Transform Drug Policy Foundation Blog

Mephedrone and Methadone - keep calm and review the evidence

Author: Danny K

There is a two pronged drug panic now in full swing, with the media calling for 'someting to be done' about mephedrone and methadone (Always get the journalist to spell it before you start rabbiting on about the wrong drug...)

Mephedrone 

I was up at 5.30am this morning in order to prepare for 5Live news at 6.00am to respond to the media furore regarding the deaths of two young people who had allegedly taken mephedrone. By 7.00 am I'd done eight interviews for local radio stations, warning of the dangers of rushing to make it illegal.

As ever the call is being driven by hysterical media hype (for example TelegraphDaily MailThe Sun and Guardian) about deaths of young people, none of which have unequivocally been linked exclusively to the use of mephedrone.

Leah Betts anyone?

Transform's call is three-fold:

1. Calm down. A knee jerk response to classify may in fact increase harms, rather than reduce them. Mephedrone is not a threat to humanity or even a significant threat to the lives of users (we would have seen far more deaths if that were the case, given the high levels of use). Reduce the threat level to the correct proportions and begin to explore options. Recognise that the media massively over report illegal drug deaths, as opposed to all drug deaths, such as alcohol and tobacco, whose dangers are well known and demonstrably kill many more than mephedrone has (in relative or absolute terms).
   
   
   
   
   
   
   
    
2. All drugs have dangers associated with their use. Put as much harm reduction information out there as we possibly can (knowledge of mephedrone is limited - here is a a decent guide to current knowledge).
   
   
3. Recognise that criminalising drugs causes harms that may significantly outweigh any benefits. Conduct an independent and comprehensive impact assessment to explore all the options: do nothing, criminalise production, supply and posession, legally regulate its production and supply. Until that work is done, we cannot say which is the best option.

However, anecdotal evidence from Guernsey sugggests that the ban on importation there has pushed the price up from £10/gram to £60-80/gram and consequently acquisitive crime is now being committed by heavy users to fund their use/habit. Organised crime has taken over distribution (no guns on Guernsey, so samurai swords are the order of the day for fighting turf wars). This cannot possibly have made things better for the good citizens of Guernsey, and we would hope that (despite the differences between Guernsey and the UK) the Advisory Council take this evidence into account before recommending classification.

Methadone 

I also had a chat with The Times yesterday to try and give some balance to their anti-methadone line. It could have been worse (Leader Here and Feature Here)

What has been forgotten in the drive to turn the rhetoric of 'getting people off drugs' into reality, is  some of the basics.

1. The vast vast majority of problematic users are not ready to stop using. The question then is how do you we manage that fact and reduce the harm that they cause themselves and the wider community.
   
   
2. Methadone is not just for 'getting people off drugs', even if it can help with that goal for some. It is primarily used to reduce the amount of injecting of street heroin. Its purpose is to improve individual and public health by reducing both offending (acquisitive crime or prostitution to support a habit) and prevalence of high risk injecting behaviours, and thereby reduce transmission of blood borne viruses.

Methadone does not stop people becoming drug free. Anyone on methadone who wants to stop should be supported to do so. But whilst the majority of heroin users remain using, we would be foolish to throw away the medicine that has helped the UK keep its HIV rates amongst injectors relatively low, and reduced the collateral damage of making heroin illegal for non-medical use in the first place.

Transform is working with partner organisations to counter this pernicious move to undermine opiate substitute prescribing in the UK.

Home Office forced to evaluate its drugs strategy...but not yet

Author: Martin Powell

Whilst we were busy at the Commission on Narcotic Drugs in Vienna a potentially really important meeting of Parliament's Committee on Public Accounts happened, following up the National Audit Office report on the UK Drugs Strategy we blogged about. To recap, the NAO report said:

"Without an evaluative framework for the [Drug] Strategy as a whole, the NAO is not able to conclude positively on value for money." and, "So overall performance measurement across the range of programmes needs to be put in place."

This was no shock. For decades, successive Governments have avoided developing meaningful measures of success, or research to objectively test the effectiveness of their drugs strategies.

For example, Parliament's Science and Technology Committee pointed out in their 2006 report "Making a Hash of it." that there was no evidence of a deterrent effect from criminalising drug use. The Government promised to do research to prove the link, but...hasn't.

Even the limited evaluations of the drugs strategy that have been done have been suppressed - like the value for money study of the last ten year drugs strategy that Transform recently prised from the fingers of the Home Office only after a three year Freedom of Information battle.

Why this coyness about evaluating billions of pounds of public spending? Well, in 2003 at a press conference, we asked the drugs spokesperson at the Home Office, Bob Ainsworth MP, whether the government would support a cost benefit analysis of drug law enforcement. "Why would we want to do that unless we were going to legalise drugs?" he replied.

So no evaluation, because they know it would show prohibition is failing.

Of course it is not just the UK that fails to evaluate its approach to drugs in a rational, effective way, it is a worldwide problem, including in the American heart of the drug war, as the US National Academies report, "Informing America's Policy on Illegal Drugs: What We Don't Know Keeps Hurting Us" back in 2001 makes clear.

And let's not fool ourselves, this failure to evaluate is not a victimless crime. It is a double hit. Not only do we squander billions that could be spent on treatment, schools, hospitals or other social goods, but the current policies themselves are often actively counterproductive.

That is why Transform, The Howard League for Penal Reform, the Institute for Criminal Policy Research, Release, the International Drug Policy Consortium, the Green Party, Plaid Cymru, the Liberal Democrats, the Home Affairs Select Committee etc. are all calling for one or more of; a cost benefit analysis, a value for money assessment or a full Impact Assessment comparing current policy with the alternatives. Then we could move forward based on evidence of what works, not what is politically convenient.

Now the good news. Maybe, just maybe the Government will now have to put in place the first step towards a genuine evaluation of its current strategy. So back to where this blog started, with the Committee of Public Accounts: Tackling Problem Drug Use meeting on the 10th March 2010.

