ISCD Formal Response to Drug Strategy 2010
The Independent Scientific Committee on Drugs [ISCD] is committed to providing information on drugs to the public based on the scientific evidence base as a means of reducing the real harms that the use of drugs including alcohol and tobacco can entail. The government’s Drug Strategy 2010 will strongly impact on significant proportions of the public in terms of health, as well as criminal justice and social harms. The ISCD were thus prompted to draft a considered assessment of the government’s Strategy incorporating feedback from our supporters in the field.
Proper assessment of harms
Both treatment and punitive measures aim to reduce harm, thus they must be based in a thorough understanding of the evidence base as well the relative risk of each drug compared to others commonly used to reduce harm effectively. A scale of harm, such as that published by the ISCD in the Lancet 1 November 2010, could form a suitable starting point for policy. At the very least, a minimum data set for each new drug to controlled should be devised to ensure that the harms of criminalising users do not outweigh the potential harms of the drug itself [LINK]. Similarly, the Misuse of Drugs Act needs to be reviewed - the impact/harms of the Act in comparison to the harms of drugs must be considered.
The complete absence of harm reduction as part of the strategy is worrying given that there is a substantial body of evidence that shows harm reduction strategies to be effective. Measures such as drug substitute therapy and needle exchanges directly contribute to a reduction in death and communicable disease. The evidence for the abstinence approach advocated in the 2010 Strategy is lacking.
Drivers of strategy
Decisions need to be based on science. The ACMD should be the driver as it is the appropriate government body. The ACMD needs to be sufficiently funded to do the work that is required to fulfil its role. NICE recommendations should be followed. Action on legal highs should be led by the ACMD rather than the Home Office. Ministers should be required to consult the ACMD before initiating temporary banning order.
The re-tendering process for drug and addiction services precludes employing people with long experience. Cherry picking will be an issue on contracts. More costly but effective treatments such as injectable maintenance (diamorphine) will be jettisoned in favour of cheaper treatments. A race to the bottom in terms of service provision is likely to be hard to avoid.
A holistic approach to treatment is needed. When up to 80% of alcoholics have some sort of mental health issues other than addiction, carving up services to different service providers fails users. Despite the on-paper savings that can be made, long-term inefficiency is inevitable, as small cuts from one area can lead to much more funding needed in others.
There is a need for a scale of goals – not just getting a job, which is setting the bar very high in today’s climate! Goals must be appropriate to the individual – complete abstinence is not achievable for everyone. There should also be a particular focus on children on drug abusers.
The Government is to be commended for its commitment in principle to the concept of recovery. However, it is imperative that what is meant by recovery is properly defined in order that it might be achievable and, in theory, measurable.