Drug policy needs to focus on public health, not criminal justice, if it is to save lives

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By Hannah Cahill, Fourth Year Biochemistry

The close links between drugs and crime, health issues and morality make it a political hot potato rarely treated rationally. It is time we change this.

The Advisory Council on the Misuse of Drugs (ACMD) was set up in 1971 as an independent expert panel providing recommendations on government drug policy to prevent it becoming a political leverage tool. However, all too often its recommendations have been ignored, with far-reaching and disheartening consequences.

The UK’s drug class system has been repeatedly criticised by the ACMD and wider groups, for example in cannabis’ re-upgrade to Class B in 2009, despite an extensive ACMD study finding weak correlation between its use and psychosis. The Home Secretary chose to move it up anyway, to ‘err on the side of caution’.

But does increasing the prison time, stigmatisation and fear surrounding a drug actually reduce its harm to society?

Professor David Nutt (a neuropsychopharmacologist and then chairman of the ACMD) began to ask this, and in 2010 conducted a study into the harms of 20 drugs across 16 weighted criteria. His panel of experts found alcohol ranked highest in harm, while the bottom of the scale was littered with Class A drugs. Overall, the correlation between this ranking system and the government class system was 0.04 – i.e. non-existent.

Contrasting the UK’s class approach, the successes of Portugal’s decriminalisation of all drugs in 2001 are well documented.

Decriminalisation was put in place when a staggering 1 per cent of the population were addicted to heroin. Since, cases of HIV and overdoses have fallen dramatically while the number of addicts seeking treatment has soared. As well as the legal change made by Portugal’s government, it is arguably the change of attitudes towards drugs that has improved and saved lives.

In 2017, Norway revealed plans to follow suit, and Scotland’s 2018 Drugs Strategy clearly moves towards decriminalisation. Importantly, Scotland’s strategy combines alcohol and drug misuse; treating legal and illegal activities together and allowing a focus on public health rather than criminal justice. They poured an additional £20million into the strategy, which included fix rooms allowing addicts to take heroin safely under medical supervision. The UK Home Office have since declined this proposal, stating it is illegal.

When countries so geographically and culturally close to us are supporting evidence-based harm reduction policies, it is discouraging to see what the UK has been working on.

In July 2017, the Home Office rolled out their new drug strategy, complete with continued focus on criminal justice as the primary means of prevention, refusal to consider decriminalisation and no increase in funding – in fact since 2014, UK drug and alcohol services have been cut by £162million.

Contrasting the UK’s class approach, the successes of Portugal’s decriminalisation of all drugs in 2001 are well documented.

There are some positive points. More focus on prevention through education, better prison recovery programmes and clearer guidelines on opioid treatments. But the report ignored most recommendations from the ACMD, with no incorporation of evidence-led harm reduction, while still having the audacity to claim it will be ‘leading and driving action on a global scale’.

There is not time for the UK’s drug policy to remain stagnant.

In 2016, it was reported that UK drug-related deaths were at a record high, whereas the number of people taking illegal drugs was at a record low.

The UK’s focus on prevention as a form of harm reduction is not working. It makes the most vulnerable people more isolated, while stopping demographics who are unlikely to become problem-users.

While some claim the UK drugs policy is not harsh enough, in a recent poll, 56 per cent of the public believe drug users should receive treatment rather than be criminally charged.

In 2016, it was reported that UK drug-related deaths were at a record high, whereas the number of people taking illegal drugs was at a record low.

The public are ahead of the game.

Harm reduction charities such as The Loop are growing in popularity, and the government even stated ‘we won’t stand in your way’ regarding their legality. They provide drug safety testing and give harm reduction advise at nightclubs, festivals and even Bristol city centre. Their work has allowed identification of high-strength pills to avoid, and although they are too new to give exact figures, it is obvious that being able to tell a drug user that his ketamine is actually fentanyl is likely to reduce drug-related harm.

There are localised moves towards more progressive drugs policy. For example, Avon and Somerset Police Force have tested de facto decriminalisation.

The UK government however lacks these advances. Of course, it is important for laws to be followed, but they must be informed laws.

The general public is expected to use drug laws to make decisions that could have profound impact on their lives, and when government advise does not align with what other sources recommend about safe drug use, they risk losing credibility.

Scientific understanding changes with new evidence, and drug laws imposed across the UK should mirror this.

Until the policy-makers truly understand, it is addicts and those around them who will be paying.

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