This paper argues that a meticulous review of the effectiveness of UK drug policy is urgently needed. Policy – as contained in the Misuse of Drugs Act 1971 (the MDA), Drugs Act 2005, Medicines Act 1968 and strategy document ‘Drugs: Protecting families and communities] – is currently in a state of disrepair. The question suggests a contemporary over-influence of rhetorical bases in policy formation and evaluation, to the detriment of a frank review of its actual effectiveness, however I am unconvinced this artificial annexation of such broad notions will forge the more effective drug policy to which the question also refers. Rather, I propose that these notions describe the many authorities manipulated and dovetailed to produce and justify a much wider policy model. And it is this model, and the weight given to those authorities that currently hinders the effectiveness of the UK drug policy and deserves review. I call into question the way in which our current system is criminalised via the implementation of the MDA’s class system, limited to non traditional drugs, and based on control as justified by rhetoric. I propose a more appropriate direction in the adoption of an evidentially based harm reduction model, in line with the home office’s most recent policy.
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2. UK Drug Policy
In order to explore the necessity for a rigorous evaluation of the current UK drug policy; one must gain a comprehensive understanding of what the contemporary policy actually is, and why. [2] This can be demonstrated most thoroughly and accurately through a brief analysis of some of the most important policy models affiliated with our domestic drug policy. Through extrapolating the wider reasoning behind our current system I hope to decipher the influences on policy decisions and where – the weight imposed on such factors is unsatisfactory – the balance should be changed.
2.1. “Medicalization”
A timeline stretching from the nineteenth century keynotes the first defined drug policy of full ‘medicalization’ at the end of the century. [3] This stance places drug users within a medical paradigm, seeing addiction as a disease. [4] Whilst this ideology can still be seen as a strand within medicinal interactions with problem drug users, in terms of treatment and the Medicines Act 1968; it no longer works as the basis of domestic strategy.
2.2. A ‘War on Drugs’
Nixon’s 1973 use of the metaphor of warfare in relation to drug policies has since seen the USA ‘[wage] an ever-escalating “war on drugs”‘. [5] This has impacted the UK, where it is argued that criminal law and arguments of morality are deeply embedded in UK drug policy, [6] evidenced through a movement ‘towards a largely American-inspired prohibitionist approach’ in post war years, simply echoing the Pharmacy Act 1869’s earlier quasi-medical control of certain substances. [7] And I argue that this prohibitionist control still ‘underpins UK drug policy today’; [8] framing contemporary strategy documents. [9] My research suggests this ideology that has lead to drug policy becoming ‘crime-focused to an extent that it can be viewed as distinctively and substantively different’ in the twenty first century. [10]
2.3. Criminalisation
Academics have noted that the home office has ‘used its influence to try to push Britain towards a system similar to that of the USA…reliant solely on control measures’. [11] With the MDA ‘regulating drugs using a complex legislative framework’ revolving around the criminalisation of a band of illicit drugs – focussing on penal control, apparently based on risk assessment of the harms these drugs cause – to the exclusion of traditional drugs such as alcohol and tobacco. [12] This was compounded further by the Drugs Act 2005 – placing ‘law enforcement and crime reduction [as] central features’ of the agenda, working alongside the MDA in criminalising the activities surrounding certain drugs. [13]
The government has maintained that this ‘fundamental purpose’ of providing ‘a framework within which criminal penalties are set’ is correct, compounding the overwhelming priority of criminalisation in the current drug policy. [14] I argue this undermines current drug strategy aim ‘to reduce the harm that drugs cause to society, to communities, individuals and their families’. [15] Gower has expressed a deep concern regarding this ‘over-reliance on criminalisation as the means of control’, arguing that ‘it lacks a clear grounding in evidence, and it does not achieve its objective to reduce the misuse of drugs’. [16] This criticism coming from a strong academic feeling that criminalisation seems to define our current definition of the “drugs problem”, with critics calling into question this nonsensical and unjustified focus on punishment and enforcement. [17]
2.3.1. ‘Why has the drug-crime link come to be the principal lens through which the drug problem is viewed today?’ [18]
The government’s criminalisation of drug use is validated by suggestions that ‘drug use and crime are linked in some way’; [19] as demonstrated by the home office website. [20]
This ‘contemporary obsession with the drug crime link’, [21] refers to a belief that ‘the drug trade is linked to serious organised crime.’ [22] Officials argue that the coincidence of drugs and criminal activity can be understood through a theory of causation, and remains a key strand in current drug policy.
