Mixing Drugs and where to draw the line.

Drug Policy Harm Part Five: Conclusion (and bibliography)

Please note this paper was drafted April 2009 and has not been updated



Continued from ... Drug Policy Harms Part Four: The Legal Harms


Conclusion

There is a clear relationship between violence and illegal drugs and alcohol. Indeed alcohol and illegal drugs contribute to a range of social harms. In exploring these harms we need to differentiate between those which are consequences of the substances and those which are generated by policy. We can not completely remove the harms of drugs; but an effective drug policy, covering both currently legal and illegal drugs can minimise the harms these substances cause.

Figure 11 (Source TDPF 2009:21)


Controls over supplier

• Hours of opening
• Location/appearance of outlet, number of outlets
• Licensing/training of vendors/staff
• Controls over marketing/advertising

Controls over purchaser

• Age controls (minimum age, ID / proof of age required for purchase)
• Restriction of sale if purchaser is intoxicated
• Volume rationing
• Purchase tracking
• Licensing of purchaser
• Delay between order and pick up
• Required membership of group or union for purchase
• Consumption on licensed premises only

Controls over product

• Packaging (plain packaging, tamper proofing, health and safety warnings etc)
• Preparation, dosage, quantity
• Coded for individual licensed purchaser

Such a policy must involve government taking responsibility for regulation of these substances markets. This would include intervention on pricing and would allow a range of controls, as set out in Figure 11 above.  Clearly treatment and law enforcement have a role to play under such a regime but they would no longer be the key to the minimisation of harm or indeed violence. By rejecting the idea that harm and violence is the consequence of individuals making irresponsible choices in an unregulated market we can adopt a new policy paradigm. The policy, based on scientific evidence, will allow us to significantly reduce violence and other harms by implementing effective regulation and control, based on the public health principles of promoting well being and minimising harm. Criminologists can contribute to this, but only if they escape the straight jacket of their discipline and approach the issues using a broader social harm perspective.

J.M. Moore

j.moore@uwe.ac.uk
23 April 2009

Bibliography

 
Academy of Medical Sciences (2004) Calling Time: The Nation’s drinking as a major health issue, London, The Academy of Medical Sciences

AMCD (Advisory Council on the Misuse of Drugs) (2009) MDMA (‘ecstasy’): A Review of its Harms and Classification under the Misuse of Drugs Act 1971 London, Home Office

BBC (2009) ‘Drug adviser criticised by Smith’ BBC News on-line 9th Feb. 2009. Online at http://news.bbc.co.uk/1/hi/uk_politics/7879378.stm (Accessed 11 April 2009)

Behr, E. (1996) Prohibition: thirteen years that changed America New York, Arcade Publishing

Brown, J & Langton, D. (2007) ‘Legalise all drugs: chief constable demands end to ‘immoral law’ Independent 15 October 2007

Burnham, A. (2008) Written ministerial statement by Andy Burnham on the Evaluation of the impact of the Licensing Act 2003 Online at:
http://www.culture.gov.uk/reference_library/minister_speeches/1997.aspx (Accessed 23 April 2009)

Cabinet Office (1998) Better Regulation Task Force Welcomes Liquor Licensing White Paper, London Cabinet Office Press Release

Cabinet Office (2004) Alcohol Harm Reduction Strategy for England. London, Prime Minister’s Strategy Unit

Caulkins, J.P. & Reuter, P. (1998) ‚What price data tell us about drug markets’. pp. 593-613 in Journal of Drug Issues No. 28, Vol.3.

Dills, A.K., Miron, J.A. and Summers, G (2008) ‘What do economists know about crime?’ Working Paper 13759 National Bureau of Economic Research Cambridge, MA

Donaldson, L. (2009) 150 years of the Annual Report of the Chief Medical Officer, London, Department of Health

Dorling D., Gordon, D., Hillyard, P., Pantazis, C., Pemperton, S. and Tombs, S. (2008) Criminal Obsessions: Why harm matters more than crime. (2nd Edition) London, Crime and Society Foundation.

Easton, M. (2009) ‘Could we save billions by legalising drugs?’ BBC News online at: http://www.bbc.co.uk/blogs/thereporters/markeaston/2009/04/heroin_and_cocaine_cost_britai.html (Accessed 11 April 2009)

Glenny, M (2008) McMafia: Seriously Organised Crime London Vintage Books

Goodacre, S. (2005) ‘The Licensing Act: an act of stupidity?’ pp. 682 in Emergency Medical Journal Vol. 22

Gordon, L,. Tinsley, L, Godfrey, C and Parrott, S (2008) ‘The economic and social cost of Class A drug use in England and Wales, 2003/4’ pp. 41-45 in Singleton, N., Murray, R. and Tinsley, L. Measuring different aspects of problem drug use: methodological developments (2nd Edition) London, Home Office

Haldeman, H.R. (1994) The Haldeman Diaries: Inside the Nixon White House. New York, G. P. Putnams Sons

Hillyard, P., Pantazis, C., Tombs, S. and Gordon, D (2004) ‘Introduction’ pp.1-9 in Hillyard, P., Pantazis, C., Tombs, S. and Gordon, D Beyond Criminology: Taking Harm Seriously, London, Pluto Press

