is why this review and anything that follows it are so welcome. It’s also unclear to me why the council’s remit does not include alcohol and tobacco.

18. That said, more important is that the government doesn’t follow the advice. The one time I recall the ACMD tackling a broad topic—the classification system, requiring the assessment of many drugs at once—ended in the ACMD losing many of its members and the project itself!

19. Another problem with the process of the ACMD advising the Government is that while it’s easy for the council to say that something is “harmful”, backed up by solid statistics, there is nonetheless a lack of context of whether that’s harmful enough to justify action and how it compares to other risks (other drugs, soft drinks, skateboarding...) and possibly too few MPs trained in statistics. Again, the last time such a comparison was attempted it did not end well.

D. Displacement between drugs

20. In my view, far too little attention is paid to displacement between drugs. Often, rises and falls in the use of one drug are looked at in isolation while, for example, an increase in the price of alcohol might lead to increased ecstasy use.5

21. Similarly, success in reducing ecstasy use might only mean an increase in the use of another drug, such as a “legal high” (one far less studied than ecstasy) and so on ...

22. It’s not clear to me whether the overall demand for drugs can be reduced at all (other than through tackling poverty etc), only shifted between drugs. If all illicit drug use were eliminated, demand would shift to alcohol, or nutmeg, or solvents, or crushed-up antiretrovirals.

23. This emphasises the importance of sensible classification based on harms. A recent study suggests increased cannabis use amongst young people means fewer accidents via less drink-driving.6 Policies should nudge people towards the least harmful drugs (and encourage the development of even safer ones), using these to saturate the demand for drug use.

E. Corruption, organised crime and terrorism

24. “Even President Bush has made the connection: “It is important for Americans to know that the traffic in drugs finances the work of terror, sustaining terrorists, that terrorists use drug profits to fund their cells to commit acts of murder.”7

25. Examples include profiteering by the Taliban (and poppy destruction arguably driving people into terrorism), the North Korean and Burmese regimes, Al Qaeda guarding smugglers in the Sahara, growing corruption in African transit states, and of course the cartels of Latin America. Displacement of drug production and transit—the balloon effect—is part of the reason why so many Latin American countries have been harmed so badly.

26. The UNODC report, Estimating illicit financial flows resulting from drug trafficking and other transnational organized crime, states that the illicit drugs trade accounts for half of all transnational organised crime proceeds and is the most profitable sector. It also states that around $2 trillion was laundered in 2009 and that probably around 0.2% of illicit financial flows are currently being seized and frozen.

F. More harms of prohibition

27. It may be that prohibition has benefits in terms of reducing drug use but it also has many costs (in addition to those already discussed).

1.Loss of liberty, and other intentional harms such as searches, imprisonment, criminal records; often doing more harm to that individual than the drug use itself, presumably for the greater good. This also harms respect for the police and law.

2.It makes drugs more dangerous—with unknown strengths or different drugs, cutting agents and contaminants. It drives users to more concentrated drugs which are easier to smuggle and to novel drugs. Research, palliative care and other medical uses are impeded. Education and harm-reduction advice can’t easily be directed at users.

3.Drug-trade profits are more attractive to the disadvantaged than school or legitimate work, while prison only leaves them less able to find other work.

4.Inflated prices and a criminal rather than medical approach to addiction drive robberies, burglaries and shoplifting and force women into prostitution.

5.Without regulation, disputes are settled violently, no tax is collected to even cover health costs, there is environmental damage, and there are no restrictions on who can buy drugs and where and when.

28. Many of these harms are often conflated with the intrinsic harms of the drugs themselves. Harms caused by illegality can not be used to justify illegality!

29. Conversely, I hope you will acknowledge that regulation would have benefits: it’s simply a question of whether or not there are greater costs.

30. As is common in discussions of the costs and benefits of alcohol, we must also acknowledge the fact that many people enjoy drug use, physically and socially, and have done so for millennia across the world. For some, use is medicinal or functional rather than recreational.

31. Anti-drug policies can be even more harmful in other countries, with forced labour and countless human rights abuses all too common (whilst remaining ineffective). This may not be an argument against prohibition in the UK, but does help show that it is possible for government policies to do more harm than what they were intending to prevent.

G. Alternatives

32. Should detailed consideration ought to be given to alternative ways of tackling the drugs dilemma? Yes! At UK, European, and international levels. The Misuse of Drugs Act is over 40 years old; prohibition has had “unintended consequences”; state interventions that involve “erosion of individual freedom” need to be frequently checked to ensure they’re justified; and there is reasonable evidence to suggest alternatives are viable.

33. A report from the UN Special Rapporteur on the Right to Health to the General Assembly recommended that member states decriminalise drug possession and consider the creation of a regulatory framework—similar to that used for tobacco—for some drugs. The ACMD has also effectively called for decriminalisation, as have many health, development, human rights and children’s organisations—see the Vienna and Beirut Declarations.

34. Decriminalisation of possession of some or all drugs in many countries and American states seems to have no impact on use compared to others in the region. Portugal’s experience seems if anything to have had positive effects.

35. The onus should be on the Government to show that criminalisation of users is beneficial.

36. The international conventions do not aid a scientific approach and should be amended to make clear that decriminalisation is an option, and to give sovereign states the freedom to experiment with some legalisation. Britain could then learn from others’ experiences or vice versa. Legalising the least harmful drugs may, as discussed, draw users away from more dangerous drugs.

37. Legalisation is not descriptive of the range of post-legalisation regulatory options. Prohibition can also include a large range of approaches and spending priorities. “Decriminalisation” also covers many possibilities, some de jure, others de facto.

38. I would like to see a detailed, quantitative comparison of such systems, eg the status quo vs Portuguese-style decriminalisation vs laissez-faire legalisation vs strictly regulated legalisation vs a much more punitive approach to illicit drug users. However, different drugs may need different solutions.

January 2012

1 tvnz.co.nz/our-drugs-war/about-4190786

2 David Blakey CBE QPM, “How can enforcement agencies reduce drug harm?”, Police Professional, 11 September 2008.

3 Werb, D, et al Effect of drug law enforcement on drug market violence: A systematic review. International Journal of Drug Policy (2011).

4 http://www.sciencedaily.com/releases/2010/10/101004101137.htm

5 www.theage.com.au/national/alcohol-price-spike-fuels-switch-to-ecstasy-20101022-16xvj.html

6 www.examiner.com/top-news-in-denver/uc-denver-study-finds-legal-mmj-cuts-traffic-fatalities

7 Mo Mowlam—http://www.guardian.co.uk/society/2002/sep/19/drugsandalcohol.comment

Prepared 8th December 2012