England has the best drug treatment system in the world; it exists because of the vision of far sighted people from all political parties and the dedication of amazing staff, organisations, charities and public officials over the last 50 years.
Cuts in drugs and alcohol funding, along with the lack of political leadership and the lack of priority in England may in the coming years have a major negative impact on some of the most vulnerable people in our communities.
The moving of drugs funding into Public Health England, where illicit drug use is not a strategic priority, has given a green light to some local authorities to make heart breaking cuts in services, Birmingham being one example.
There has never been a more urgent need to have clear English government leadership matching that of Scotland. Spelling out the responsibilities of local authorities along with the levers to ensure they deliver. I would like the next government to take clear action to protect the best drug and alcohol treatment system in the world. Provide better opportunities for those in recovery and significantly reduce the death toll by committing to harm reduction, responding more robustly to rapidly increasing numbers of drug and alcohol related death and serious illness. I also would like to see a greater emphasis on responding to other health needs of those with drug and alcohol problems.
Any government with an ounce of decency would follow the Portuguese example and move rapidly to bring hepatitis C treatment up to the standards of HIV treatment. If hepatitis C treatment was running trains only 3 in every 100 would get to work and many would die on the platform.
I would like to see the incoming government do the following things with drug and alcohol treatment policy and funding;
- Identify and appoint a single Senior Government Minister to be responsible for drug and alcohol policy, accountable to Parliament
- Commit to evidenced-based practice
- Ensure everyone in recovery from drug and alcohol problems has opportunities to rebuild their lives
- Develop a national harm-reduction strategy to reduce drug and alcohol related deaths and ill health
- Widen of the access to residential treatment focusing on need rather than the failure of everything else
- A minimum unit price for alcoholic drinks is introduced along with health warnings on labels and prominent display of calorie’s
- Create a national commissioning Ombudsman, to ensure transparency and accountability for local commissioning decisions
- Widen the remit of the Care Quality Commission (CQC) to include all local authority-commissioned drug and alcohol services
- Ensure the competence and appropriate accreditation of the drugs and alcohol sector workforce, in line with other areas of health and social welfare, by investing in an independent association
- Follow the guidance provided by the Advisory Council on the Misuse of Drugs (ACMD)
- Reinvigorate independent research on drugs and alcohol to fill the gap left by the UK Drug Policy Commission (UKDPC)
- Ensure comprehensive access to the life-saving drug Naloxone, across the whole of the United Kingdom, in line with World Health Organization (WHO), ACMD and public health guidelines and advice.
- Ensure the availability of services and National Institute for Health and Care Excellence (NICE) -approved treatments for all patients diagnosed with hepatitis C, in line with international guidelines
- Everyone in recovery from drug and alcohol problems has opportunities to rebuild their lives,
- Ensure access to safe and secure housing, employment and meaningful activity and support for health and mental health
- Investment is provided for a national programme to tackle the stigma and discrimination experienced by people in recovery from drug and alcohol problems
- ensures expenditure on drugs and alcohol treatment is maintained at a time of severe budgetary pressure on local authorities
Blenheim 
Thanks for this John – i agree with all of it, but I wonder you would agree with including the removal of criminal penalties for possession offences. This appears to be a big gap in your otherwise comprehensive set of calls
– You note the Portugal example regards Hep C treatment but don’t mention that they decriminalised possession of drugs in 2001 with very positive outcomes in terms of reduced injecting use, reduced deaths and HIV transmission, improved access to services (paid for with redirected enforcement spending), reduced prison populations, and reduced school age use. Portugal are, of course, not the only country to go down this road – more that 25 have done so (in one form or another) across the world. There is ample precedent and a growing body of evidence in support of the approach – particularly where it is part of wider realignment from criminal justice to public health interventions for drugs more broadly. Support would fit with your call for the government to follow the evidence
– You call for the the advice of the ACMD to be followed; they have twice recommended non-criminal sanctions for drug possession offenses (they refer to it as diversion – but it is effectively Portugese style decrim)
– Similarly you note support fir the WHO position on naloxone – but don’t mention the WHO support for decriminalisation in their best practice treatment guidelines – echoing similar long standing support of UNAIDS, and soon to be announced support from UNODC.
– A key part of the narratives in favour of decriminalisation of users promoted by the various UN agencies, Portugal, the ACMD, and many others relates to you point regarding “the stigma and discrimination experienced by people in recovery from drug and alcohol problems”. Criminal records actively stigmatise and undermine life chances of people in treatment, recovery, or harm reduction serves. The threat of criminalisation creates barriers to services even for those who don’t yet have a record. This is all quite aside from the majority of people who use drugs largely non-problematically who do not need services, but are criminalised en mass regardless. In which other field of public health is blanket criminalisation of our key target population and client group seen as an appropriate front line policy model?