Hillyard, P and Tombs, S. (2008), ‘Beyond Criminalogy?’, pp. 6–23 in Dorling D., Gordon, D., Hillyard, P., Pantazis, C., Pemperton, S. and Tombs, S. Criminal Obsessions: Why harm matters more than crime. (2nd Edition) London, Crime and Society Foundation

Hoare, J and Flately, J Drug Use Declared: Findings from the 2007/08 British Crime Survey England and Wales London, Home Office

Home Office (2008) Drug Strategy Equality Impact Assessment Available Online at: http://drugs.homeoffice.gov.uk/publication-search/drug-strategy/equality-impact-assessment?view=Binary (Accessed 23 April 2009)

Hough, M., Hunter, G., Jacobson, J. and Cossalter, S. (2008) The Impact of the Licensing Act 203 on levels of crime and disorder: an evaluation. London Home Office

Howker, E. (2009) ‘The Big Question: Do we need a new debate about relaxing drugs policy in Britain?’ The Independent 11th February 2009

Human Rights Watch (2004) Not enough graves: The War on Drugs, HIV/AIDS, and violations of Human Rights, New York, Human Rights watch

Hunter, G. and May, T (2004) Solutions and Strategies: Drug Problems and Street Markets, London, Home Office

Independent (2009) ‘PM rejects minimum alcohol price idea’ Independent 16th March 2009 online at: http://www.independent.co.uk/news/uk/politics/pm-rejects-minimum-alcohol-price-idea-1646077.html (Accessed 23 April 2009)

Jason-Lloyd, L (2007) Misuse of Drugs: A Straightforward Guide to the Law Winchester, Waterside Press

Jones, S., Miller-Mack, E. & Ahrens, L. (2005) Prisoners of the War on Drugs, Northampton Ma, The Real Cost of Prisons Project

Joseph, M (2000) Ecstasy, London, Carlton Books

Labour Party (1991) Drugs: A Consultation Document London, Labour Party

London Ambulance Service (2009) ‘Alcohol-related calls’ Available online at: http://www.londonambulance.nhs.uk/news/alcohol-related_calls.aspx (Accessed 23 April 2009)

Marks, H. (1996) Mr Nice London, Secker and Warburg

McGreal, C (2009) ‘Retaliation theory as president of Guinea-Bissau is assassinated.’ Guardian 3rd March 2009 Online at: http://www.guardian.co.uk/world/2009/mar/03/guinea-bissau-africa-president-assassination (Accessed 21 April 2009)

McSweeney, T., Turnbull, P.J. & Hough, M. (2008) Tackling Drug Markets and Distribution Networks in the UK: A review of the recent literature London, UK Drug Policy Commission

National Statistics (2009) ‘Alcohol Deaths: Rates stabilise in the UK’ online at http://www.statistics.gov.uk/CCI/nugget.asp?ID=1091&Pos=1&ColRank=2&Rank=1000 (Accessed 19 April 2009)

Newton, A., Sarker, S.J., Pahal, G.S., van den Bergh, E. and Young, C. (2007) ‘Impact of the new UK licensing law on emergency hospital attendances: a cohort study’ pp. 532-534 in Emergency Medical Journal Vol. 24.

Newton, A., Hirschfield, A., Armitage, A., Rogerson, M., Monchuk, L. and Wilcox, A. (2008e) Evaluation of Licensing Act: Measuring Crime and Disorder in and around Licensed Premises, Home Office Research Study SRG/05/007 Final Report. Huddersfield: University of Huddersfield Applied Criminology Centre.

Norris, P, & Williams, D. (2008) ‘Binge Drinking, anti-social behaviour, and alcohol-related disorder: examining the 2003 Licensing Act’ pp. 257-272 in Squires, P. Asbo nation: The Criminalisation of Nuisance Bristol, Policy Press

Nutt, D.J. (2009) ‘Equasy: An overlooked addiction with implications for the current debate on drug harms’ pp 3-5 in Journal of Psychopharmacolgy Vol. 23. No. 3.

Nutt, D.J. (2006) ‘A tale of two Es’ pp. 315-317 in Journal of Psychopharmacology No. 20, Vol. 3.

Nutt, D.J., King, L.A., Saulsbury, W. & Blakemore, C (2007) ‘Developing a rational scale for assessing the risks of drugs of potential misuse’. Pp. 1047–1053 in the Lancet Vol. 369:

ONS (Office for National Statistics) (2005) ‘Alcohol related death rates in England and Wales, 2001 to 2003.’ Available online at http://www.statistics.gov.uk/STATBASE/ssdataset.asp?vlnk=8905 (Accessed 20 April 2009)

Pemperton. S (2007) ‘Social harm future(s): exploring the potential of the social harm approach’ pp. 27-41 in Crime, Law and Social Change Vol. 48, Nos. 1-2.

Phillips, M. (2009) ‘Drugs no worse than horse-riding? The folly of those ‘experts’ simply beggars belief’ Daily Mail 9th Feb. 2009

Rayner, G. (2006) pp. 174-182 in Griffiths, S. & Hunter, D.J. (2006) New perspectives in public health, Oxford, Radcliffe Publishing

Reuters (2008) online at http://africa.reuters.com/country/SL/news/usnL1148907.html (Accessed 19 December 2008)

Rolles, S., Kushlick, D. and Jay, M. (2006) After the War on Drugs: Options for Control Bristol, Transform Drug Policy Foundation

Rush, B.R., Gliksman, L. and Brook, R. (1986) ‘Alcohol Availability, Alcohol Consumption and Alcohol-Related Damage: The Distribution of Consumption Model’ pp. 1-10 in Journal of Studies on Alcohol and Drugs Vol. 47, No. 1.

