Select Committee on Home Affairs Minutes of Evidence

Examination of Witnesses (Questions 280 - 294)



Mr Prosser

  280. One of the criticisms of the present prescription of methadone is that the user or the addict will have his prescribed rationed amount and then will go out on the streets and top it up and go back to the black market. Under your scheme, will he have open house to say to the GP, "I want a bit more this time", then a bit more and a bit more, until he gets to overdose levels? How will that be controlled?
  (Mr Davies) Thinking about the balance of benefit, basically give the user what he needs/wants to stay off the black market. You can visualise two worries occurring. One is you might end up giving this guy so much he is going to "top" himself, he will end up dead. The most recent Home Office memo says there is no ceiling on the amount a user will consume. That is not right and there is very sound research, for example, by a man called Alan Parry who is a specialist heroin consultant. There is certainly a ceiling. The other thing is you have heard about tolerance, that the dose which is fatal for what they call an opioid-naive user, an early user, is different from the dose for an experienced user, so it follows, thank god—it is a rather beautiful internal mechanism—that insofar as you are a long-term heavy user, the level at which the dose would kill you has risen, so the fatal dose rises with consumption. Bear in mind that the gap is anyway wide. I certainly would not suggest that the doctor should give a patient a lethal dose, but we are long way out of that territory. The other worry is leakage, is it not? "If I give this guy too much, he will sell it on the streets." If you have set up the system of prescription in the way it was in 1926 by the Rolleston Committee right through to the late 1960s, ie there is no barrier to access—

  281. —there would be no market on the street?
  (Mr Davies) There is no market for it. Why would you buy from this scummy creature on the street corner when you can get it free from the doctor, who can give you the information and a clean needle? It worked for years.

Angela Watkinson

  282. We have heard a lot of argument this morning about the likely reduction in the levels of acquisitive crime if drug-taking were to be decriminalised, people would not need to break into homes and commit robberies and so on. What about crimes committed by people who are addicted to stimulant-type drugs, which can induce psychotic or aggressive behaviour? Would that type of crime be likely to increase?
  (Mr Kushlick) I think it is important to look at the different effects of different drugs. If we are looking specifically at the effects of amphetamine-type substances and particularly crack, there are some real problems associated with the use of those drugs which do cause significant mental health problems in chronic long-term users. A lot of those problems are still associated with prohibition. There is a lot of paranoia involved in the whole market. Once you are involved in that kind of environment, it is one where there is a lot of violence, a lot of other messed up people, a lot of damaged people around. So the environment inculcates an enormous amount of problems surrounding the misuse of those drugs. There is still an overbearing context that is produced by the policy of criminalising those users. In terms of an increase in crimes committed under the influence, again we need to keep this in perspective. There is only a very small number of people committing crimes only under the influence of amphetamine-type substances. The vast majority of crimes are committed under the influence of alcohol. This is the place where the Home Office ought to be stepping in and talking to the Department of Health, saying, "Why the hell are we not sorting this out?" rather than all these other drugs which the Department of Health ought to be dealing with, which it is not. Once you start levelling the playing field and looking at what our responses are at the moment, it is anomalous if we start focusing on the potential dangers of a massive increase in use of crack and offences committed under the influence. Certainly if they are, those people need to be hit, and hit hard in terms of criminal sanctions. But we must also be aware the whole time that those people who are involved in chronic misuse of drugs are generally damaged and it is the underlying causes we need to look at. So, yes, the criminal justice system needs to play a part for those people who are causing damage to other people, but we do need to look under the surface at what is going on and recognise that most drug misuse is a symptom and not a cause. The same stuff will go on in those people's lives, those life histories are still the same—abuse, poverty, unresolved bereavements, being in care, drug-dependent parents—it is all the same, the same stories come out again and again and again, and if you tackle those issues those people will not get into those problems in the first place.

