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All Substances News Archive

So What WAS in the News?

Substance abuse, whether legal or illegal, is so widespread in modern society that there are many stories about it in the news everyday.

This page contains stories, related to substance use in general, which were, originally, placed on the Substance Abuse News page but which can no longer be called 'News'.

Please go to the 'Phantastica' page to access stories related to specific substances.

Happy Anniversary Mexico? Not really
11th December 2011

Five years since Mexico's president launched his war on drug cartels and over 50,000 people are dead.

Read more in today's blog

HASC to Examine Drug Policy
2nd December 2011

The Home Affairs Select Committee is to comprehensively examine government drugs policy. The announcement produced an almost instant 'How dare they?' response from Kathy Gyngell.

Read more in today's blog

The Lies They Tell to Justify Prohibition
18th November 2011

A number of documents from official bodies (governments, agencies, UN organisations) all use misleading information and lies to try and sustain the myth that the 'war on drugs is working.

Read more in blog entries for today and yesterday.

Advisory Council on Misuse of Drugs (ACMD) on Simple Possession
15th October 2011

A small media storm results from a realisation that the ACMD has been saying, for some time, that those whose only offence is simple possession should not be processed via the criminal justice system.

Read more in today's blog.

Cathy Gyngell Agrees with Global Commission on Drug Policy
23rd September 2011

Attempting to rubbish GCDP report Gyngell demonstrates that the war on drugs has failed which is GCDP's main conclusion.

Read more in today's blog.

‘Smoking, drinking and drug use among young people in England in 2010’ published.
29th July 2011

The NHS in England publishes an annual survey of substance use by 11-15-year olds. A discussion of its findings can be found in the blog.

BCS Report, ‘Drug Misuse Declared’ Published
28th July 2011

The British Crime Survey (BCS) publishes an annual report on drug use based on a self-reporting survey. Some of its findings are discussed in the blog. A key finding, this year, is that mephedrone's legal status did not encourage new users to try a psychoactive substance for the first time.

2011 'World Drugs Report' Published
23rd June 2011

The United Nations Office on Drugs and Crime (UNODC) has published its annual 'World Drugs Report'. This is the first to be produced under the new Executive Director, Yury Fedotov, and, though it puts use ahead of production, which may be a significant change, it continues the tendency to highlight truths about the illicit drug world, such as that it provides enormous amounts on income to criminals, without drawing the obvious conclusion that fifty years of UN based prohibition has only succeeded in greatly increasing the harm caused to millions of people.

You can access the report from the UNODC website or read more about my thoughts on it in my daily blog.

'The global war on drugs has failed, with devastating consequences for individuals and societies around the world.'
4th June 2011

The opening sentence of the 'REPORT OF THE GLOBAL COMMISSION ON DRUG POLICY' published on the 2nd June expresses a truth that is becoming increasingly acknowledged in the mainstream and not just by those who have been calling for reform for some time.

This excellent report should be read in full (it is only 25 pages in total but the main text covers only 16 of those) and I shall not attempt to summarise it here.

Given the membership of the commission, including former presidents, a former UN Secretary General, former senior staff at the UN and high profile business leaders, it is not surprising that the report received large scale media attention.

Some of that coverage has continued to follow the idealistic line that 'drugs' should be eliminated from society but quite a large part has focussed on the healthcare issue and, especially, on the lack of quality control of substances supplied via illegal markets.

Some reformers are asking if this is, at last, the 'tipping point'. It may be, but concern remains that the current UK government is looking to reduce the harm reduction approach to substance use in favour of 'tougher' law enforcement. The reasons for this are all to do with the politics of being in a coalition with the Conservatives anxious to show the right wing that it has not been abandoned by the need to work with the Liberal Democrats.

I said I wouldn't attempt to summarise the report but there are three individual items that particularly struck me.

The 1961 UN Single Convention on Narcotic Drugs does talk in terms of complete eradication and this has been used to justify the 'war of drugs' since President Nixon declared it forty years ago. The report, however, notes that the convention 'made it clear that the ultimate objective of the system was the improvement of the ‘health and welfare of mankind’'. In other words, there is no need to throw out the 1961 convention which is what the opponents of reform claim reformers wish to do. Instead, a harm reduction approach is a way to implement it.

The report gives a number of case studies involving countries that have implemented harm reduction policies including things like substitution provision and decriminalisation for possession of small quantities. The Swiss experience is of particular interest. Switzerland's harm reduction policies including prescriptions for hard-core users not only produced the expected health benefits for addicts and crime reductions as users no longer had to commit property crimes to obtain their supplies. By reducing the demand for illegal heroin from these high users, it appears that the criminal market became less viable overall and the availability of heroin to new users was reduced. In Zurich, in 1990, 850 new heroin addicts were registered. In 2005, that number had fallen to 150.

And the third point in the report that struck me was the call for 'credible' information on the risk of drug use. That struck a particular chord with me because, on Thursday, I visited the Alnwick Gardens for the first time this year. New information boards have been placed on the fence close to the entrance to the Poison Garden and one of these says 'some plants become killers only in the hands of men, like tobacco, coca, cannabis and opium poppies'. Suggesting that cannabis is a 'killer' plant is not credible and, I would argue, destroys any hope of the Alnwick Garden's 'anti-drug' message being listened to by young people. You cannot expect people to accept what you say about heroin, alcohol or tobacco if what you say about cannabis is complete nonsense.

The Duchess of Northumberland has a strong commitment to improving the lives of young people in all manner of ways. It is, therefore, a pity that she is being ill-advised when it comes to what is 'credible' in the eyes of young people who may be tempted to experiment with psychoactive substances.

More Detail on Relative Harms
12th February 2011

In 2007, while still chairing the Advisory Committee on the Misuse of drugs (ACMD), Prof David Nutt and colleague published a study intended to try and establish a harm scale for a variety of substances, legal and illegal. That work can still be viewed on the Lancet website (link goes to a summary but the full paper is available with free registration). This paper was used as the basis for the Harm Scale page in this section of this website. One criticism I raised, was that by giving equal weight to the three areas examined, physical harm, dependence and social harm, the distinction between harm caused to those involved directly in consumption was being equated with harms to society.

Prof Nutt and his colleagues at the the Independent Scientific Committee on Drugs have now published, again in the Lancet, 'Drug harms in the UK: a multicriteria decision analysis' (as above, the link goes to a summary but the full paper is available with free registration). This looks at a more detailed way of evaluating harm and gives weight to the differences between harms caused to users and harms caused to society (referred to as 'others').

The paper concludes that overall the greatest harm to both users and others is done by alcohol with heroin, crack cocaine and metamfetamine following. Interestingly, metamfetamine scores its fourth place in spite of being judged to cause almost no harm to others.

The work has been portrayed by some as an attempt to change the classification scheme. Prof Nutt has said, however, that the work simply demonstrates, that 'the current classification is based on something other than harm'. He has called for an investigation to determine what the classification system is based on.

His point that harm is not the determinant of classification is best seen with Ecstasy which rates as 17th out of the 20 substances considered yet is classified as a Class A substance putting it alongside the No. 2 & 3 substances.