Sivarajasingam, V., Moore, S. and Shepherd, J. P. (2007) Violence in England and Wales 2006: an accident and emergency perspective. Violence Research Group, Cardiff University Available Online: http://www.cf.ac.uk/dentl/resources/Trends_violence_England_Wales_2006.pdf (Accessed 21 April 2009)

Smart, C (1990) ‘Feminist approaches to criminology or post modern woman meets atavistic man.’ pp. 70-84 in Gelsthorpe, L. & Morris, (eds.) A. Feminist perspectives in criminology. Milton Keynes, Open University Press

SU Drugs Project (2003) Phase 1 Report: Understanding the Issues Leaked to Guardian and available at: http://image.guardian.co.uk/sys-files/Guardian/documents/2005/07/05/Report.pdf (accessed 11 April 2009)

TDPF (2009) A Comparison of the Cost-effectiveness of the Prohibition and Regulation of Drugs, Bristol, Transform Drug Policy Foundation Full Document Available Online at: http://www.tdpf.org.uk/TransformCBApaper.pdf (accessed 12 April 2009)

Tree, S. (2007) What Darwin teaches us about the drug war (online at http://www.commondreams.org/archive/2007/12/27/6018) (Accessed 12 April 2009)

Wilson, L. and Stevens, A. (2008) Understanding Drug Markets and How to Influence Them. Oxford, The Beckley Foundation

Drug Policy Harm Part Three: The Failure to Regulate

Continued from ... Drug Policy Harm Part Two: Misrepresenting Harms




Prohibition – Generating Harms



If we look at other aspects of prohibition we see the generation of significant violence and harms.  The MDA makes all consumers criminals. A third of the population admits drug use in the British Crime Survey. (Hoare and Flately 2008:5) Of course all these people are not subjected to criminal justice intervention, the system simply couldn’t cope, but all of them are liable to arrest, a criminal record and imprisonment. Events that could have a dramatic bearing on their lives. Jobs and homes are lost regularly by consumers who come into contact with the criminal justice system.  The impact of this is not spread evenly across the community. I have not been able to calculate the racial profile in the UK but figure 5 below shows how this process plays out for African-Americans.

Figure 5 (Source Jones et al 2005:13)

The war in drugs was launched by Richard Nixon. His Chief of Staff recorded in his diary, that Nixon had ‘emphasized that you have to face the fact that the whole problem is really the blacks. The key is to devise a system that recognises this while not appearing to.’ Halderman 1994:53) The war on drugs has proved to be such a system.


The inequality generated by the selective enforcement of drug prohibition in Britain urgently requires detailed research. The Home Office was required to carry out an Equality Impact Assessment on their new drugs strategy in 2007. The first section of the assessment, titled Preliminary Screening, includes the question: ‘Could the aims of the policy be in conflict with equal opportunity, elimination of discrimination, promotion of good relations?‘ (Home Office 2008) To which the Home Office replied ‘NO’. This and the document in general demonstrate contempt for equality, which is reduced to a form filling exercise cynically ignoring a considerable body of evidence of inequality generated by the war on drugs.

The illegality of substances does not just impact on crime by criminalising their consumers. It has much wider impacts both within the UK and internationally and generates dramatic levels of harm. Central to this generation of crime and violence is prohibition, which in terms of policy, places the entire market, production, distribution, wholesale and retail, into the hands of organised crime. The illegal drug market is a state sponsored, tax free monopoly for criminals. The consequences of this are dramatic; however because of limited space I will restrict myself to a few examples

1.    Generation of acquisitive crime

Figure 6 below shows the cost of drug use for a heavy user in 2003. Having a Cocaine or heroin habit is expensive, raising £300, £400 or even £500 a week is impossible for most people through legal means. They resort to crime. The Strategy Unit estimated that 56% of the total number of crimes; some thirty six million crimes, are ‘drug-motivated crimes’ committed by drug users. (SU Drugs Project 2003:22) This is illustrated in Figure 7, again copied from the Strategy unit report to the cabinet.

Figure 6 (Source: SU Drugs Project 2003:12)

Figure 7 (Source: SU Drugs Project 2003:22)

Home Office Research has estimated that drug-motivated crime in total costs victims just under ten billion pounds per year and the economic costs to the community of the average ‘problematic drug user’ is in excess of £44,000. (Gordon et al 2006:44 & 41) In this market, unregulated prices emerge which lead to increased crime. The government’s own analysis finds that over half of all crime and victimisation are linked to behaviours generated by the economics of this market - which the government chooses not to regulate.


