Moving targets

In 1998, the government proudly unveiled an ambitious 10-year
drug strategy, hailing ex-police officer Keith Hellawell as the man
to fix the nation’s drug problem. Just four years later Hellawell
was unceremoniously dumped, his much-trumpeted targets dropped (see
panel) and an updated strategy launched.¹

So what happened? What are the key features behind the new drugs
strategy? And will the updated version be any more
successful?

Newspaper headlines made much of the government’s new approach to
drugs, questioning the wisdom behind reclassifying cannabis from a
class B to a class C drug and allowing heroin to be more easily
available on prescription. It was the cannabis issue that proved
the final breaking point between Hellawell and the government, as
the former drugs tsar believed that downgrading would lead to more
drug taking.

But the new strategy’s pragmatic approach may give it more chance
of success. First, the drugs budget has been increased from just
over £1bn in this financial year to nearly £1.5bn by
April 2005.

Second, there is an emphasis on harm-reduction measures, such as
needle exchanges. This recognises that people need to know the
risks of drug use and be supported to use them safely, says Richard
Kramer, head of policy at Turning Point, a voluntary organisation
that helps people with drink and drug problems among others. It
also recognises that there may be a long delay between developing a
drug habit and coming into contact with a service.

“These measures can be a bridge to treatment,” says Kramer. “They
recognise that drug use takes place and attempt to reduce the
harmful effects. It’s trying to allow people to control their
habit, which may reduce crime.”

Third, the strategy promises new aftercare and throughcare services
to help people leaving treatment or prison avoid reoffending and
reconviction -Êalthough, as Kramer says, the government has
not spelt out in detail how this will happen.

What the strategy is missing is any mention of alcohol. One in 13
people are dependent on alcohol – twice as many as the number
dependent on drugs. Drug workers want the National Treatment
Agency’s remit to be broadened to include alcohol so that the
alcohol strategy and the drugs strategy work alongside each
other.

But there is a greater emphasis on the links between treatment and
the criminal justice system and the government intends to expand
treatment options in prisons. Although this is welcomed, drug
workers would not want to see these initiatives take priority over
treatment for people in the community who have not committed a
crime and could be prevented from doing so by receiving treatment.
If the criminal justice system becomes the main route of access to
treatment it will result in a two-tier system, warns Kramer.

Priority is also focused on improved treatment for the most
problematic users, such as those on heroin or crack cocaine. The
strategy promises to reduce waiting times for treatment services
and to plug holes in services, particularly for crack users and
groups who are difficult to reach, such as people from ethnic
minorities and young people. To succeed in this huge task, Kramer
argues that local drug action teams will need to have more
effective assessment and care planning arrangements in place.

The change to the Misuse of Drugs Act 1971 is one of the strategy’s
most controversial elements. Previously, it was illegal for
organisations to allow cannabis or prepared opium to be used on
their premises. But section 8(d) of this act was amended by the
Criminal Justice and Police Act 2001 which extends this to cover
all controlled substances, including heroin and cocaine.

There are fears, particularly among those working with homeless
people, that housing organisations might refuse to house homeless
drug users because of the risk of prosecution, leaving large
numbers of homeless people with drug problems without accommodation
and support.

The Homeless Link, which represents more than 700 agencies working
with homeless people in England and Wales, believes the amendment
is unworkable and detrimental to drug users and voluntary
organisations. Agencies owning or managing premises will be
expected to contact the police whenever they suspect substance
misuse and take steps to prevent further misuse. Drug users who
suspect they will be reported to the police are unlikely to use
residential centres or other services.

Kramer says: “The guidance doesn’t give sufficient protection to
drug agencies engaged in harm-reduction. We would not want to run
the risk of criminalising agencies that are treating people with
drug problems. There needs to be clear protocols for police so that
they aren’t prosecuting a drug agency in one area and not in
another.”

Freelance consultant Ruth Wyner believes the amendment will
“condemn people to work with the Sword of Damocles over their head.
It will criminalise projects housing drug addicts because workers
know they will use drugs on the premises.” The homeless sector
cannot work with zero tolerance, she adds.

A former charity worker, Wyner was jailed in 1999 with her
colleague John Brock after being found guilty under section 8 of
knowingly allowing drug dealers to supply heroin at Wintercomfort,
a Cambridge drop-in centre for homeless people. They were freed on
bail in July 2000 but lost their appeal the following January,
although they did not have to return to jail.

She, and many others, want section 8 to be amended to say
“wilfully” committing an offence rather than “knowingly”, a
proposal that was also recommended last year by the Police
Federation’s independent inquiry into the Misuse of Drugs
Act.

“The law has to be linked to what’s happening rather than what they
hope is happening,” Wyner adds. This is why she is in favour of the
government proposal that drug users who have a clinical need for
heroin will be able to receive a regulated supply on prescription.
It recognises that an addict is not going to give up immediately
and access to a regulated supply is better than relying on street
drugs, she says.

Hellawell’s targets faced accusations of being unmeasurable,
unachievable and unspecific. The updated drug strategy is certainly
more realistic. Now it is up to all parties to turn the objectives
into reality.

– For more information visit www.drugs.gov.uk  and www.homeless.org.uk  

¹ Drugs Strategy Directorate,
Updated Drug Strategy, HMSO, 2002

Hopes and reality – Former drug tsar Keith Hellawell’s
targets:

• Target 1: To reduce the proportion of under-25s using class A
  drugs by 25 per cent by 2005 and 50 per cent by 2008. Abandoned.
  The government still wants to reduce drug use by under-25s but
  there are no specific targets.
• Target 2: To reduce availability of class A drugs by 25 per
  cent by 2005 and 50 per cent by 2008. Abandoned. This has been
  replaced by more general measures about increasing the level of
  drug seizures and working with the government of Afghanistan to
  reduce opium supply.
• Target 3: To reduce the levels of repeat offending among drug
  users by 25 per cent by 2005 and 50 per cent by 2008. Abandoned.
  The targets have been abandoned but the commitment to reduce repeat
  offending remains.
• Target 4: For 55 per cent of drug users to be participating in
  drug treatment programmes by 2004 and 100 per cent by 2008. Target
  kept.