Drugs market has ‘never caused greater harm’, says Carol Black review

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The illegal drugs market ‘has long existed but has never caused greater harm to society than now’, according to the first phase of Professor Dame Carol Black’s independent review of drugs. Even if more money became available for drug treatment, there would still be ‘a lot of work to do’ to build up capacity and expertise, the document adds.

Professor Dame Carol Black: Appointed by government to lead a wide-ranging review of drug harm

Professor Black was appointed by the government last year to lead a wide-ranging review into drug harm and the way in which drugs are fuelling violence (DDN, March 2019, page 5), with publication in two phases – an analysis of the problems in phase one and recommended policy solutions in phase two.

Published in a week that saw rival drug summits held in the same Glasgow venue by Scottish and UK governments increasingly at odds over drugs policy, the phase one report says that increased funding for treatment is vital as a ‘prolonged shortage’ has resulted in a loss of skills, expertise and capacity.

The illicit drugs market is worth around £9.4bn per year, the document states, and not only are drug deaths at an all-time high but the market has become ‘much more violent’. The report estimates the health harms, cost of crime and wider societal impact to add up to almost £20bn, ‘more than twice the value of the market itself’. More than a third of people in prison are there for crimes related to drug use – mainly acquisitive crime – serving short sentences and ‘very likely to re-offend’, while efforts to restrict the supply of drugs in the country have had ‘limited success’.  

The county lines model has meant that young people and children have been pulled into drugs supply on ‘an alarming scale, especially at the most violent end of the market’, the report says, with strong associations with increases in child poverty, school exclusions and the number of children in care. Social media has also played a ‘facilitating role’, it adds. ‘Some 27,000 young people now identify as gang members, many drawn into drug dealing, often with deadly consequences as the supply and distribution of drugs have become increasingly violent,’ Professor Black states. 

In terms of treatment, funding pressures have led to the disappearance of some services and rationing of others. ‘Because treatment is commissioned separately from other healthcare and is outside of the NHS, it is much harder to control the quality of care and clinical safety,’ the report says, with drug treatment operating in a similar way to adult social care.

‘Like in the adult social care market, drug treatment providers have been squeezed, staff are paid relatively badly and there has been high turnover in the sector and a depletion of skills, with the number of medics, psychologists, nurses and social workers in the field falling significantly. The unregulated role of drug and alcohol or recovery worker, which is inconsistently and poorly defined, makes up the vast majority of the workforce’, while the number of training places for addiction psychiatrists had ‘plummeted’.

Phoenix Futures welcomed the report and stated that ‘those of us working in the treatment sector are acutely aware of the picture she describes. Reduced funding making it difficult to reach the people that need our help when they need it, and people feeling increasingly isolated and desperate for help but not knowing how they can get it. Drug use costs the country £20bn a year and only a mere £600m of that is in treatment. We think that makes no sense. Communities across the country deserve better.’

Collective Voice said that it was ‘deeply concerned’ by the document and called for a reverse in ‘the funding cuts that have devastated addiction services over the last eight years and blighted the lives of so many people. Sadly, for many in our sector – which has lost over a quarter of its funding since 2015 – the report’s findings will come as no surprise. They echo the serious and legitimate concerns raised over recent years. We hope this landmark report reinvigorates political focus on this most pressing of issues.’

Independent review of drugs by Professor Dame Carol Black available here