Drug policy is working – why do we prefer to think otherwise?

Britain’s heroin habit isn’t what it was. Marcos Mesa, Sam Wordley via Shutterstock

On all sides, our politicians and commentators seem convinced Britain’s drug policy has been a failure.

Party conference season saw Liberal Democrat leader Nick Clegg rehash his old refrain that we’ve “lost the war on drugs”. Iain Duncan Smith’s Centre for Social Justice still portrays drug addiction as one of the main drivers of worklessness, poverty and social exclusion in our poorest communities. And on October 30, the narrative of failure will be rehearsed yet again when Green MP Caroline Lucas initiates a three-hour debate in parliament calling for an impact assessment of our current drug laws.

But these diagnoses are misleading: for all the problems that remain, the major successes of our drug policy deserve to be acknowledged. Here are some of the headline facts, which can take even informed observers by surprise.

Turning it around

Drug use is much less common than most people assume. In England and Wales, about one adult in three will have used a drug in their lifetime; for the vast majority, this will be short-term or intermittent cannabis use.

Use of the most dangerous drug, heroin, is much rarer. Public Health England estimate there are now fewer than 300,000 heroin users in England, compared to estimates of more than 450,000 at the height of the heroin epidemic in 1999.

The biggest fall in heroin use has been among young people; our addiction problem is in a cohort of middle-aged users, who began using heroin in the 1980s and 1990s and who also suffer from poor mental health, alcohol misuse, homelessness and social exclusion. By and large, they are not the vulnerable teenagers of popular imagination.

Meanwhile, a range of research suggests that a major part of the sharp rise in crime experienced in the 1980s and 1990s was caused by the dramatic increase in heroin use during that period; it is also estimated that ready access to treatment (including in prison) currently prevents 4.9m crimes per year.

Levels of HIV, closely associated with needle injection around the world, are also very low among British injectors, largely thanks to the harm-reduction policies pioneered by Norman Fowler when he was Margaret Thatcher’s health secretary in the 1980s. In the USA, up to 20% of injectors have HIV; in Byisk, in Russia, it’s more than 70%. But in England, the rate is just over 2%.

Of course, not all the news is good. Drug-related deaths rose startlingly in 2013, after falling each year since 2010. The immediate and long-term health risks of “legal highs” are still poorly understood; the poor integration of drug and mental health services is a continuing scandal.

But if we resist the meaningless rhetoric of “winning” or “losing” the “war on drugs”, we’ll see that the broader reality of England’s drug problem today is that fewer people are using drugs, fewer are becoming addicted, and the social and economic impacts of drug use are shrinking.

We’ve clearly come a long way since the first national drug strategy, Tackling Drugs Together. While drug addiction still has a disproportionate impact on vulnerable citizens living in Britain’s poorest communities, there is no longer a plausible argument that drug addiction is destabilising our society.

Yet despite rapidly declining use, falling crime, an ageing cohort of users as young people shun heroin and still-low levels of HIV – all of which would once have been seen as causes of celebration and proof of success – British drug policy is almost universally derided as a failure. Why?

Decline and fall

For ideologues of a traditionalist conservative bent, drug use is part of a broader liberal folly, a social program that has trashed the morals – self-reliance, responsibility, deferred gratification, sacrifice, duty – that supposedly characterised family and social life across all classes before the social upheaval of the 1960s.

To accept that drug use has been falling for years and that its attendant harms are clearly in retreat would destroy this dystopian vision. It would also invite a less politically convenient explanation for poverty, one that emphasises structural inequality rather than the individual failings of the poor. Faced with this prospect, the easier option for ideologues is to ignore the facts, thereby sustaining the integrity of their analysis and the power of their polemic.

Meanwhile, the liberal intelligentsia apparently sees recreational drug use as relatively benign, chalking all harm up to the consequences of prohibition and the “failed war on drugs”. Prohibition is blamed for the mass incarceration of young black men in the USA and the deaths of thousands in Mexico’s drug wars, as well as providing a justification for continuing US interference in supposedly sovereign Central and South American states.

These arguments usually conclude with a call to review the 1971 Misuse of Drugs Act, as if that’s the prime cause of racism in the US justice system, explains the history of US-Latin American relations, or drives the brutal internecine struggles of the Mexican cartels.

But given the reality of the situation, an honest discussion of the real situation in Britain – less use, less harm, ready access to treatment – would hardly support a wholesale review of drug laws and the UN convention.

Running riot

Across the commentariat, opinions on drugs are a means to signal political identity and affiliation. The brand value of being in favour of either legalisation or prohibition is much too potent to allow it to be diminished by inconvenient truths.

The real public health and crime crises that followed in the wake of the heroin epidemic spawned an evidence-based cross-party consensus that still underpins the policies in place today. And it is that same success that has freed the ideologues from the necessity to engage with messy reality and let them loose in an anarchic ideological playground.

Flagrant ideological posturing along these lines flourishes in our nonsensically combative political culture. It’s almost impossible for any government policy to be called a success; politicians have learned that to claim a win for any policy is to invite a charge of complacency today, and risk humiliation tomorrow.

The resulting fixation on problems, failures and misfires drives any genuine improvement so far down the agenda that it falls out of sight. In Whitehall, political invisibility means being starved of cash and influence – and this creates a dynamic in which civil servants, producer interests and service users learn to displace good news with a constantly evolving narrative of failure.

Get real

There are obviously legitimate debates to be had about how we protect the public from the harms of illegal drugs – and the role of criminal sanctions. On the one hand, is it morally justifiable to lock people up for possession to protect them from themselves? On the other, under a more liberal regime, how would we stop a free market driving up both use and harm?

These are not easy questions to answer, and they demand a proper debate. But as things stand, our absurd ignorance of our own success means we’re drifting towards unnecessarily radical “solutions” – even though it’s entirely possible to develop incremental improvements to our management of illegal drugs to sit alongside our responses to alcohol and legal highs.

The stale, ideological alternatives our political tribes are still pushing would scarcely be contemplated if the successes of our current policy got a tenth as much airplay as its problems do. And the losers from this will not be publicity-hungry entrepreneurs or misguided think-tankers, but rather the 0.5% of our population for whom drug policy is genuinely a matter of life and death.