The ‘tough on drugs’ approach is impractical, outdated and costly in every sense, according to a meeting of the APPG for Drug Policy Reform.

Considering pieces of evidence from home and abroad – including Germany, Portugal and the Czech Republic, where legislation had decriminalised drug consumption – the group discussed how the lack of a clear national strategy was resulting in inconsistent law enforcement relating to drug possession and consumption in the UK.

A decade ago we were familiar with arrest referral schemes and their successor, the Drug Interventions Programme. This government-funded programme was used in courts and custody suites to divert people who had been arrested in possession of drugs into education and treatment programmes, rather than prison. With funding withdrawn, drug-related crime rates were rising as fewer offenders with drug problems were being referred into treatment.

Furthermore, the group was concerned at the ‘postcode lottery’ playing out – in some areas people might receive a warning or a fine; in other areas they would receive a short prison sentence for the same offence. Those on the receiving end of harsher punishment, it was noted, were more likely to be from poor areas and minority ethnic groups.

Mike Trace, ex deputy drug czar to the Blair government, said that in the UK we used to be very enthusiastic about diverting people into treatment, but that this had declined over the last ten years. However, he believed the Ministry of Justice was now interested in diversion and deflection as it was cost effective.

Some police and crime commissioners were running early stage deflection schemes, referring people into education and treatment programmes. Among them, chief inspector Jason Kew had become increasingly convinced of the value of this approach in the Thames Valley. ‘We have had nothing but private engagement and support and acknowledgement that we need to reform,’ he said. Pre-arrest diversion was ‘as close to decriminalisation as you can get in the current framework’, but it was a postcode lottery. Two miles down the road you could end up in custody.

‘If we were using decriminalisation [a system like in Portugal] we wouldn’t need to be talking about diversion,’ he said, adding ‘We are trying to evolve and innovate, but are also having to deal with the effects of austerity on drug services.’

Despite the constraints of the current legislative framework, there had been an opportunity to give evidence to the Home Office independent review of drug markets and violence, led by Dame Carol Black. The National Police Council were contributing, said Kew, and Kirstie Douse added that Release were submitting a full response.

The review would be looking at drug harms – an opportunity, the meeting agreed, to provide strong evidence on harm reduction that should pave the way for legalisation. Evidence would include detail and working practice – such as in Switzerland – on heroin assisted treatment (HAT) and drug consumption rooms (DCRs).

While evidence was being collated and debated there was an urgent need to engage now with people about their drug use, as Fiona Measham explained.

Her service, The Loop, had been bringing a mobile drug testing service to outdoor events, with a great deal of positive engagement – from local police as well as festival-goers. It’s a model that has become a much-valued part of the festival scene – ‘one in five people hand over their drugs when they find it’s not what they expected,’ she said.

But there was now a major obstacle to operating the service: the Home Office had announced they would be licensing mobile testing (previously ‘a bit of a grey area’, as there wasn’t a licence that fitted a mobile lab situation). The application would take at least 12 weeks, meaning The Loop was ‘on hold’ until then.

‘So the concern is, we’re moving into the summer season and have had to cancel presence at imminent events,’ said Measham. ‘We’re all in limbo waiting for the licence, but don’t want to endanger the support of the Home Office long term.’

Members of the APPG hoped there would be a way around this. ‘We can’t let bureaucracy make this a lost summer,’ said Trace.

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Border intelligence

The Drugs, Alcohol and Justice Cross-Party Parliamentary Group also met in May to discuss what England could learn from drug and alcohol strategies in Scotland and Wales.

 A new strategy for Scotland, Rights, respect and recovery had the aspiration of putting recovery at its centre, said Andrew Horne, director of Addaction Scotland and an advisor to the Scottish government for the last 14 years.

There were now at least 120 organic self-starter recovery groups, which were ‘about people taking back their own recovery and not led by services’.

Scotland had 60,000 dependent drug users and a predicted 1,000+ drug-related deaths in 2018 – three times the rate in England. There had been recent rises in HIV and hepatitis C, in both the chemsex and mainstream using community. Horne mentioned the ‘Glasgow effect’ – the drop in life expectancy by seven years for residents, irrespective of their social group, age or ethnicity.

The news was that there had been a mind shift, said Horne. Scotland was now treating substance misuse as a health and social issue – a health issue first, rather than a criminal justice issue. ‘People have the right to be safe and well,’ he said.

There was a ‘big need to address stigma’ in personal and media references. ‘Stigma stops people from entering treatment,’ he said. Service users were still a very disempowered group that needed more advocacy to help challenge decisions about their treatment. Scotland still had health boards, ‘which can be clinical and consumer led and seen to lack compassionate care’, he explained, and it was important to listen to what peer-led groups had to say.

Drug treatment in Wales was health led and there was an holistic approach, but it could get lost in the ‘huge portfolio’ of devolved responsibility, said Caroline Phipps, CEO of Barod, a third sector organisation for adults and young people.

It was an interesting time, she explained, as Wales was coming to the end of a ten-year strategy that had started to see a reduction in harms. The strategy review was showing evidence of short-term impact and the value of a harm reduction approach, but intelligence was missing on longer-term impact and whole-population intervention.

One of the main concerns was that those with the most complex needs were being failed, often because of stigma. ‘We need to review concerns around OST, waiting times and access to services,’ she said, as well as looking at some of the criticism being levelled at commissioners and services.

‘People die of stigma – it’s the biggest issue,’ she said. Well-being of Wales gave a policy framework that needed to ensure service user voices were heard.

An ageing population, strong drugs, lack of funding and a spike in drug-related deaths gave the ‘most challenging conditions of the last 20 years’, underpinned by county lines, alcohol-related harms, hepatitis C rates, poverty and isolation.

In positive news, there was a ten per cent increase in funding for the sector in Wales, with a focus on harm reduction, protecting families and reducing drug-related deaths. There were good projects on distributing naloxone, said Phipps, as well as effective service user involvement and a pragmatic approach to patient choice. There was now a need to be ‘brave and bold’ with DCRs, diversion schemes and decriminalisation.