Though some commentators have expressed surprise that tobacco only ranks sixth in the list, Prof Nutt says this results from the analysis looking at a much wider range of harms than simply the shortening of life.

This new paper certainly offers a more detailed analysis than the earlier work but the recent pronouncement from the Home Secretary on what she believes the ACMD should do does not suggest that this rational approach to harm will be adopted by the government.

Slight Fall in Alcohol-related Deaths in 2009
10th February 2011

Adding to the snippet of information, previously noted, the UK's Office of National Statistics has recently published its annual survey of 'Alcohol-related deaths'. I've put quotes around that because it is important to note that these figures relate only to deaths directly attributed to alcohol. There are known to be deaths due to, for example, falling when drunk that are not attributed to alcohol in such a way as to be included and there are known to be instances where deaths after long-term alcohol use are attributed to some other cause that would not have arisen unless the deceased had been a regular drinker. Thus, the total number of deaths in which alcohol is a factor is much higher than this report states but, by collecting data on a systematic basis, it may be more useful in terms of identifying trends.

(Because of the rather odd way that the UK is structured, this report gives figures for the UK, in total, and separate figures for England and Wales. Separate figures for Scotland and Northern Ireland are available.)

In total, in 2009, at 8,664, there were 367 fewer deaths in the UK directly attributed to alcohol than in 2008. This is the first year, since 2000, that such a year on year reduction has occurred but the total, 5,690 men and 2,974 women, is still substantially higher than the 2000 figures, 4,483 men and 2,401 women. Taken on a per 100,000 of population basis, alcohol deaths have risen from 11.2 in 2000 to 12.8 in 2009. These figures should be viewed with caution since they take no account of the change in the make up of the UK population over the period.

This relatively small reduction may be the result of the UK's economic situation rather than any realisation of the dangers of alcohol but, because the figures do not separate deaths from short-term high consumption as opposed to long-term abuse, it is not possible to estimate the effect this may have had.

What is undeniable is that alcohol continues to cause many, many more deaths than all the illegal substances combined.  

'And There is a Correct Answer'
8th February 2011

Very often people ask questions in such a way that the answer they are seeking is perfectly clear. This starts in childhood, 'Shall we clear up this mess?', and continues, for many, throughout their lives.

Thus, on 2nd February, UK Home Secretary, Theresa May, wrote to Prof. Les Iversen, Chairman of the ACMD, setting out the priorities for the ACMD in the coming year.

Before going further it is worth being reminded of the purpose of the Advisory Council on the Misuse of Drugs. The Home Office website says;

'The Advisory Council makes recommendations to government on the control of dangerous or otherwise harmful drugs, including classification and scheduling under the Misuse of Drugs Act 1971 and its regulations. It considers any substance which is being or appears to be misused and of which is having or appears to be capable of having harmful effects sufficient to cause a social problem.

'It also carries out in-depth inquiries into aspects of drug use that are causing particular concern in the UK, with the aim of producing considered reports that will be helpful to policy makers and practitioners.'

Granted, that suggests a degree of presupposition. The ACMD investigates a substance if it 'is having or appears to be capable of having harmful effects' so the ACMD wouldn't be investigating if the substance weren't harmful but the perceived purpose of the ACMD is to look at evidence and make recommendations based on that.

Ms May's letter contains a number of instances where she makes the correct answer she is seeking perfectly apparent. The ACMD has already indicated that it intends FOR THE FIRST TIME IN ITS HISTORY to look at the 'harms of cocaine as a single substance'. This review is because of 'the need to disabuse the misapprehension that cocaine is a relatively safe drug'. So, before the ACMD has even begun its review, it knows that the evidence about cocaine use is a 'misapprehension'. Quite why the committee needs to spend time on a review when the result is known is unclear.

In spite of completing a full review in 2005, and the fact that little or nothing has changed since then, the ACMD returned to the subject of khat in October last year. Commenting on this Ms May says that she understands that ACMD will make 'particular reference to the societal harms of khat'. Inclusion of 'possible' or 'potential' or 'extent of' might have left the ACMD thinking that Ms May did not already know what she expected the committee to report.

Ms May asks the ACMD to proceed with its work on cocaine 'with immediate effect' but then says that it should continue 'the review of khat at the next available opportunity within its work programme, giving khat priority over any other further planned work'. (my emphasis)

So, Ms May considers khat to be more important than the ACMD's work on novel psychoactive substances, more important than its work on polysubstance use and more important than assessing the effectiveness of treatment programmes.

It's quite hard to avoid the conclusion that the importance of khat, a substance used by a very limited number of people that shows no signs of becoming more widely adopted, is simply that the government has already decided to make it illegal and wants the cover of the alleged 'evidence' of the ACMD before it acts.

Hans-Christian Raabe 'Outed' by ACMD
7th February 2011

Just two weeks after his appointment raised concerns about the future direction of the Advisory Council on the Misuse of Drugs (ACMD), Dr Raabe has been dismissed from the committee. In the entry dated 22nd January, I wrote that Dr Raabe was known for his anti-gay views. These, most notoriously, came in a paper in which he contended that all paedophiles are gay and implied that this meant that all gays were paedophiles.

Though there was immediate condemnation of his appointment both online and in the conventional media, it seems the Home Office was not aware of the existence of this paper at the time of his appointment. He has, therefore, been dismissed for failing to advise the government of anything in the past that could cause controversy.

It does seem a little bizarre that, it appears, the extent of the checks into Dr Raabe's suitability for the role extended only as far as asking him. Especially as, in 2007, he was found to have concealed his anti-abortion views from a House of Commons committee to whom he gave evidence as a 'medical expert'.

The government has said it plans to move swiftly to appoint another GP in his place. Let's hope the move is not so swift that they don't assess the ability of the proposed new member to analyse evidence without prejudice.

Where's the Harm?
6th February 2011

It is often said, by opponents of prohibition, that the harm caused by the illegal substances is dwarfed by the harm that results purely from that status. Those arguing for the status quo are accused of using arguments that relate to the harm caused by criminalisation rather any innate harm in the substance itself. The most obvious, of course, being that drug users steal to be able to buy drugs so there must be criminal sanctions against them. That, of course, ignores the fact that, if drugs were regulated and problem users treated as in need of health care, the need to commit crime would be diminished.

Given the difficulty of dealing with a situation which is affected by two different factors, you would assume that any government would have looked at how to separate the two effects in order to design the best means of approaching them.

Not so.

On 1st February 2011, Bob Ainsworth* MP, the former Defence Minister in the UK's last Labour government, asked James Brokenshire, Parliamentary Under Secretary of State at the Home Office, a position which Ainsworth held from 2001 to 2003, whether the 'Department has (a) undertaken or (b) evaluated research on (i) harm caused by drugs and (ii) harm caused by the criminalisation of drugs'.

Mr Brokenshire detailed the extensive work undertaken in connection with section (i) of the question which I shan't reproduce here.

I shall, however, reproduce his complete answer on the government's level of interest in understanding the harm cause by criminalisation;

'(ii) The Home Office has not undertaken or evaluated any research into any harm caused by the criminalisation of drugs.'