Chair Sir Edward Leigh MP:
Sir David, if I may start with you and refer you to paragraph eight of the Comptroller's Report [NAO] on page five, it starts off by saying, "Neither the current Strategy, nor the supporting action plan for 2008-2011, set out an overall framework for evaluating and reporting on the degree to which the Strategy is achieving the intended outcomes ..." Sir David, how are you going to evaluate and measure your success?

Sir David Normington, Permanent Secretary at the Home Office:
"...we have not had an overall framework of evaluation. We accept that in the new Strategy that is what we need to have..."


Chair Sir Edward Leigh MP:
So if you come back to this Committee in a couple of years' time we will have this overall evaluation at a more sophisticated level, will we? Remember that was the very first question I asked Sir David and he said, "We are doing it individually but we are not doing it comprehensively". This is your job, so you are going to be working with us now and you will be able to report back to us within a couple of years, will you?

Ms. Mandie Campbell, Director, Drugs, Alcohol and Partnerships Directorate, Home Office: Yes, I will. We have agreed with the National Audit Office that we will put a framework for evaluation in place that will look to identify and address those areas that are not evaluated at the moment.

So there it is - Make a note. the Home Office has promised to put in place a framework to evaluate its drug strategy...in theory we should have more detail in about four months from now, so watch this space...But perhaps don't start holding your breath just yet.

Costa's legacy: Human Rights and the UNODC

Author: Martin Powell

Before talking about far more important things going on at this years CND, briefly to this morning, when the NGO representatives had a particularly fractious meeting with the UNODC Executive Director, Antonio Maria Costa. Instead of having a constructive dialogue with the NGOs representatives present, the Director prompted an audible gasp as he immediately lashed out, angrily accusing half of us of being 'pro-drug' (again) and not caring if we killed millions in poor countries. Inevitably several present felt bound to take him to task on these offensive, and frankly ridiculous comments, and depressingly familiar scenes ensued. All rather pointless. There may be other accounts of all this but I won't dwell on it now. Costa is stepping down in May and hopefully a more positive relationship will be possible with his successor. We should also remember that the UNODC is far more than just its figurehead.

More on the activities at CND today from IHRA HR2's day three report , and all the nerdy detail on the CNDblog

Despite Costa parting company with many in the NGO community on a rather sour personal note this morning, the UNODC under Costa has, in fact, seen some considerable improvements in some areas of its NGO engagement - even if often rather begrudging, and more often behind the scenes than at the big showpiece events like the CND, as we have seen.

We should give credit where due; this engagement has delivered some meaningful progress, the Beyond 2008 NGO meeting, for example, producing a potentially useful document (even if CND chose to completely ignore it). Perhaps the most significant development on this front has been the dramatically improved incorporation of human rights analysis from the NGO sector into the wider drug control discourse (for which IHRA's HR2 program and others including Human Rights Watch can take considerable plaudits). Costa, to his credit, has made a series of useful statements on human rights issues, notably on the death penalty.  

As he prepares to bow out he may well also look back at today's publication by the UNODC of new a discussion document, 'Drug control, crime prevention and criminal justice: a human rights perspective - Note by the Executive Director' , as one legacy for which he can be justifiably proud. It contains a level of sophistication in its analysis that has long been absent from the high level drug policy UN discourse. It is an authoritative document and one of potentially huge importance in the longer term. UN drug control, and international drug policy more generally has been uniquely divorced from much of the mainstream human rights analysis that flows through the very core of the wider UN family. This new document goes some way to correcting this historical anomaly  - at least on paper - covering a range of issues including:

• The nature of state human rights obligations within drug enforcement, 
• Issues of proportionality in sentencing
• The use of imprisonment and the death penalty for drug offenses, 
• Due process and treatment of drug offenders, 
• The right to health - including access to clean needles and substitute opiate prescribing for injectors (including in prisons)
• Personal rights regarding coerced treatment and testing 
• The right to provision of essential medicines
• Mainstreaming of human rights in international drug control, including - we were pleased to see  - a call for  a human rights impact assessment  to be used as a evaluative and developmental policy tool, as well as incorporating a human rights compliance assessment into the annual World Drugs Report, and provision of human rights training.

You will forgive the lengthy excerpts that follow, but this is material really worth highlighting. I fully recommend you read the complete report (which provides the context and the references for the quotes below, (that btw include my emphasis)). The body of the report is only 15 pages and by UN standards, its pretty accessible and free of heavy legalese/waffle.

from Para 2:

"The normative foundation of the United Nations’ work in the area of the rule of law work is the Charter and the body of international law, including international humanitarian law, international criminal law, international refugee law, and international human rights law. Responses to drugs, crime and terrorism that are based on the rule of law must therefore also incorporate human rights law and principles. Too often, law enforcement and criminal justice systems themselves perpetrate human rights abuses and exclude and marginalize from society those who most need treatment and rehabilitation"

Para 3:

"Placing human rights at the centre of drug control, crime prevention and criminal justice provides an organizing set of principles that dissolves boundaries between the fields and promotes a single coherent response. Effective drug control cannot exist without fair criminal justice and successful crime prevention. Human rights offer guidance on the delicate balance between the protection of fundamental freedoms and the protection of public health, morals and security. It sets out the broad responsibilities of the State to respect, protect and fulfil the health and wellbeing of its peoples and specific due process guarantees, such as for those suspected or accused of a criminal offence."

 Para 4:

"Such an approach represents more than “added value”; it is a legal obligation. In the 2005 World Summit Outcome, Member States resolved that the promotion and protection of human rights should be both integrated into national policies and mainstreamed throughout the United Nations system. That the fight against drugs, crime and terrorism must conform to human rights is clear. The challenge is to understand how these policies may be pursued in a manner that not only respects and protects human rights, but also contributes towards their positive fulfilment."

