Lynne Jones MP Lynne Jones MP working hard for Birmingham Selly Oak

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ILLEGAL DRUGS POLICY

Current policies for tackling drug addiction are inadequate.  Experienced police officers have for some time been stressing the importance of concentrating on addiction to drugs like heroin and crack cocaine.  We need some radical thinking if we are to reduce the numbers of our young people who fall victim to the drug trade profiteers.  

January 2002

I tabled the following Early Day Motion On January 14 2002:

ILLEGAL DRUGS POLICY

This House notes that the UK has one of the biggest drug problems in Europe; believes it is unhelpful and inaccurate to bracket all illegal drugs together as equally harmful; notes that there is evidence to show that the availability of criminal sanctions does not deter small-scale possession of cannabis for personal use; also notes that there is no evidence to show that imprisonment prevents small-scale possession of other drugs or is an effective measure in stopping problematic drug use longer term; therefore calls for an end to imprisonment for possession of any drug for personal use; notes that according to extensive research carried out by the leading charity, DrugScope, such changes would be compatible with current UN treaty obligations; notes the National Treatment Outcome Research Study’s estimate that for every £1 spent on treatment £3 is saved on the criminal justice system; welcomes the Home Secretary’s decision to review heroin prescribing; calls on the Government to allocate significant new resources, over and above current provision, directed towards treatment services and the training of professionals to deliver the Government’s drugs strategy; notes that 38% of injecting drug users are thought to have Hepatitis C; calls on the Government to consider providing ‘safe injecting rooms’ such as those run in Switzerland and The Netherlands for intravenous drug users to reduce the risk of fatal overdoses, transmission of blood borne diseases, dangerous injecting practices and abandoned needles.

I have worked with the charity, DrugScope on this issue and they have produced a briefing on the EDM:

DrugScope Briefing, December 2001
EDM on Illegal Drug Policy

This House notes that Britain has one of the biggest drug problems in Europe and is extremely concerned about the damage caused to individuals and communities by it

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), the EU wide body that provides comparable information concerning drugs and drug addiction and their consequences has recently published the 2001 Annual Report. (20 November).

The EMCDDA’s chairman, Mike Trace, the former deputy Drugs Tsar, was quoted in the Independent on Sunday as saying: "Britain has the worst drugs problem in Europe"

  • The figures collected show the UK has the highest illegal drug usage across a whole range of drugs:
  • The UK along with France has the highest levels of cannabis use amongst 15 and 16-year-olds at 35% of the population.
  • The adult use of ecstasy and amphetamines in the UK is more than double the rate of that in the rest of Europe.
  • Out of 7,266 deaths from overdoses in the EU in 1999, well over a quarter (2, 857) were in Britain
  • Heroin use is also rising in the UK - against the trend of most other countries.
  • Cocaine use is a particular worry in the UK and elsewhere. Only in the United Kingdom has there been a confirmed increase in lifetime prevalence of cocaine use among young adults aged 16-29.
  • Britain also accounts for most of the amphetamines, ecstasy and LSD seized in the EU and one third of all heroin.
  • Germany and the Netherlands have the smallest levels of problem drug use in the EU.

believes that it is unhelpful and inaccurate to bracket all illegal drugs together as equally harmful

"We have concluded that the most dangerous message of all is the message that all drugs are equally dangerous. When young people know from their own experience that part of the message is either exaggerated or untrue, there is a serious risk that they will discount all of the rest. " Page 4, "Drugs and the Law – Report of the Independent Inquiry into the Misuse of Drugs Act 1971" , published March 2000 by the Police Foundation, chaired by Viscountess Runciman DBE

Simply, some drugs are more harmful in terms of health risks. They are, however, also judged on their impact on society. Cannabis is not a harm free drug but causes little real harm to society.

Heroin, however, is physically addictive, and has a greater knock on effect for the whole of society. There are also very real harms from unsafe injecting practices such as the risk of transmitting blood borne diseases. For these reasons, cannabis and heroin are rightfully in different classifications and should be treated differently.

