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Submission of Independent Drug Monitoring Unit

Matthew J. Atha BSc MSc LL.B & Simon Davis DipHE (SocSci)


House of Commons Home Affairs Select Committee Enquiry


F1 The issues raised by the committee are complex, and cannot adequately be addressed within a limit of 1000 words. We have however endeavoured to keep the length of this document to a minimum, whilst addressing all the major issues raised by the committee, and question arising therefrom.

F2 IDMU is a small independent research consultancy specialising in the study of illegal drug consumption patterns, prices and effects. We are funded wholly via professional fees earned in providing expert evidence for the criminal and civil courts, with experience of over 900 criminal cases since 1991. The evidence mainly covers personal consumption and drug valuations, but includes yields of cannabis cultivation systems, effects of drugs (re criminal intent, driving impairment etc.), and a range of other aspects, most notably therapeutic uses of cannabis. Our mission is to provide accurate, up to date and impartial information on drugs to all parties to the debate over drugs policy. Other than legal casework, we have provided consultancy for GW Pharmaceuticals, the House of Lords enquiry, the Home Office, Transport Research Laboratory, and Northamptonshire Police.

Executive Summary

S1 Existing drug policy is clearly not working, for reasons outlined herein.

S2 Decriminalisation is a vague term which requires clarification

S3 The effect of law reform on availability of and demand for drugs would depend upon the policies adopted. Alternative methods of control could reduce the availability of drugs, particularly to young people, who view legislation as a challenge rather than a deterrent.

S4 The effect of law reform on drug-related deaths would depend on the drug and upon the policies adopted. Pragmatic reforms could cut the number of drug-related deaths significantly.

S5 The effect on crime would depend upon the policies adopted. Options are outlined which could lead to a substantial fall in acquisitive crime.

S6 Decriminalisation (permitting possession but not supply) could have advantages and disadvantages. The main disadvantage would be to leave the supply of drugs in criminal hands.

S6 There are a number of practical alternatives outlined. A system of regulated and licensed supply could avoid many problems currently experienced, and raise substantial revenues (£1 to £5 Billion per year) for the exchequer from a combination of excise duties, greater productivity, and reduced law enforcement costs.

S7 The following appendices are provided with the report

A Medicinal Use of Cannabis

B Drug Driving

C Drug Trends (IDMU survey research data 1984-2000)

D How IDMU can contribute to policy development

1 Does existing drugs policy work?

1.1 The question raises several issues:

(a) What are the goals of current drugs policy

(b) By what criteria can existing policy be judged

(c) How is current policy performing against such criteria, what are the successes and failures

(d) To what extent are current successes adequate, and failures acceptable

1.2 The goals of drugs policy can range from the absolutist achievement of a "drug free society", to the pragmatic "harm minimisation" approach. For the absolutists, being seen to "fight the fight" at all costs, is more important than achieving practical results. Those favouring the pragmatic approach would seek to minimise the harm caused by drugs, both to the individual and to society.

1.3 A range of criteria can be used to evaluate the effectiveness of drug policy - these can include:

(a) Prevalence - all drugs and/or more dangerous/addictive drugs

(i) Lifetime drug use

(ii) Current/recent drug use

(iii) Problem drug use (treatment episodes)

(iv) Drug arrests

(v) Teen drug use (age of first use)

(b) Drug related deaths

(i) Poisonings/overdoses

(ii) Accidental deaths

(iii) Suicides

(iv) Deaths from health problems caused by chronic drug use

(c) Crime

(i) Drug-trafficking

(ii) Acquisitive Crime

(iii) Drug-related violence

(iv) Prostitution

(d) Market trends - all drugs and/or more dangerous/addictive drugs

(i) Drug availability

(ii) Drug Prices

(iii) Drug Purities

(iv) Attitudes to drugs

1.4 Taking a global view, there is overwhelming evidence that current drug policies do not work.

(a) Prevalence, particularly of Class A drugs is increasing.