However, this ‘long history of exaggerated claims’ has been damned by experts, recognising that whilst there are links; ‘it is surprisingly difficult to show that any of the commonly misused drugs directly “cause” any behaviour’. [23] A number of studies have identified only vague correlations, [24] with limited evidence showing any ‘causal connections between drugs and crime’, somewhat questioning any conviction that “drugs cause crime”. [25] The perceived drug clime link is simply a rhetorical justification of the criminalisation of policy direction, lacking any real evidential strength. [26]
2.2.2. The Role of the Media
Consultation papers work as a key resource in the government’s current evaluative process. [27] However, public opinion and thus their responses are fundamentally manipulated by the media. Newspapers work in many ways as a talking shop for politicians to inform ‘much of what we know, or think we know, about crime’; with careful choices by such outlets ‘triggering a variety of public responses’. [28] Schlesinger et al assert that ‘media representations are a key moment in the process whereby public discourses concerning crime and justice are made available for general consumption’. [29] Thus, in consultation papers – recognised as conversations with the public and the limited existing form of evaluation – media’s interpretation is likely to implicate subsequent responses; somewhat negating the productivity of consultation. [30]
Distorted media presentation of substances can influence popular belief about their harmfulness, which then directly implicates change in drug policy; with clear inconsistencies between reality and reports. [31] Manning’s commentary on ecstasy depicts how ‘a series of well documented media-led moral panics’ can lead to an ‘evolution of the government’s policy’, based on ‘individual tragedies and anecdotes rather than rational analysis of evidence and pragmatic public health responses’. [32] The rushed classification of Mephedrone recently echoed this to the letter. [33] Whilst it denies reviews react to media attention, [34] I argue that through sacking David Nutt following such pressure, [35] government ‘showed [its] willingness to “[bow] to public mood”‘, feeding policy with rhetoric. [36] I assert that this amplified role of media in the formulation of drug policy forges political moves driven by people pleasers, rather than evidence.
2.3.3. The role of ACMD
The Advisory council on the Misuse of Drugs (ACMD) is ‘a statutory body which aim[s] to advise the government on drug policy and treatment’ [37] . However, its validity is questionable. Firstly, ACMD ‘has a statutory duty to consider both medical and societal harms when making recommendations’, [38] with a number of factors feeding into decisions, including unconvincing theories, the media, culture and what the public is thought to think [39] . Secondly its remit seems to be restricted to those substances the government are concerned with – notably excluding alcohol and tobacco. And finally, when scientific bodies bring evidence at odds with governmental direction; it is disregarded. [40] Despite Professor Wiles’ assertion that ‘the Government does not interfere with the independence of the ACMD and that ACMD have freely decided not to advise them about traditional drugs,’ [41] their ambit is limited to illicit drugs, because their advice – intended to be independent – at present, depends on government policy, not just scientific evidence. ACMD is forced to be political in nature; used as ‘puppets of government’ in its attempt to legitimize a framework that simply does not correlate with the statistical evidence experts propose. [42]
2.4. Cultural prejudice
The government itself notes that the distinguishing factors regarding the illegality of drugs are based ‘in large part on historical and cultural precedents’ [43] . Politicians are – it would seem – unwilling to tackle traditional drugs, simply because it would ‘conflict with deeply embedded historical tradition and tolerance’. [44] ‘Safe.Sensible.Social’ promotes a ‘sensible drinking culture’ rather than the prohibition of alcohol, [45] which is of stark contrast to any policy regarding what are regarded as “illicit” drugs. The reasoning for this polarity is defended though the social acceptability of alcohol and tobacco; which are void of any scientific basis. [46] This method of distinction questions the validity of our drug policy; emphasising how arbitrary the nature of the way in which we currently decipher which drugs fall within the ambit of the MDA really is. [47]
2.4.1. Traditional Drugs
‘Because of a preoccupation with illicit drugs in recent decades there has been, until relatively recently, much less discussion on alcohol. This is changing’. [48] The government has introduced two alcohol policies, the most recent being ‘Safe.Sensible.Social’ in 2007, however ‘health professionals who had pressed for the alcohol strategy were critical of it when it appeared in 2004 and the 2007 review was thought to be little better’. [49] Whilst the government discredit direct comparisons between illegal drugs and alcohol as ‘inappropriate’, [50] the evidence brought to government by the Health Select Committee covering a huge breadth of harms concludes that ‘England has a drink problem’. [51] Comparisons are appropriate and necessary. WHO deduces that two million deaths are caused by excessive alcohol consumption world-wide each year, with it being ‘responsible for 11% of the total disease burden in Europe’. [52] Alongside this, 90% of all drug related deaths are attributed to alcohol and tobacco. [53] In addition there are arguments of a strong correlation between binge drinking and offending, [54] even satisfying the flimsy ‘drug-crime link’ precedent of the MDA.