Without clear messages about the relative risks of drugs, young people may be far more likely to try other, more dangerous drugs. It is therefore imperative to ensure that there is a clear and realistic risk assessment of all drugs that can provide a guide to users.

notes that there is no evidence that the availability of criminal sanctions or imprisonment deters small scale possession for personal use or are effective measures in stopping cannabis longer term

From a review paper, ‘Legislative Frameworks for Cannabis: Impact on Enforcement and Patterns of Use’ written by Mike Ashton, Editor of the Journal ‘Drug and Alcohol Findings’, the following conclusions were drawn:

Despite laws against cannabis use having been in place for most of the twentieth century, most studies show that over one third of the population of Western countries have used cannabis at least once.

There is considerable evidence to show that even very substantial increases in law enforcement activity alter neither availability of nor consumption levels of cannabis to any significant degree.

Whilst deterrence may stop some people from using cannabis, the threat of legal sanctions has been shown to play a very minor part in the decision making of cannabis consumers.

A survey of drug use trends in Europe revealed that cannabis use has been declining since the early to mid 1970s and seems unrelated to the type of control regime in place in specific countries.

North American research demonstrates fairly conclusively that legal sanctions do not deter or inhibit future cannabis usage.

calls for an end to imprisonment for small scale possession of any drug for personal use

The overwhelming majority of users of drugs cause no real harm to society although there may be risks to their own health. Prison is a disproportionate response to small scale personal possession. Criminal sanctions may begin a downward slope of exclusion.

Criminalisation is not a proportional response for small scale possession for personal use. The British Crime Survey 2000 reported that 1 in 3 (37%) of 16-19 year olds had indicated they had ever taken cannabis. The law, as it stands, would seek to criminalise all of them.

People who develop problematic drug use need help and treatment, not prosecution. Criminal sanctions will exclude them still further from society and make rehabilitation harder.

notes that such changes would be compatible with current UN treaty obligations according to extensive research carried out by the leading drugs charity, DrugScope.

As part of the evidence to the Home Affairs Select Committee, DrugScope submitted a study that shows that the UK could change its drug laws without breaking international drug treaty obligations. It found that the Government could if it wanted:

  • abolish imprisonment as a sanction for people possessing drugs.
  • introduce civil penalties (like fines) for drug possession.
  • deal similarly with some small-scale ‘social supply’ through civil measures.

European countries deal with illegal drugs in fundamentally different ways and none have been reported as flouting any of the three UN drug conventions.

The international drug conventions require the UK and other signatory states to establish drug possession as criminal offences ‘subject to their constitutional principles and basic concepts of law’. There is, however, significant room for manoeuvre within these conventions as shown by the different legal frameworks applied to drug possession across Europe:

Holland: Possession is criminalised but an expediency principle means non-prosecution in practice.

Italy: Possession is prohibited and an administrative (i.e. not criminal) infringement.

Spain: Possession is unlawful but not an administrative offence unless in public.

note that the National Treatment Outcome Research Study’s estimate that for every £1 spent on treatment £3 is saved on the criminal justice system

The National Treatment Outcome Research Study (NTORS) is the largest study of treatment outcome for drug misusers ever conducted in the UK. The project was commissioned by the Task Force established by the Department of Health to review the effectiveness of services treating drug misusers in England and is funded by the Department of Health. It began operation in 1995 when more than a thousand problem drug users were recruited into 54 residential or community treatment programmes.

At intake, the most common drug problem was long-term heroin dependence, often in conjunction with polydrug and/or alcohol problems. Many clients had psychological health problems, and high rates of criminal behaviour were reported.

The outcomes 4-5 years after starting treatment is as follows:

Drug Use

  • After 4-5 years, the clients showed marked improvements in drug use.
  • Reductions were found in the percentages of clients who were using drugs, and

in the frequency of illicit drug use.

  • Abstinence is one of the most rigorous outcome criteria for drug misuse

treatment. More than a third (38%) of the residential clients were abstinent from

illicit drugs at 4-5 years.

  • Daily opiate use among the residential clients fell from 51% before treatment to

18% at 4-5 years.

  • For the residential clients, regular use of cocaine powder and amphetamines was

significantly reduced over the course of the study.

Injecting

  • The majority of NTORS clients were injecting drugs prior to treatment.
  • The rate of injecting fell from 60% at intake to 37% at 4-5years.

Crime

  • During the course of the study, there were marked reductions in criminal activity. At one year, rates of acquisitive crime had approximately halved among both the residential and community clients. These improvements were maintained at the 2 year and 4-5 year follow-ups.
  • Many of the greatest reductions in criminal activity occurred among the most active offenders.

