Examination of Witnesses (Questions 280
TUESDAY 6 NOVEMBER 2001
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 godit is
a rather beautiful internal mechanismthat 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
(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.
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 sameabuse, poverty,
unresolved bereavements, being in care, drug-dependent parentsit
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
issuesBrixton, Moss-side, Bristol, everywhere where drug
misuse takes place and it is done in that unregulated waythe
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
(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
(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 onescrime, 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
(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
(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
(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
(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