Closer Than You Might Think: Where the UK Can Look for Drug Policy Answers

This week, the 56th Session of the United Nations Commission on Narcotic Drugs - the single most important drug policy gathering in the world - met amidst new calls for legalization from some NGOs (no, Colorado and Washington did not send delegates and the US federal government maintained their position favoring demand reduction over legalization). These legalization groups, which represent a minority who want radical change, are riding a recent wave of renewed interest in their ideas from the landed gentry.

In January, for example, the United Kingdom All-Party Parliamentary Group for Drug Policy Reform launched a new report on drug policy recommending the decriminalization of all drugs, including crack-cocaine, heroin, ecstasy, and cannabis. The Group also called for the legalization of "less harmful drugs" because then "they will not be sold by dealers who sell dangerous substances and they will not be adulterated." The Group went on to indict UK drug policies as harsh and ineffective, praising other countries like Portugal instead. In fact, despite a very mixed record, Portugal has peculiarly become the poster-child for legalization, even though its policy represents nothing of the sort.

The UK, however, is an interesting example worth examining in detail. The Conservative-Liberal Democrat coalition government has rejected legalization and will soon embark on an international expedition to find out what works. Indeed, the rest of the world has a lot to show Her Majesty's government - for example, the importance of community-based prevention and efforts to move addicts from incarceration to treatment. But while the recent emphasis on health-oriented approaches should be welcomed, the UK doesn't have to look as far as it might think to find real progress in drug policy.

In fact, one could argue that the current UK approach is one of Europe's best-kept secrets.

Slowly and quietly, with much contemplation and little fanfare, the UK has, over the last ten years, embarked on a new, recovery-oriented drug strategy that has produced impressive results.

And it deserves our attention.

Drug use has been falling in the UK while it has been rising in other countries (like the US and Portugal): overall drug use has fallen almost 15% between 2005 and 2011. And fewer people are using or injecting heroin and crack in England. This has translated to fewer people needing treatment. And it is not just drug use where we have good news. The National Treatment Agency is able to report that the average wait time for treatment has fallen from 9 weeks in 2001 to 5 days in 2012. Five days is still five too many, but it is certainly dramatic progress. The number of people living drug-free now has almost tripled. And, finally, their efforts contributed to a dramatic decrease in crime, saving the UK taxpayer almost a billion pounds.

Of course, it is hard to measure how many people stay drug free once their treatment (e.g. methadone) is terminated. We don't really know what happens when they do not return to treatment. There are likely multiple, complex factors that have contributed to these numbers. But Her Majesty's policy approach deserves at least some credit. Emphasis has been placed on prevention and treatment, while also reducing the harms drugs cause. The ultimate goal was to get people off of drugs, not maintain or encourage their addictions. This was done in a health-orientated way: involving hospitals and doctors, vastly expanding treatment, and implementing evidence-based drug prevention. It turns out that this has paid off, even if we have heard little about it amidst calls for reviews and Royal Commissions.

That the UK has experienced some unheralded successes in drug policy does not mean there isn't room for improvement. The "drug treatment court" model, which offers treatment alternatives to prisons has been successful in places like Scotland but desperately needs to be scaled-up and expanded in other regions. Drug prevention must begin to move from school-based interventions to more holistic approaches involving multiple community sectors. Efforts to curb the UK's dangerously high binge drinking rates, which result in car crashes and violence, must be tackled immediately through expanding existing pilot programs centered on random testing and modest sanctions. And the UK might learn something from innovative drug market initiatives shown to reduce street-crime and give low-level drugs dealers an honest second chance at entering the legal economy.

Besides omitting these real successes, the recent drug policy debate has put too many eggs into the legalization basket. Regulation of drugs by the state will do little to ensure street versions of those very same drugs - in higher potency and at a cost that just undercuts the government's offer - will simply go away. These drugs, then, still run the risk of adulteration and misuse. Advocates make the mistake of claiming that since alcohol and tobacco - two highly addictive drugs - are legal, others should be too. These two legal highs, however, point precisely to why we don't want to legalize anything else: they are cheap, easy to obtain, normalized, and ruthlessly promoted by big industries that rely on addiction for profit. As a result they are used more - and are the cause of more illness and crime - than all illegal drugs combined. How, then, do they provide any example for what to do with crack-cocaine or heroin?

And then there is the famous Portugal example, grossly mischaracterized by almost everyone in the drug debate. It is important to remember, first, that Portugal has not legalized or "regulated" drugs by any stretch of the imagination. They have removed criminal penalties for drug possession and they do refer people to panels of social workers that determine what is best for the user. And their record of success is mixed: overall drug (including cocaine) use has risen there and drug-deaths are also slightly increasing, but more people are entering and completing treatment than before. It seems that their policy is more of a work in progress than a case of unequivocal victory. One could argue that the UK policy is still a work in progress, but if we are to be frank about the numbers, the UK is farther along than one might initially think.

We are often faced with a false choice in this debate: either we must incarcerate drug users or we must legalize drugs. This false dichotomy fails to recognize that we can both reduce the consequences of drug use and discourage people from taking up drugs in the first place.

Isn't that, after all, what this is all about?