*Mr Ainsworth was criticised in December 2010 for calling for all drugs to be legally available. He said that his time, 2001-2003, as the government minister responsible for drugs policy had led him to conclude that the war on drugs could not be won. Prohibitionists produced their usual arguments and anti-prohibitionists asked why Mr Ainsworth hadn't shared his thoughts during the seven years after leaving the Home Office when, as a member of the government, something might have been done.

Waiting until he was a back-bencher gave the impression that he did not want to blight any chance he might have of holding office by speaking out for all the people, drug users and victims of the crimes committed by problem users, whose lives are ruined by prohibition.

President Obama says it is time to talk
29th January 2011

The development of technology means politicians no longer have to go out on the streets to interact directly with the people. On Thursday, President Obama took part in a video forum, organised by YouTube, to enable selected members of the public to put questions to the president. In this extract, the off-screen moderator can be heard explaining that drugs policy had not been one of the subjects intended to be raised but that it had dominated the submissions from people requesting the chance to put a question to the president.

The selected question came from a former law enforcement officer who is now a member of LEAP (Law Enforcement Against Prohibition). It brought the response from President Obama that, though he does not believe in legalisation, he does believe it is "an entirely legitimate topic for debate". He goes on to compare the problem of reducing drug use to the way that attitude change was what made seatbelt wearing the norm.

His tone, that there should be a "serious debate" about how to reduce drug use and how to reduce the use of incarceration as the attempted means of control and that drug use should be looked at as a public health problem offers some encouragement that the topic of how to deal with these substances better may, finally, be on the table.

It certainly suggests a more pragmatic approach than that which seems to be emerging from the UK government. Here, the mindset seems to be a return to the failed notion that you can create a drug free society.

Mixed Messages on Substance Misuse
29th January 2011

Within the past week the UK's NHS has published information about use of illegal drugs and alcohol. Understanding what this information really means is complicated by a number of factors. Because of the different areas of responsibility for things like health and law enforcement, some of the figures cover the whole of the UK, some only England, some only Wales and some England & Wales. Drawing conclusions from comparing different data is, therefore, fraught with danger.

Another complication comes from the separation between illegal drugs and alcohol. This means that these two, strongly related, areas are dealt with in separate reports. On 27th January the NHS Information Centre released  Statistics on Drug Misuse, England - 2010 Report (note that the title makes no mention of Wales) and, on the same day, according to newspaper reports dated 29th January (for example, the Daily Mail) it published figures showing an increase in under 15 drinking, especially amongst girls.

So far, I have not been able to locate the source document for the press reports so it's hard to offer a considered analysis.

What I have found is this summary on alcohol deaths in the UK in 2009.

Both the report on drug use and the alcohol deaths figures suggest a decrease in usage. With alcohol, it is suggested that the economic downturn is responsible for the reduced deaths. With drugs, the tone of reporting has been to suggest that young people, in particular, are turning away from illicit drugs. This is being used, by some commentators, to suggest that current policy is working and enforcement efforts should be increased.

Given that alcohol related deaths may result from years of misuse it would seem to be a stretch to suggest that a decrease in deaths in one year was the result of economic conditions in that year. Indeed, if the Mail report is correct, the signs are not the economy did not affect consumption of alcohol in all sectors.

Because of the difficulties mentioned above, I shall try and avoid making the same mistakes these commentators have, that is over-stating the conclusions to be drawn from the data.

What does not appear to have been considered is the effect of a switch from illegal substances of dubious strength, like ecstasy and cocaine, to legal highs (for much of the period reviewed mephedrone was legal and widely available). Nor is it possible to estimate whether alcohol was substituted for illegal drugs to any large extent meaning that young people continued to expose themselves to harm in the interest of having a good time rather than eschewing all chemical manipulation of their physical and mental states.

Though there do seem to have been reductions in Class A drug use, the main downturn is reported for cannabis. With the lag between cause and effect, it is worth considering whether the move away from cannabis results from the downgrade to Class C which came to an end in January 2009. Note that the '2010' report actually looks at the period April 2009 to March 2010.

Reading this back, I realise I have, probably, done no more than create confusion in the reader's mind. I shall return to the subject once I have the source data on alcohol reported in the press and try for greater clarity.

One conclusion I think is clear; there is no chance of understanding the situation regarding use of potentially harmful substances unless they are dealt with in a single document covering 'drugs', alcohol and 'legal highs' so that substitution effects are brought out.

New Appointments to the UK's ACMD
22nd January 2010

Following the changes to the requirements for membership of the UK's Advisory Council on the Misuse of Drugs (ACMD), see below, the UK Minister for crime prevention, James Brokenshire, has announced nine new appointments to the committee.

The function of the committee is to examine the evidence relating to substance use and recommend action, based on the evidence, to the government.

It is, therefore, no surprise that there has been considerable concern that the nine new appointees includes Dr Hans-Christian Raabe, a GP who is a prominent member of the Manchester-based Maranatha Community, an organisation with very strong anti-gay views. Dr. Raabe is on record as believing that the government and the nation must be totally committed to the ideal of a drug-free society. Not much chance there then that he will look at evidence in an open-minded way and provide advice based on science.

But Dr Raabe is not the only new appointee who may have less than perfect respect for scientific evidence. The announcement does not say why each appointee has been thought suitable so it can only be hoped that Susan Graham's appointment is not because she believes that acupuncture can be used to cure addiction.

It appears that, in the same way that Labour appeased its left by banning fox hunting, David Cameron is looking to appease the right-wing of the Conservatives by being 'tough on drugs' regardless of what additional harm is done to users as a result. And regardless of his personal belief that the present Misuse of Drugs Act needs re-examination.    

UK Government to Ban Alcohol & Tobacco
2nd December 2010

Actually, the UK government isn't planning to ban alcohol and tobacco but they do intend to give themselves the power to do so.

At present, the Misuse of Drugs Act (MDA) gives the government the power to classify a substance as Class 'A', 'B' or 'C' if there is evidence that the substance is harmful. The Advisory Committee on the Misuse of Drugs (ACMD) is the body which is supposed to look at the scientific evidence and make recommendations based on its findings.

This process, if it is to be done properly takes time and, faced with a media onslaught against a particular substance, time is something which government doesn't have. With mephedrone, media hysteria about deaths (which, later, turned out to be unrelated to mephedrone) forced the ACMD to abandon all pretence of being an independent scientific body. The chairman, Prof Les Iversen, was presenting the committee's conclusions to the, then, Home Secretary while the committee was still meeting to determine what those conclusions should be.

Realising the ridiculous position this created, the current government wants to give itself powers to issue a temporary ban on any substance that the Daily Mail decides is bad. Sorry, that should read any substance that is raising concerns about its harmful effects.

But, this is where the problem comes. Drafting any law is complex and can have unforeseen consequences but drafting laws in a hurry without having a clear idea of what is intended greatly increases the chance of something going badly wrong.

The Police Reform and Social Responsibility Bill deals with a great many areas of the criminal justice system.  Schedule 16 to the bill details amendments to the MDA to be made in order to give the temporary banning powers the government wants. This gives the government the ability to issue a 'temporary class drug order' against any substance that is not already classified as Class 'A', 'B' or 'C'. 'ANY' substance.