2. Prostitution of drug users

For many women and girls and a few men and boys, fundraising is achieved not through acquisitive crime but by prostituting themselves. Research carried out for the Home Office has shown that the drug and sex markets are intrinsically linked. (Hunter and May 2004) The same factors detailed above for acquisitive crime drive adults and children into prostitution. The Home Office’s Equality Impact Assessment makes no mention of the contribution of drugs policy in generating supply within prostitution nor does it acknowledge the gendered status of prostitution. (Home Office 2008)

3. Generation of Violence

In a review of economists’ contribution to the study of crime, Dills et al (2008:3) concluded that ‘economists know little about the empirically relevant determinants of crime.’ Applying various hypotheses on subjects as varied as arrest rates, capital punishment, gun laws and abortion rates, to an examination of aggregate data over long time periods and across countries exposed the various theories as wanting. However, they did ‘find one theory that is consistent with the aggregate time series and cross-country data on crime: the view that enforcement of drug prohibition encourages violent dispute resolution.’ (Ibid:22) Drug markets operate outside the law and have no recourse to legal procedure to resolve disputes. Drug dealers use violence to collect debts, they use violence to resolve disputes between themselves and they use violence to resist law enforcement efforts. Prohibition makes violence a cost effective business strategy. It introduces guns and knives on to our streets as routine business tools. Sometimes the state responds with violence. China celebrated UN world anti-drugs day in 2002 with the mass execution of 64 drug offenders. (Rolles et al 2006) Thailand’s security services murdered almost two and half thousand alleged drug dealers in just three months, in pursuit of the war on drugs. (Human Rights Watch 2004) Even lawful criminal justice responses generate perverse outcomes. As Sanho Tree has argued, law enforcement operates as a Darwinian natural selector removing less ruthless and less violent market participants. (Tree 2007) Over time law enforcement has driven out the non violent hippys like Howard Marks and replaced them with brutal, callous and vicious gangsters. (Marks 1996, Glenny 2008) The violence of the market raises prices; Caulkins & Reuter (1998) estimate that 33 per cent of the retail price of cocaine is paid to compensate dealers for their risk of death or injury. This in turn increases the fundraising requirements of problematic users, thus increasing crime and its associated victimisation.

4. Destabilisation of producer and transit countries

As well as generating considerable levels of violence in consumer countries like the UK the drug business has a far more dramatic impact on producer and transit nations. In Latin America, the Caribbean, Africa and Asia nations have been destabilised as a direct consequence of the so called war on drugs. Last year Michael Schulenburg, the UN Mission Chief in Sierra Leone observed ‘that the exposure to the international drug trade is the single biggest risk affecting the future of Sierra Leone’. (Reuters 2008) Guinea-Bissau has seen both its President and army chief murdered this year, killings directly linked to the country’s status as a transit country for the cocaine trade. (McGreal 2009) Internationally the war on drugs has subjected many poor nations to wave after wave of violence.

Continued ... Drug Policy Harm Part Four: The legal harms

Drug Policy Harm Part Two: Misrepresenting Harms

Continued from Drug Policy Harm Part One: Social Harm Theory -v- Criminology

The Myth of the Misuse of Drugs Act and Harm


The prohibition of certain classes of drugs is a policy decision which has cross-party consensus with both the last Labour and the current Conservative/Liberal Democratic Governments supporting this arrangement and indeed keen to include any new drugs that emerge on the market.  The core piece of legislation underpinning this policy is the Misuse of Drugs Act 1971 (MDA) which seeks to control specific drugs through criminal justice interventions based on the scientific classification of their harms. (Jason-Lloyd 2007) Although harm appears to be an established component of this regime this is an illusion than needs exposing. To do this I want to highlight the work of David Nutt, an eminent scientist and former chair of the scientific committee, established by the MDA, to advise the Home Secretary on drug policy.

Nutt (2009:4) raises ‘the critical question of why society tolerates –indeed encourages – certain forms of potentially harmful behaviour but not others’, highlighting the comparative risks of ecstasy and alcohol, ecstasy and horse riding and the relative harms of legal and illegal drugs. (Nutt 2006, 2009 & Nutt et al 2007) In figure 1 below Nutt (2006:316) compares the relative harms of the two E drugs, ethanol, better known as alcohol, and ecstasy and his figures make clear that the harms caused by alcohol are dramatically greater than ecstasy. 

Figure 1 (Source: Nutt 2006:316)

In fact what is clear from this is how much harm alcohol causes; twenty two thousand premature deaths, one thousand five hundred road traffic deaths and over 10,000 cases of interpersonal violence per annum, and how little harm is caused by ecstasy. Yet earlier in 2009 the government choose to retain ecstasy’s classification as a class A drug under the MDA. (Home Office 2009, ACMD 2009)

In an interesting analysis Nutt et al (2007) attempted to incorporate both legal and illegal drugs in a single hierarchy of harm. The results, published in the Lancet and shown in figure 2 below, clearly demonstrate the lack of any clear correlation between a drug’s harm and it’s classification under the MDA. Methodologically this study is not unproblematic and remains trapped in the paradigm of prohibition. For example, considering the most harmful drug, heroin, it fails to separate those harms intrinsic to it as a chemical substance and those harms that are generated by its legal status. (TDPF 2009:12-13) Hopefully this exercise will be repeated with the harms directly attributable to prohibition disaggregated. Would illegal street heroin have exactly the same level of risk of harm as prescribed heroin?