The longer-term outcomes for the NTORS clients over this 5 year period demonstrate the substantial reductions in drug use and in other problem behaviours which can be made after treatment by people with serious and long-term drug problems.

notes that there has been a drop in acquisitive crime in pilot heroin prescribing schemes elsewhere in Europe and welcomes the Home Secretary’s decision to review heroin prescribing;

A study has been carried out into heroin prescription in Switzerland between January 1994 and December 2000 which assessed 1969 opiod dependent drug users who began heroin assisted substitution. The results of the survey were recently published in the Lancet.

  • More than 70% of patients remained in treatment for more than one year.
  • Treatment showed positive effects with respect to health and social outcomes, including criminality.
  • A long stay in treatment was related to a higher chance of starting abstinence-oriented therapy than a short stay

It is important to note that:

  • Many professional believe this kind of treatment should only be for the most intractable of cases of drug misuse and should be used as a bridge into other forms of treatment, rather than constituting the treatment itself.

calls on the Government to allocate significant new resources over and above current provision, directed towards treatment services and the training of professionals to deliver the Government’s drug’s strategy.

The Government has recognised the shortfall in treatment and has granted long overdue additional resources to increase provision and speed of access.

DrugScope hears anecdotally that in some parts of the country, there are still unacceptably long waits for access to treatment. Just last week the story of Julie and Ian Gell, the parents who were forced to buy heroin for their son (The Observer), highlighted the problems many have in finding help or treatment.

DrugScope has concerns that the very welcome new resources for drug treatment from the Spending Review 2000 may be stretched too thinly to provide high quality treatment for the number of additional people expected to be referred from the courts.

The new National Treatment Agency needs to ensure that those working in the field receive better training and raise the quality of drug treatment."

notes that 38% of injecting drug users are thought to have Hepatitis C;

Hepatitis C is a major concern for the future. 38% of injecting drug users are thought to have Hep C. Only 1% of injecting drug users have HIV. With these kinds of statistics, the numbers who die prematurely are likely to exceed those who die from overdose and the other immediate effects of drug misuse.

Hepatitis C lives longer outside the body than HIV, and so is easier to transmit.

DrugScope is aware that the Advisory Council on the Misuse of Drugs has been considering changing Section 9A of the Misuse of Drugs act on drug paraphernalia for a long time. This would make legal the supply of other pieces of equipment used by injecting drug users that have the potential to carry the disease. DrugScope would like to see an early resolution to this issue so ensure that those implementing harm reduction practices do not fall foul of the law unwittingly.

DrugScope believes it is imperative that there is a continuation of investment into needle exchanges.

Although 27.5 million needles annually, this only constitutes one injection for one injector a day. Intravenous drug users tend to inject more than once a day. DrugScope therefore believes that that there is a need to extend existing provision.

DrugScope would also advocate an increase in the levels of testing for Hepatitis C and for an expansion of the subsequent treatment of the disease that is available.

calls on the Government to substantially expand harm reduction programmes and to consider providing ‘safe injecting rooms’ such as those run in Switzerland and the Netherlands for intravenous drug users to reduce the risk of fatal overdoses, transmission of blood borne diseases, dangerous injecting practices and abandoned needles.

Cross Government Action Plan to reduce drug related deaths – a direct response to the ACMD report published last year that cited:

"A young person [in the UK] who is injecting heroin has about a 14 times higher risk of death than someone who is not".

Britain has the highest number of acute drug related deaths recorded of any EU Country Out of 7,266 deaths from overdoses in the EU in 1999, well over a quarter (2, 857) were in Britain

Injecting rooms are one way to combat this. Spain, Switzerland, Sydney, Austria and in some German towns, injecting rooms have been set up.

Experts believe that the two most important contributors to overdose deaths are haste and isolation.

The injecting room concept removes these two risk factors so that, with more security, and with less panic and haste, a drug users is able to exercise a more careful judgement in self injecting. Add to this the presence of medical staff and the risks drop yet further.

Injecting rooms can also be beneficial as a means of bringing people into contact with drug services, harm reduction guidance and advice. In the recently established Sydney injecting room, up to 30% of users have taken up advice regarding treatment. This group is likely to include a proportion of isolated people who otherwise may not be exposed to treatment options.

In Sydney, there is no ‘overt’ message that drug use is acceptable or recommended. Moderation, supervision, prevention and treatment are constant messages from the staff, posters and brochures in the centre.

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