KFx Drugs Blog

Getting needled #1

2011-11-10T21:12:00.001Z

How much needle exchange equipment is wasted? I don’t mean how much ends up not getting returned. That’s an issue I want to return to at a later date. But how much of it gets discarded unused?

This has been an issue since the early days of pre-packaged equipment. I remember when, long ago in the West End of London we moved from pick-and mix equipment to prepacked bags of 10 needles/syringes one of the big discards wasn’t used equipment but large amounts of unused equipment. People wanted one or two needles, we insisted on giving them ten needles and so, predictably, most of the equipment was chucked away, unused.

Anecdotal information suggests that this situation has not get better and, in some areas, has got much worse. Discussions and training sessions with housing organisations and community wardens has, in some areas, raised the issue of larger quantities of unused equipment being discarded. This has included virtually complete needle exchange packs, suggesting users only wanted one or two syringes and on other occasions discarded spoons.

As the range of needle exchange equipment has increased, with the advent of (for example, sterile spoons) and more distribution takes place with prepackaged equipment from pharmacies so, the risk is more equipment gets discarded unused.

The rationale for such bundling is to reduce cost – bulk purchasing reduces costs and prepackaging makes distribution faster. In theory giving out more equipment in bigger bundles should be a winning situation: less episodes of exchange reduces the burden on pharmacies, should mean each episode can be more intensive, and by giving more equipment out should reduce episodes of sharing or reuse. But has this happened in practice?

In one area for example the package size is 20 syringes per bundle with associated paraphernalia. It makes for a fairly large and obvious package – not discrete. And anecdotal feedback suggests that it is not uncommon for significant amounts of these packs to be discarded unused.

We don’t know how much equipment is discarded unused. It might be things that the person simply never wanted – such a person who didn’t want to use the provided sterile spoons. It might excess be excess syringes when the person, for whatever reasons, didn’t want all twenty, just one or two for use today. Or it could be the “other” needles – the twenty orange 25G needles that the person didn’t need because they were using the 23G blue needles in the same pack. They had to be provided together as a compromise necessitated by prepackaging equipment, in the knowledge that one lot of needles will be surplus and discarded unused.

Without knowing how much equipment is being discarded unused, we can’t start to put a price on it. This is bad enough. Worse, without a clear picture of how much equipment is distributed but not used, we risk working under the false impression that we are getting more equipment out to injectors and that it is being used. So we may end up looking at the headline figures – how much equipment is going out – where this figure has gone up, assume that our injectors are getting more clean equipment.

In the statistics for one area that I was looking at, the quantity of injecting equipment distributed almost doubled in the period from last year to this. We know in the same period that the number of injectors hadn’t gone up. In fact it had gone down. So the doubling in quantity of injecting equipment distributed should mean that the reuse or sharing of equipment would halve, which would be a great outcome. The fear though should be that a significant proportion of this additional equipment distributed is not being used, but discarded.

Perhaps the reason for the doubling of the distribution is in part because of large pre-packaged bags.

Across the same time frame in South Wales, pack sizes reduced instead of increasing (from ten needles per pack to three.) And while the number of packs distributed increased by around 30% the net result was an overall reduction of the number of needles distributed. Did this mean that the level of sharing and reduce increased? Or did it result in a reduction in wasted equipment?

We need to know the answers for two key reasons:

We can’t start to accurately assess the extent to which distribution meets need, if we can’t say with any confidence what proportion of distributed equipment is actually being used;
We could be wasting significant resources if we are distributing equipment which is being discarded unused.

There are several things we can do to try and better understand and address this issue.

The first requires some detailed research. There is a huge information gap that needs to be overcome. In many needle exchange areas the return rate is low, coming in below 50%. But at the same time the level of public discards is (mercifully) very low. This makes it very difficult to assess whether non-returned equipment is being discarded used or unused. We don’t know where it is going. Domestic waste? Building up at home? Public bins? Not known. And this isn’t the key question to be honest. It just means that it makes it harder to assess how much equipment is being discarded unused.

The only reliable way of eliciting this information will be research with needle exchange customers to assess what proportion of collected equipment is used, and what proportion is discarded, unused. Such research should ideally be cross-correlated against model of needle exchange, and type of equipment. Does large pre-packaging, for example increase the amount of unused equipment discarded. Is there less discarding with pick and mix?