(b) Lifetime prevalence will continue to increase for the next couple of decades irrespective of drug policies, until more users/ex-users start to die out through old age or ill health than new teenagers initiate drug use - evening out the demographic bulge.

(c) The key policy objective should be to minimise the number of people initiating or continuing to use Class A drugs.

(d) Our surveys suggest that the effect of an arrest on drugs charges is to increase the probability of that person progressing to use of class A drugs.

(e) Drug-related death rates in the UK are much higher than many other countries, most notably the Netherlands and others with more liberal regimes.

(f) Current policies also fuel crime via maintaining the cost of addiction at high levels, and providing high profit margins for drug traffickers.

(g) Availability of drugs is increasing, drug prices are falling, in some cases dramatically, and purities are increasing.

(h) The public at large is growing increasingly tolerant of drug use, notably cannabis, although attitudes among drug users to different drugs appear relatively stable.


2. What would be the effect of decriminalisation on

(a) the availability of and demand for drugs

(b) drug-related deaths and

(c) crime?

2.1 The term "decriminalisation" causes much confusion. It may be used broadly to reflect a general move towards relaxing the current regime, or narrowly to mean permitting personal possession (e.g. below a certain limit) but maintaining criminal controls on drugs supply. By contrast the term Legalisation would normally be taken to mean abolishing legal controls and permitting a free market in supply of drugs. Regulation or licensing would introduce a degree of control whilst permitting a legal supply of drugs - the degree of control could vary from the off-licence/tobacconist model for the less dangerous drugs, and/or on-licence such as cannabis pubs or cafes, to prescription only for the drugs of addiction.

2.2 The key to reducing demand for drugs is to make drug use "boring" or "uncool", and reduce the excitement and glamour associated with the drugs scene. Availability, particularly to minors, could be reduced if age-limited legal sources were available, reducing the profits from selling drugs, and if addicts did not need to sell class A drugs to support their own habits.

2.3 Most drug-related deaths are caused by drugs of unknown purity, contaminants within illicit preparations, and unsafe practices associated with drug use.

(a) Heroin/Opiates

(i) Illicit heroin powders can range in purity from under 10% to over 70% - injecting drug users are therefore at risk if they take a "normal" dose of high purity powder.

(ii) Heroin addicts who are abstinent (e.g. through rehab or prison) lose tolerance to the drug, and are at risk of overdose if they relapse and inject a "normal" dose.

(iii) Recent outbreaks of heroin deaths have been caused by microbial or viral infections, serious health complications (abscesses, amputations etc.) arise from other contaminants when injected

(iv) Allowing GPs to prescribe heroin, in injectable form where appropriate, of pharmaceutical purity and of known dosages, could dramatically cut the death rate from overdoses and impurities - the experience in Switzerland and Australia.

(b) Stimulants (Cocaine, Amphetamine)

(i) Deaths attributed to cocaine and amphetamine generally involve cardiovascular effects (strokes, heart attacks) caused by the drug itself.

(ii) Relaxation of the law is unlikely to have a significant impact on stimulant-related deaths, unless this were to result in an increase in stimulant use, and of excessive binge use in particular.

(iii) Permitting low-dosage or natural preparations (e.g. coca tea) may be one way to provide a legal supply of stimulants. Caffeine use also carries risks.

(c) Ecstasy - Deaths attributed to ecstasy fall into the following categories

(i) Dehydration/heat-stroke arising from the circumstances in which the drug is taken (hot, sweaty atmosphere, intense and prolonged physical activity)

(ii) Adverse reactions - toxic effects of the drug often involving liver failure

(iii) Deaths attributable to impurities (e.g. ketamine/ephedrine/procaine combinations)

(iv) Evidence as to the neurotoxic effects of MDMA is compelling - Long-term use of the drug is likely to result in chronic mental health effects.

(v) If "decriminalisation" were to result in increased use, deaths could increase. Steps should therefore be taken to screen all phenethylamine analogues identified by Shulgin with a view to licensing alternative drugs which carry more acceptable health risks whilst retaining acceptability to the users.

