October 23, 2019

expert reaction to report on UK drug policy

A report, published by the House of Commons Health and Social Care Committee, calls for radical changes to the UK’s drug policy, moving from a criminal justice approach to a health approach. 

Dr Emily Finch, Vice Chair of the Addictions Faculty at the Royal College of Psychiatrists, said:

“The increasing numbers of people needlessly dying from drug addiction shows the government’s approach to treating addictions is failing.

“We emphatically support the report’s calls for urgent investment in drug treatment services and a return to harm reduction.

“Funding for addiction services has been slashed in recent years, starving services of the funding needed to treat people suffering with this illness. The Government must now act on the recommendation made in this report and urgently invest significant sums of money into services to ensure this vulnerable group of people can access treatment.

“Harm reduction approaches are proven to reduce drug-related deaths and minimise health risks. The Government must start treating addictions as an illness and ensure needle exchanges and life-saving drugs – like naloxone – are available to all who would benefit from them. For too long drug addiction has been presented as a criminal issue rather than the potentially life-threatening health issue that it is.”

Prof Sir Robin Murray, Professor of Psychiatric Research Institute of Psychiatry, Psychology and Neuroscience, King’s College London, said:

“In general this seems a sensible report, in particular the recommendations regarding improving treatment services, which have been cut significantly by the Conservative Government. Since 2010 we have seen increased drug deaths and harm reduction measures are in my opinion long overdue.

“Regarding decriminalisation, I would be in favour of this for cannabis with a system like that in Portugal where people repeatedly found using cannabis are referred to counselling/treatment services.

“Regarding decriminalisation of harder drugs like heroin, cocaine and amphetamine, I would be more cautious. Best to see how we get on with cannabis first.”

Prof Sir John Strang, Head of the National Addiction Centre, Institute of Psychiatry, Psychology & Neuroscience, King’s College London, said: 

Comment on the report

“This first report on ‘Drugs Policy’ from the House of Commons Health and Social Care Committee is an extremely important and well-considered contribution. The report urges radical re-orientation of our approach to UK drugs policy, recommending moving from the current criminal justice approach to a health approach. This switching of the balance so that the health perspective is dominant has been done by previous governments, to the great benefit of individuals and society. In the late 1980s, the Thatcher government recognised the threat that HIV posed and the need to address addiction problems to prevent an anticipated epidemic spreading through society. This required creation of more available treatment and also better quality treatment (based on international scientific reviews). As a result, HIV was virtually stopped in its tracks amongst the drug-using population who were otherwise considered a bridgehead to a wider societal epidemic.

“The report also recognises that a switch to a health approach needs government action to make it happen, so the report recommends that ‘responsibility for drugs policy (should move) from the Home Office to the Department of Health and Social Care’. As a society, we increasingly recognise the merits of a public health approach to problems such as knife crime and associated deaths. The time has come for us to recognise the merits of a public health approach to problems of drug use and associated deaths.

“The bracing assessment that ‘UK drugs policy is clearly failing’ is bold and correct, drawing our attention to how we are failing to pay proper attention to a rapidly growing death rate from drug overdose, which now causes more deaths than road traffic accidents. The casualties are particularly amongst more disadvantaged sections of our society. The report also states that ‘every drug-related death is preventable’ which is the challenge that we must accept and address. As doctors, as family members, as society, this is where we need better use of effective treatments which save lives and offer pathways to reconstruct broken lives.”

Commenting more generally on addiction and addiction services:

“As a society, we need to have more commitment to treatment for those caught up in problems of addiction. But we are currently failing to give this problem the attention it deserves, and we are reaching for the wrong tools in our armamentarium to have the most effective response. We are looking too much for sticks to beat people with and we spend too much time and effort encouraging exit from treatment, when we should instead recognise the major benefits to individuals and also to society from long-term treatment and care for those whose lives have been seriously derailed by addiction and where internationally recognised treatments exists with repeatedly tested and proven effectiveness. Addiction does not go away after a short intervention: for some people it is a life-long problem and certainly a life-long vulnerability. As with other health problems with a social dimension, treatment and care planning should be long-term and should adapt to the changing stage of treatment response and recovery.

“The report draws attention to a developing health crisis in which there are growing numbers of deaths from drug overdose while numbers in treatment are falling, and we are failing to recognise its severity. These deaths particularly involve heroin and other opioid drugs: other drugs also contribute, but the particularly deadly contribution of heroin and the opioids is striking.

“How could this increase in deaths have occurred when the addiction problem is thought to have plateaued? We need to be honest and point out that, over the last decade over which period the deaths have increased, there has been a 30% reduction in funding for addiction services in England – with the result that treatment is ‘thinner’ with fewer people in treatment, and fewer trained staff in the remaining services. Control strategies and prevention initiatives are important components of our overall response, but our choice of types of intervention seem more driven by popular appeal rather than evidence of actual effectiveness.”

Prof David Nutt, The Edmond J Safra Chair and Head of the Centre for Neuropsychopharmacology, Division of Brain Sciences,  Dept of Medicine, Imperial College London and Chair of DrugScience, said:

“This is not the first time parliamentary committees have recommended major changes to the drug and alcohol laws. Let’s hope that this one is the last, and that the government take heed of this report. For this to happen the government must accept the vast body of evidence that they have ignored for decades and make the recommended changes. It is now time to take decision-making on drugs out of petty party politics and into health.”

‘Drugs Policy, First Report of 2019-20’ by the House of Commons Health and Social Care Committee was published at 00:01 UK time on Wednesday 23^rd October. 

Declared interests

Dr Emily Finch: RCPSYch gave evidence to the Committee

Prof Sir John Strang: JS is a researcher and clinician who has worked in the treatment sector with a wide range of NHS and non-statutory and voluntary agencies and who, through his university, has received research grants from government departments and research councils and charities concerned about ther addiction problem, and has also worked with pharmaceutical industry to identify new or improved treatments and his employer (King’s College London) has received grants, travel costs and/or consultancy payments from companies including, past 3 years, Martindale, Indivior, Mundipharma, Camurus. JS’s research is supported by the National Institute for Health Research (NIHR) Biomedical Research Centre for Mental Health at South London and Maudsley NHS Foundation Trust and King’s College London. JS is an NIHR Senior Investigator. For fuller account, see http://www.kcl.ac.uk/ioppn/depts/addictions/people/hod.aspx  

Prof David Nutt: DrugScience gave evidence to the Committee

None others received.