Editorial

Citation

Klein, A. (2011), "Editorial", Drugs and Alcohol Today, Vol. 11 No. 4. https://doi.org/10.1108/dat.2011.54411daa.001

Editorial

Article Type: Editorial From: Drugs and Alcohol Today, Volume 11, Issue 4

Once again, though without the media rumpus attending the cannabis classification fiasco or the equasy related sacking of Professor Nutt, the government has rejected advice from the Advisory Council on the Misuse of Drugs. The ACMD recommended that people arrested in possession of controlled drugs for the purpose of their own consumption should be sent on drugs awareness courses rather than fined or sent to prison. The advice was inspired by the Portuguese experience, where drug possession was depenalised in 2001, with people caught in possession by the police being directed to “dissuasion panels”. The model has received international attention (Greenwald, 2009; Hughes and Stevens, 2010; Moreira et al., 2007) for realising significant health gains without leading to a rapid rise in drug consumption. Easing the pressure on drug users has not led, as alarmist critics of the policy had warned, to a dramatic increase in drug use, or the arrival of hordes of “drug tourists”. Instead, injecting drug use, and particularly heroin use has been falling, while overall drug consumption is stabilising. Whether any of these consequences can be attributed causally to the policy is of course, a complex matter, but the same question can be posed in reverse – are current levels of use in the UK, the result of their rigorous prohibition, and would any change in direction lead to a dramatic increase? One should, therefore, look at the results of the Portuguese experience, and keep in mind that drug control is as the former chief of the United Nations Office on Drugs and Crime reminded us, first and foremost a public health policy. Albeit, one that has been almost universally displaced by criminal justice measures (Costas, 2008). A second benefit of the policy, have been savings in police time, allowing law enforcement to allocate resources to other areas of public safety. At a time when there is much concern over public safety and the stress on police resource surely an important consideration?

Yet, the Home Office took none of these arguments on board, indeed, it does not seem that there was any consideration of argument at all. The response appears visceral and doctrinaire, disappointing for a government that promised inter alia pragmatism, reducing the unnecessary intervention by government in the lives of its citizens, and most urgently of all, a reduction in government spending. Instead of seizing this opportunity, a tired old line was spun out: “We have no intention of liberalising our drugs laws. Drugs are illegal because they are harmful – they destroy lives and cause untold misery to families and communities.”

This is of course, facile and hypocritical – nicotine has destroyed far more lives but is not illegal. The remedy for dealing with these problems, arresting tens of thousands of people is causing equally untold misery. Specifying the actual harms the statement continues: “Those caught in the cycle of dependency must be supported to live drug-free lives, but giving people a green light to possess drugs through decriminalisation is clearly not the answer.”

It is the cycle of dependency, which shows that the drafters of this statement have heard about relapse. Indeed, the entire policy seems to be driven by concern with wellbeing and social care that seems contrary to conservative principles of self-reliance and individual responsibility. Yet as we come to the methods proposed to realize the lofty goal of healthy lives and happy family that the underlying objective becomes apparent. “We are taking action through tough enforcement, both inland and abroad, alongside introducing temporary banning powers and robust treatment programmes that lead people into drug-free recovery.”

We have previously highlighted the underlying paradox of drug policy as we know it, which uses the criminal justice system to achieve public health and social policy objectives. It would seem that a time of financial crises was opportune for reviewing this arrangement. If healthy individuals and stable families are the desired outcome, then courts and prisons are not the best way of getting there. There will clearly be difficulties in making changes, after all combatting the importation of Class A drugs is now the top priority of the serious and organised crime agency. Cracking down on drug markets, distribution networks and the open consumption of drugs ties up a large segment of law enforcement agencies. Processing drug offenders is one of the main occupations of magistrates up and down the country, and looking after drug offenders makes up a good 15 per cent of the prison service workload. Such investments cannot be withdrawn overnight without causing considerable upset.

Another way of looking at it is that the government has contracted a piece of work to get better health and happier families. Strangely, though, the main beneficiaries are not social or medical care providers but the criminal justice system. What the Portuguese experience goes to show is that reallocating spending does achieve the ostensible objectives of reducing those drug related harms. But they do not provide the added benefit of opening a resource flow to the most favoured and perhaps original government agencies.

The treatment sector itself stands to gain a few scraps from the commitment to help people into recovery. How agencies that have built up expertise in providing opiate substitution over the years will fare when the emphasis is so decidedly on clients being drug free, remains to be seen. Where harm reduction figures in all this remains a mystery. There is a bitter irony in that harm reduction, one of the most effective public health initiatives generally, seems to have dropped off the policy landscape. When talking about drugs, where the rapid increase in resource allocation and state sponsored violence has proven ineffective in preventing the rise in drug use and associated harms it could even be argued that harm reduction has been the only successful policy model. There are of course, numerous conceptual problems around the term, which is often less than the sum of its constituent parts. Many struggle with giving a coherent definition, and provide a list of activities instead. One working assumption voiced in the early days and now assimilated into the mainstream is that drugs are part of social reality and that policy should be directed towards reducing the greatest harms – infectious diseases, overdoses, chronic dependency. One further notion that we would like to promote is that HR addresses the very problems caused by a misguided policy model. One would point how the replacement of milder by powerful substances – opium being replaced by heroin, low THC cannabis strains by high-THC cannabis strains, cocaine by crack – are consequences of policy. The same would apply to dangerous practices, particularly injecting, but also the use of unknown substances, or of substances of unknown strength.

Many professionals working in the field, be this in law enforcement or treatment, have long recognized this and made their own pragmatic arrangements. At the cutting edge practitioners make informed decisions to minimize harmful consequence, in which policy and legal framework are just another factor. There was some hope that the combination of a coalition government with, where drugs are concerned, a radical liberal democratic wing, and the virtue of financial necessity, would lead to a root and branch reform. Whether from conviction or political calculation, this government remains unwilling to seize that opportunity.

Axel Klein