  283. Do you think society could afford decriminalisation?
  (Mr Kushlick) Can it afford prohibition? The costs of prohibition are so huge, we are talking about well over £10 billion a year. The costs have not been worked out, which is why we need this audit, and I am concerned that the Treasury are not anxious to do it as well. The issue is, first and foremost, we cannot afford prohibition, which is one of the main reasons why this is going on at the moment; global capitalism cannot afford it; the Treasury cannot afford it; the Home Office cannot afford it; I cannot afford it as a taxpayer. We cannot afford what is going on at the moment. In terms of what happens under legalisation, we are going to save money, and we are going to benefit overall financially. Legalisation is not a cure-all. The only thing legalisation cures is prohibition. Prohibition is the disease, legalisation is the vaccine which will remove that, but it will not stop people dying, people getting ill, and it will not stop some of the things which still revolve around misuse. We will save money, vast amounts of money, overall, but not only save money, in terms of the social costs involved, in terms of what goes on in those developing countries who produce at the moment, whose whole political and social systems are destroyed by prohibition. Then when it comes down to the consumer issues—Brixton, Moss-side, Bristol, everywhere where drug misuse takes place and it is done in that unregulated way—the benefits are huge, both financially and socially.

  284. Do you think decriminalisation should also be accompanied by a widely extended treatment service? Should the objective of the policy be to relieve the addiction of current users?
  (Mr Kushlick) It certainly should be to allocate resources where we know they are well-spent. We know from the NTORS Study for every £1 you spend on treatment, you save £3 on criminal justice costs, but not only that, you can also begin to address all those problems which lead them into difficulty.

  285. Do you think that should be the objective?
  (Mr Kushlick) Absolutely. If you take the money away from criminal justice, you spend it somewhere better. Again, the audit will show where that money is best spent. You need to monitor and evaluate all the way through according to rational, reasonable, key performance indicators and see what is working.

  286. You are not advocating people should be allowed to take whatever drugs they like because they like it, you think the policy should be directed to getting them off those drugs?
  (Mr Kushlick) No. The policy needs to be directed across a whole series of key performance indicators, including prevalence of use and misuse, but not over-archingly above anything else. If you use reduction of use and misuse as your over-arching key performance indicators, you will come up with strange policies which will not work on the other indicators. Yes, it needs to be in there as part of the policy, but not as your number one, over-arching priority to the exclusion of all other issues. Prevalence is an important indicator but it needs to be seen alongside all the other ones—crime, health and significantly health. At the moment there are no health indicators in the UK drug strategy. It is absolutely shameful. We have a situation where about 80 per cent of injecting drug users at the moment have Hepatitis C. Most of them will die in the next 20 to 30 years as a result of that. Where is health?

  287. You would not say, per se drug-taking is harmful therefore it should be Government policy to try and reduce it?
  (Mr Kushlick) No.
  (Mr Davies) The underlying assumption about harmfulness would be wrong.


  288. Can I press you finally on this point about the link between crime and drug use? Research by the Department of Justice in America suggests that six times the number of murders occur under the influence of drugs than are committed to obtain money to buy them.
  (Mr Kushlick) It is a crazy comparison. What is that comparison about?
  (Mr Davies) This was the other quiet concession which I thought was so important. Apart from no longer listing all the alleged harm, the argument we all put forward is about the reduction in property crime, and the Home Office are not arguing with us on that. Let us let that sink in first. If we could reduce property crime in that way, that is good news. Here is a Home Office official struggling to reconcile the emerging truth with years of bad policy and he comes up with this odd figure with no reference and no explanation from the Department of Justice. What do we know about the motives for these murders? If a man comes back and finds his wife sleeping with somebody else and kills her out of jealousy but he is also a drug addict, does that mean the drug caused the crime to be committed or would he have committed it anyway? There is simply no information about that anywhere in there. I would suggest that the number of crimes which are committed by people who have lost touch with reason as a result of drug consumption is so marginal as to be negligible. I do not think I have come across it. This is a desperate official trying to—

  289. Let's try the Centre for Addiction Studies, whom you might give more credit to than the Home Office. They are based at St George's Hospital Medical School. They say, "Whilst acquisitive crime might reduce if drugs were decriminalised, it is known that alcohol consumption is linked to increasing rates of violent and impulsive offending. There is therefore likely to be an increase in impulsive offending driven by stimulants and cannabis misuse for example."
  (Mr Davies) That is silly.