It feels like ending the criminalisation of users is a missing link connecting many of the points you make. Given the level of international, evidential, and institutional support for it, it strikes me as a surprising omission. Not to mention it implies tacit support for the status quo. Yes, the Government are opposed on ideological grounds – but that is something that needs to be specifically and systematically challenged rather than pandered to by the treatment sector. Decriminalisation is only part of the jigsaw – but as the WHO notes – it is a ‘critical enabler’ of a whole raft of other vital public health interventions. It would be great if Blenheim and others could be more proactive and open on this front – and I would be happy to support greater engagement in any way I can.
Hi Steve
I was saving this agenda for another blog as it deserves it’s own space!
but you point is well made.
I agree with the removal of criminal penalties for possession offences, perhaps following the Portugal Model.
It is time to review drugs (including alcohol) policy both in UK and internationally.
Blenheim and other organisations are continuing to call for the Government to
“Commit to review drug policy at both national and global levels and make meaningful input to the United Nations General Assembly Special Session (UNGASS) on drugs in 2016”
This issue will be raised with Minister’s in the coming weeks, and we will seek again to gain wider support in Parliament
In June 2014 Blenheim signed a letter to the Prime Minister along with the following organisations:
Adfam
The Beckley Foundation
DrugScience
DrugScope
FullyFocussed
Harm Reduction International
Health Poverty Action
Inquest
International Doctors For Healthy Drug Policies
International Drug Policy Consortium
International HIV/AIDS Alliance
International Network of People Who Use Drugs
Kaleidoscope
Law Enforcement Against Prohibition
Million Youth Media
National AIDS Trust
Prison Governors Association
National Black Police Association
Release
Reprieve
StopWatch
Substance Misuse Management in General Practice
Transform Drug Policy Foundation
Westminster Drug Project
Dear Prime Minister
Today is a Global Day of Action calling on world leaders to work together to achieve more effective drug policies and to end the criminalisation of people who use drugs. In more than 80 cities across the globe, people are coming together to highlight the failure of the ‘War on Drugs’ and the harms that it creates for individuals, their families and communities. As part of this action we, the signatories of this letter, call on the Government to review drug policy at both national and global levels, including a commitment to meaningful engagement at the UN General Assembly Special Session (UNGASS) on drugs in New York in 2016.
Nationally the use of criminal sanctions for the possession of drugs has led to the unnecessary criminalisation of more than 1.5 million people in the last 15 years. Even more alarming is the inequality of our drugs laws which have resulted in mostly the young, black and poor being the focus of drug law enforcement. In England and Wales black people are six times more likely to be stopped and searched for drug offences compared to white people and Asian people are twice as likely. This is despite the fact both groups use drugs at a lower rate than the white population.
The cost of drug law enforcement can be measured in both economic terms and social costs, where young people’s opportunities are limited due to a criminal record and where there is evidence that exposure to the criminal justice system for low level possession offences can lead to an increased risk of recidivism.
The use of criminal sanctions does not deter drug use, and causes unnecessary harm. Evidence from other countries, including the Czech Republic, Portugal and Australia, demonstrates that when a non-criminal response is adopted, use of drugs does not increase and the significant harms associated with criminalisation, including HIV transmission, are dramatically reduced.
The global ‘War on Drugs’ also allows for significant human rights abuses. Thirty seven countries maintain the death penalty for drug offences on their statute books; in 12 of these, it is a mandatory punishment. Furthermore, in some countries people who use drugs are subject to forced detention. Added to this is the fact that the global war on drugs is driving the HIV/AIDS and hepatitis C pandemics among people who use drugs and their sexual partners. This situation must end.
Both nationally and internationally, calls for drug policy reform are growing stronger, with political leaders from countries at the forefront of the drugs war leading the way. Thanks to the courage of the Presidents of Colombia, Mexico and Guatemala, the UNGASS on Drugs will take place in 2016. It is these countries that have witnessed the highest levels of drug-related violence leading to hundreds of thousands of deaths. We must support them to end the cycle of brutality and destruction that results from the current drug control framework.
It is important that the UK fully engages in this process and works with other governments to ensure that the opportunity in 2016 for a much needed honest and serious debate on the future of international drug control is seized.
In 2002, as a member of the Home Affairs Select Committee, you supported the recommendation that the then Labour Government ”initiates a discussion within the Commission on Narcotic Drugs of alternative ways—including the possibility of legalisation and regulation—to tackle the global drugs dilemma”. Now is the time to reaffirm this position. By committing to a review of national drug policy and pledging to support more effective approaches in the imminent UN debates, the UK Government will demonstrate its commitment to reducing the harms caused by drugs and current drug policies, and its desire to move towards an evidence-based approach
We stand by this letter and are actively seeking the issues it raises to be progressed.
Kind Regards
John
John
Dear John I agree with all you say above and the points well made by Steve but I am left with one anxiety, particularly with IDS and the conservatives in government. You use the word “recovery” 3 times without explaining what that means. I know what you mean by it but many equate it with “being abstinent”, especially the Tories who don’t know or want to know the evidence.
This example particularly worries me: “Investment is provided for a national programme to tackle the stigma and discrimination experienced by people in recovery from drug and alcohol problems” – we need almost more investment in reducing stigma in people who use drugs where ever they are on the spectrum.