No apparent link between ‘toughness’ of drug laws and use, says Home Office report

There is ‘no apparent correlation’ between the toughness of a country’s approach to drugs and levels of use, according to a Home Office study of international drugs policies.  

Drugs: international comparators reviewed different approaches ‘in policymaking and on the ground’ based on a series of fact-finding missions between May 2013 and March this year. Ministers and Home Office officials visited Canada, the Czech Republic, Denmark, Japan, New Zealand, Portugal, South Korea, Sweden, Switzerland, the US and Uruguay, looking at a range of issues including decriminalisation of possession for personal use, consumption rooms, heroin-assisted treatment, drug courts and supply-side regulation of cannabis. 

‘Without exception, every country we considered sees drug use as undesirable,’ says the document, and while all were ‘taking steps to disrupt, reduce, or regulate supply’ there was a ‘variety of responses to the individual user’. In terms of the effectiveness of drug laws, researchers studied Portugal, which removed criminal sanctions for personal use in 2001 and the Czech Republic, where possession of small quantities is treated as an administrative offence punishable with a fine. They also looked at Japan, which operates a ‘zero tolerance’ policy with possession of even small amounts of drugs attracting lengthy prison sentences and Sweden, whose approach to possession ‘has grown stricter over several decades’. 

‘While levels of drug use in Portugal appear to be relatively low, reported levels of cannabis use in the Czech Republic are among the highest in Europe,’ says the report. ‘Indicators of levels of drug use in Sweden, which has one of the toughest approaches we saw, point to relatively low levels of use, but not markedly lower than countries with different approaches.’ 

The report discusses evidence of ‘improved health prospects’ for drug users in Portugal, with the caveat that these ‘cannot be attributed to decriminalisation alone’ and adds that it is unclear whether decriminalisation ‘reduces the burden on the police’, with Portugal’s resourcing at similar levels after decriminalisation as before. The country has, however, reduced the proportion of drug-related offenders in its prison population, says the report. 

The document acknowledges that ‘what works in one country may not be appropriate in another’, and states that ‘the legislative and enforcement approach to drug possession is only one strand of any country’s response to drug misuse’, which is also informed by wider social and cultural factors. It also stresses that there is ‘robust evidence that drug use among adults has been on a downward trend in England and Wales since the mid-2000s’ and that the UK’s ‘balanced approach enables targeted demand-reduction activity, and good availability and quality of treatment. Indeed, while in Portugal, we were encouraged to hear that drug treatment in the UK is well-regarded internationally.’

In terms of supply-side regulation of cannabis the document states that the policies in Uruguay and the US are ‘highly experimental’, with no evidence so far to ‘indicate whether or not they will be successful in reducing the criminality associated with the drug trade’. 

‘The differences between the approach other countries have taken illustrate the complexity of the challenge, and demonstrate why we cannot simply adopt another country’s approach wholesale,’ said crime prevention minister Norman Baker, who had accused Conservative colleagues of ‘suppressing’ the document, which had been ready for publication for a number of months. ‘The UK’s approach on drugs remains clear: we must prevent drug use in our communities, help dependent individuals through treatment and wider recovery support, while ensuring law enforcement protects society by stopping the supply and tackling the organised crime that is associated with the drugs trade.’

The Home Office has also published the findings of its expert panel study of new psychoactive substances (NPS), and the government’s response, which includes plans for a blanket ban similar to that introduced in Ireland in 2010, improved training for NHS staff and new PHE guidance for local authorities on integrating NPS into treatment, education and prevention work. 

Drugs: international comparators; New psychoactive substances in England: a review of the evidence, and Government response to new psychoactive substances review expert panel report at www.gov.uk

Government accepts ACMD’s ketamine recommendation

Ketamine is to be upgraded to a class B drug, crime prevention minister Norman Baker has confirmed. Baker has written to Advisory Council on the Misuse of Drugs (ACMD) chair Sir Les Iversen to say that he accepts the council’s recommendation that the drug be reclassified in the light of health concerns and the numbers of people seeking treatment (DDN, January, page 5).

The government will now consult to assess the impact of reclassifying on the medical and health sectors, said Baker, with the parliamentary process to reclassify to begin ‘shortly’. Excessive ketamine use has been associated with a range of health harms including chronic bladder and other urinary tract damage. However, Baker acknowledges in the letter that ‘ketamine use in adults in the UK has gone down in the past two years, although it is too early to establish whether this downward trend will continue’.

Meanwhile, the latest figures from the National Programme on Substance Abuse Deaths (NPSAD) at St George’s, University of London, show a 600 per cent increase in the number of deaths caused by new psychoactive substances between 2009 and 2012 – from 10 to 68. The prevalence of the new drugs in post-mortem toxicology reports also increased from 12 cases to 97 over the same period.

The total number of drug-related deaths reported to NPSAD during 2012 was 1,613. Opiates – alone or in combination with other drugs – accounted for 36 per cent, up 4 per cent on 2011 and reversing the declining trend of recent years (DDN, March 2013, page 5). There was also an increase in the proportion of deaths involving stimulants including cocaine, following a decline in 2009 and stabilisation in 2010.