(d) Cannabis/Hallucinogens - few, if any, deaths are attributed to cannabis or the tryptamine hallucinogens (LSD, DMT, Magic Mushrooms) although the latter can cause long-term mental effects in susceptible individuals.

(e) Long-term health risks

(i) Health risks associated with clean opiates are relatively low, the major cause of ill health is unsafe practices associated with use (smoking heroin, unsterile injection) or impurities or adulterants present in illicit preparations.

(ii) Use of stimulants (amphetamines, cocaine, ecstasy) increases long-term risks, notably of cardiovascular problems (cocaine/amphet) and serotonin depletion (ecstasy). Increased use would be expected to increase associated death rates.

(iii) Cannabis - Unlike in the USA, where herbal cannabis is smoked "neat", in the UK most cannabis or cannabis resin is smoked mixed with tobacco, which carries its own risks. Increases in smoking any substance are likely to increase long term risks from cancer, pulmonary or cardiovascular disease. Increased use of alternative forms of administration (food or drink products, inhalers/sprays etc.) in a legal market could reduce the risks from smoking. The health risks associated with the use of cannabis have been thoroughly investigated over the past century, and there is no evidence that increased use of cannabis would have a significant adverse impact on public health.

2.4 The effect on crime would depend on the nature of the policy, and the type of crime involved:

(a) Acquisitive crime - This would include theft (burglary, robbery, shoplifting), fraud (petty credit-card fraud, benefits fraud, and larger-scale financial embezzlement).

(i) A substantial proportion of acquisitive crime is driven by the need to find money to buy the addictive drugs - heroin and, to a lesser extent, cocaine.

(ii) Any policy which permitted possession of heroin but did not permit a legitimate supply would be unlikely to cause a significant reduction in acquisitive crime.

(iii) Prescription of diamorphine preparations, at nominal cost, or even at cost price where there is the ability to pay, should result in a dramatic reduction in acquisitive crime.

(iv) Were acquisitive crime to fall dramatically, and stolen goods no longer need to be replaced by victims (on insurance or otherwise), there could be an adverse impact on manufacturing industry from such a reduction in consumer demand.

(b) Trafficking-related violence (turf wars etc.) - the death rates would be broadly linked to the profit margins available, and risks involved, within the illicit trade.

(i) A policy which permitted personal possession but left supply of drugs in criminal hands could result in an increase in violent deaths (assassinations/murders) within the drugs trade, if such a policy were to increase demand

(ii) A policy of licensed distribution of cannabis would only remove the profit incentive if levels of excise duty were not excessive. Any duty levied in excess of £1.50 per gram would encourage "bootlegging" on a similar scale to that currently seen with alcohol and tobacco.

(iii) Prescription of heroin would remove the profit incentive in the drugs trade, rendering it uneconomic, abolishing turf wars for drug supply

(iv) If the consequences of arrest on trafficking charges were to be less severe, there may be reduced motive to assassinate suspected informers within trafficking organisations.

(c) Drug-Induced Violence

(i) Stimulants - amphetamine and cocaine are associated with increased aggression and psychotic behaviour, particularly when used to excess. The incidence of such behaviour, and violent deaths arising from stimulant use, would be expected to increase with a wider increase in use.

(ii) Alcohol - Alcohol is a causal factor in the majority of violent incidents in society. If policies were to reduce alcohol consumption, fewer violent deaths might result.


3. Decriminalisation and alternatives

3.1 Is decriminalisation desirable?

3.1.1 If decriminalisation involves removing criminal penalties for possession (e.g. of less than a designated amount), but leaving supply of drugs in the hands of criminals, there would be some benefits, but many problems would remain.

(a) Benefits

(i) The move would be popular among users of drugs, reducing the levels of conflict between young people, police and society

(ii) Removing the threat of a criminal record (and/or expunging existing criminal records for simple possession) would reduce the financial impact of an arrest on the individual and society.

