Ministers are fond of saying that government policies are based on evidence. In the case of drugs policy they have the benefit of expert advice from a statutory body, the Advisory Council on the Misuse of Drugs (ACMD). It should not be difficult for interested parties to examine the evidence and form an opinion about the ingredients of a sensible policy. The only requisite is a common language. Plain English would do.
In February 2016 the experts from ACMD submitted detailed comments and suggestions to Ministers. On 14 July 2017, only seventeen months later, the government launched a repackaged Drugs Strategy. At the same time, Sarah Newton MP, the Minister for Crime, Safeguarding and Vulnerability wrote back to the ACMD ‘hoping’ (sic) it would recognise its contributions in the new strategy. Some hope. Long passages of her seven page letter drown in gobbledegook; it might as well be written in her native Cornish. Sprinkled liberally with ‘challenges’, sensible discussion is rendered impossible.
Getting our approach right, the letter begins, is fundamental to achieving a range of priorities. Hard to quibble with that truism. The Strategy apparently takes a ‘smarter, partnership-based’ approach. The approach is being ‘enhanced’. A new fourth strand promotes an ‘evidence-based approach’ and a ‘balanced approach, internationally’. ‘ACMD advice will continue to be essential in informing the approach’, allegedly.
This right, smarter, partnership-based, enhanced, evidence-based, internationally balanced, ACMD-informed approach will support: ‘wider, cross-government ambitions’; ‘key actions’; three updated ‘strands’; a ‘new fourth strand on Global Action’, which in turn spearheads ‘new initiatives’; and two ‘overarching aims’ expanded with a ‘raft of new measures’. Take your pick.
One of the two overarching aims is to ‘increase the rates recovering from their dependence’, whatever that means. Thus expanded, the new measures [performance indicators or metrics, understood] will include ‘segmenting our recovery data to facilitate even greater ambition for particular user groups’. I think they intend to collect more detailed data, not necessarily to massage statistics to justify abstention as a policy.
The letter then gets in a muddle about why people with mental health and drug misuse issues cannot get adequate care, either because of lack of coordination or ‘exclusion criteria by both [sic] sets of services’. A joint measure [sic] will be developed for individuals who have ‘co-occurring mental health problems’. More guidance and better capture of data is promised. There is no mention of the experts’ complaint about the damage being caused by shrinking resources being dedicated to drugs services.
The letter then moves on to a section on reducing demand. The Strategy, it says, makes clear that in order to prevent the onset of drug use and to protect society and individuals from ‘ the harms’ (sic), action needs to be taken at the earliest opportunity. By whom, is left unanswered. There will be – when, is not clear - new action at a national and local level to ensure ‘an effective universal approach’ to preventing drug misuse. As an afterthought the letter says existing evidence-based programmes at home and abroad will be monitored, the evidence shared and future substance misuse and crime initiatives identified. If it sounds like waffle, it is.
A smarter, adapted, approach is promised to restrict the supply of drugs. Consignment targeting capability will be made more effective in the hope of spotting drugs entering the country. Somewhere, there will be a new intelligence unit dedicated to tackling the criminal use of the darknet. There is no mention of cost or likely benefits.
The Minister appreciates the proactive role the ACMD has taken to establish how to best advise under the new Psychoactive Substances Act and the Misuse of Drugs Act (1971) in future. The Government’s position, she says, on the role of the two Acts is clear and ‘as such this will not be a focus of the strategy’. The meaning is obscure, not clear, but she seems to be telling the ACMD to mind its own business.
Moving on to the third pillar, recovery, the government recognises that ‘we need to go further to drive progress in this challenging area...’. There is no mention of driving round to the Treasury to get some more money. But ‘wider recovery capital’ may come to our assistance: ‘We recognise....it is right that services are aligned in responding to wider health needs and the wider recovery capital that is integral to achieving and sustaining recovery’. ‘New, jointly owned, outcome measures’ will spur ‘joined-up commissioning’. Clients of cash-strapped services may be forgiven for their scepticism.
There is time for to convene a committee. A new board, chaired by the Home Secretary herself, will drive action ... and support local areas in the challenge of aligning services. How, is not explained.
In response to well-evidenced concerns about the damaging impact on drugs services of frequent re-tendering, not least the loss of expertise, the Strategy will, according to the Minister, promote a fully-trained workforce through ‘working with the Royal Colleges and other bodies’ to produce guidance...and ‘work with Health Education England’ to ensure the development and retention of the workforce. This is a vacuous thing to say in the face of the current crisis, in which lives are being lost because services are being closed. It sounds like passing the buck.
Finally, introducing the new pillar, Global Action, the Minister says it seeks to promote a balanced approach. The government is committed to learn from others (although not, heaven forbid, those jurisdictions which have de-criminalised possession of drugs). Somehow this balanced approach will reduce the global supply and demand for drugs, which will in turn help minimise drug harms at home. It is a tellingly short paragraph.
The letter runs out of steam with some special pleading about research and monitoring. It claims, some might argue disingenuously, that local areas and providers have the responsibility to implement evidence-based interventions for drug ‘misuse’. There is, of course, no mention of practical interventions advocated by the ACMD to tackle the rising number of overdose deaths. The Minister concludes with another doff of the cap to those old favourites, ‘challenges ahead’ and ‘new opportunities’ to embrace.
There is precious little tangible evidence in the seven pages of the Minister’s letter, other than of someone murdering the English language with what the Civil Service calls boilerplate: cliché and jargon. The ACMD deserve better. So do all the people suffering, in some cases losing their lives unnecessarily, because of the utter inadequacy of this rehashed, failing, strategy.
Author: Roger Golland, Chair of Transform Drug Policy Foundation