Regulating drugs will save lives and reduce misery, says Dr Alison Bedford Russell.
My eldest son George was one of many who needlessly died of a heroin overdose in 2016. Social status and education do not protect from drug use and dependence, and mental health problems. I was a medical director of an acute NHS trust at the time, and he had just graduated from university. The multiple system failures which contributed to his death nine years ago have not improved sufficiently to prevent the same happening again today, and drug-related deaths are at unacceptably high levels in the UK.
That is why I’ve joined Transform and the Anyone’s Child campaign group. A network of families, like mine, whose lives have been destroyed by current drug policies and are now calling for a new approach – the legal control and regulation of the drug market.
Dame Carol Black published an excellent review in 2021 which highlighted the disjoint between NHS-run mental health services and council-run addiction services as major barriers to good quality care. The Royal College of Psychiatrists (RCPsych) recently published a report warning that people who have a co-occurring substance use and mental health disorder (CoSUM) are being failed by a system that is not designed or equipped to meet their complex needs (see news, page 5), as was the case for George.
RCPsych is calling on the UK and devolved governments to provide substance use and mental health services with the training, staff, and funding they need to address these difficulties. The college is also calling on all health and local authority commissioners to ensure the number of people with CoSUM disorders, and their outcomes, are routinely monitored. This will help improve understanding the scale of the issue while supporting better resource allocation and strategic planning. The college’s report is aimed at helping the general public, healthcare professionals and commissioners to better understand CoSUM, and has recommendations for how people can be better cared for.
What is omitted from the Carol Black and RCPsych reports, however, is the need to revise the very outdated and not fit for purpose UK drugs laws. Punitive drug laws exacerbate the problems by driving them underground, and stigmatise those affected. Drug-related deaths are rising year on year and have such devastating impacts on family and friends.
Approximately 50,000 children in the UK are frontline dealers for heroin and cocaine as part of ‘county lines’ activity. Using children to sell illicit drugs is an unanticipated adaptation by organised crime in response to police activity and does not feature in legally regulated markets.
Anyone using unregulated recreational drugs may be harmed from ingesting substances of unknown dose and purity, including ecstasy. Most users of illegal recreational drugs are not addicted and do not have mental health problems – they are seeking similar social enhancements to alcohol.
Alcohol is a risky but largely regulated recreational drug: an uncomfortable fact. Addiction to alcohol can result in illness or death. Regulation versus prohibition provides harm mitigation: consumers make reasonably informed decisions about consumption and are not criminalised. Producers and suppliers are regulated and held accountable.
The UK criminal justice-led ‘war on drugs’ strategy should be replaced by a focus on public health and legal control and regulation of the market. Regulation of the drugs industry and all it encompasses would save lives by mitigating direct harms. Regulation of suppliers would reduce the collateral damage linked to the illegal drug trade.
Successive governments have avoided implementing the evidence-based solutions outlined by the Global Commission on Drugs Policy, because of insecurity that the solutions could be unpalatable to the voting public. It is vital that members of Parliament as well as the general public receive good quality, evidence-based information on drugs and drug policy.
This year marks Anyone’s Child’s ten-year anniversary and on 24 June we will once again be returning to Parliament to show the public and politicians that we stand for better drug laws. To achieve change, we need you there.
Change is possible when all stakeholders unite, consider all the available evidence and work together to prevent further unnecessary deaths through implementation of an effective, evidence-based drug strategy. So join us on 24 June, speak out on the need for reform and help us to protect more young people like George.
More details here
Dr Alison Bedford Russell is a consultant neonatologist