Para 8:

"These bodies of treaty law are interdependent and are intended to support elements of the same pillars of peace and security, development and human rights. Nonetheless, references to human rights within the crime, terrorism and drug-related treaties are sparse. This does not mean that human rights law has no application to drugs, crime and terrorism. Rather, where references to human rights do occur in the drug, crime and terrorism conventions, it is clear that the intention is to highlight that international human rights law must be fully respected in their implementation. This is consistent with the core Charter obligation to promote respect for, and observance of human rights."

Para 9:

"No treaty, however special its subject-matter, applies in a normative vacuum, as both general international law (including customary international law) and particular concurrent international obligations affect its interpretation and application.

The question of whether a particular criminal law is inconsistent with international human rights must be assessed on a right-by-right basis. One reason for this is that while some rights (such as freedom of expression, for example) may be limited on the grounds of public safety, order, health, morals and the rights and freedoms of others, other rights may not be limited under any circumstances."

from Para 15:

"In particular, the balance between State action and individual rights can be different when it comes to vulnerable groups. Indeed, human rights law can be said to have a particular focus on marginal groups, vulnerability, disadvantage and discrimination"

Para 17 (on children drugs and rights):

"With respect to children who use drugs and abuse alcohol, the United Nations Committee on the Rights of the Child considers that the right of the child to protection demands that such children should be treated as victims and not as criminals. Indeed, the United Nations Convention on the Rights of the Child — as the only core United Nations human rights treaty to refer specifically to drug use — has a strong focus on protection rather than punishment."

Para 18 (on harm reduction):

"Similarly, as concerns persons vulnerable to HIV/AIDS, the International Guidelines on HIV and Human Rights emphasize that criminal law should not be an impediment to reducing the risk of HIV transmission among injecting drug users, or to provision of HIV-related care and treatment for injecting drug users. " In particular, Member States should consider the repeal of laws criminalizing the possession, distribution and dispensing of needles and syringes, in favour of the authorization or legalization and promotion of needle and syringe exchange programmes.

 from Para 21 (on proportionality)

"..the principle that the severity of penalties must not be disproportionate to the criminal offence is found in a wide body of human rights related standards. This principle includes the notions that imprisonment should be used as a penalty of last resort, and that the choice between penalties  should take into consideration the likelihood of the offender being rehabilitated"

Para 23 - (making a clear case from decrim of personal possession/use)

"In the context of drug laws and sentencing, the drug-control conventions generally require parties to establish a wide range of drug-related activities as criminal offences under their domestic law. Nonetheless, they permit parties to respond to them proportionally, including through alternatives to conviction or punishment for offences of a minor nature. Serious offences, such as trafficking in illicit drugs, must be dealt with more severely and extensively than offences such as possession of drugs for personal use. In this respect, it is clear that the use of non-custodial measures and treatment programmes for offences involving possession for personal use of drugs offer a more proportionate response and the more effective administration of justice. Moreover, the criminal justice response should not be considered proportionate if it results in the denial of another individual human right. Where imprisonment for possession/use offences precludes access to appropriate drug-dependence treatment, for example, this may constitute a denial of the right to the highest attainable standard of health or even the right to freedom from cruel, inhuman or degrading treatment, rendering the criminal justice response de facto disproportionate."

Para 25/26 (making it clear the death penalty is illegal for any drug crime including trafficking):

"The International Covenant on Civil and Political Rights specifies that in countries which have not abolished the death penalty, the sentence of death may be imposed only for the “most serious crimes”. The concept of “most serious crimes” is limited to those where it can be shown that there was an intention to kill which resulted in the loss of life. The weight of opinion indicates that drug offences (such as possession and trafficking) and those of a purely economic nature do not meet this threshold. Moreover, States that have abolished the death penalty are prohibited to extradite any person to another country where he or she might face capital punishment."

"Despite such prohibitions, a considerable number of the 47 retentionist States that continue to use capital punishment have carried out executions for drug offences in recent years. In some of these countries, drug offenders constitute a significant proportion of total executions As an entity  of the United Nations system, UNODC advocates the abolition of the death penalty and calls upon Member States to follow international standards concerning prohibition of the death penalty for offences of a drug-related or purely economic nature.

Para 27:

Overall, while human rights law does not usually direct the content of criminal laws or penalties per se, it does demand strict scrutiny to ensure that laws do not deny the rights of individuals. In the case of drug laws in particular, obligations to establish offences under the international drug conventions must be fulfilled while at the same time respecting a range of rights, including the right to health, to the protection of the child, to private and family life, to non-discrimination, to the right to life, the right not to be subjected to torture or cruel, inhuman or degrading treatment or punishment, and the right not to be subjected to arbitrary arrest or detention. As noted by the United Nations High Commissioner for Human Rights, drug laws frequently overemphasize criminalization and punishment while underemphasizing treatment and respect for human rights.

Para 41 (clarifying the right to health includes access to needle exchange and opiate substitution)

"Accordingly, the right to health calls for access to measures such as counselling, advice, clean needles and syringes, and drug dependence psychosocial and pharmacological treatment, including, where appropriate, opioid-agonists therapy (or long lasting opioid-agonists). Such requirements are fully compatible with those of the international drug control conventions. The International Narcotics Control Board notes that governments should adopt measures that may decrease the sharing of hypodermic needles among injecting users in order to limit the spread of HIV/AIDS.72 It is also of the view of the Board that the implementation of drug substitution and maintenance treatment does not constitute a breach of treaty provisions, whatever substance is used for such treatment in line with established national sound medical practice."

Para 59: (on human Rights Impact Assessments)

"UNODC will consider using, where appropriate, the Human Rights Impact Assessment (HRIA) as a predictive tool for assessing the potential human rights impact of a policy or programme, with the aim of informing decision makers and affected persons. By helping to identify the nature and extent of the potential impact, the HRIA facilitates the adjustment of the proposed policy, mitigating the negative and maximizing the positive human rights impacts. HRIA is a combined tool for risk assessment, civil society engagement and decision-making, geared towards ensuring, from the outset, that human rights are at the centre of all policy and programmes. This is a relatively new and developing area and not without its difficulties, but one which could be of significant value for UNODC as a mechanism to mainstream human rights and operationalize human rights commitments and responsibilities. To this end, the HRIA includes a wide range of activities intended to identify and  manage human rights risk and to evaluate humanrights impact, positive and negative, throughout the life of each project."