(iii) The credibility of government messages among wide sections of society may increase. Our recent survey showed that the least trusted sources of drugs information were Government Ministers, the Drugs Czar, and the Police.

(iv) Society as a whole could benefit from a more tolerant climate of individual rights and responsibilities, with a less authoritarian relationship between the government and its citizens.

(b) Problems

(i) Leaving civil penalties in place for possession would not remove the "naughty" or "forbidden fruit" image of drugs, and would decrease the attractions of usage.

(ii) Civil fines would be paid by a small minority of users (those who are caught), and would therefore represent a very inefficient form of taxation.

(iii) If demand increases, the untaxed profits of drug traffickers would increase, and with this the levels of corruption and violence associated with any illegal trade.

(iv) Decriminalisation would mean users still having to get their supply from a source. If the "legal" source of drug (GP, licensing) is inferior in quality to the "illegal" sources, then the criminal control of the drug trade would not be halted. To be effective the criminal element that controls the supply of drugs must be put out of business. This can be achieved by ensuring the supply of drugs is at least of a standard users are already accustomed to. In the case of cannabis the easiest solution would be to allow anyone to grow their own supply for own personal use only. This would enable relatively law abiding citizens who only smoke cannabis to avoid visiting criminal suppliers.

(v) The government would not benefit from Excise Duty revenues payable on (particularly) cannabis. Our surveys have indicated that such duties, along with reduced enforcement costs, could generate between £2 Billion and £5 Billion per year for the exchequer.

3.2 If not, what are the practical alternatives?

3.2.1 Status Quo - No change in legislation. Public opinion is steadily moving towards support of drug law reform and some form of liberalisation. Opportunities have been missed in the past (e.g. following Wooton Report and 1979 ACMD report) to reduce the criminal status of cannabis, and those failures are at least in part responsible for the levels of drug problems we face today (ten times as many drug users/arrests today as when the Misuse of Drugs Act was introduced)

3.2.2 Reduce penalties (reschedule cannabis to class C, Ecstasy/LSD etc. to class B) - These proposals from the Police Foundation in essence echo those of the ACMD in 1979. This would represent tinkering with the system, as the damaging effects of a criminal record for drugs on the individual and society would remain.

3.2.3 Regulation/Licensing: In the long term, some form of regulated supply of cannabis must be considered. The extent to which licensing could cover existing illicit preparations would depend on international agreements (i.e. for cannabis resin or herbal imported from countries where production remains illegal), although domestic production could supply the bulk of the UK cannabis market. The objective of such models would be to satisfy existing demand without creating additional demand. Different models may be appropriate for different drugs:

(a) Prescription and dispensation from Pharmacy - this could be appropriate for opiates, but would impact on NHS resources (GPs" time). Individual use could be regulated.

(b) Individual licenses to possess/purchase - Users could apply for a licence (smartcard?) which would enable them to buy (e.g. opiates) in appropriate amounts at or near cost price.

(c) Licenses to produce - cannabis growers could be allowed a "duty free" surface area or lighting wattage, but could apply for licenses to produce larger amounts. Duty could be levied at quarterly intervals based on the available surface area, subject to regular inspection.

(d) Licensed supply

(i) Outlets such as "coffee shops" could be licensed to supply cannabis, with appropriate restrictions on advertising, age restrictions (as with alcohol or tobacco), and location (e.g. not within 1/4 mile of a school).

(ii) Alternatives would include a "club" model whereby licensed clubs could supply cannabis to their members, who would have to produce a membership card. Reciprocal agreements could allow cards to be valid in all clubs within an association.

3.2.4 Free Market (Legalisation) - This would involve drugs being sold in normal retail outlets (e.g. supermarkets/tobacconists) without significant controls. Excise duties could be levied on producers and/or wholesalers as with tobacco or alcohol. This policy would probably lead to increased usage (particularly among middle-aged or elderly citizens), although this would also generate the highest duty revenues for government.