London had the highest proportion of cocaine-related deaths at 15.2 per cent, while Liverpool recorded more drug-related deaths than Manchester for the first time since 2006.  The highest rates of drug-related deaths per 100,000 adult population were in the DAAT areas of Liverpool (12.57 per cent), Blackburn with Darwen (11.45 per cent) and the London Borough of Hammersmith and Fulham (11.34 per cent). More than 72 per cent of deaths were in males, and more than 67 per cent in under-45s. 

‘We have observed an increase in the number and range of [novel psychoactive substances] in the post mortem toxicology results and in the cause of death of cases notified to us,’ said NPSAD spokesperson Professor Fabrizio Schifano.  Clearly this is a major public health concern and we must continue to monitor this worrying development. Those experimenting with such substances are effectively dancing in a minefield.’

Government accepts ACMD’s ketamine recommendation

Ketamine is to be upgraded to a class B drug, crime prevention minister Norman Baker has confirmed. Baker has written to Advisory Council on the Misuse of Drugs (ACMD) chair Sir Les Iversen to say that he accepts the council’s recommendation that the drug be reclassified in the light of the health concerns associated with it and the numbers of people seeking treatment (DDN, January, page 5). 

The government will now consult to assess the impact of reclassifying on the medical and health sectors, said Baker, with the parliamentary process to reclassify to begin ‘shortly’. Excessive ketamine use has been associated with a range of health harms including chronic bladder and other urinary tract damage. However, Baker acknowledges in the letter that ‘ketamine use in adults in the UK has gone down in the past two years, although it is too early to establish whether this downward trend will continue’. 

Meanwhile, the latest figures from the National Programme on Substance Abuse Deaths (NPSAD) at St George’s, University of London, show a 600 per cent increase in the number of deaths caused by new psychoactive substances between 2009 and 2012 – from 10 to 68. The prevalence of the new drugs in post-mortem toxicology reports also increased from 12 cases to 97 over the same period. 

The total number of drug-related deaths reported to NPSAD during 2012 was 1,613. Opiates – alone or in combination with other drugs – accounted for 36 per cent, up 4 per cent on 2011 and reversing the declining trend of recent years (DDN, March 2013, page 5). There was also an increase in the proportion of deaths involving stimulants including cocaine, following a decline in 2009 and stabilisation in 2010. 

London had the highest proportion of cocaine-related deaths at 15.2 per cent, while Liverpool recorded more drug-related deaths than Manchester for the first time since 2006. Deaths in Northern Ireland, however, showed ‘a marked difference from the rest of the UK’, with most linked to prescription drugs like tramadol, benzodiazepines and anti-depressants. The highest rates of drug-related deaths per 100,000 adult population were in the DAAT areas of Liverpool (12.57 per cent), Blackburn with Darwen (11.45 per cent) and the London Borough of Hammersmith and Fulham (11.34 per cent). More than 72 per cent of deaths were in males, and more than 67 per cent in under-45s. Accidental poisoning accounted for 68 per cent of the deaths. 

‘We have observed an increase in the number and range of [novel psychoactive substances] in the post mortem toxicology results and in the cause of death of cases notified to us,’ said NPSAD spokesperson Professor Fabrizio Schifano. ‘These include amphetamine-type substances, dietary supplements, ketamine derivatives, among a host of others. The worrying trend is that these type of drugs are showing up more than ever before. Clearly this is a major public health concern and we must continue to monitor this worrying development. Those experimenting with such substances are effectively dancing in a minefield.’

Government announces new drug powers as Baker replaces Browne

The government is to create new powers to seize chemicals suspected of being used as cutting agents for illegal drugs, as part of its Serious and organised crime strategy. The move will ‘drive up the cost and risk for organised criminals’, it says.

Other measures set out in the strategy include doubling the size of HMRC’s criminal taxes unit – which uses tax interventions to ‘attack the finances’ of people involved in drugs trafficking and other offences – and moves to increase pubic recognition of offences, with the document citing a recent Home Office-funded ‘crimestoppers’ awareness-raising campaign on cannabis cultivation that led to a 25 per cent increase in public reporting. There will also be more use of intervention programmes around gangs and troubled families. 

The document states that, although drug use is falling in the UK, the country’s illegal drugs market is still worth around £3.7bn a year and is ‘controlled by organised crime’. The strategy ‘focuses on preventing people from getting involved in organised crime, improving Britain’s protection against serious and organised criminality and ensuring communities, victims and witnesses are supported when serious and organised crimes occur’, the government says. 

Meanwhile, Norman Baker has replaced Jeremy Browne as crime prevention minister in a government reshuffle. His responsibilities will include the drugs strategy, alcohol – including the Licensing Act and police and local authority powers – public health, domestic violence and homelessness. The appointment is a controversial one, in part because Baker is the author of a book arguing that the verdict of suicide in the death of former weapons inspector Dr David Kelly was ‘not credible’. Elsewhere, Jane Ellison has taken over as public health minister from Anna Soubry.

Serious and organised crime strategy at www.gov.uk