Figure 2 (Source Nutt et al 2007:1050)

 In an editorial in the Journal of Psychopharmacology, Nutt returned to comparisons of the relative harm of two ‘e’s, this time Ecstasy and Equasy (Equine Addiction Syndrome). Figure 3 below summarises his results. The legitimacy of his comparison of their respective harms generated a strong backlash with, the Home Secretary, Jacqui Smith, declaring that she was  ‘sure most people would simply not accept the link that he makes up in his article between horse riding and illegal drug taking.’ (BBC 2009) 

Figure 3 (Source: Nutt  2009:4)


Melanie Phillips (2009) commenting on Nutt’s paper declared ‘The only reason there are not many more deaths from ecstasy is that unlike horse riding, it is illegal.’ In fact the relationship between ecstasy’s illegality and fatalities associated with use are more complex. Its illegality removes the opportunity for any quality controls, it has led to moral panics, misinformation and has potentially impacted on levels of consumption. Lack of quality control means the consumer has no reliable information about ingredients and this lack of regulation leaves the control of the exact composition of the product retailed, and the health and welfare of consumers in the hands of organised crime. Moral panics over ecstasy have undoubtedly created harm; Leah Betts, the iconic ecstasy victim, died from water intoxication, consumed on the misunderstanding promoted by the press that vast quantities of water were the antidote to ecstasy. (Joseph 2000:91) Illegality therefore certainly increases the risk of death but does it deter use, thereby reducing the risk as well?

The Home Office claims that ‘(d)rugs are controlled because they are harmful. The law provides an important deterrent to drug use and legalisation would risk a huge increase in consumption’; though they provide no evidence to support their assertion. (Easton 2009) The Number Ten Strategy Unit, whose confidential report on drug policy to the cabinet in 2003 was leaked to the Guardian, concluded that ‘attempts to intervene have not resulted in sustainable disruption to the market at any level.’ (SU Drugs Project 2003:104) This conclusion was backed up by the UK Drug Policy Commission whose research concluded that ‘seizures and enforcement efforts have had little adverse effect on the availability, purity and price of illicit drugs in the UK ‘ and that ‘(s)ince 2000, average street prices in the UK have fallen consistently for heroin, cocaine, ecstasy and cannabis.’ (Mc Sweeny et al 2008:48 & 40)

Figure 4 below is reproduced directly from the Number 10 Strategy Unit’s report to the Cabinet. It demonstrates how effectively use of Heroin has been controlled since the introduction of the MDA. Illegal drugs are today widely available, at historically low prices, suggesting that prohibition has neither reduced supply nor demand, both of which have actually grown dramatically over the last forty years. Whatever their ambitions it is clear that the MDA and the prohibitionist paradigm in which it operates have not reduced harms.



Figure 4 (Source: SU Drugs Project 2003:38)
The lighter columns are addicts notified to the Home Office, and the darker columns from 1997 when the HO notification system was shelved, are numbers in treatment.



Continued ... Drug Policy Harm Part Three: The Failure to Regulate

Drug Policy Harm Part One: Social Harm Theory -v- Criminology

This post is based on a paper I delivered at the University of Wales, Newport in 2009.  I am delivering a modified version at the University of Bath this Friday.

The Elephant in the Room: Drug and Alcohol Policy as Generators of Violence and other Social Harms

The wide-scale use and abuse of legal substances such as alcohol and tobacco inflicts far more harm on individuals and society than illicit drugs … We need a calm non-sensational approach to policy development in this area and one which places these serious problems in context. (Labour Party (1991) Drugs: A Consultation Document)

Things have gone from bad to worse; there is no possibility of an honest discussion now. Anyone who sticks their head above the parapet and calls for a rational consideration of the drug laws gets it shot off and kicked around by a horde of lunatics (Austin Mitchell, Labour M.P. 10 Feb. 2009 cited in Howker 2009)

This paper seeks to do two things. Firstly to introduce an emerging theoretical paradigm, social harm theory, which seeks to refocus our attention from behaviours defined as 'crime' to a wider set of behaviours, those that generate harm. Secondly it seeks to rethink the issues of alcohol and drug harms and violence by incorporating those caused by state policy alongside those generated by individual consumers, producers and suppliers of currently illegal drugs and alcohol.

My conclusion is that violence and other social harms associated with illicit drugs and alcohol could be dramatically reduced. However this reduction will not be achieved through a focus on the individual user or indeed on drug and alcohol services. Such initiatives, whilst undoubtedly making significant positive contributions to the lives of individual problematic consumers, are effectively swimming against the tide of avoidable violence and other harms generated by existing policy. Reducing violence and other social harms associated with both legal and illegal drugs requires the government to accept its responsibility for public health and to implement an effective framework to regulate all drugs.

Social Harm Theory

Criminology focuses on crime, the criminal and the resolution of problems through the criminal justice system. However, the events and actors we label crimes and criminals operate in a wider context that criminology often ignores. As Carol Smart (1990:77) has observed, the great weakness of criminology is that it:

cannot locate rape or child sexual abuse in the domain of sexuality or theft in the domain of economic activity or drug use in the domain of health. To do so … would involve abandoning the idea of a unified problem which requires a unified response.