Of course, This should all have been said years ago - and might have helped avert all manner of drugwar excess and horror if it had been. None the less, progress is progress and this is a useful foundational document for moving forward. So, well done Costa, thank you, and farewell.

How the UNODC welcomes NGO involvement : slurs and exclusion

Author: Martin Powell

• NGOs were initially excluded from the key meetings where the real decisions are taken on resolutions (The Committee of the Whole ), despite having been allowed to attend in previous years. This was only resolved following a procedural intervention from the UK delegation.
• NGOs have one room available for their use, that is too small for us all to fit in at once
• NGOs are expected to share a handful of computers with all the delegates
• The microphone for the single seat allocated for NGOs in the plenary was removed, though has now been returned after we complained.
• The 160 representatives from 55 NGOs (according to the UNODC website) have just this one tiny table (see pic below) to display and share all our materials. Despite assurances that space would be provided to put out materials for delegates to pick up, even this table only materialised today after NGOs complained yesterday.
   

To be meaningful, NGO engagement has to be about more than just letting us through the main door - it has to be about providing genuine opportunities for us to express our views and engage in meaningful dialogue with decision makers at the UN, and country delegations both in and outside the formal meetings.

I understand UNAIDS is pretty good on all of this, but to take an example I am familiar with, when I was working on international development issues I went to many Annual and Spring meetings of the IMF and World Bank where all the member countries get together.

• NGO townhall style meetings with the Heads of the Bank and Fund, and Chairs of key committees where we got time to publicly question them on their policies, and closed meetings with them on key themes with groups of key NGOs
• Staff dedicated not just to NGO registration and support at the events, but also for liaison all year
• Plenty of computers and space dedicated for NGOs
• Plenty of space to display materials, posters etc where the delegates could pick it up
• Controlled but ready access to the press rooms and help distributing press releases to media

NGOs have a huge amount to offer in terms of independent and fresh thinking, factual knowledge and analysis that is not tied to a particular party or national political agenda. This input is invaluable not least forensuring transparency and accountability of these sprawling and often bureaucratic UN organisations to the public at large.

I just hope that Mr. Costa's successor (this is his last CND) takes NGO engagement far more seriously, rather than viewing it as an inconvenience and chore, and at the very least doesn't actively denigrate people and organisations like Transform whose sole purpose is to see the harms from the use and trade in drugs minimised - particularly when they have been awarded UN ECOSOC accreditation to attend and contribute to CND on a formal basis.

Further reading:
Civil Society: The Silenced Partners? Civil Society Engagement with the UN Commission on Narcotic Drugs (IHRA 2009)

UPDATE 16.00

i ) Mr. Costa is now going to have an informal dialogue meeting with NGOs tomorrow morning - at a time that clashes with a planned NGO briefing meeting.

ii) A second table has belatedly appeared to display NGO materials. (But where is the  designated and signposted NGO zone? Should we really have to beg for these things?)

Transform at CND in Vienna

Author: Martin Powell

As Steve Rolles heads off for California, I am at the UN's annual Commission on Narcotic Drugs meeting in Vienna for which Transform has ECOSOC special consultative status.

We are here as more than just spectators. In addition to attending a range of meetings that I will report on over the next few days, we have co-organised our own event, as part of the rapidly growing campaign for an Impact Assessment of drug policy, with our colleagues at theInternational Drug Policy Consortium. We are particularly pleased Carel Edwards the Head of the EC's Anti-Drugs Policy Unit has agreed to speak, as well as the Chair of IDPC Mike Trace, and myself (details below).

I would also recommend checking out the live CNDblog run by IHRA and IDPC which will provide regular  independent updates and reporting throughoutthe CND. IHRAs HR2 blog will also be reporting daily (report on Day 1 is already up)

CND 2010 side event -Time for an Impact Assessment of Drug Policy

10 Mar 2010
Vienna, Austria

All stakeholders in the drugs debate share the goal of a policy and legal structures that maximise social, environmental, physical and psychological wellbeing. Particularly at a time of economic stricture, it is also crucial that drug policy expenditures are cost-effective. Yet despite the many billions of dollars in drug-related spending each year, there are great concerns about the outcomes of the current approach, at the domestic and international level.

• How Impact Assessments can help;
• How Impact Assessments might be commissioned and structured, both nationally and internationally;
• Opportunities and Barriers; and
• Impact Assessment of drug policy and the EU.

• Carel Edwards, Head of the EC Anti-Drugs Policy Unit, DG JLS
• Mike Trace, Chair of IDPC
• Martin Powell, Campaigns Manager, Transform Drug Policy Foundation.

* pic: Steve Rolles 2008

Transform goes to California

Author: Steve Rolles

Steve from Transform is speaking at the Students for Sensible Drug Policy (SSDP) conference in San Francisco this Saturday, presenting Transforms latest publication 'After the War on Drugs; Blueprint for Regulation', at a panel discussion titled 'should we legalize all drugs'. The full SSDP conference program is available here (pdf).

Immediately following the SSDP event Steve is attending the 2-day RAND International Society for Study of Drug Policy 4th annual conference in Santa Monica, where he is chairing a panel discussion on 'Prevention and other community approaches to drug policy'. 

NAO drugs report - No framework to evaluate value for money. Again.

Author: Danny K

"Without an evaluative framework for the Strategy as a whole, the NAO is not able to conclude positively on value for money."