The grounds for making such an order are that 'the substance or product is a drug that is being, or is likely to be, misused, and that misuse is having, or is capable of having, harmful effects'. The definition of 'drug' is one of those circular ones beloved of governments. A substance is a 'drug' if it is subject to one of the four classes under the MDA. In other words, if the minister classifies something as being in the 'temporary class' of drugs, then it is a drug.

The classification as a 'temporary class' drug is to be made by means of Statutory Instrument and is, thus, not, normally, subject to consideration in parliament.

There can be no doubt that both alcohol and tobacco fall into the definition of substances causing or capable of causing harm if 'misused'. Though the government would, I'm sure, say that it has intention of banning these two substances, these amendments to the MDA, if passed, would create another law where the only control over draconian measures would be trusting a government not to use the powers it has.

Schedule 16 of the bill can be read here and the rest of the Police Reform and Social Responsibility Bill can be found by following links from that page.

Transform Renews Impact Assessment Call
2nd December 2010

Transform Drug Policy Foundation has renewed its call for an Impact Assessment (IA) to be made of UK drug policy.

Impact assessments are a standard tool of government designed to demonstrate that a policy, either in place or proposed, is the most cost effective way of dealing with a situation.

Nearly every area of policy has been subjected to an IA except drugs. In 2007, the, then, government concluded that an IA could not be successfully made on drug policy. In 2010, the UK Home Affairs Select Committee strongly disagreed and called for 'a full and independent value-for-money assessment of the Misuse of Drugs Act 1971 and related legislation and policy'.

Former PM, Gordon Brown, took a 'because I say so' attitude to drug policy by indicating that, regardless of the outcome, an IA into drugs policy would not change the policy and was, therefore, a waste of effort.

The UK's coalition government is led by two men, Prime Minister David Cameron and Deputy Prime Minister Nick Clegg, who have both, in the past, called for drug policy to be re-examined. Transform's renewed campaign points out that undertaking an IA is not making any commitment to change. People on all sides of the argument should be willing to subject their beliefs to review.  

Many More Calls for Drug Law Reform

July & August 2010 saw a large increase in the number of people calling for changes in the prohibition based drug laws around the world. Those expressing their opinion that the 'war on drugs' is a harmful failure and another way must be found include a former Mexican president, the UK's Observer newspaper and Angus Macqueen who made a three part television documentary for Channel 4 entitled 'Our Drugs War' in which he explained why his assumption that drug prohibition must be the right approach was demolished when he began to look at the subject in detail.

Also adding his voice to the calls for change was Professor Sir Ian Gilmore, the outgoing president of the Royal College of Physicians, who welcomed, chairman of the Bar Council of England & Wales, Nicholas Green QC's call for decriminalisation of personal use but went further and called for 'a regulatory framework' around drugs.

A year ago, each of these pronouncements would have merited a separate section of this page but, it seems, what were isolated voices calling for change have become a clamour. It may be that the UK has started on a road which will lead to a more sensible way of dealing with the problems caused by substance (ab)use.

Who's Using?

Two recent reports in the UK, when taken together, illustrate how difficult it is to quantify illegal substance use.

The British Crime Survey (BCS) was established in the hope of getting a clearer view of the actual level of crime because it was recognised that police statistics for reported crime were missing crimes, generally minor in nature, which weren't  being reported to the police. As part of the BCS, a confidential self-report survey of illegal drug use is conducted.

The UK Home Office has just released 'Drug Misuse Declared: Findings from the 2009/10 British Crime Survey'.  The pdf file of the report is available here (opens new window).

The UK National Health Service (NHS) runs the National Treatment Agency for Substance Misuse (NTA) which, in turn, operates the National Drug Treatment Monitoring System (NDTMS) (click to visit website in new window). In February 2010, the NTA published the NDTMS annual report for 2008/9. Click here to access the pdf of the NDTMS annual report (opens new window).

The NTA estimates that there are 330,000 'problem users' of heroin and/or crack cocaine in England and the NDTMS annual report says there were 167,256 adults who received treatment for problem opiate use from a total of 210,815 total 'clients'. This could be taken to suggest that around  260,000 of the 330,000 'problem users' are using opiates. These figures are for England alone.

The BCS, which in spite of being the 'British' Crime Survey has data for only England & Wales, finds that 55,000 people use opiates and estimates the accuracy of its measure as being between 42,000 and 103,000.

Even taking the highest estimate, the BCS is saying opiate use is less than half the NDTMS estimate and, given that the NDTMS has actual data on treatment events which far exceed the BCS estimate you have to conclude that the BCS figures are unreliable.

The NDTMS numbers, however, are also not complete because they ignore opiate users who are not in the 'problem user' category. Now, for opiates, that may not be many but, with something like cannabis, only a tiny percentage of users will be 'problem users' and the NDTMS figures are no help in determining how many people are using cannabis.

So, if the NDTMS figures don't help with estimating cannabis users and if the BCS figures for cannabis are as unreliable as its figures for opiates clearly are, then there really does seem to be no answer to the question 'Who's using?'.

Bar Council Chairman in Call to Legalise 'Personal Use'

The UK's Bar Council is the organisation which represents, and regulates, barristers. On 29th June 2010, its Chairman, Nicholas Green, sent out a newsletter to members covering a range of topics.

By 19th July, the mainstream press had noted that one paragraph of this newsletter suggests that, if the growing evidence that decriminalising personal use can have positive consequences is correct then it would be 'rational' to pursue such a policy.

The reports draw on the 'usual suspects' to condemn Mr Green and try to paint the picture that he is advocating drug use amongst children. This sort of reaction is expected from the media. In this case its vehemence may be to do with the fact that, elsewhere in the same newsletter, Nick Green welcomes Kenneth Clarke's views on cutting the prison population and, when calling for a 'rational approach' to policy notes that 'A rational approach is not usually the response of large parts of the media when it comes to issues relating to criminal justice'.

The full newsletter, which amounts to just a single page, can be read at The Bar Council's website (opens new window).

UNODC World Drugs Report 2010 - No Change

The United Nations Office for Drugs and Crime (UNODC) issued its 2010 'World Drugs Report' on 26th June. In its central features, it remains very much the same as previous reports.

In his introduction the Executive Director, Antonio Maria Costa, expresses his concern that drug users are being treated inhumanely.

'Around the world, millions of people (including children) caught taking drugs are sent to jail, not to treatment. In some countries, what is supposed to be drug treatment amounts to cruel, inhuman or degrading punishment – the equivalent of torture. In several Member States, people are executed for drug-related offences. In others, drug traffickers are gunned down by extra-judicial hit squads. As human beings, we have a shared responsibility to ensure that this comes to an end. Just because people take drugs, or are behind bars, this doesn’t abolish their right to be a person protected by the law – domestic and international.

He goes on to state that 'drug production and trafficking are both causes and consequences of poverty' and that 'Drug-trafficking has become the main source of revenue for organized crime, as well as to terrorists and insurgents: in other words, drug-related illegality has become a threat to nations in so many theatres around the world'.

The Executive Summary notes that, since 1998 when 'a special session of the UN General Assembly decided to work towards the “elimination or significant reduction” of illicit drug production' worldwide opium production has increased by 78%.