A less reliable, but useful interim measure will be more accurate monitoring of drug litter and discards to ensure that all such monitoring differentiates between used and unused equipment. While some areas do this it is not universal, and to do so would help monitor trends over time and the impact that changes in provision have on discards.

If research shows up high levels of equipment is discarded unused, it will highlight the need for changes in practice and policy to reduce this senseless waste. But in the meantime some measures can be taken to maximize the chances that equipment taken from exchanges is used, and not discarded unused:

Maximizing pick and mix distribution to ensure people can take as little equipment (or as much) as they want
Avoiding prepackaged equipment exclusively in large quantities
Ensuring that local policing policy and practice does not discourage people carrying quantities of clean equipment
Ensuring that policies in hostels and supported housing is supportive of injectors storing clean injecting equipment on site
Provision of suitable bags to carry injecting equipment discretely (such as backpacks) rather than pharmacy carrier bags
Provision for homeless injectors and those for whom carrying large quantities is impractical – including distribution of small quantities of equipment with suitable means of disposal.
Raising awareness amongst injectors of the cost of equipment distribution with a view to reducing avoidable waste.

dope hyper inflation

2011-09-16T09:16:00.000+01:00

Just over a year ago, I wrote about the wide variance in the value ascribed to cannabis plants during court proceedings. In the article the range of cited values was from £150 - 800 a plant.

So a piece in the Sheffield Star caught my eye as it highlighted that the values ascribed to cannabis had increased massively - with a meagre haul of five plants valued at £9050 - a staggering value of more than £1800 being ascribed to each plant.

It's just as well that the values placed on cannabis aren't included in the RPI because we'd then see inflation heading towards the 10% mark in no time.

Publish Post

Is your Drugs Policy fit for purpose?

2011-03-21T18:55:00.000Z

I've been doing a lot of work lately reviewing organisation drugs policies. Some of these have been big organisations, some small. But a clear issue to emerge is the difficulty organisations still seem to be having in writing their Drugs Policies and the accompanying procedures.
The problems seem to fall in to three main groups:

1: No policy: I remain astonished that so many organisations still don't have drugs policies at all. It's almost fifteen years now since the Wintercomfort trial which saw senior Day Centre staff in Cambridge prosecuted for offences under the Misuse of Drugs Act, and this case should have ensured that every organisation engaging with people who use controlled drugs would have a workable policy in place. But this isn't the case. And the worst offenders? Local Authorities! On numerous training sessions, the social housing providers and day centres tend to have a drugs policy, but the Local Authority staff don't. All too often, the explanation is that the Local Authority has a "zero tolerance" approach to drugs and this is meant to form the basis of the drugs policy. Which leads on to...

2: Unworkable policy: where policy is in place, all too often it is so keen to demonstrate its anti-drug credentials, that it introduces unworkable clauses that are wholly unrealistic. These policies, if implemented, would see Police being called out for any suspicion of drug activity, and empty buildings where transgressors had been evicted. In truth such policies are never adhered to, leaving a void of confusion where staff, managers and residents interpret their policies as they see fit.

3: Mismatched Policies: sometimes, the policy itself is fine - but is at odds with the organisation's stated aims. All too often an organisation which should be working in an accessible and flexible way with homeless drug users has a robsutly zero tolerance policy which drives drug use underground or sees people being evicted - the very people the organisation is seeking to house.

The problems organisations have with their drugs policies are going to be compounded at present by the financial climate and funding cuts. To provide safe, supportive housing in an average sized hostel with people with significant drug related need, higer staffing levels are essential. Realistically three members of staff should be on shift at all times - less than this makes it hard to manage a crisis safely. One member of staff to tend casualty, one to go and summon help and admit emergency services and one to ensure that the rest of the building and residents are safe. Less than this is an accident waiting to happen. And "less than this" will increasingly become the norm.

Low staffing levels are likely to be worsened by under-trained staff. As budgets are slashed,. so is staff training and so organisations are likely to reduce the amount and quality of staff training which leaves both staff and residents at risk.

