- Ewan Hoyle, founder of Liberal Democrats for Drug Policy Reform
On 18 September at their annual party conference the Liberal Democrats will debate a motion about policy for illicit drug use, which my colleagues and I have prepared. It’s not a hugely radical motion. How radical is it to call for an examination of the impact of current policy and a thorough investigation of the potential impact of alternative approaches? This is how we should expect governments to formulate policy for all of the areas for which they have responsibility.
Sadly though, politicians have long believed that drug policy is not like other policy: to follow the evidence risks being seen as being “soft on drugs” and recklessly endangering the vulnerable bodies and minds of our nation’s children.
If Liberal Democrats are to challenge the tabloids—particularly the Daily Mail, whose influence over politicians in suppressing debate on this matter is chilling—and gain the support of backbench Conservatives to have a meaningful impact on government policy, then they must instead adopt a policy that can be framed as “tough on drugs” by effectively restricting their ability to cause harm (Why do we so wilfully cover up the failure of the war on drugs?” 1 Aug 2010, www.guardian.co.uk/commentisfree/2010/aug/01/angus-macqueen-drugs-trade-policy).
Although some have suggested that a discussion of drug policy might be an attempt to win back the student vote, that was far from my intention in preparing the motion. Indeed, for the approach to have any chance of meeting the Conservatives’ approval, it will need to address the concerned parents of middle England far more than it appeals to experimenting youths.
Although not explicitly requested by the motion, three policies that could emerge from this process have potential for strong approval from this demographic. Firstly, the decriminalisation of possession of drugs for personal use, if we are to follow the Portuguese model, is not a policy that will turn a blind eye to drug misuse. Rather it allows individuals to request treatment without fear of prosecution, and, perhaps more importantly, it allows family and friends to request help for their loved ones without creating any damaging resentment. The police—rather than making judgments on whether it is right or a worthwhile use of their time to arrest or caution people in possession of drugs—can instead, without prejudice, issue citations for individuals to appear before expert panels, which can judge what education, treatment, or counselling is appropriate. It is a policy that should allow the early signs of problematic drug use to be identified and treated before jobs are lost, relationships ruined, and families torn apart.
Secondly, the legal regulation of cannabis can also demonstrably hold the health of young people as a paramount consideration. I find the evidence linking cannabis use and later psychosis persuasive and biologically plausible, and I am well aware of the terrible impact that undiagnosed psychosis may have on a person’s life chances and family. If cannabis were sold from pharmacies, the government could require education on the early warning signs of psychosis to be delivered before anyone makes a first purchase, and pharmacists could advise on alternative varieties or cessation should customers have concerns. For those who argue that illegality sends a message that drug misuse is harmful, legal regulation allows that message to be delivered every time cannabis is purchased, and for that message to be delivered by a trained health professional. Additionally, unlike the illegal market, there is zero possibility of a pharmacist suggesting to young customers that they progress to try cocaine or heroin.
There is no need to speculate as to how the concerned parents of middle England would respond to such proposals. My colleagues and I last year commissioned a poll through the Angus Reid polling agency, which provided descriptions of such a strict regulatory regime alongside light regulation and prohibition alternatives (http://twitpic.com/4z8bmt). Although 70% of the sample of 2000 representative British adults supported some level of legal regulation, those who were most supportive of strict regulatory measures were Daily Mail and Express readers and middle aged women, the groups we would expect to hold the greatest prejudice against “legalisation,” and, in middle aged women, the group with the greatest caring role for teenagers.
The third policy, and one that is so well supported by evidence that we have judged it not to necessitate further investigation, is for widespread provision of the highest quality, evidence based treatment facilities, and for this provision to include diamorphine maintenance clinics for the most disruptive or vulnerable heroin users. Studies in Scotland and England have shown that untreated problematic drug users cost society on average £50 000 (€57 000; $82 000) to £60 000 a year. Spending relatively small amounts of money on treatment facilities that divert people away from street drugs, acquisitive crime, and prostitution can surely be framed by experienced politicians as a worthwhile use of government cash. This effort could be made so much easier if this cash was the newly available ringfenced proceeds of the taxation of the other “irresponsible drug users” purchasing their cannabis from pharmacists.
So what chance does this motion have of changing coalition policy? It should have few problems being passed by the Liberal Democrats’ conference. Liberal Democrats to me are defined by their instincts to try to understand and sympathise with people whom others might rush to judge. Indeed, a spring motion at our Scottish conference backed diamorphine maintenance clinics without a single vote against.
Ultimately, though, these proposals have little chance of affecting policy unless there is a force of popular and professional opinion that the Conservatives find impossible to ignore. A poll this year again found doctors to be the most trusted profession in Britain, with politicians right at the bottom of the pile. The families and communities that suffer because of our failing drug laws could certainly use your help.
Cite this as: BMJ 2011;343:d5235
Competing interests: None declared.
Provenance and peer review: Commissioned; not externally peer reviewed.
bmj.com/archive Editorial: Evidence based policy for illicit drugs (BMJ 2010;341:c3374, doi:10.1136/bmj.c3374); Analysis: An alternative to the war on drugs (BMJ 2010;341:c3360, doi:10.1136/bmj.c3360); Medicine and the Media: How the media helped ban mephedrone (BMJ 2011;342:d1138, doi:10.1136/bmj.d1138)