Of the estimated 155-250 million people who use an illegal substance at least once a year it is estimated that up to 38 million of them can be classified as 'problem users' and that the most optimistic view suggests only 30% of these people had access to treatment.

And what is the suggested answer to this situation where millions are being mistreated by their governments, where actions by governments are increasing the earnings of organised crime and terrorists and where up to 25 million people with health problems resulting from their substance use are unable to access treatment of any kind?

The answer, of course, according to Mr Costa, is to ignore 'the renewed calls to dump the three UN drug conventions that critics say are the cause of crime and instability' because 'dumping' the conventions would undo the 'progress' which has been made. 'Progress' which includes, lest we forget, a 78% increase in the production of opium, a significant increase in the adulteration of substances like cocaine and ecstasy and a major switch from the well-known psychoactives to novel formulations like ketamine and mephedrone whose long-term effects are not well understood.

In other words, the 2010 World Drug Report can be summarised in the same terms as it predecessors, 'The policy isn't working - let's have some more of the same policy'.

The full report and ancillary information is available from the UNODC website (opens new window). It is important to treat all the figures given with care. The report notes that collection of reliable data, especially from less-developed countries, is very difficult but then goes on to quote some figures as being accurate to within 100,000.

Who Said That?

The following are quotes extracted from a newly available 'discussion paper', but can you tell which organisation is behind this document?

Drug dependence is a health disorder (a disease)

In fact, incarceration in prison and confinement in compulsory drug treatment centres often worsens the already problematic lives of drug users and drug dependent individuals, particularly the youngest and most vulnerable

There is considerable evidence that effective drug dependence treatment offering clinical interventions (inpatient or outpatient) as an alternative to criminal justice sanctions substantially increases recovery, including a reduction in crime and criminal justice costs

The most rigorous and conservative scientific estimates from five “meta-analyses” have all concluded that drug courts significantly reduce crime by as much as 35 percent compared to imprisonment.

Treatment as an alternative to criminal justice sanctions is specifically encouraged in the international drug control conventions and it has been found to be more effective than imprisonment in encouraging recovery from drug dependence and reducing drug related crime.

All these quotes come from a draft discussion paper entitled 'From coercion to cohesion' with the subtitle 'Treating drug dependence through healthcare, not punishment'. It comes from the United Nations Office on Drugs and Crime (UNODC) though, it appears, it is not, yet, available from the UNODC website.

It can. however, be obtained from the International Drug Policy Consortium website. (opens new window)

It will be interesting to see if this document survives in its present form to go from draft discussion paper to formal UNODC policy.

[Update The full paper can now be found on the UNODC website (opens new window - pdf file) but it retains the status of a 'discussion paper' rather than being UNODC policy.] 

There are a number of occasions where the paper points out that treatment rather than sanction is encouraged by the UN conventions on drugs and it is true that Article 38 of the 1961 Single Convention on Narcotic Drugs mentions treatment as a means of dealing with 'persons involved' in drug abuse but this comes after Article 36 has said that dealing with serious offences, including possession, should be dealt with by 'adequate punishment particularly by imprisonment'. 

What's in That?

A new report 'Cut - A Guide to the Adulterants, Bulking agents and other Contaminants found in illicit drugs' offers the first detailed study of what does actually get added to drugs to either bulk them up or change their effects.

The authors say there is little evidence of harmful substances being deliberately added which, as they say, would be a bizarre way for suppliers to act but they do note that many substances which are added are harmful in their own right and that poor manufacturing controls can lead to contamination. The present anthrax outbreak amongst heroin users is, probably, more to do with unhygienic processing that anything else.

Some examples are, however, given of adulteration for profit, such as lead in cannabis as a means of increasing the saleable weight and it is reported that up to 10% of cannabis seizures in the UK have glass present.

The report concludes that substances may be intentionally adulterated for a variety of reasons or contaminated by poor manufacturing practice. It also notes that too little attention is paid to identifying and quantifying adulterants in seized samples where the amount of the illegal substance is, generally, the only concern.

The report stops short, however, of the obvious conclusion that the way to control adulteration and contamination of drugs is to apply quality standards to manufacture within a regulated regime.

Money well spent?

The UK's House of Commons Committee of Public Accounts has published 'Tackling problem drug use' (pdf file, opens new window) the result of its investigation into the £1.2bn a year spent on trying to reduce the number of people, especially the young, who become problem drug users and reduce the estimated £13.9bn annual cost of drug related crime.

It's an understatement to say that the committee are not impressed. Its first conclusion is 'The Government spends £1.2 billion a year on measures aimed at tackling problem drug use, yet does not know what overall effect this spending is having.'

Finally, after pressure from the National Audit Office, the Home Office is to produce 'an overall framework to evaluate and report on the value for money achieved from the strategy' but this 'framework' is not expected to be available before late 2011 so it will be some time after that before useful data is collected.

For many people, one possible explanation for the absence of any proof that the government's drug strategy is working is that it knows it is not so does not want the spotlight turned on the failure to deal with substance use using prohibition as the main weapon.

Transform Launches Book on What Happens After Prohibition

Transform Drug Policy Foundation (TDPF) has published a book, by its Head of Research, Steve Rolles, entitled 'After the War on Drugs; Blueprint for Regulation'.

There are an increasing number of people willing to say that the 'war on drugs' isn't working and that prohibition is not the way to deal with psychoactive substances. Even the political editor of the Sunday People has called for a Royal Commission to look at the current situation.

For many, however, the question of what the alternatives are has been harder to answer. 'After the War on Drugs; Blueprint for Regulation' looks at possible models for dealing with the end to prohibition. Importantly, it suggests different ways of dealing with different substances to take full account of the effects of each substance.

The full text of the book can be downloaded, free, from the TDPF site (as well as an Executive Summary in English, Spanish and Portuguese) or a paperback version can be purchased from Amazon and others.

EMCDDA* Publishes 2009 Annual Report

*European Monitoring Centre for Drugs and Drug Addiction

The following are some key quotes from the 2009 annual report of EMCDDA.

• Polydrug use and concomitant alcohol problems are now the defining elements of the European drug problem.
•Individuals who use drugs almost never restrict their consumption to a single substance.
•In Europe today, polydrug patterns are the norm.
•Actions to reduce the supply of one drug are clearly devalued if they simply open the door for the use of a substitute, which may be even more damaging.
•[I]t has become recognised that a defining factor in Europe’s substance use problem is the concomitant consumption of alcohol. This too can be seen across every age group. Among schoolchildren, the latest data show a strong association between binge drinking and drug use.

Because EMCDDA's brief excludes alcohol it is not able to look closer at its concerns about this substance.

On the matter of substitution, the report notes that there is limited data available but takes a look at some research on ecstasy, which is usually assumed to have MDMA as its active ingredient. Studies of ecstasy in Denmark and the Netherlands, however, found that in up to half of all tablets analysed, no MDMA or any of its analogues were found. Rather, the pills contained 1-(3-chlorophenyl)piperazine (mCPP) either alone or in combination with another psychoactive substance.

This suggests that the apparent success of efforts to choke off the supply of MDMA precursors has simply resulted in even more substance users being exposed to unknown risks by having no information on what they are actually using. Later in the report, the growth of 'legal highs' such as 'spice' is discussed.