Appendix A - Medicinal Use of Cannabis

A1 I have appeared in court as an expert witness in numerous cases where defendants have claimed to be using cannabis for therapeutic purposes, either in mitigation or claiming necessity. Most Crown Court trials, where defendants have invoked the defence of "duress of circumstances", have resulted in jury acquittals on all charges.

A2 Irrespective of policies on other aspects of drug legislation, this issue should be addressed as a matter of urgency. The Attorney General should draw up guidelines for prosecuting authorities as many prosecutions clearly fail to take account of either the reasonable prospects of a conviction, or whether such a prosecution would be in the public interest.

A3 At present, prosecutions would fail to reach the 51% threshold in all cases involving simple possession or personal cultivation (production) for relevant medical conditions (including chronic pain, Multiple sclerosis and other movement disorders, cancer chemotherapy or AIDS, epilepsy or glaucoma. Perhaps a designated list should be maintained of conditions for which prosecutions should not proceed where a medical diagnosis is provided. In cases of supply to a medicinal user, prosecutions are again unlikely to succeed, nor would "possession with intent" charges on relatively large amounts claimed to be for personal use, unless there is other (paraphernalia) evidence of dealing. In cases of other medical conditions, the CPS should seek expert advice before contemplating prosecution.

A4 Such a policy should not fetter the hands of the CPS where medicinal use is incidental to commercial supply of drugs, or other criminal offences.


Appendix B - Drug Driving

B1 The law currently prohibits driving "whilst unfit through drink or drugs". The current law does not require major modifications to be effective. However, there may be a case for secondary legislation to be amended to provide more effective enforcement.

B2 To secure a conviction, the police/Crown must prove that

(a) The driver was under the influence of drugs

(b) His ability to drive properly was for the time being impaired

(c) That the impairment was due to drugs rather than other factors (e.g. disability, illness, fatigue etc.)

B3 IDMU has been consulted by the Transport Research Laboratory and Northamptonshire Police in developing more effective methods of enforcement for the existing laws.

B4 The "field impairment testing" (FIT) currently being adopted by many police forces, represents an improvement on previous enforcement techniques, but fails to address abilities which are directly related to the ability to drive, in particular reaction time and tracking ability. These could be addressed via development of an in-car simulator to allow suspects to be tested at the time, with objective pass/fail standards. We have also recommended that all FIT tests are recorded on videotape where such facilities exist within a police vehicle, as too much of the present test is subjective on the part of the police officer involved.

B5 The taking of samples of blood for drugs provides a snapshot at the time the sample is taken, which may represent a baseline level or the residue of a higher dose influencing the driver at the time (particularly for cases involving cannabis). We recommend that legislation be amended to require the taking of at least two samples a fixed time (e.g. 15 minutes) apart to determine whether a drug level is stable or declining, and to enable back-calculation to the time of the incident in question.

B6 Despite much public alarm, the effect of most controlled drugs on driving provides less of a risk of accidents than alcohol or prescribed benzodiazepine drugs:

(a) Cannabis - Increased risk for new users or new drivers, for established users/drivers appears to reduce accident risk by improving driver behaviour (slower speeds, larger gap, fewer risky manoeuvres) compensating for any performance impairment (tracking ability may be affected, no effect on reaction time)

(b) Stimulants - Low doses of amphetamine or cocaine may improve performance (alertness, quicker reaction times), although high doses impair judgement (overconfidence, aggressiveness)

(c) Opiates - Impair našve users, addicts probably drive better with drug in system than when withdrawing

(d) Ecstasy - Our surveys suggest significantly increased risk of accidents, but may be confounded by social factors (e.g. fatigue due to driving in the small hours of the morning when returning from clubs/raves)

(e) Hallucinogens - severe impairment of perception and judgement - few users would contemplate driving under the influence.


