Some shocking facts about substance abuse in Britain in 2005 are available in the UK Drug Report 2005 produced by the EMCDDA. Particularly of concern is the fact that Britain shows the highest levels of cocaine and amphetamine abuse in the EU, though in light of recent stories regarding abuse by famous celebrities it perhaps shocks us less than it might. Indeed a statistical modelling of the prevalence of crack (the purer and more addictive form of cocaine) abuse indicates it may be as high as 1 in 100 in London amongst 15-44 year olds. Cannabis is now normative amongst young people in some 31 developed countries where leisure time and a significant disposable income amongst 15 year olds correlate with increased abuse, even girls it seems are finding themselves increasing under its influence and most worryingly passing on there habit to younger generations. The positives from the UK Drug Report do however point to a levelling off of the rises in cocaine and ecstasy use since 2001. While cannabis usage amongst young adults’ stands at 38% it has now fallen to fourth in the EU behind the Spain, France and the Czech Republic.

If we are to take an optimistic view of the evidence of Britain’s addiction to substance abuse and the damage it continues to do to the fabric of our society we need to realise that it is yet to be cracked by the conventional prohibition approach.

The justification for such an approach is described in the 1961 UN Convention, being in place to control the serious evil of addiction to narcotic drugs and the social and economic danger to mankind. Differentiations between drugs with respect to the degree of control are based upon the extent to which the substance is liable to abuse and its production of ill effects balanced against there therapeutic usefulness. Therefore our national drug control system is based upon differentiating substances by the single dimension degree of risk of social or health problems or dangerousness. This is however fraught with difficulty as the dangerousness of substances is not uni-dimensional nor does their use occur in isolation. Indeed the fact is that drugs themselves are not dangerous but rather the risk resides in the interaction between the substance, the individual, the method of consumption and the context of use.

Indeed it is worth remembering that the contributions of opioids, cocaine and amphetamines taken together as a fraction of the global burden of disease found that they contribute just one fifth of those accounted for by alcohol and tobacco while the estimated cost of illicit drugs to Canadian Society was less than one fifth of the costs off alcohol and tobacco.
The point remains therefore that in classifying narcotics in the way that we do we leave alcohol and tobacco in an anomalous status that actually ends up making an ass of the law. These contradictions are increasingly obvious to educated young adults as well as those in more deprived social groupings. The fact is that alcohol and tobacco are so engrained within Western societies that to many any talk of considering alcohol in the same categories as prohibited narcotics is simply unacceptable. In looking for a way to approach the issue of addiction then we could do worse than look the experience in Portugal since 2001 where they have attempted to solve this anomaly not by tightening controls on tobacco or alcohol or taking the unrealistic and unpractical view of legalising drugs but rather to limit harm by a de facto de-criminalisation.

Decriminalisation relies on dealing with drug abuse not through the criminal justice system but through administrative processes, treating the user as a person with a medical addiction rather than a criminal. The Police no longer have the power to arrest the user but instead dispose of the drugs, take the users name and address and refer them to the Commission for the Dissuasion of Drug Use (CDT). Panels from the commission which include social workers, medical professionals and technical experts then decide on the appropriate combination of sanction, education and treatment. Fines can subsequently be applied by the commission if the user does not take the steps offered to them to remedy their addiction. In 2003 the Commission processed some 6100 cases with all the evidence showing that the commission is using its new powers enthusiastically with the result of shortening the time of dealing with the user. Before 2001 the criminal justice system in Portugal could take as long as two years to bring the user to court, in all but the most complex of cases the commission now deals with in four to five weeks with an amazingly low 6 per cent of cases relapsing.

The evidence shows that Portugal has managed to successfully implement a significant national programme of change in the way of dealing with drugs users without major delays or administrative problems. It has allowed the police, health and social services to work together in providing help to drugs users and preventing relapse rather than issuing punishment that failed to tackle the problem at root, something which is particularly valuable when young people just beginning to become involved with drugs are concerned. Most strikingly it has not despite the predictions of certain doom mongers on the right led to either an increase in drugs use or drugs tourism in Portugal.

Portugal’s experiment shows the benefits of taking a fresh view to the problem of addiction in Britain today by concentrating the resources of government on education and treatment. Crime statistics in Britain demonstrate the shocking level of thefts that are now carried out by drug addicts to pay for their next fix. The stolen laptop or mobile phone is rarely traded for anything but a single fix, indeed such is the desperation and clinical need of those with lives blighted by addiction that they will not only steal from their neighbour but in many cases from their own families. It is obvious to anyone that drugs are ripping apart the fabric of our society and indeed destroying families yet we still continue to take counterproductive, punitive and criminalistic approach to narcotics while the NHS openly offers treatment packages tailored to alcohol and tobacco abuse.

The time is ripe for a sensible and long sighted review of drug policy in Britain today- the emphasis of such a review should surely focus upon minimising harm, supply and usage while maximising the availability of treatment and pervasiveness of drugs education. The Police should be given similar powers to those in Portugal to refer drugs users to commission made up of social and medical professionals. For hard drugs use particularly in of heroin the availability of rehabilitation facilities should be increased with trained medics on hand to proscribe methadone and diamorphine to users in carefully managed programs to wean them off their addiction . The provision of clean needles and the life saving heroin overdose remedy naxalone has already been shown in recent research to limit harm and prevent drugs related deaths, access to such facilities should be more widespread and referral to such clinics compulsory for hard drugs users.

Addressing the social service needs of the user, such as those life problems leading to cycles of abuse, has been shown in the United States to significantly increase the number of improved outcomes in the years following treatment. It has shown the benefits of not only providing medical services but also vocational services such as job training and housing. By bringing hard drugs users into such a coordinated environment we can not only prevent the users from inflicting harm upon themselves and the community via the related criminal activity, but also restore the users’ sense of social purpose and go someway to restoring their life prospects. Hand in hand with such an approach should be an increase in the use of former addicts to speak in education classes in schools along with a thorough teaching of the scientific facts relating to the physical harm and clinical dependency caused by drugs.

However rehabilitation is not suitable for such users of soft recreational drugs such as ecstasy and cannabis, for there is little benefit in exposing them to users of hard drugs whose problems are normally far more severe. We must be prepared to take a more pragmatic and realistic approach to this issue if we are to make the law credible to users of recreational drugs. They should be dealt with by the same confiscation and referral process by the police with the subsequent focus upon education- quite simply bombarding them with scientific information about what they are doing to their bodies perhaps with the threat of financial penalties for those repeatedly relapsing into re-use

While rehabilitation and education can go so far in dealing with the problems of drug abuse by minimising demand and harm the fact remains that for those people caught with an amount that can only be construed as trafficking (in Portugal anything above a three day supply) the penalties should remain severe. The need to improve Britain’s border protection as well as the resources made for the interception of narcotics by the Royal Navy is also evident. If we can achieve results similar to Australia’s Federal Police where increased government funding led to large scale heroin seizures we too can have had definable impact upon street level supply.

A radical evidence based policy approach to dealing with drugs abuse is now open to British politicians that can correct the anomaly of treating alcohol and tobacco abuse while criminalising hard drugs users whose need is just as severe a medical condition. If we can take the example of Portugal and build upon it using the lessons from some of the latest research mentioned in this article then we can not only minimise harm but also cut crime and limit use. The only thing that is required is the political will to take a fresh approach to the oldest of problems- that of addiction.

References

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