The report notes that the latest European drugs action plan calls for a better balance in drug policies, in favour of drug demand reduction, and the implementation of evidence-based interventions, as well as monitoring and quality assurance mechanisms. Unfortunately, it note, the latest UN document does not explicitly acknowledge the contribution of harm reduction.

The report continues with separate chapters for groups of substances. On cannabis, it points out that cannabis use in the United Kingdom has been steadily declining since around 2003, particularly among the 16–24 age group, suggesting a generational shift. It also notes that very few countries attempt to assess daily prevalence, which would give a view of the estimated 4 million adults who fall into this category. The Netherlands is one country which does collect this data and it shows a fall in daily cannabis prevalence in spite of the more liberal policies adopted.

Prevalence is examined in three age bands; 15-64, 15-34 and 15-24. The highest prevalence of cannabis users is in the 15-24 age group for all countries except Portugal. This highlights the comment that there is no indication that Portugal's change of approach on drugs has had the detrimental effects many people said it would.

Overall, the report leads one to conclude that most of the problems of substance abuse are the result of the illegal status of these substances rather than the substances themselves. Naturally, the EMCDDA is not in a position to highlight this conclusion.

Excluding alcohol from the consideration of the problems related to the use of psychoactive substances, however, means that the work of the ECMDDA is of limited value overall.

Professor David Nutt Sacked from ACMD

Following a tabloid press outcry about Prof Nutt's views on cannabis and relative harms, UK Home Secretary, Alan Johnson, has 'asked' him to step down as Chair of the Advisory Council on the Misuse of Drugs.

It seems, yet again, that the government is not interested in evidence if that contradicts its prejudices and risks causing problems with the media.

Make the World a Better Place - Legalise Drugs

'Far from protecting us and our children, the war on drugs is making the world a much more dangerous place.'

So begins a piece in the New Scientist, 09 September 2009. It is one of ten articles aimed at creating a better world. Author Clare Wilson makes the point that a large part of the harm associated with drugs results from their legal status not from the drugs themselves.

Most of the points made have been made before by others but the significance of this piece is its appearance in the leading popular science publication in the UK. Ms Wilson notes that 'a legal market would at least ensure that the substances people ingest or inject are available unadulterated and at known dosages'.

Interestingly, two days later, the drug charity Drugscope published its 'Street Drug Trends Survey 2009' which found an increasing tendency for people to become poly-drug users because they can not get a predictable effect from their initial substance of choice. Drugscope stops short of proposing how the question of variable quality could be addressed but it points out that treatment services may struggle to cope with the complex interactions possible as a result of using multiple substances.

2008 'Drug Deaths' Figures Released

The UK Office for National Statistics has published a 'Statistical Bulletin' entitled 'Deaths related to drug poisoning in England and Wales, 2008'.

The ONS takes all recorded deaths and compiles a database of those where 'drug' use is mentioned. For this purpose, 'drug' may mean illegal substances or over the counter remedies such as paracetamol.

In total, 2,928 deaths were recorded on the database in 2008 of which 1,738 are attributed to 'drug misuse'. In 2007, the comparable figures were 2,640 and 1,604.

There are a number of problems in assessing these statistics. The defined cause of death is based on post mortem examination and this examination cannot separate morphine when prescribed for pain relief from heroin taken as an illegal drug.

For the 2,928 deaths covered overall there are 4,130 mentions of substances, that is there is a substantial number of deaths where more than one substance is mentioned. In these cases, it is impossible to determine which substance did the greatest harm.

Press reports have focussed on a reported 20% increase in cocaine related deaths to 235 from 196. That, however, is total mentions. Looking at deaths where cocaine is the only substance mentioned, deaths have risen from 84 to 86, a rather smaller increase. There are a further 75 deaths where alcohol is mentioned with cocaine up from 52 in 2007, an increase of 44% which could be seen to show that alcohol is of more concern. There is no indication of the other substance(s) involved in the balance of the 235 mentions.

Just over 60% of all deaths occur in the 30-49 age range suggesting that long-term drug misuse is of greater harm that social use by young people. Unfortunately, the report does not go into a detailed age/substance breakdown to see if there is a correlation between substances and the age at which deaths occur.

UKDPC Calls for Focus on Harm Reduction

The UK Drug Policy Commission, the body set up to provide government with expert advice on drugs, has published Refocusing Drug-Related Law Enforcement to Address Harms.

Taking its lead from the recent UNODC World Drugs Report, the central recommendation of the UKDPC is that enforcement should focus on reducing the harm done in the community by drug-dealing. It suggests that attention should centre on open drug markets in residential areas which, it says, can have seriously detrimental effects.

It notes that simply arresting drug-dealers only results in them being replaced by others and can result in a high level of violence stemming from the turf wars which this produces.

The recognition that a great deal of the harm caused by drugs is the result of the legal status rather than the substances themselves is to be welcomed. The logical conclusion to be drawn from the report is that harms caused by illegal drug markets can best be dealt with by changing the legal status of the substances being sold but, of course, the UKDPC does not publicly acknowledge this.

It remains to be seen whether government accepts the message of the report. In the past, with cannabis classification for example, the government has preferred the views of Daily Mail readers to those of its own experts. Worryingly, the Daily Mail begins its story with 'Police should turn more of a blind eye to drug dealers'. The BBC headlines its coverage with 'Call for 'smarter' drugs policy' so it must be hoped that the UKDPC document will make a helpful contribution to the debate aimed at separating the harm caused by drugs from the harm caused by the illegal status of drugs.

Two Reports Look at Substance Use/Misuse

In the same week, the Home Office released 'Drug Misuse Declared: Findings from the 2008/09 British Crime Survey - England and Wales' and the NHS Information Centre released 'Smoking, drinking and drug use among young people in England in 2008'. Click on the titles to go to sites (opens new window) where you can download the full reports.

The first deals only with adults, aged 16 to 59 and the second is concerned with 11 to 15 year-olds.

The BCS survey finds that just over one third of adults have ever used an illegal substance; about 10% used in the last year with half of those having used in the last month. As might be expected, last year and last month use by 16 to 24 year-olds is more than double the average for all 16 to 59 year-olds. In numbers, rather than percentages 3.2m people reported last year use of any drug.

When it comes to analysing use by substance, the problem of multi-substance users comes into play. Thus, 2.5m people are said to have used cannabis (a Class B substance) in the last year but 1.2m people used Class A substances giving a total of 3.7m not 3.2m. By taking the 1.2m Class A users away from the 3.2m total you get a figure of 2m who used nothing but Class B or C substances. The overwhelming majority of these will be cannabis only users. The survey confirms, therefore, that cannabis remains the substance chosen by most users.

Overall, the BCS reports very little change in trends except for an increase in powder cocaine use. Interestingly, it notes that the decline in cannabis use seems to have halted and it is tempting to point out that this follows the reclassification of cannabis as Class B but it would be wrong to draw that conclusion. Rather, it seems to confirm that there is no correlation between substance use and classification. If people want ot use these substances they will.

The NHS survey includes smoking and alcohol as well as the illegals and reports that one third of 11 to 15 year-olds have smoked at least once but this is substantially down from 1982 when over half of this group had smoked. The report notes the importance of family influence with those who live in households with other smokers being twice as likely to smoke.