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The government’s response that ‘the classification system under the MDA is not a suitable mechanism for regulating legal substances such as alcohol and tobacco’; [55] is met with criticism of their complacency in the face of the ‘seriousness of our current predicament’. [56] Nutt expresses that ‘it is this omission from the classification system that, perhaps more than any other, truly lays bare its fundamental lack of consistency, reasoning or evidence base’. [57] ‘If classified under any realistic assessment of toxicity, addictiveness and mortality rates both drugs would certainly be criminalised and prohibited under the current system’ [58] . There is a clear presumption; were alcohol introduced today it would be classified and criminalised. [59]
2.5. Political rhetoric ‘is far removed from the reality’ [60]
The government’s use of broad definitions, reliance on rhetorical justifications and a seemingly unconvincing distinction of legal and illegal drugs despite their harms, leads us to ‘a strange statutory framework which legalizes drugs – alcohol and nicotine – that are equally, if not more, addictive and cause more death and ill health than…the most feared illegal drugs’. [61]
The moral panics constructed by the failure of politician’s promises of ‘a drug free world’, have lead to claims that the current policy is an ’embarrassment’, unproductive, and based on a band of rhetoric amidst a failing model of criminalisation and penal thinking. [62] Whilst both the alcohol and drug policies suggest a dedication to minimizing the harms caused by drug use, the prevalence of ‘tough talk and political posturing has invariably triumphed over common sense’, with the key aim of harm reduction lost within the framework of a criminalisation model. [63] This clearly calls into question the legitimacy of the advisory council, politicians, and the effectiveness of our drug policy and legislation.
3. A Call for Evaluation
The governmental strategy is ad hoc in its foundations, attracting a plethora of criticism regarding the artificiality of the dominant construction of criminality. ACMD suggest that ‘there is scope to explore how effectively the current system is operating’, [64] and Journalists are led to similar conclusions following indications of the insufficiency of current policy. [65] As reports continually conclude, this war on drugs has been a ‘disaster’. [66] With Boland encapsulating this exasperation in his assessment that ‘the logic of continuing to pour huge amounts of public money into fighting a war that is patently not going to be won must be revisited with a more questioning mind’. [67] Both scientifically and rhetorically, there are calls for evaluation with an eye to a more effective policy model in which evidential distinctions will thrive.