This limitation has inspired the development of a social harm perspective which seeks ‘to move beyond the narrow confines of criminology, with its focus on harms defined by whether or not they constitute a crime’ and instead calls for ‘(a)ll forms of harms’ to be ‘considered and analysed together.’ (Hillyard et al 2004:1,2) We are all vulnerable to a wide range of social harms throughout our life course and social harm theory argues that to separate out crimes from other harms considered ‘outcomes of the market economy, … accidents or mistakes’ creates ‘a very distorted view of the world’. (Ibid:1,2) Social Harm approaches lead away from a focus on individual blame and towards policy responses designed to minimise future harms. (Dorling et al 2008)

Social harm theory rejects the boundaries of criminology and the exclusive focus on crime and criminals. It seeks to place crime in the context of other harms, an approach which allows us to respond to the totality of harms generated by a particular problem. For example it allows us in the case of alcohol to consider the harms generated by deregulation alongside the harms caused by the individual drunk and the harms suffered by the solitary middle aged heavy drinker in the quiet of his own home alongside the harms caused by the drunken teenager disturbing the peace of her local community. Social harm theory seeks to embrace not only physical harms but also financial/economic, emotional and psychological harms. (Hillyard & Tombs 2008:15)

Simon Pemberton (2007:33-36) has highlighted the potential of the social harm perspective to explain the failure of criminal justice policies and generate the space for alternative social policies which, freed from the rhetoric of law and order, can genuinely reduce the harm communities experience. Relating this paradigm to alcohol and unlawful drugs provides the opportunity of exploring the impact of these substances within a much wider perspective than criminology offers. It enables us to give equal consideration to legal and illegal acts, explore individual, corporate and state behaviours and to measure the harms directly associated with the drugs alongside the harms generated by failures to control and regulate their market places.  Most significantly for this talk it allows us to look at all drugs, both legal and illegal, within the same paradigm.

Continued ... Drug Policy Harm Part Two: Misrepresenting Harms

Podcast of the Public debate - Addiction: should we penalise or treat?

On April 8th I took part in a public debate at The Watershed in Bristol about how we respond to drugs.  The debate was recorded and is now available on the web as the August Philosophy Monthly Podcast.

You can listen to the Podcast here

BMJ on the health consquences of the War on Drugs

The British Medical Journal has started producing short videos.  This one is worth a view.

Strict laws on the criminalisation of drug use and drug users are fuelling the spread of HIV and other serious harms associated with the criminal market and should be reviewed, say experts. In this video, epidemiologist Elizabeth Pisani and other leading commentators describe which countries are leading the way in tackling HIV infection among injecting drug users.

Hat tip Transform

Better safe not sorry?

The precautionary principle seems like good common sense. If in doubt play safe.  If we are not sure of the actual harms something may cause we should take action now rather than wait for firm evidence. In short better safe than sorry. However the reality can be rather different as David Nutt points out in an excellent blog entitled Precaution or perversion: eight harms of the precautionary principle.

Essential Nutt argues that in respect to drugs the precautionary principle leads to increased harm.  In particular he identifies these 8 harms:

1. Increases personal harms
2. Distorts markets to greater harm to society
3. Impossibility to refute
4. Disproportionate penalties
5. Entrenchment of a flawed institutionalised moral position on drugs
6. Encourages other drug use
7. Blocks new drug discovery
8. Denies innovation and medical progress

This counter-intuitive argument is an important one and one that I have used to argue that the harms of drug and alcohol policy are actually greater than the direct harms of the specific substances.


 

Britain Safe for 48 hours

Following bold action by Home Secretary, Alan Johnson, the young people of England, Scotland, Wales and part of Ireland were safe for 48 hours this weekend.  Johnson in the early hours of Friday morning banned the drug Mephedrone following advice from the AMCD that they hadn't got a clue.

Websites that sold so called "legal highs" are temporarily closed as they stock up with a new product range

Hot tip is 5,6-Methylenedioxy-2-aminoindane normally referred to as MDAI which is very similar to ecstasy.

A quick internet search shows a growing wholesale market

Is it safer or more harmful than Mephedrone?  Is it safer or more dangerous than alcohol? 

Who knows?  Certainly the Government has no intention in providing good quality scientific advice.  Instead they will after a few months of soundbites end up banning it and giving us a 48 hour break before the next "legal high" hits the online retailers.

Meanwhile what is the bet this new product will be heavily promoted by media condemnation over the coming weeks?

Daily Telegraph Moral Panic Journalism and Mephedrone Pushing

On the 17th March Daily Telegraph hack Heidi Blake wrote about Mephedrone and the dangers it presented; which she claimed, following the Telegraph editorial line required an immediate ban. Her article went under the headline Mephedrone: the truth about 'miaow miaow' In the article Blake claimed that:

In November Gabrielle Price, 14, of Worthing West Sussex, died after allegedly taking the drug.

What Blake didn't say was that in December, less than a month after Gabrielle's tragic death Sussex police announced that following toxicology tests:

It has now been established that death resulted from cardiac arrest following broncho-pneumonia which resulted from a streptococcal A infection.

As it was clear that Gabrielle's death was from natural causes, and had nothing whatsoever to do with Mephedrone or any other drug, there was no need for a full inquest.

I therefore saw a certain irony when my attention was drawn to th screen shot below posted on the web by badjournalism. It shows a search for stories on mephedrone on the Daily Telegraph website. As well as these stories the viewer is also directed to a number of suppliers of the drug. These are paid adverts provided by google. So although the Telegraph demands an immediate ban in the meantime they are happy to earn their referral fees from the pushers.

As you can see Heidi Blake story is shown up by the search which looks like it was done on the following day, March 18th.

The Telegraph has subsquently run a story revealing the Government's tax revenue from the plant food/ drug was £584,303.  How could they make money off the pedling of this evil? A case of throwing stones in a glasshouse methinks.

Hattip badjournalism

Transform Drug Policy Foundation Scotland

I met Katrina and Jolene when they visted Bristol in late 2008.  Both are a real inspiration.