On alcohol, the report notes that there has been an increase in the percentage of 11 to 15 year-olds who have never had an alcoholic drink from 39% in 2003 to 48% in 2008. It also notes a drop in last week prevalence from a high of 26% in 2001 to 18% in 2008. Those last week drinkers, however, are consuming an average of 14.6 units a week and 60% of them drink more than 4 units on drinking days in the week.

63% of 15 year-olds who had drunk in the previous four weeks said they had been drunk on at least one occasion during that time. It seems that, like other substances, the biggest problem with alcohol is that some of its users do so to excess.

On illegal substances, the report notes that any drug use has fallen from 29% in 2001 to 22% in 2008 with a fall also (from 42% to 33% in the number who have been offered drugs). Cannabis remains the drug used most often, though its use is trending downwards. Last year prevalence of Class A drug use was 3.6% with only 0.5% reported last year use of heroin. This should be seen against last year prevalence of solvent sniffing at 5%. Clearly, the challenge is not restricting the supply of substances but reducing the demand by better education of the real potential for harm.

The report makes no mention of Salvia divinorum which is the media's current favourite bogeyman.

Reactions to the World Drugs Report 2009

The discussion of the case for an end to prohibition included in this year's UNODC report has resulted in a number of articles looking at the UN position on currently illicit substances. Following are links to a selection of these pieces. (All these links will open new windows so you can easily return to this page.)

George Monbiot, in the Guardian, calls for a worldwide study of the implications of an end to prohibition.

'Why Prohibition' welcomes the report's discussion of prohibition and uses the quote wrongly attributed to Gandhi "First they ignore you, then they ridicule you, then they fight you, then you win."

Law Enforcement Against Prohibition (LEAP) is highly critical of UNODC's misrepresentation of the anti-prohibition arguments. (See also this short YouTube video extract from the press launch featuring the LEAP media director.)

The 'Council on Hemispheric Affairs' responds to the report with a call for a detailed study of the options.

Transform Drug Policy Forum has a number of relevant items.

My own comments on the second part of the report can be found here.

UNODC World Drugs Report 2009

The United Nations Office on Drugs and Crime, UNODC, has published its 'World Drugs Report 2009'. This year's report contains two significant changes.

For the first time, UNODC gives a range to its estimates of drug use. Thus, 2008's estimate of the prevalence of adult drug use at least once per year of 208 million becomes, in 2009, a range of 172 to 250 million. Though this makes it much more difficult to see trends over time it is a more realistic approach.

The second, and more significant change, is that UNODC has acknowledged that prohibition has created a huge criminal market. The Executive Summary to the report says 'The system of international drug control has produced several unintended consequences, the most formidable of which is the creation of a lucrative black market for drugs'.

UNODC's realisation of the seriousness of this issue means that the second part of the 'World Drugs Report 2009' is entitled 'Confronting Unintended Consequences: Drug Control And The Criminal Black Market'. What UNODC does not do, however, is conclude that an end to prohibition is required to end this black market. Instead, in his preface, Executive Director, Antonio Maria Costa, presents a distorted view of the case against prohibition and then demolishes it. He claims that the main aim of the anti-prohibitionists is to make drugs legal so they can be taxed and governments can generate substantial revenue by encouraging drug use.

To his credit, Costa calls on governments to turn away from punishing individual users and offer them treatment. He seems to believe, however, that more could be done to arrest and punish the dealers and manufacturers.

It is interesting to note that poppy cultivation in Afghanistan fell by 19% to 157,000 hectares even though eradication fell from 19,047 hectares in 2007 to 5,480 hectares in 2008. This suggests that eradication, or the threat of it, is not related to the activities of growers.

The full report can be downloaded from the World Drug Report page of the UNODC website (opens new window).

'Nice People Take Drugs' Ads Removed

The Committee of Advertising Practice, which offers advice on compliance with advertising codes of practice, has advised CBS Outdoor, the company which sells advertising space on buses that the adverts for the Release campaign, see following item, should be removed because they could be outside the code of practice.

Sebastian Saville, the chief executive of Release, noted that no actual complaints had been received.

It would seem that Release has shown, what is set out to demonstrate, that having a rational debate about substance use and misuse is very difficult in the UK.

'Nice People Take Drugs'

Release, the charity which, in its own words, 'is the national centre of expertise on drugs and drugs law' is running a campaign entitled 'Shift the Debate' which aims to 'highlight the completely out of touch approach taken to drugs by much of the UK’s media and political parties'.

As part of that campaign, adverts have been placed on the side of buses in London with the simple message 'Nice People Take Drugs'. The intention is to draw attention to four key facts;

  • Over a third of adults in England & Wales have used illicit drugs

  • More people have used cannabis than voted for Labour at the last election

  • 13,000 children were arrested for drug offences in 2006/07

  • Over 1 million adults used class A drugs last year

Release hopes its campaign will enable 'politicians and the media [to] have a realistic and honest discussion about drugs'.

More information is available at the Release website (opens new window).

Report Says Decriminalisation is Working in Portugal

In 2001, a law was passed in Portugal which decriminalised personal possession of illegal substances. Anyone found in possession of less than ten days average usage of any illegal substance is dealt with not by the criminal justice system but by Dissuasion Commissions set up in local areas which have the power to impose non-custodial sanctions, such as fines, curfews, travel bans and the like or to impose no penalty if the offender agrees to enter treatment.

The Cato Institute, a non-profit public policy research foundation, named for Cato's Letters, a series of libertarian pamphlets that helped lay the philosophical foundation for the American Revolution, recently published a report looking at the working of this law. The law was introduced because Portugal was perceived to have a particularly serious substance abuse problem and it was recognised that the criminal justice route was making matters worse not better.

Opponents of the change in the law argued that drug use would increase uncontrollably and that Portugal would become a place of drug tourism. The Cato Institute found that drug usage rates have remained broadly the same or decreased slightly but that rates of sexually transmitted disease amongst drug users and deaths from drug use have both fallen dramatically. New cases of HIV infection have declined substantially as needle exchange programmes have been able to operate more openly. In addition, over 95% of people appearing before Dissuasion Commissions are Portuguese indicating that drug tourism has not become a problem.

Though it is still too early to make detailed statistical comparisons between pre- and post- decriminalisation in Portugal or between Portugal and other countries, it is clear that the new law, which was part of a change of perspective moving to looking at individual drug use as a health issue not a criminal matter has produced benefits.

The report concludes that 'the Portuguese model ought to be carefully considered by policymakers around the world'.

More information and access to the full report (opens new window) is available from the Cato Institute website.

New York City Bar Association Repeats Call to End Drugs Prohibition

In 1994, the New York City Bar Association, through its Committee on Drugs and the Law, called for a national dialogue on alternatives to prohibition as a means of dealing with the problems arsing from use and misuse of currently proscribed substances.

In a report published in April 2009, the association notes that the called for dialogue did not occur and repeats its argument in favour of a review of the US Controlled Substances Act of 1970.

As lawyers, their criticism is based on the legal illogicalities of the current rating system which sees cannabis treated more strictly than cocaine, methadone and morphine. The law makes law enforcement agencies responsible for determining if a substance has a legitimate medical use rather than anyone with a medical qualification.