3.1. The Ambit of Evaluation
An evaluation should cover all substances regarded as harmful drugs. Scientists and academics struggle to specifically define what a drug is; mainly retracting back to science with reference to mixtures of chemicals and their effects on users. [68] ‘It is fundamentally the mission of the law to draw distinctions’, writing laws ‘that draw careful and appropriate distinctions between the permitted and the prescribed’. [69] The war on drugs has become a war on certain (illicit) drugs, with traditional others such as alcohol and tobacco falling outside of the scope of the ‘draconian enforcement of controls’. [70] The ‘one obvious basis for distinction’ between legal and illegal drugs are that illicit drugs are those that ‘create a high risk of harm to the users or others’, however even this has been proved to be, inherently flawed. [71]
3.2. ‘Drugs and Harm: A New Agenda for a New Government’ [72]
‘Although law enforcement has been given a higher priority in recent years…they coexist with a quite different line of thinking and action’, that of harm reduction. [73] An evaluation of the current policy should use an increasingly evidence based approach, with particular regard to the classification of traditional and non traditional drugs within this harm reduction model. If a harm reduction approach is adopted, the policy will work to reduce the harms that result from the misuse of drugs, which ‘waste lives, destroy families and damage communities’. [74] However, legislations’ hidden implication of harm reduction is currently insufficient. [75] Any such base has been overshadowed in recent decades through the MDAs more prominent regime of classification and subsequent criminalisation of illicit substances. [76] Through exploring classification in its present form compared to how it could be improved through using this model, I hope to illustrate how the government could develop strategies ‘which may lead the drug user into less harmful patterns of drug use’, ‘rather than simply enforcing the law and punishing wrongdoers’. [77]
4. ‘Drug Classification: making a hash of it’ [78]
Despite indications that the current classification system is ‘indefensible’; [79] the home office has said it has little intention of changing this framework, deciding ‘not to pursue a review of the classification system at this time’. [80] I counteract that this is a mistake, with the ‘the methodology and processes underlying classification systems’ inherently flawed. [81] As per Forte et al, ‘in a freedom loving society no conduct by rational adults should be criminalised unless it is harmful to others’; I argue that a transparent evaluation of the way in which our policy works and should work is long overdue. [82]
4.1. ‘Policy needs to informed by evidence’ [83]
Critics have, in many ways, attributed the failing classification system to it being ‘closed to scientific evidence’. [84] Many arguing that the MDA simply reflects ‘official perceptions of relative harmfulness’, [85] claiming that the government ‘routinely cherry picks and “spins” figures…to give a misleading impression’. [86] I suggest that this can be remedied through a clearer, ‘more sagacious approach’ [87] . And support the notion that evidence should not dictate all aspects of drug policy, but that ‘clear distinctions need to be made when policy is based on scientific evidence and when it is made on the basis of particular conception of what society should be like’. [88] Nutt has said that ‘people really don’t know what the evidence is. They see the classification, they hear about evidence and they get mixed messages [with the] scientific probity of government…undermined in this kind of way.’ [89] The public should be fully informed of the basis of the framework presented to them, and the reasoning behind this. Rhetoric and cultural influences are an important factor in formulating policy decisions and communicating with the public and their impact should not be wholly negated, rather a limitation of rhetoric’s weighted influence in key decisions regarding the harmfulness of drugs is needed.
5. Policy Consequences
Upon evaluation I suggest that the current system will be regarded as outdated, ineffective and in need of a complete regeneration. Whereas at present it seems the ‘ACMD can only recommend prohibition’, [90] I have not explored, nor will I advocate, the notion of legalisation or indeed the criminalisation of harmful substances. Rather, I suggest such an approach is unproductive, and envisage a two pronged approach; involving the current penal system as just that – a system of punishment, running parallel with a more scientifically based approach.
5.1. One Policy
In accordance with my discussion regarding the scientific evidence about alcohol induced harm, I believe that alcohol policy’s separation from the UK drug policy is unnecessary and unproductive. We must ‘fully endorse harm reduction approaches at all levels and especially stop the artificial separation of alcohol and tobacco as ‘non-drugs’. [91] As it stands, ‘there is no sign that the government’s aims to reduce harmful alcohol consumption have been achieved’. [92] Increasingly strong evidence suggests a long term trend towards the integration of traditional and non traditional drugs. [93] And I support a more comprehensive policy that amalgamates drugs and alcohol, using the evidence bases made available to the government to truly work to reduce the harms caused by drug misuse in the UK. [94]
6.2. Rational Scale
Based primarily on the work of Nutt, King, Saulsbury and Blakemore, I am calling for a second scale that doesn’t simply masquerade itself as an indication of the harmfulness of drugs; but is an accurate scientific representation of the harmfulness of each drug. This would be ‘decoupled from penalties, to give the public a better sense of the relative harms involved’, working as a second pillar to a continued penal classification system, with very little change. [95] Transform has supported the pragmatic nature of this scheme, and my research would suggest that many critics would welcome this scientific inclusion, [96] offering ‘scientific evidence of actual risks’ as a way of ‘replacing perceived risk’ in the classification process [97] . A key issue with this approach is the deciphering of what harm actually is, however I propose that this scale would allow for flexibility in the interim period of its existence. Whilst Nutt has criticised the current system’s lack of flexibility, [98] he is confident that this modified scale is ‘remarkably robust as data is added to it’, clearly opening its doors to a workable and scien
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