Parliamentary Cocaine Trade Report - Good, bad and downright ugly

Author: Danny K

Today the Home Affairs Committee publishes a report on the Cocaine Trade - to which Transform made a written submission and was invited to give oral evidence. Whilst there is some limited useful content and recommendations, the report overall is desperately disappointing and unlikely to impress or please anyone. It is characterised by weak analysis and poor scholarship, leading to a set of mostly pointless recommendations. Occasionally the recommendations are actively obnoxious (see sentencing recommendations below) - the overwhelming impression being of an ill considered and rushed inquiry that has been badly chaired and poorly supported - and one that has a distinct pre-election feel to it (the evidence has been shaped around a pre-decided narrative).

This is particularly disappointing coming from the same committee that in 2002 produced one of the most important, thorough and influential drug policy reports of the modern era (especially given the fact that three of the committee members from 2001 are still members). Also disappointing is that the report lacks anything approaching the analytical rigor of the last major Select Committee drug report; the Science and Technology committee report on the classification system from 2006, with key analysis from that 2006 report (on, for example, drug harms or the deterrent effect) notably absent from this new HASC cocaine report. It really does seem like a massive step backwards - with few lessons learned, and others forgotten or actively abandoned.

Before chronicling some of the report's multiple failings, first we should acknowledge its strengths. Transform is pleased that the Committee has called for “a full and independent value–for–money assessment of the Misuse of Drugs Act 1971 and related legislation and policy”. This was one of Transform's specific calls to the committee in both our written and oral evidence, and something we have campaigned for since 2002.

We hope that the Government will now reconsider our call to evaluate drug policy using established Impact Assessment tools in the light of this new HASC recommendation, as it was dismissed by the PM, following a private meeting with a Transform representative last year.

We were also pleased to see this recommendation being supported by discussion of the Home Office 'value for money' study that Transform secured publication of earlier this year. Given that the media will almnost certainly ignore this section of the report I think it is worth reproducing in full (note: i. Steve Rolles is from Transform, ii. David Nutt was still chair of the ACMD at this point):

20. Some witnesses suggested there was a need for a cost/benefit analysis of the Misuse of Drugs Act 1971, to assess the evidence of whether the Government’s drugs policy offered value for money. Steve Rolles called specifically for a value for money impact assessment of the 1971 legislation, and told us that the Act had “never been subject to that kind of scrutiny and it is time that it was”. Professor Nutt supported an impact assessment, saying “I think my Council would be quite comfortable if people wanted to review the Act”

21. On 21 January 2010 the Home Office published an evaluation completed in June 2007 by an academic at the University of York entitled Drugs Value for Money Review, which Transform had been campaigning for three years to have released under a Freedom of Information request. The review as published made two key conclusions. Firstly, that there was a real lack of data collected by Government to enable an assessment of how effective its drug policy had been, particularly on the supply side. It stated:

Policies to reduce the availability of drugs produced the greatest analytical challenge. The absence of robust and recognised measures of success, combined with a limited base of research evidence makes it particularly difficult to draw conclusions about supply-side policy.

Secondly, it concluded that Government spending on drugs had not been properly evaluated, making it hard to draw conclusions about whether resources were appropriately allocated:

There is no single, comprehensive, agreed overview of cross-government expenditure. Evaluations of effectiveness are patchy and incomplete, making it difficult to assess value for money and to decide how to best allocate resources in the future

There was a similar indictment in analysis carried out by the UK Drug Policy Commission—a grouping of expert drug treatment and medical practitioners—in April 2007, which concluded that it was “difficult to estimate government expenditure on drug policy, as it is not transparently reported” and that “the UK invests remarkably little in independent evaluation of the impact of drug policies, especially enforcement. This needs redressing if policy makers are to be able to identify and introduce effective measures in the future”

22. The Home Office review was intended to inform the Government’s new Drugs Strategy 2008–2018.32 However, the publication of the strategy in February 2008, only eight months after the review was completed, suggests it is extremely unlikely that the serious criticisms voiced in the review about the lack of an evidence base on which to assess the effectiveness of expenditure on drugs could have been addressed in time.

24. We were very interested to learn that a Government review completed in 2007—the publication of which the Home Office had fought for three years—concluded that the effectiveness and value for money of the Government’s drugs spending could not be evaluated. It is at best careless that the Government nevertheless pressed ahead and published its Drugs Strategy in February 2008 without publishing a proper value–for–money analysis of where resources would be most effectively targeted. We therefore support calls for an full and independent value–for–money assessment of the Misuse of Drugs Act 1971 and related legislation and policy. This assessment must also address the concerns about inadequate data collection raised in the 2007 review.

Beyond this section there is little positive to be said about the report, and much to criticize. Large swathes of it are essentially a workmanlike summary of evidence taken from various sources, prominently including the UNODC World Drugs Report, and various documents from the EMCDDA, NTA, SOCA, UKBA and others. There is nothing wrong with any of this of course, the researchers having done an adequate job of compiling some potentially useful supporting evidence. There are, however, some serious sins of omission. The problems come partly from the evidence that was missed or ignored, but perhaps more importantly, the weak policy analysis that flows from all the evidence presented as we will discuss.

The most notable omission from the evidence considered is the World Health Organisation' s cocaine report from 1995 (details and link to the full report here) the largest global study of cocaine use, risks and policy ever undertaken. This report was suppressed under pressure from the US (until it was leaked into the public domain years later) essentially because it did not fit with the prevailing prohibitionist political narrative. That the HASC has chosen to overlook it, despite it being flagged up in Transform's written submission (and sent separately to the committee secretariat) is a telling reflection on the committee's mindset.


The tone and overarching narrative of the report are framed in the press release that accompanies it, which contains some very dramatic language about the nature of cocaine, and from the outset makes the cardinal error of conflating prohibition policy harms with drug use harms:

"In a report published today, Wednesday 3 March, the Home Affairs Committee warns that a deadly, socially and environmentally destructive drug seems to be becoming more widely acceptable in the UK, and says more must be done to tackle the demand side in the UK alongside international efforts to disrupt smuggling."