From the Herald

Beyond the law

‘I was still at school when I had to tell my parents, ‘I think Alan is on drugs’.

After that I was always breaking terrible news: he’s been arrested; he’s in prison; he’s dead.”
Schoolteacher Katrina Robertson, now 28, lost her heroin-addicted brother Alan in a drug-related stabbing two years ago last week – March 17, 2008. He was killed as he stepped in to protect a flatmate caught up in a scuffle at the entrance of a block of flats in Glasgow’s Shawlands.
Katrina and her cousin, Jolene Crawford, didn’t respond by calling for crackdowns on the social menace of drugs, or demanding that dealers be strung up – Alan himself was a minor dealer.
Instead, they launched Transform Drug Policy Foundation Scotland (TDPFS), a thinktank calling for a wholesale review of drug laws, including an end to the blanket prohibition of heroin. They would like to see the drug available on prescription, and argue that removing the criminality from drugs would cut much of the damage they cause. Neither do they support the banning of “legal highs” such as mephedrone.

“We are the least likely drug reform campaigners, a mother and a teacher,” says Katrina. “But Alan had used heroin for 12 years and stayed alive and relatively healthy … I am convinced he was killed not by the drug, but because of the society he was involved in.”


TDPFS was launched last autumn, and has the backing of heavyweight supporters from across Scottish society (see panel). Jolene and Katrina have never spoken before about the personal tragedy which led to their conversion from ashamed relatives who did everything they could to conceal Alan’s addiction, into campaigners who believe Scotland needs to change the way society deals with drug addiction. But now, two years after Alan’s murder, they are telling their story in the hope of provoking a public debate which they say politicians are unable or unwilling to confront. Katrina says she watched her brother slide from a happy, able boy growing up in Aberdeen, to an addict sleeping rough and ending up in prison in 2004. His death didn’t come as a surprise, but the manner of it shocked her: “I felt like I’d lost Alan to heroin years ago, but I’d been waiting for him to come back.”

They were pupils at Aberdeen Grammar School when it began. She says many children their age were experimenting with drugs. Katrina and Jolene describe Alan as a “charmer” who once boasted: “I’m the best looking boy in Aberdeen.”
“He was a bad boy,” Katrina says. “Girls loved him and boys wanted to be him. But he lacked confidence and he struggled at school. We think he may have been dyslexic.” She and their elder brother, Neil, found out he was smoking heroin. “Money went missing, mum’s bank card, piggy banks. I found a shoebox full of ‘makings’ under his bed. There was a pen with no ink or lid, several clipper lighters and some foil with funny stains on it.” Alan was still living at home with his siblings and his mum. Their parents had separated but his dad was involved with the family and later paid for Alan to go to rehab – unsuccessfully.

Katrina watched as Alan became two people – the brother she knew and a darker figure who gradually took over: “He could be charming polite and well-mannered, but then there was ‘street’ Alan whose phone was constantly going and he would speak tersely, making arrangements to meet people. The longer the drug use went on the more the Alan I knew was being eroded and taken over.” His drug use landed Alan in Aberdeen’s Craiginches prison for a short sentence. By the time he came out, Katrina was in Glasgow, about to begin a teacher training course. “He came with me to enrol. He was excited for me and I could tell he was sad about what he was missing out on,” she says. “Because of his record, the kind of jobs he could go for were not jobs he wanted to do.”

While he was in jail, she had received phonecalls telling her to deliver money to people, otherwise he would be hurt. Desperate, she did so – feeling vulnerable sitting outside dodgy Glasgow flats in her conspicuous blue VW beetle. After prison Alan stayed with his sister for a year. He had come out clean, but rapidly slipped back to his secret life.
“When I was in third year he turned up at my door bleeding and badly beaten. He said he had been attacked by two Liverpudlians with golf clubs and he had to give them £200 or they would kill him.” At the age of 19, Katrina was as tortured by his addiction as he was, and also hiding much of what was going on from her mother.

She says: “I was worried and feeling sick all the time, but at the same time just wanted to say, ‘Get out of my face, let me get on with my life’.
“I used to blame Alan, but it is the current system that put me in that situation. We felt ashamed as a family … but it wasn’t our fault. Why should people feel like that?” In the year or two before Alan died he had shown signs of getting his life back on track. Having started out smoking heroin, he had moved to injecting, but was back to smoking it again. His life appeared calmer and his addiction at least under control. He was living with another heroin user and petty dealer in Shawlands. They looked after each other. One night when his flatmate went out only his dog came back. “Alan would have thought ‘where is he?’,” Katrina says. “He went down and found his friend was being attacked. He had been stabbed dozens of times. Alan stepped in to try to save his friend from being murdered and was stabbed twice. He was killed by one unlucky stab wound to the heart.” Alan’s friend survived. The attacker, Ian Hislop, was sentenced to life in December 2008. Katrina adds: “Alan was a heroin user and a low-level dealer, so was his flatmate, so was the man who killed him. We don’t know, but I would guess somebody owed money to somebody. There were no drugs or weapons on Alan or in the flat.”

