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Putting Health First: An Approach to UK Drug Policy

The Institute published a proposal for a universal basic income to be tested within Fife Council. The proposal was launched with RSA Scotland's Jamie Cooke and Cllr. Matt Kerr, both who are strong advocates for a UBI.





Sarah Breslin

Jonny Ross-Tatam

Executive Summary

Chapter 1

Policing drug possession: the current situation

The first chapter outlines the impact of the UK’s current criminal drug laws and policing policy. It found that the current UK drug policy puts a considerable strain on the UK’s criminal justice


  • The number of criminal convictions from drug possession trebled from nearly 15,000 in 1993 to nearly 45,000 in 2010.

  • 93% of those convicted for marijuana possession were considered to be ‘recreational’, at a cost of £80 million to the UK Justice System.

  • Between 1996 and 2011, there were 1.2 million criminal convictions handed out for personal possession of drugs. Widespread prosecution not only has damaging implications for the individual convicted, but for the social and economic health of society as whole.

  • On average, a criminal record for personal drug possession results in an average of 19% loss in earnings. Decreasing employability, earning potentials and the opportunity to contribute to wider society.

This chapter also analyses the negative racial and socio-economic impacts of the current ‘stop and search’ policy on UK society:

  • Research from Release has shown that someone is ‘stopped’ and ‘searched’ for drugs every 58 seconds on average in England and Wales.

  • While drug usage among the Black and Ethnic Minority (BME) population is almost half that of the white population, the former are 6 times more likely to be stopped and searched.

  • In Scotland, where the rate of ‘stop’ and ‘search’ is four times higher than in England and Wales, the majority of ‘stop’ and ‘searches’ taking place in areas with the highest levels of poverty and unemployment.

  • Research from the Guardian and the London School of Economics in 2011 lists ‘stop and search’as a key factor in the anti-police sentiment surrounding the 2011 riots in English cities.

Chapter 2

The case for a health-centred approach

Decriminalising the personal possession of drugs is only one step towards a new health-centred approach to UK drug policy. This also requires redirecting resources towards investment in

treatment, rehabilitation and harm reduction services. In this, the successful Portuguese drug policy sets a leading example, as they have been particularly successful in treating and

rehabilitating problematic drug users. Their accomplishments lie in the adoption of a health centred approach:

  • Between 2001 and 2011, the number of ‘problematic’ users – i.e. those who inject drugs or repeatedly use “hard” drugs – has halved.

  • The number of newly diagnosed HIV cases per year fell in Portugal from 1,016 to 56 between 2001 and 2012, whilst a similarly dramatic decline can be witnessed for Hepatitis B and C.

  • Drug-related deaths fell from approximately 80 in 2001 to 16 in 2012.

UK policymakers ought to take note of this success, particularly when considering the rise in drug-related deaths in the UK. In Scotland, drug-related deaths more than trebled between 1996

and 2013.Furthermore, the economic cost to society of the estimated 380,000 ‘problematic’ drug users in the UK is estimated to be at £15.4 billion and nearly £3.5 billion for Scotland alone.

If the UK managed to achieve similar success as the Portuguese in treating drug addiction, savings as high as £7.7 billion for the whole of the UK and £1.75 for Scotland could be achieved.

This proposal also examines other successful, health-centred approaches to drug policy, notably the use of heroin-assisted treatment (HAT), which involves proscribing heroin users with heroin in a sanitised, supervised environment. This has proven to have had significant success for harm reduction in Switzerland and the Netherlands.

  • In 1986, Switzerland had approximately 500 HIV cases per million people in 1986, the highest proportion in Western Europe at the time and in 1985, some 68% of new HIV infections in Switzerland were caused by injection drug use. After a decade of the HAT policy, however, it was down to approximately down to 5% in 2009.

  • In the Netherlands HAT has caused a marked reduction in heroin-related deaths, HIV infections, heroin-related crime and heroin use. Indeed, by the late 2000s, the Dutch incidence of new heroin users had fallen close to zero.

  • HAT has also proven to improve health and reduce crime in the UK where it has been tested and is supported by both Government ministers and H.M. Government’s official advisors, the Advisory Council on the Misuse of Drugs (ACMD). Despite the evidence of its success and vocal support from the Government, funding for HAT centres was reduced in 2016 leading to closures. However, both Durham and Glasgow council are set to pilot HAT centres.

The final section of this chapter looks at drug-testing facilities at music events and festivals, which have been used in the Netherlands for decades. Recent use of drug-testing facilities in UK festivals have proven to be a success, so there is a need for further evidence-based examination of this approach as a harm reduction strategy.

Chapter 3

Does decriminalization increase use?

This chapter responds to a common concern often aired in regard to decriminalisation, whether it would lead to increased drug use.

  • Research from the Global Drugs Policy Commission, the UK Drugs Policy Commission, Release, and the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) and the UK Home Office have found no correlation between the toughness of a country’s drug laws and prevalence in drug use.

Chapter 4

Common concerns addressed

This chapter further analyses common concerns with a decriminalisation policy:

  1. That it does not go far enough and full legalisation would be preferable. We recognise that decriminalisation would not solve problems of drug production, violence in the smuggling industry and lost tax revenue for the government. Decriminalisation is by no means a panacea for all drug-related ills, but we see decriminalisation as a practical and progressive next step for UK drug policy and a proven, evidenced-based way to effectively reduce drug abuse, drug addiction and drug-related crime.

  2. That a ‘softer’, health-centred approach to drug policy would never be accepted by the UK electorate. However, analysis of available polling data, from Observer, Ipsos Mori and YouGov, seems to undermine this assumption and suggest a growing appetite for a considerable appetite for a new, health-centred approach to UK drug policy:

  • An Observer commissioned poll found that 84% believe that the UK’s current drug policy is failing.

  • A 2013 poll conducted by Ipsos MORI found that legalizing or decriminalising possession of cannabis garnered 53% of public support, with only 1 in 7 of those polled supporting the implementation of heavier criminal penalties for drug possession.

  • A You Gov poll from 2012 found that a majority (59%) agreed with the statement:‘people who use illegal drugs but have not committed any other crime should, in general, be treated as people who may need treatment and support’.

Policy Recommendations

  • The UK Government should decriminalise personal possession of all drugs, defined by up to ‘10 days of personal use’, and redirect police resources away from individual drug users.

  • Since the Scottish Government does not have the authority to formerly decriminalize possession, we recommend that they redirect Police Scotland’s resources away from targeting personal possession of drugs and towards drug trafficking and other crimes.

  • The UK Government should adopt a similar approach that has been used in Portugal, where decriminalisation of personal possession is combined with a focus on treatment, rehabilitation and harm reduction services.

  • The UK and Scottish governments should move appropriate responsibilities for drug policy away from government departments focused on criminal justice and policing, to those focused on health and rehabilitation.

  • The UK Government should adopt Portuguese-style ‘dissuasion committees’ for those found in personal possession, consisting of a legal, social and health worker. If a drug user is perceived to be ‘problematic’ they are then guided, not coerced, towards available treatment, rehabilitation or harm reduction services.

  • The UK Government should heed the strong evidence for the improvements in health and crime reduction outcomes for heroin-assisted treatment (HAT), by following the Swiss example and making HAT available to 10-15% of the heaviest long-term users. The Scottish Government should build on the work in Glasgow City Council and collaborate with more local authorities to introduce HAT centres.

  • We urge the UK and Scottish Governments to take an evidence-based approach to drug-testing facilities, working with local authorities and police forces to establish more pilot experiments for this approach and to assess the evidence-base for further expansion.

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