This mistaken conflation of drug use and drug policy harms (something that, disappointingly, David Nutt's evidence also failed to challenge) was something Transform specifically warned against in its written submission;

"Any discussion of the cocaine trade in the UK, and what our response should be, requires that we separate the public health problems associated with cocaine use per se, from the secondary criminal justice harms associated with its prohibition."

The press release then produces a 'must try harder' admonition of supply side enforcement agencies' commitment to 'stemming the flow':

"The Committee praises SOCA’s and UKBA’s general approach, namely to actively disrupt the cocaine trade overseas and thereby prevent it reaching the UK..... The Committee was shocked to discover only 3.5 tonnes of the estimated 25–30 tonnes of cocaine which does enter the UK border was seized in the UK last year. The Committee says interception of 12–14% of cocaine reaching the UK is ‘woefully inadequate’, while UKBA’s target to seize 2.4 tonnes of cocaine this year is ‘deeply unambitious’ and lower than the amount it seized in both previous years"

Adding that :

"The Committee suggests UKBA’s low seizure target reflects a culture of complacency"

This summarizes the key failing of the report's analysis; the implied suggestion that the failings of supply side enforcement could somehow be solved with more resources or better organisation, or that the supply of cocaine could genuinely be prevented such that the cocaine problem would somehow diminish or even disappear. This all harks back to the denial-of-reality prohibitionist analysis that: drugs are bad, therefore we will ban them and make the problem go away. Once you have bought into this hopelessly naive premise, as the committee chair seems to have done, all other facts and analysis naturally have to be shaped around it. This is the process that we then have to endure for the majority of the report.

For no obvious or stated reason, the report spends an inordinate amount of time critiquing both UK cocaine seizure rates and the collection and presentation of seizure statistics, somehow managing to completely avoid grappling with the actual impact of seizures on levels of availability. It is important to bear in mind that seizure rates, even if you buy into the overarching prohibitionist analysis (see above), are a proxy measure (or process measure) for the efficacy of supply side enforcement - the actual outcome measures of which are levels of availability, and ultimately levels of use/misuse. At one point the report does note that:

The doubling in wholesale price of cocaine at the UK border between 1999 and 2009 does indicate that more effective supply-side enforcement may have squeezed the supply of the drug to the UK. However, we do not consider that the substantial fall in purity of cocaine at street level can be attributed to supply-side enforcement. The consistency of purity at the UK border but fluctuating levels found in street–level seizures within the UK—some with as little as 5% purity—suggest to us that the fall in purity is not so much driven by overall squeezing of the cocaine supply to the UK, but rather associated with the emergence of a ‘two-tier’ market in which there is demand for lower price, more heavily cut cocaine on the street, as well as higher end product by other consumers. The use of more sophisticated cutting agents which themselves mimic the analgesic effect of cocaine may mean that less pure cocaine has gone to some degree unnoticed. And the increase in the number of users may in itself have driven the available cocaine to be more thinly spread, thus reducing purity levels. (Paragraph 162)

This is the nearest we get to a discussion of the impact of seizures on actual availability but appears to suggest that the impact is marginal at best. The committee suggests that current seizure rates of around 10% are inadequate, but does not suggest what % would be good enough - or suggest how such improved seizure rates might be achieved, or explore possible knock on impacts even if it were (like, for example, displacement to other drugs). There are some rather random examples of enforcement best practice based on the committee's field trips, but it is far from clear if they are seriously suggesting that such models - if rolled out nationally/ internationally - would somehow deliver the desired outcome of actually reducing cocaine use/harms. Crucially they fail to engage with key elements of the analysis:

1. The unintended negative consequences of supply side enforcement - as spelt out in detail in the submissions of Transform and others, as well as being detailed by the UNODC. Some of these harms are mentioned - such as environmental destruction, but again these are blamed on cocaine users rather than the prohibitionist policy environment the committee is evidently supporting. The role of prohibition in creating opportunities for criminals is mentioned only once, in a Transform quote (below).
   
   
2. The' balloon effect' - that even seemingly 'successful' localised supply side enforcement will only achieve a displacement of illicit activity, not elminate it. Steve is quoted in the report saying that: 'History shows with crystal clarity that an enforcement response cannot get rid of the illicit drug trade…it is a fundamental reality of the economic dynamics of unregulated illegal markets where demand is huge; the opportunity is created and criminal entrepreneurs will always exploit that opportunity. Every dealer or trafficker you arrest, another one immediately fills the void.' Only for this analysis to translate into an ambiguous conclusion that 'Neither supply–side enforcement nor demand reduction can on its own successfully tackle cocaine use.'.
   
   
3. At no point do they get to the heart of the matter to highlight the futility and counter-productive nature of supply side enforcement as evidenced by 40+ years of increasingly expensive failure. No examples are given of countries that have delivered good overall drug policy outcomes (in terms of reduced drug use/harms) from more effective or well resourced supply side enforcement (for the simple reason that there aren't any).

As Transform made clear in our written submission:

10. Decades of supply-side enforcement experience at all scales, from international interdiction efforts to arresting dealers on street corners, demonstrate how its successes can only ever be marginal, temporary and localised. This failure results not from incompetence, flaws in execution, or under-resourcing, but because this approach ignores the economic forces of supply and demand in an unregulated illicit market controlled by criminal profiteers.

We also quoted the committee's previous drugs report:

12. Enforcement also has a Darwinian-style ‘survival of the fittest’ effect – it is the most efficient, ruthless, and violent criminal networks that prosper. So the more energetically prohibition is enforced, the worse the ‘cocaine problem’ becomes. In short, as the 2002 HASC drug inquiry report concluded:

“If there is any single lesson from the experience of the last 30 years, it is that policies based wholly or mainly on enforcement are destined to fail.”

Whilst the committee isn't bound to agree with any of this well established historical critique of supply side enforcement, they should at least have tackled it and made the case in support of the wider supply side enforcement paradigm. Nowhere in the report is there anything even approaching this sort of discussion. The Prime Minister’s Strategy Unit Drugs Report of 2003 demonstrated in detail how global prohibition creates much of the harm associated with the production, supply and use of cocaine and heroin. Like the SciTech classification report, and the 2002 HASC drugs inquiry report, it is not mentioned, nor its central findings engaged with.

