The problem with prohibition

Published May 2003

What would you do if you house was on fire and the fire brigade turned up and started drenching it with petrol?

Late last year, the Home Office finally acknowledged what any specialist detective or drugs worker could have told them at any time in the last ten years, that Britain’s uncontrolled black market in heroin and cocaine has expanded to include a vigorous new market in crack cocaine. Like all drugs markets, this is spawning property crime as its consumers search for funds. This one also has spawned a peculiarly malign degree of violence and social chaos from the Yardie gangsters who dominate it.

In 1996, the National Criminal Intelligence Service warned that crack had spread to such an extent that it represented “a threat to the security and stability of the nation”. Six years later, with politically-sensitive crime figures heading the wrong way and its own research finally confirming that six out of eight sample markets were ‘awash’ with crack, the Home Office in December 2002 produced its National Crack Plan. This is where the fireman gets out his petrol.

The Home Office have organised a national and international effort to disrupt the supply of crack. To anybody who works in Whitehall and understands little about drugs markets, that sounds like an obviously sensible move: cut the supply, cut the consumption, cut the crime committed by consumers. But is that really what will happen? We have put this question to officers of just about every law enforcement agency in the country and received the same response: a blank shrug.

If you reduce the supply of a commodity on a free market, its price rises. Does consumption then fall? It depends on what economists call ‘elasticity of demand’. If the commodity is non-essential (gold watches), consumption falls dramatically, ie its demand is elastic. If the commodity is more important (school shoes), consumption falls less dramatically because its demand is relatively inelastic. In the first year of GCSE economics, students are taught that the demand for all goods is somewhat elastic, with one notorious exception – addictive drugs.

If the National Crack Plan succeeds in its aim of reducing supply, it will increase the price of crack. If the demand from crack addicts remains the same, the amount of money which crack users need to find will increase. The National Economic Research Association two years ago estimated that, on the available data, the street market in crack cocaine was worth £1.8 billion. The National Criminal Intelligence Service estimates that users fund at least 48% of that (£864million) by stealing goods which are sold on the blackmarket for between 20 and 25% of their real value: ie crack users are stealing at least £3.45 billion of property a year. On that basis, if the Home Office succeeds in raising the price of crack by just 5%, they will inflict an extra £172.5 million of property crime on the communities they are pretending to protect.

(In an extreme case, if supply were cut to the point where it could no longer meet some of the demand, the result would be the same but by a more complex route: if users can’t buy crack in Liverpool, they go to Manchester, pushing up the price there; or they may switch temporarily to other stimulants, pushing up their price as well. In any case, they have to commit more crime.)

There is a pool of published research which clearly warns of the perverse effects of attacking the supply of illicit drugs. Apart from highlighting increases in price and crime, this research also warns that taking out an established supply network can stimulate new suppliers (the classic case is the bust of Turkish heroin dealers through the French Connection to New York in the 1970s, which sent street prices rocketing and brought in at least three new national sources of blackmarket heroin to the US.) There can even be perverse effects which are beneficial: in the last 18 months, police in Bristol have arrested nearly 800 street dealers; they have made no discernible impact on drug supply or price but they have cut their burglary, mugging and car crime dramatically, almost certainly because the street dealers are also users who are involved in property crime. But the research warns that even this beneficial effect can turn bad: an open street market is like a shop window for local criminals, allowing police to make relatively easy arrests; but if they arrest too many, they will drive the market underground, the dealers will leave the streets and use phones to set up deals, making it more difficult to arrest these prolific offenders.

The National Crack Plan cites 15 different research papers – but never refers even once to these published expert warnings on the perverse effects of attacking supply. Since the departure of the ‘drugs tsar’ Keith Hellawell, there is no institutional link between the attack on supply (which is run by a Whitehall committee known as CIDA) and the attack on demand, run by the National Treatment Agency. The new national plan does call for more crack users to be put into treatment, but it never once warns police of the dangers of cutting supply without cutting demand by the same amount. And all of its references to treatment are compromised by a strategy which is not only mismanaged (as we explain elsewhere on this page) but still fundamentally misconceived.

The whole plan reflects the underlying weakness which has condemned UK drugs policy to failure since the late 1960s: it is based on the ideology of prohibition. It assumes that the object of drugs strategy must be to separate the drugs from their users, failing to recognise that the result is to generate an ever-expanding blackmarket which precisely produces the deaths and illnesses and crime and disorder which the strategy is pretending to reduce. This weakness pollutes official thinking not only about law enforcement but also about treatment which continues to be distorted by a drive for abstinence at the expense of more effective alternatives.

Switzerland is now leading the way out of prohibition. In 1994, they started prescribing free heroin to long-term addicts who had failed to respond to law-enforcement or any other treatment. In 1998, a Lausanne criminologist, Martin Kilias, examined the results and found that the users’ involvement in burglary, mugging and robbery had fallen by 98%; in shoplifting, theft and handling by 88%; in selling soft drugs by 70%; in selling hard drugs by 91%. As a group, their contacts with police had plunged to less than a quarter of their previous level. The Dutch and the Germans have similarly encouraging results with the same strategy.