Appendix C - Drug Trends

C1 The following pages represent data from IDMU surveys conducted between 1984 and 2000. Surveys were all conducted using anonymous questionnaires distributed at pop festivals and other outdoor events. A number of "core" questions appear each year, allowing year on year comparisons to be made. The number of respondents in each year were as follows

1984 - 607, 1994 - 1333, 1995 - 191, 1997 - 1136, 1998 - 1153, 1999 - 2173, 2000 - 2352

C2 Drug Prevalence

C2.1 The lifetime prevalence of using most drugs has remained relatively stable among the user population as a whole, however amphetamine and LSD appears to be declining steadily, whereas cocaine and ecstasy appear to be increasing slightly. Prevalence of magic mushroom use (not shown) is similar to that of LSD. Crack and Ecstasy were not listed options in 1984, although 1% mentioned MDA as a write-in option. Users of crack in 1984 (then known as freebase) did not report it directly, but some of the cocaine would have been used in that form

Fig 1 - Lifetime prevalence of use of different drugs among users of any drug by year

C3 Frequency of use

C3.1 Users of each drug were asked to state how often they used the drug. Other than cannabis and legal drugs (caffeine, tobacco, alcohol), there were few daily users, with experimental or occasional use the norm.

Fig 2.1 Frequency of Cannabis use by year


Fig 2.2 Frequency of Amphetamine use by year

Fig 2.3 Frequency of LSD use by year

Fig 2.4 Frequency of Ecstasy use by year


Fig 2.5 Frequency of Cocaine use by year

Fig 2.6 Frequency of Crack Cocaine use by year

Fig 2.7 Frequency of Heroin use by year


C4 Retail Prices

C4.1 Prices of cannabis resin have been falling steadily since 1994, actually having peaked in the late 1980s, with the most substantial falls seen since 1998. Data for a range of cannabis resin and herbal varieties are available, only the most common Moroccan/Soap Bar resin is shown. Prices for imported herbal cannabis are also in decline, as is the market share, which has been overtaken by domestically produced cannabis (skunk). Skunk prices have remained relatively stable, with roughly a 50% price premium as compared to resin.

Fig 3.1 - Cannabis Resin Price Trends

C4.2 Prices of amphetamine have again remained relatively stable, although the average purity has increased substantially. LSD prices are becoming less commonly reported, and remain stable. Ecstasy prices have fallen by nearly 50% since 1995, and the fall appears to be continuing.

Fig 3.2 - Retail price trends for amphetamine, ecstasy and LSD


C4.3 Prices of cocaine and crack have remained stable, although the purity of cocaine is increasing at street level. Heroin prices have fallen sharply since 1995, with purities currently at historically high levels. Heroin is very rarely "cut" in the UK, with differences normally arising in the country of manufacture, and are likely to vary with climate conditions in the producer country (analogous to "vintages" in wine production).

Fig 3.3 - Retail price trends for cocaine, crack and heroin

C5 Drug Ratings

C5.1 Drug Users were asked to rate each drug (whether or not they had used it) on a scale of 0-10, with 0 the most negative and 10 the most positive rating. These figures give an indication of the popularity and/or social acceptability of particular drugs within the subculture. Note this data was only collected from 1994 onwards.



Appendix D - How can IDMU assist with development of policy

D1 IDMU can advise Government on much of the baseline data outlined in Hellawell"s reports, but not available from "official" sources. We have been conducting large scale surveys of drug users since 1984, involving data on frequency of use, consumption levels, demographic data, indicators (arrest/treatment episodes) and market data, including attitudes towards and prices of drugs at street and wholesale levels. Although some of the data is published, the vast majority remains unpublished but available for appropriate analyses.

D2 Our research and experience can assist the Government on the following aspects of policy:

Drug Prices & Market Economics

Appropriate levels of excise duty

Appropriate limits for personal possession (i.e. limits below which no action would be taken, or below which no charges for "intent" would be brought)

Appropriate limits for personal cultivation (e.g. maximum size of flowering area or wattage of lighting)

Legal distribution systems (e.g. licensed clubs, cannabis cafes)

Individual licensing (e.g. for medical users or for small scale grower/suppliers)

Criteria for decisions whether or not to prosecute medicinal cannabis users

Drug Driving Policy

Research and Information (questions in future surveys or data from previous surveys)

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