The same analytical shortcomings and conceptual misunderstandings of supply side enforcement flow through the analysis of crop eradication in South America and the comments on localised UK police operations. Even where useful insights do occasionally appear in the report , in the form of quotes or references, these are never allowed to impinge on the unrelentingly poor analysis of the recommendations and conclusions. It is particularly noteworthy that nowhere in the report is the detailed submissions from the Transnational Institute (arguably the world's leading NGO authority on the international cocaine market and related policy) or the International Drug Policy Consortium quoted or referenced.

In large parts of the report there is evidence that either the inquiry's remit was far to broad, or (looked at another way) that the inquiry has dealt with a series important issues with a woeful lack of depth and detail. Key debates and areas of policy are dealt with in a few paragraphs - a couple of cursory quotes and facts (when far more substantive literature reviews are needed) followed by a rather limp and unconvincing recommendation. Without going into tedious detail on each of the many areas the report attempts to cover, consider for example:

• Prevention and media campaigns - much backslapping about the Government's FRANK campaign supported a single piece of Home Office polling research, but nothing on the wider literature critiquing such mass media campaigns (including that of the WHO 1995 cocaine report, which is not referenced despite its commentary on this point being flagged up in Transform's written submission), or any reference to the ACMD Pathways to Problems report which did consider such efforts in the sort of detail the HASC has conspicuously failed to.
  

• The role of celebrity drug users: Whilst the committee, you suspect rather dissapointedly, acknowledged that 'There is no evidence that celebrity use has made more people turn to cocaine, indeed our witnesses argued strongly against it,' they were, almost laughably, unable to stop themselves from continuing to makes such an assertion regardless, 'However, the seeming propensity of celebrity users to ‘get away with’ using cocaine does contribute to a general trend of glamorising use, as does the social acceptability and normalisation generated by ‘successful’ people who appear to function normally, often holding down high-flying careers, whilst using cocaine.' . This was another example of fitting the facts around a pre-determined narrative (see this appearance of HASC Chair Keith Vaz on channel four news 8 months before the report is published). Guess which part of the report was given most prominence in the press? To find out put cocaine into Google news search...
  
  
• Treatment - a very cursory analysis followed by a call for more residential rehab - but no comparisons of value for money related to treatment outcomes are provided, that would actually support such a call.

• Cocaine harms - The discussion of cocaine related health harms lacks any sophistication, seemly built around the preconceived requirement to make it clear that cocaine is not 'safe'. This seems like a classic straw man, as we are not aware that anyone has been saying that cocaine was 'safe' (no drug is), nor do the committee provide any examples of anyone doing so. The concept that there are a range of cocaine products and range of cocaine using behaviours associated with a spectrum of risks (from negligible to extreme) is largely jettisoned in favour of less-than-useful headline grabbing generalisations about 'lethal' cocaine. Public understanding of risk is not helped by this sort of language - its hard to see what it seeks to achieve, and it goes against much of the more nuanced analysis we have seen from the Sci-Tech committee in 2006,and the HASC in 2002. The discussion of cocaine deaths similarly lacks any breakdown, analysis, or caveats - rather defaulting again to the the 'lethal cocaine' narrative, or cocaine the 'dangerous and lethal drug' (presumably in that order) as HASC chair Vaz describes it in the press release.

There was a similarly limited engagement with the debate on legalisation and regulation. This was a marked contrast to the HASC 2002 drug inquiry which recognised the harms of current policy, and called on the UK Government to initiate a debate on alternatives to prohibition, “including the possibility of legalisation and regulation drugs – to solve the global drugs dilemma” (It is worthy of note that one of the members of the 2002 Committee who supported that recommendation was David Cameron). Steve's contribution is key to the section the Enquiry calls 'Decriminalisation':

Decriminalisation

Several witnesses argued that the supply of and demand for cocaine could not be effectively tackled whilst it remained an illegal drug, but one which for which there was demand. Steve Rolles of Transform Drug Policy told us that:

"When prohibition of something collides with huge demand for it you just create an economic opportunity and illegal criminal entrepreneurs will inevitably exploit the opportunity that it creates."

Lord Mancroft agreed:

"We have controlled drugs in this country but you only have to walk within a mile of this palace to realise that the controls do not work, because anywhere on the streets of London you can buy any of these drugs… The way forward is a range somewhere from the way we control alcohol or indeed the most dangerous object in our everyday lives, the motorcar. If you go outside in the street and step in front of a moving motorcar you will find out how dangerous it is, so what do we do? We do not prohibit it. We license the vehicle, we license the users, we made them pass a test, we make them have insurance so if they damage anybody they have to pay up, we tell them how fast they can use it, on which side of the road. That is control."

The response to this is the most cursory of engagements with the concept of deterrence associated with punitive enforcement, deploying two quotes, one from John Strang:

However, others told us that there was little evidence that decriminalisation would affect demand, and that in fact it would be likely to increase it. For instance, Professor Strang of the National Addiction Centre told us:

"There is no question that the illegality of a substance is a major deterrent to its use…one would have to presume that if legal constraints were taken away the level of use would almost certainly increase."

And one from David Nutt, then ACMD chair:

Professor Nutt also said he would be “surprised if making drugs legal would actually reduce use”. He argued that the, at least partial, success of controlling drugs could be seen in the rise in popularity of ‘legal highs’ being bought over the internet: "People are buying drugs over the Internet which are currently legal, presumably because there is a deterrent to getting illegal drugs…The law must influence people to some extent."

That is all we get - no evidence provided in support of the above Nutt and Strang comments, and no review of the literature on deterrence, no more discussion or analysis. Nothing. This section just ends, somewhat patronisingly, with the comment:

"There is no doubt that the arguments set out by Transform Drug Policy and Lord Mancroft will continue to be debated."