  290. "This is likely to be most evident amongst those who also have a mental health problem."
  (Mr Davies) That comes back to the point about the murders in America. If you have a mental health problem, you may well commit a crime. The idea that cannabis encourages criminality, other than the possession itself, really is off-beam. I will tell you what the underlying problem here is, there are huge piles of cash from Whitehall for people who will research the alleged dangers of drugs, and you can hear by the way the first sentence is phrased, "There might be some reduction in property crimes." For heaven's sake, let's look at the reality, there would be. If you cut off the black market, there would be, but there is this reluctance to say that because that is not what you are being funded to deliver. Then we have these people scrambling around in the darkness, "For heaven's sake, there must be some evidence somewhere of something going wrong with drugs", and they come up with this. I am deeply unimpressed.

  291. Yes, I got that point. When I lie awake at night in my house in the centre of Sunderland I can hear the mayhem going on outside, caused mainly I think by alcohol, so it is not unreasonable to suggest, is it, that if you allow people greater use of other stimulants it will lead to more bad behaviour?
  (Mr Davies) Not heroin, not cannabis. Maybe amphetamine sulphates.

Mr Cameron

  292. Crack?
  (Mr Davies) Crack is a beastly drug, is it not? I am not sure we are going to find evidence anywhere of crime being committed because of crack as against whatever surrounding circumstances there are for the crime to be committed.


  293. You do accept that alcohol in excess does lead people to smash up things. A lot of violence is alcohol-related.
  (Mr Davies) Let us take the worst case scenario. Let's say you are right, that there is some unspecified drug out there, it might be amphetamine sulphate, which encourages violence which would not otherwise be committed, I think it comes back to Mr Prosser's point about treatment. At the moment those people are deterred from seeking treatment because they may get into trouble with the law or they are frightened of hospitals. If the result of legalisation is to encourage those people back into the system where they get treatment, even if there were some incidents where the available drug created violence, the overall level would fall, would it not, if we get these people into treatment so whatever it is which is in their personality that is combining with the drug is being addressed. I cannot promise you we will create a perfect world, but I think we are out on the fringes of possibility here.
  (Mr Kushlick) We have to look at different drugs and the effects they have. Under the influence of heroin, people nod, and that is generally the state they will be in, or they are just stable. It is not a stimulant. There are stimulants which do cause people to really lose it in terms of committing crimes under the influence. Cannabis is not one of them.

  294. You say cannabis is not one of them, but here is a quote from the Criminal Justice Association, "Research in New Zealand shows that . . . young men who take cannabis are five times more likely to be violent than those who do not."
  (Mr Kushlick) Let us look at that evidence. It reminds me of the gateway theory of cannabis. The original stuff on the gateway theory on cannabis was they took heroin users and asked them what their first illegal drug of choice was, and it was cannabis, surprise, surprise. They then said, "Let's run it the other way, so cannabis led them to use heroin." Studies have also been done on offenders to look at what is in their urine after they have committed their crimes, and there is a whole bunch of drugs there. Again, it is a marginalised group of people who are involved in drug-taking who are also involved in criminal activity. Surprise, surprise. Then there is this causal relationship established in the same way the Home Office suggested it was the commercialisation of cannabis in coffee shops which increased prevalence. They happened at the same time but the increase in prevalence would have happened had they had the coffee shops or not. It is important to look at the causal relationship. If it is there and if it is specifically to do with the drug, that needs to be addressed, and there are a whole number of ways of addressing that, through treatment and criminal justice orders could be put on people just as abstinence orders are put on people who abuse alcohol. They are not being used, it is not included in abstinence orders. For god's sake, why not, if this is the major drug causing people to commit crimes? We need to be clear and again it is about levelling the playing field and saying, "What are we doing with these other drugs?" Let us not get overly energised about the problems associated with stimulants which are currently illegal and what might happen if we legalise them, when we are not even doing it with the main drug that people commit violence under, that 25 per cent of child abuse is committed under. We are not doing it there so let us just be real here.

  Chairman: Gentlemen, thank you very much. We have had a very stimulating session and have travelled where politicians normally do not dare tread. The session is closed. Thank you very much.

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