Time to put things right

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How will we look back on our drug laws in another 50 years, asks Paul Townsley.

50 years of substance misuse jobsI was two years old when the Misuse of Drugs Act (MDA) became law. It has overshadowed my whole working life. Working in treatment services, it can be easy to disconnect from the law and its impact on the people who use our services – and indeed the way we have to work as a result. We react to the effects of the law, and its intended and unintended consequences, but without pause to consider the bigger ramifications or constraints that treatment is under.

Paul Townsley is CEO of Humankind

Many of the people who use our services use a mixture of legal prescribed and non-prescribed drugs and illicit drugs which are made by the pharmaceutical industry, organised crime or the alcohol industry with tax revenue going to HMRC. This complex interplay between a broad range of psychoactive substances is not reflected in the act in a meaningful, rational and logical way. The criminalisation of, and stigma towards, people who use a range of drugs creates a hypocritical approach from the get-go.

Throwing out the act in its entirety isn’t practical though. At this point, it seems there isn’t the political will or the public appetite for that to be our initial goal. From my perspective, the next best thing would be for the MDA to be updated to be fair, evidence based and reflect the needs of the UK in 2021 – not 1971. Throwing out the act without a developed alternative position may create unintended consequences. But it’s important to agree in law and practice that the criminalisation of people using ‘illegal’ drugs is a flawed model that ultimately punishes rather than protects and helps people.

One way to ponder the validity of the MDA is to wonder what things would be like in 2071. Would we be reflecting on 100 years of the act and the ‘war on drugs’? What might that world look like, and what would be better?

To state the blindingly obvious, to be politically acceptable we must create the pressure, conditions, and pathway to change and move from binary discussions of ‘for and against’ to what’s in the best interests of everyone in society in the long term. We need to be pragmatic about what can be achieved, but also recognise that things are changing and we need to push that door open more widely. The increasing harms caused by alcohol, the increase in drug-related deaths and waste of resources sentencing people and their families to a life within the criminal justice system all demand urgent change.

We have a window of opportunity to take some radical steps forwards, with a new government committed to invest and the impending release of the second part of the Dame Carol Black review. We need to take a public health approach to treatment and rehabilitate people caught up in the criminal justice system – instead of referring people on in criminal justice settings we need to embed public health interventions in these settings. For people caught up in using, dealing and committing crime we need to make sure they are rehabilitated and get treatment first and foremost – not punishment.

We need to improve and protect the skills of staff working in both specialist and non-specialist settings so that people get the help they need when they are either motivated to change or require basic health and social care interventions. Senior figures in both police and probation services are stepping up and saying let’s do something different, as they can see that the MDA does nothing, save from reinforce the revolving door of custody-release-custody. As treatment providers we need to make sure our voices are as loud as others and improve treatment outcomes as we apply the evidence base of what works.

New investment needs to rebuild what has been lost over the recent years of cuts and look to the future to make sure we work with as many people as we can with the resources available. We have a once in a generation opportunity to go with the evidence base rather than what’s politically tolerable in the short term. Early intervention potentially breaks the cycle of trauma and deprivation altogether.

My hope is that in 2071 people can look back at a well-intended but flawed approach to drug and alcohol use and the moment that came when we as a country bravely changed course and moved towards decriminalisation and a public health approach.