Finally we were deeply disturbed by the recommendation to increase sentences for users, purely on the basis that current sentences were not long enough for prisoners to finish there prison-based treatment programmes. Again - no evidence is given that such programmes are more cost effective than the various non-prison based cocaine treatment options (which have a pretty poor efficacy record anyway - albeit better than prison, and much cheaper).

Related, is the call for harsher penalties for supply, which reeks of populist posturing and is, once again, unsupported by evidence that it would deliver better outcomes. Both of these calls - which would incur significant expense and add to pressures on an already overstretched prison service - sit entirely at odds with the work taking place as we speak by the Sentencing Advisory Panel, (also mentioned in the Transform submission, but ignored in the report) which is seeking to reduce drug related penalties across the board.

We could go on picking holes in the report - but hopefully, if you have read this far, you will have got the point. This is a dreadful report; ill-conceived and poorly executed, a wasted opportunity and a publication for which the committee should be, quite frankly, embarrassed. It entirely fails to do what Select Committees should be doing; scrutinize a policy area shrouded deliberately in obfuscatory myth and taboo. Instead it keeps politicians protected by the glass bubble of pseudo-science and populist fear mongering. The real tragedy is that this process could have been used to expose a failing policy to useful scrutiny and instead has, in large part, wasted taxpayers' time and money on a report that serves primarily to entrench a hugely counterproductive status quo.

It will surely be ignored and quickly forgotten. Indeed our initial glee at finding our Impact Assessment recommendation had been adopted progressively turned to despair as we read through the rest of its shoddy analysis, which rather undermines the one thing about it worth celebrating.

thanks to Steve for help preparing this analysis

Book of the Month - Chasing Dragons

Author: Emily C

Our book of the month for March is Chasing Dragons by Kyle Grayson. The book is listed in our extensive library of relevant and interesting titles and as ever we are grateful to our book reviewer David Hart who has written the following .


From Chinese opium smokers at the start of the 20th century to Somalian khat chewers at its end, Canada has long been home to groups of people whose drug use has led them to be defined as a security threat, and who have been subject to repressive measures by the state.

This book sets out to show how the way drug users have been portrayed in Canada has always been contingent on who has been regarded as speaking the truth about drugs, how Canadians have wished to see themselves, and how they have sought to position themselves relative to other countries, particularly the USA.

A central theme in the book is the tension between the degree to which Canadian authorities are prepared to use repressive measures against drug users and the country's self-image as a liberal, progressive state sharing a border with a punitive, conservative one. It will be a surprise to some readers to learn that Canada was at the forefront of prohibitionist lawmaking in the early 20th century, and that less has changed since than many Canadians would like to believe.

Several subject areas are discussed in the light of this: the popular perception of the relationship between drug use and race, which in the early part of the 20th century was overtly racist in seeing ethnic minorities as a threat to the morals and health of white Canadians, now manifests itself as a sort of cultural racism, whereby Canada cannot claim to be an inclusive multicultural society if it persecutes ethnic minorities simply because they are ethnic minorities, but it can and does limit its inclusiveness non-politically threatening cultural practices such as cuisine, music and dance, while still portraying, say, Somalian-Canadians who abstain from using khat as more enlightened, or at least more welcome in Canada, than those who continue to use it despite it's contraband status.

The process leading up to the decriminalisation of cannabis for medical purposes is also discussed, and again there is a discrepancy between the degree to which Canadians can claim to be living in a more liberal society than the USA after Canada's federal government was forced by the courts to introduce its Marihuana Medical Access Regulations in 2001, and the fact that it remains very difficult for patients to actually receive medicinal cannabis, and the state still pursues a punitive approach to non-medical use. There is also an informative chapter on Canada's rave culture which sprung up in the 1990s and soon found itself demonised by law enforcement representatives for condoning MDMA use, and compelled to organise itself politically in defence. Again, the end result is a situation that looks more liberal on paper than on the ground; while a code of conduct for rave venues was created, so much power was left in the hands of the police in determining how many officers to assign to an event (and charge the organisers for) that the law enforcement community is effectively able to make legal raves economically unviable.All the while, the book seeks to demonstrate how the policy options that could legitimately be debated regarding drug use have been constrained by the public attitudes about drug users.

Unfortunately, much of the early part of the book is phrased in the densely structured, obscure-word-laden language of the post-modernists, making it difficult to follow the sentence structure, let alone the argument. I'm sure it could have been expressed concisely and clearly, but probably the author is just following the fashion in academic circles, rather than willfully seeking to obscure the message. At any rate, once we hit chapter 4 the text becomes comprehensible, so don't be put off; this is a book that has a worthwhile contribution to make to the study of how defining behaviour or persons as a security issue shapes the very way a country can define itself.

UNODC censors its own website making the case for cannabis decriminalisation

Author: Steve Rolles

The page on the UN Office on Drugs and Crime site that we flagged up on the blog earlier this week, has now been censored to remove the section featuring a rare outbreak of pragmatism making the case for cannabis decriminalisation.

This seems rather pathetic. The page in question has sat unmolested since September 2006, over 3 years, only to be stripped of the decrim-arguments now, the day after we blog about it. Why, its almost as if......

Anyway, as people should all know by now the internet never forgets, and you can read the page as it was using the ever useful Internet Archive Wayback Machine.

• Page before
• Page now (note missing section 4)

I hope that the fact they have rather childishly censored this page on their own site will help teach the UNODC another lesson: Internet users do not like being treated like idiots and tend to respond rather badly.

So to all our internet friends: Please link this and the previous blog as much as possible, blog about it elsewhere, and use twitter, facebook and all your other internet toys to get the original page (and its censorship) as much publicity as possible.

By all means contact a few journo friends as well, see if you can get it in the news. They should be interested as it makes considerably more interesting news than (or at least an interesting counterpoint to) the latest tedious INCB report, obsessed as ever with attacking countries who, wait for it, dare contemplate decriminalising drug possession.