Peter Reynolds

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Dame Carol Black’s Review of Drugs. A Missed Opportunity To Speak Truth to Power

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Dame Carol Black

There is some useful work in Dame Carol’s review but by definition it was only ever about supporting current strategy. She was constrained from the beginning by the terms of reference which stated: “The review will not consider changes to the existing legislative framework or government machinery.”

Given such an absurd restriction, I wonder why any self-respecting expert in policy would take on the role? At best it could only ever advise on tweaks and adjustments rather than the fundamental changes that are urgently needed.

It’s clear that drugs cause harms in our society.  They cause health harms to individuals, particularly in the case of the legally regulated drugs alcohol and tobacco but other drugs cause far more harms as a result of the illegal, unregulated markets through which they are produced and distributed.  These are called social harms but there is not a clear dividing line.  For instance, drugs produced illicitly are of unknown strength, purity and consumers cannot know whether they are contaminated with other, perhaps more harmful substances.

So treatment for addiction and dependency, which is what most of Dame Carol’s review focuses on, is essential and is scandalously under-resourced.  This is an entirely false economy as the consequences are devastating for our society.  As Dame Carol writes: “The drugs market is driving most of the nation’s crimes: half of all homicides and half of acquisitive crimes are linked to drugs. People with serious drug addiction occupy one in three prison places.”

Politicians don’t put sufficient resources into drug treatment because they are fools and their failure is based on stigma and lack of vision. They don’t think such funding wins votes. Why should people who aren’t consumers of street heroin or cocaine fund healthcare for people who have a problem they have brought on themselves and for which they broken the law in the process?

This indicates the very low opinion that our so-called leaders have of the electorate.  Of course there are people who hold such a short-sighted view and believe it’s not their problem and some even take the same view about those who suffer health harms from the legally regulated drugs, alcohol and tobacco.  But these people are in the minority and if politicians paid them the respect and took the time to explain how intelligent policy can benefit us all, then this nasty and self-defeating attitude would very quickly all but disappear.



So any rational person with even a modicum of foresight must support Dame Carol’s call for increased funding, better co-ordination and accountability between government departments.  She also writes that “A whole-system approach is needed, with demand reduction a key component, to drive down the profitability of the market.”  This is where the logic, usefulness and validity of her review begins to fall down, in large part because of those idiotic constraints placed on her that she cannot propose “changes to the existing legislative framework or government machinery”.

Of course, no one in their right mind aspires to a lifestyle of addiction and dependency which dominates their life and inhibits fulfilment and success.  Substantial reduction in demand can be achieved through properly funded treatment. We should aspire to turning round the lives of the majority of the 300,000 problematic consumers of opiates and cocaine.  To do this we need to understand more effectively how and why their drugs consumption works.

Addiction to opiates shares the same dreadful reality as addiction to alcohol, that stopping or withdrawing from regular use is difficult, can be very dangerous and causes its own health harms.  Cocaine is different.  It’s not really addiction in the same sense, it’s more about compulsive behaviour. If you stop, after initial recovery from the tiredness and destructive lifestyle you will, quite quickly, begin to feel better. 

Where Dame Carol’s review falls over and becomes a little ridiculous is when she writes: “We can no longer, as a society, turn a blind eye to recreational drug use. A million people use powder cocaine each year and the market is worth around £2 billion. The vast majority of users do not see themselves as having a drug problem and they are unlikely to come forward for treatment.”

These people, alongside the vast majority of consumers of MDMA (ecstasy), cannabis and most other currently prohibited drugs are not suffering any health harms.  With very few exceptions, the only significant harms around their drug consumption are those caused by the criminal markets which current legislation has created.  The drugs themselves are, in most cases, far less harmful to health than the legally regulated drugs, alcohol and tobacco. 

The glaring error in Dame Carol’s review, forced on her by the constraints, that show her work to be propaganda in supporting an already failed policy, is when she writes “they are causing considerable harm to others through the supply chain, both here and abroad.”

This is a staggeringly irrational and biased statement, contrived to shift the blame from failed policy and irresponsible ministers onto drugs consumers.  You cannot blame consumers for the harms caused by politicians’ failure to regulate drugs markets.

In every other aspect of life we rightly expect government to act to protect us and keep us safe.  This is why we have speed limits, safety belts, MOT tests, why other forms of transport such as trains and aeroplanes are strictly regulated.  This is why alcohol, tobacco and also food are subject to regulation, why sports have governing bodies that set rules and standards to keep participants safe.

We know from history the consequences of prohibiting alcohol which gave rise to the first gangsters and we have stumbled into the same dystopia by prohibiting drugs.  When alcohol was banned in the USA and consumption went underground, people stopped drinking wine and beer, preferring high-strength, much more harmful, often contaminated hooch.  The ultimate perversion of government’s responsibility was when it started to poison illicit supplies in an effort to deter consumption.  We are on exactly the same path now with drugs.  It is a path that will lead to greater criminality, more harm, more death, misery, ruined lives, massive expenditure, crime and the degradation of our society.  This is where current drugs policy is taking us and Dame Carol Black’s review supports this stupidity.

I cannot believe that an intelligent, experienced woman like Dame Carol would not recommend changes in current policy had she been allowed.  What we desperately need is people in her position to have the courage to defy the stupidity of government minsters and speak the truth, the whole truth.  All drugs must be legally regulated in direct relation to their potential for health harms.

Thus, alcohol, tobacco, opiates and cocaine, while legally available to minimise the criminal market, must be under strict control. In my view, with its well established place in our society, the sale of alcohol should be permitted in far fewer outlets.  There should be quantity limits.  It is crazy that in a supermarket you can only but two packs of painkillers but as many cases of whisky as you want.

Opiates should be on prescription only, with compulsory therapy but much easier to access so that those with a problem get their clean supply of known strength from a pharmacy, not from a gangster-controlled dealer.  Necessary funding for treatment must be in place but there will not be a surge of demand. Most people don’t want to use heroin!

Cocaine, which is not really any more harmful than alcohol, in some ways less, should be available to adults in restricted quantity and frequency for registered consumers from pharmacies.

At the other end of the health harm scale, cannabis and MDMA must be restricted by age and regulated for quality with known strength and absence of contamination.  We can virtually eliminate the criminal market in these drugs if we regulate them properly.

If we want to reduce the harms from drugs, this is the inevitable solution.  We can either continue to delude ourselves that we can stop drug use, which is a gift to the criminal market, or we must recognise that there is no other effective policy except legal regulation.

Whoever comes next of Dame Carol’s status and influence must speak this truth to power.

Written by Peter Reynolds

July 11, 2021 at 10:26 am

2 Responses

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  1. this makes perfect political sense to the politicians! not so much with the public but when has doing what is right for the citizens been their focus! those career politicians aren’t in politics to serve the country, they are in it to further their own self interests! only a fool votes for them or supports them in anyway! they will never legalise drugs unless it benefits them or the donors.

    Stephen Brophy

    July 11, 2021 at 12:56 pm

  2. Dear Peter,

    You are probably of this – it opened my eyes as hemp could solve so many issues – health, environment and economy!

    https://canex.co.uk/current-uk-hemp-legislation-and-what-it-means-for-the-industry/

    BACK BRITISH FARMERS!

    Tracey Smart

    July 23, 2021 at 11:02 am


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