Desolate after Alan’s death, the pair felt they should do something. They thought about campaigning for more rehabilitation facilities, but the more they looked at the evidence the more they became convinced that drug policies are based on a lie. But their views are rejected by some people, including Professor Neil McKeganey, of Glasgow University’s Centre for Drug Misuse Research. He insists the suggestion that decriminalising drugs would improve the situation is “rose-coloured politics” and claims there is no strong evidence that criminalisation is harmful. “Take mephedrone – that will not become more harmful if it is made illegal. It will be made illegal because we’re increasingly aware of its harmful consequences.” Jolene is emphatic that the reverse is true. It is prohibitionists, she believes, who have no evidence for the success of current policies, while there are convincing grounds both that current policy is failing and that other approaches work better.

“We don’t want to tell people what to think, we want an open debate,” she says. “We are so confident people would see the evidence is there in black and white.” TDPFS highlights evidence such as that from Portugal, the first European country to abolish all criminal penalties for personal possession of any drugs. Since 2001, addicts have been offered treatment and therapy instead of jail time. The number of teenagers using illegal drugs has declined, rates of new HIV infections have fallen and the number of people seeking treatment for drug addiction has more than doubled.
Studies have also backed the prescribing of heroin as effective in tackling drug addiction, leading to Aberdeen City Council social work chief Fred McBride recommending earlier this year that trials in the city be considered. A report commissioned by the Home Office in 2004 but never published concluded that the drug war was unwinnable and that moving from prohibition to regulation of currently illegal drugs should be an option. “The Home Office should consider wider rolling out of injectable heroin prescription for highly dependent users through the NHS,” the report said.

TDPFS argues that giving heroin to opiate-dependent people would help them become citizens again, while cutting the gangsters out of the drug market would avoid much of the criminal collateral damage. The billions of pounds currently devoted to prosecuting the drugs war could be invested in treatment. TDPFS has been backed by former policemen, bishops, addiction workers, authors and former politicians. But the women know it is hard for sitting politicians to speak out. Jolene says: “We know so many people agree but they are not putting their heads above the parapet. They fear the public will not support them, but we want to bypass the politicians and go straight to the public.”
“We are signed up to this for the rest of our lives,” Katrina adds. “People say you can’t change anything, but if everybody said that we would still be living in caves.”
Jolene adds: “Imagine what it would be like in Scotland if old ladies didn’t have to be scared of drug gangs, or getting mugged by a junkie. We could change all that by prescribing heroin."

Original story can be seen here

Addiction: should we penalise or treat? A public debate

If you are near Bristol and fancy hearing me speak in person I will be taking part in this event next week

What: Addiction: should we penalise or treat? A public debate

When: Thursday 8 April 2010, 18:30-20:00
Where: Watershed, 1 Canon's Road, Harbourside, Bristol, BS1 5TX
Addiction: should we penalise or treat? is the topical subject of a free public debate organised by University of the West of England philosopher, Dr Havi Carel. The event will take place on Thursday 8 April 2010 from 18:30 to 20:00 at the Watershed in Bristol.

The public debate is one of the events funded by the Arts and Humanities Research Council (AHRC) as part of the three year research project - The Concepts of Health, Illness and Disease. Project leader, Dr Carel explains, “This research project brings together researchers from diverse disciplines to develop an understanding of health, illness and disease. This is crucial to society as how we define illness can have ethical, social and economic consequences. Addiction is an emotive topic that clearly highlights these issues. One example is smoking - should the NHS pay for the treatment of nicotine addiction or are smokers just weak-willed? By drawing on the expertise of a multidisciplinary team of speakers, the audience will hear multiple approaches to the issue before being invited to join in the debate.”

The speakers are:

• Dr Nick Airey, an NHS psychiatrist specialising in addiction
• Dr Piers Benn, Medical ethics
• John Moore, Criminology, UWE
• Dr Giles Pearson, Philosophy, University of Bristol
• Dr Jonathan Webber, Philosophy, Cardiff University
• Chair: Dr Julian Baggini, Editor of The Philosopher's Magazine

This event is free of charge to the public and a large audience is expected. This event is free of charge but booking is essential, to book a place e-mail Dr Havi Carel - Havi.Carel@uwe.ac.uk

Dr Carel concludes, “The event has attracted interest from clinicians, drug and addiction practitioners, and service users. It promises to be a lively debate and is a chance for the public to contribute to our research. We are planning to record the debate as a podcast on the project website, as well as on the AHRC website and The Philosopher's Magazine website.”

Mephedrone & Glue - A tale of two drugs

Mephedrone, plant food and occasional drug is to be banned by Home Secretary, Alan Johnson, on the advice of the Committee of Scientists who are prepared to give politically acceptable advice (AMCD).  This follows reports that Mephedrone may have been related to a number of its users deaths which have whipped up a moral panic with the media demanding action. There have been exceptions to this reporting most notably Edmund Conway in the Daily Telegraph whose article What economics teaches us about drugs  is well worth a read.

The number of deaths attributed to Mephedrone has been estimated as up to 25. None of these are confirmed and it could be that it turns out that none of the deaths were actually caused by the abuse of plant food. However compare this with glue and other solvents. We can still go to any major DIY retailer, supermarket, or even the average corner shop and buy this product. But glue has a number of uses one of which is as a 'legal high'. It does indeed but the only coverage of the alleged 60 deaths a year I can find is on CBBC and that is from 2003!. 

Glue and other solvents of course remains legal. As do the drugs which kill the most: Alcohol and Tobacco.

Hat tip to Mills for the idea and research.
Hat tips to Syncronium for picture - Link to Mephedrone article on that site here