All of them report that, apart from these striking benefits in crime, the users are also demonstrably healthier (because clean heroin properly used is a benign drug) and that they are more stable with clear improvements in housing, employment and relationships. The Dutch are now reporting that only 7.7% of their soft-drug users are also using hard drugs. In Northern Ireland – the only part of the UK for which comparable figures are available – 46.7% of soft users are also hard users. For those trying to tackle crack, the Swiss heroin programme shows dramatic falls in the use of all illicit drugs. The Swiss are now even reporting that, having stablished their lives, 22% of one group of users have opted to abstain from all illicit drugs.

By contrast, the United States, which has led the prohibition strategy, is stumbling deeper into failure. President Bush, in his report on drug strategy last year, was forced to acknowledge that “in recent years we have lost ground” in reducing illegal use. In February of this year, the US Office of Management and Budget reported that the vast Drug Enforcement Administration “is unable to demonstrate progress in reducing the availability of illegal drugs in the United States.” In Britain last year, Terry Byrne, head of law enforcement at Customs and Excise, told the Home Affairs Select Committee: “There is no sign that the overall attack on the supply side is reducing availability.” The latest Home Office research estimates the economic and social costs of Class A drugs as up to £17.4 billion a year – 88% of which is directly related to crime. Thus far, the best that can be said about the national crack plan is that it has not triggered a new crime boom simply because, like all previous prohibition, it has failed.

And yet the government continues to allow its strategy to be distorted by what it call “maintaining prohibition”. Two years ago, the Guardian, with Channel Four, ran a high-profile series exposing the weaknesses of prohibition and arguing for the prescription of heroin. As a result, the Home Affairs Select Committee launched an inquiry, called the Guardian to give evidence and concluded that there should be ‘a substantial increase’ in the prescription of heroin to users. In the background, the new Home Secretary, David Blunkett, was prepared to be bold and made it policy that heroin should be available to all those with a clinical need. A small group of officials wanted to launch immediate pilots, but they were obstructed by civil servants in the Department of Health and the Home Office who buried the initiative in a working party which then took 20 months to report. The working party became a flash point in the debate about prohibition.

On one side was a group which argued that Britain must move down the Swiss route. They won several crucial victories: the government now accepts that heroin should be available on prescription in every area of the country; that this prescription should be long-term; that the number of users with prescriptions should be increased. As principles, these are potentially the most important change in official thinking on drugs in the last 30 years. However, the working party also included civil servants who, in an excess of caution, resisted full implementation of the principles.

These officials defended the existing policy of prescribing oral methadone to users. The reformist group argued that methadone should be part of the strategy but that it is a more dangerous drug than heroin and more difficult to give up and, most important, that a significant proportion of heroin addicts simply do not like it and will not be diverted from the blackmarket by it. The officials, however, claimed that there was an evidence base which showed that methadone was a more effective treatment than heroin. In private, however, Whitehall sources admit that this is not true. The reality is that, because Britain has allowed the limited prescription of methadone for 30 years, there is a mass of evidence that it can work for some users – but, when it comes to comparing it with heroin, there is simply a shortage of evidence from the UK. The officials refuse to be moved by the results from Switzerland, Holland and Germany on the grounds that their samples are too small, even though the Swiss, for example, studied 1,969 users – whereas the Home Office launched its Arrest Referral Scheme from completed research into only 50 users.

The result is that, in new guidance which is not yet published, the government is embarking on a national programme to prescribe heroin which is hedged around with the kind of bureucratic restrictions which are already choking the whole treatment strategy: all users must first try and fail with oral methadone; prescriptions will be available only from specialist clinics and a handful of licenced doctors; for at least three months, new users will have to use their heroin in front of a nurse several times a day, regardless of the impact this will have on their ability to work or travel. It is not clear whether the government will provide any new money for the programme nor whether the Home Office drugs inspectorate will licence enough new doctors to generate a real increase or whether the whole programme will be diverted into a small group of pilot studies before it is rolled out.

At the moment, in England and Wales, there are only 440 heroin addicts with prescriptions for a clean supply of their drug. The Home Office told the Home Affairs Select Committee that some 1.8 million people in this country have used heroin or cocaine, of whom more than 250,000 were ‘problematic users’ who were likely to be committing crime on a daily basis. The methadone research on which the Whitehall officials based their policy suggests that some 30 to 40% of users will not respond to methadone, ie, if the policy focusses only on problematic users, there is a potential demand for between 70,000 and 100,000 heroin prescriptions. Whitehall sources say the current plan is to prescribe to only 4,500 of them.

The cruel irony is that the reformist countries are adopting a strategy which was originally created in Britain, which for 40 years allowed all GPs to prescribe opiates to thousands of users, most of whom were therapeutic addicts who had become addicted to morphine after operations. A return to this British model offers the possibility of safe, stable, constructive lives for users who are currently condemned by the black market to sickness, misery and harrassment by the police; it opens the door to a dramatic cut in the crime which these users inflict on their communities; it promises the chance of success for the government’s strategy, particularly for its arrest-referral scheme and its drug treatment and testing orders. But first, the fireman has to tell the truth about what he is doing to the fire.

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