Fifteen years ago, 'A Wiser Course: Ending Drug Prohibition' was ignored. Given the growing realisation that the 'drug war' cannot be won, it remains to be seen if the restated arguments carried more wait. The document is available as a pdf file from the nycbar website. (Left click to open a new browser window or right click to download the pdf file.)

'A Comparison of the Cost-effectiveness of the Prohibition and Regulation of Drugs'

On 7th April 2009, Transform Drug Policy Foundation published its provisional cost benefit analysis of the prohibition of heroin and cocaine in the UK, alongside a comparative costing under a speculative regulated model. According to its website, 'Transform Drug Policy Foundation exists to promote sustainable health and wellbeing by bringing about a just, effective and humane system to regulate and control drugs at local, national and international levels'.

In February 2008, an internal Home Office document claimed 'The benefits of…[legalisation/regulation] – such as taxation, quality control and a reduction in the pressures on the criminal justice system – are far outweighed by the costs and for this reason, it is one that this Government will not pursue either domestically or internationally.' This in spite of their being no study to examine whether such claims can be substantiated. 

Furthermore, the UK Treasury claims that 'no policy, programme or project is adopted without first having the answer to these questions: (1) Are there better ways to achieve this objective? (2) Are there better uses for these resources?' but these tests have not applied to UK drugs policy.

In spite of its limited resources, Transform decided to put together its own cost benefit analysis. This report, in spite of using conservative estimates where no studied figures could be obtained, shows substantial cost savings from even the worst case scenario for a regulated environment for the supply of heroin and cocaine.

As Transform acknowledges, dealing with the misery which substance dependence produces for users, their friends and families and the innocent victims of  the crime resulting from the illegal status of these substances in terms purely of costs is somewhat distasteful but, for governments, ensuring that money is being spent wisely and as efficiently as possible should be part of every policy decision.

Access to the full report together with links to media coverage surrounding its publication can be found on the Transform website. (Opens new window)

Commission on Narcotic Drugs to go for Continuing the Unwinnable 'War on Drugs'.

The Commission on Narcotic Drugs (CND) takes place in Vienna from 11 to 20 March. This is the UN body which determines drug policy. This meeting is important because it is to set the new policy for the next ten years following the expiry of the ten year plan started in 1998.

In spite of the failure of the 'War on Drugs' which was key to that ten  year programme there is little, if any, chance of the new policy being any different.

There has been very little media coverage of the preparations for this meeting except for the Economist which, in its March 5th edition, looks as some of the issues surrounding illegal drugs and has a leader 'How to stop the drug wars' which says that regulation and control is the least worst way to deal with the currently illegal drugs.

What Does Drug Treatment Mean?

The National Treatment Agency for Substance Misuse has issued its annual report and created a stir about what is and is not successful drug treatment.

The reports shows that in 2007/8 over 200,000 individuals received drug treatment indicating that the agency had passed its government target for offering more treatment to problem drug users.

The report states that 54% of the 'completed episodes' ended in a successful discharge from treatment. In the detail, however, it emerges that only 3% of people are actually drug free at the end of treatment. The majority of the 'successful outcomes' are people who have gone from an out of control heroin addiction to an in control methadone replacement programme intended to slowly reduce their substance use.

The BBC, in particular, latched on to this 3% figure in order to argue that treatment wasn't working and even found one individual who has been on methadone for eleven years to try and show that completely drug free is the only way to measure success and, on that measure, treatment isn't working.

The problem for the National Treatment Agency seems to be that different areas and different treatment approaches actually measure success in different ways so it was hard for it to refute the allegations on the BBC's 'Today' programme.

Click here for the NTA website and access to the full report. (Opens in a new window.)

Tackling Drug Markets and Distribution Networks in the UK

The UK Drug Policy Commission has published a report looking into the effectiveness of domestic efforts to tackle the drugs trade.

The report concludes that drug markets are resilient and quick to adapt in the face of increased police enforcement activity. It also notes that an enforcement crackdown can have unforeseen and undesirable consequences such as dealers moving to a new area and coming into conflict with established dealers in that area or individual injecting drug users giving up carrying sterile injecting equipment, for fear of being searched, in favour of sharing needles at the time of supply.

Most worryingly, the report concludes that there is no reliable way to compare the cost effectiveness of different strategies so there is no way of knowing if the £380m per annum being spent on reducing the supply of illegal substances is being well spent.

The authors also say that 'drug laws do not appear to have direct effects on the prevalence of drug use: ‘tougher’ enforcement measures have not necessarily deterred use'.

The report in both summary and full form can be downloaded from the UK Drug Policy Commission website. (Opens a new window.)

WHO World Mental Health Surveys

The World Health Organisation is engaged on a survey of mental health issues throughout the world based on a standardised survey.

A comparison of the results in the first 17 countries surveyed, which represent all the major regions of the world, has just been published. The full paper is available from the online open access journal 'PLoS Medicine' (Opens a new window.)

It would be unwise to read too much into these early results, particularly as cultural differences may affect the response to the survey's questions on substance use both legal and illegal, but some broad trends do emerge.

In all countries, males are more likely than females to have used substances capable of being abused and the vast majority of people have used alcohol to some degree. There were, however, indications that, amongst younger people, the gender variation is reducing.

Of particular note is the finding that legal status has little bearing on illegal substance use. The USA, which has the most draconian anti-drug policies and some of the tightest alcohol regulation, outside of countries where it is entirely banned, has rates of use at, or above, those found in places with more tolerant policies.

But, before leaping to the conclusion that the survey shows that legal status has no bearing on usage, it must be remembered that most people have used alcohol, and many continue to do so in harmful amounts. This may be because alcohol is socially acceptable. If that is the case then any move to decriminalise cannabis use, in particular, must be structured so as to not result in encouraging usage.

UNODC 'World Drug Report' 2008

The United Nations Office on Drugs and Crime publishes an annual 'World Drugs Report' looking at the overall supply and consumption situation around the world. Its 2008 report was published on 26th June and is available to download from the UNODC website (opens in new window).

In his preface Antonio Maria Costa, Executive Director United Nations Office on Drugs and Crime, states that 'Drug dependence is an illness that should be treated like any other'. 

The report shows that less than 5% of the adult population used any illicit drugs in a twelve month period, and of those around 26 million, or 0.7% of the population, may be termed 'problem users'. Of those 'problem users' about 200,000 a year die as a result of their drug use. But, the report states, this should be put in context by comparison with about 2 million a year deaths from alcohol abuse and 5 million a year deaths from the use of tobacco.

The report argues that, without the current strict regime of control, use of the substances covered could escalate to match the levels for alcohol and tobacco.

The principal concern in the report is that supply, especially of heroin and cocaine, far outweighs demand which could result in efforts to increase the market. This situation has applied, in the heroin market, for some years, yet, there is no indication, so far, of an increase in consumption. In fact, the report trumpets the success in stabilising drug use, in general, around the world.

What is clear, is that most illicit drug supply comes from areas of the world, Afghanistan, Myanmar and parts of South America, where there is no effective government making eradication almost impossible.