This is all happening at a time where, as part of the BS (Big Society, but interpret as you see fit), we are likely to see more wholly-volunteer run provision for the growing homeless population - including drop-in provision and nightshelters. While such provision my represent a much-needed response in areas of high need and low provision it brings its own risks. The well-meaning, but undertrained and under-resourced provision can become unsafe. Again, it is imperative that such provisionhas suitable training and policy in place so that it can run both safely and lawfully. The spectre of Wintercomfort hangs over provision that fails to do so.

There is one more factor that may drive some organisations towards ill-considered and mismatched policies. This is the increasingly common elision of "recovery" and "abstinence" and the proposal in the new Government drug strategy that housing provision for drug users should, along with treatment providers, increasingly receive payment by results.

The need for suitable and stable housing, with appropriate support, represents a critical aspect of the recovery journey. A lack of housing, or the wrong housing can make it much harder for people to start and sustain the process of change. BUT, and it's a big but, refusing housing to people who are not yet abstinent, or returning people to homelessness when they lapse is not beneficial.

Let's be clear: there is a need for housing which is wholly drug free and has minimal tolerance to drugs. This housing is urgently needed for people who are in recovery and abstinent and are striving to remain so. In such cases a minimal tolerance drugs policy would be wholly in accordance with the organisations aims. But where the primary aim is to provide housing to people who are homeless, and who may also use drugs, such a policy is misplaced. Organisations can and should support and nurture and aspire to the prospect of change and as this happens move people in to appropriate housing. But to use the threat of eviction to stimulate the process of changed hasn't been demonstrated to work. It just drives use underground, increases overdoses and hampers honest dialogue regarding use.

Given all these challenges and problems besetting housing providers working with drug users, it seems an opportune moment for us to relaunch the Sample Drugs Policy - a document that was originally written after the Wintercomfort Trial and has been revised regularly since then. This version - the seventh - is substantially rewritten with a longer introduction about how to develop a drugs policy. There are some more extensive procedures and flowcharts to help understand how to implement policy.

This version of the Policy is unashamedly a "high tolerance" model, aimed at organisations working with ongoing users. It will shortly be joined by other models - a moderate tolerance, low tolerance, and minimal tolerance version for use in different settings.

The development of this version has been much assisted by Homeless Link, and by Stoke On Trent Supporting People, without whom this revision wouldn't have seen the light of day.

The Sample Drugs Policy 2011 can be downloaded here

Give me your tired, your poor, your huddled masses: just not in Westminster

2011-03-20T17:30:00.001Z

Throughout mythology and folk tales, a tried and tested method for Gods and Kings to test the state of their kingdom was to don the rags of a beggar and walk the streets to see if the great and the good were indeed so great or good.

Were a latter-day deity or monarch to pitch up in Westminster, then far from hoping to get fed and tended, they may well in the future fall foul of a Council by-law which would make it an offence to give food to the hungry or for the tired or sick to lie down.

Similarly, if the sermon on the mount were relocated outside Westminster Cathedral, the redistribution of fishes and bread would be a fine on conviction.

It would be hard to miss the proposals from Westminster City Council to criminalise the distribution of food and lieing down or sleeping in an area of Westminster.

The Council's website describes this as a move "backed by Homeless Charities" and the text on the website focusses on the issue of Soup Runs, asserting that the soup runs turn the area "into a no-go area for many residents and businesses with issues around litter, urination, violence and disorder."

Few people would disagree that there has been a long-standing need to ensure that any agencies distributing free food are well co-ordinated and take responsibility for ensuring that mess is cleared up afterwards. This concern is nothing new and the same discussions were taking place back as far as the early 90s when Homeless Network attempted to provide some coordination amongst the soup-run providers.

But the proposals from Westminster Council go far beyond criminalising the distribution of food. They prohibit lieing down or sleeping in the public places covered by the order - making it an offence to "lie down or sleep in or on any public place."

If the legislation is passed - and at present it is only the subject of consultation - anyone distributing refreshment or lieing down in the designated area would comit an offence and could be fined.

When the Council asserts that this move is "backed by Homeless Charities" it is hard to find a queue of them supporting the measure. St Mungos for example fall far short of backing the measure and instead state that they do not support the proposed ban on rough sleeping.

The main cheerleader for the measure in the voluntary sector seems to be Thamesreach whose Chief Executive Jeremy Swain is quoted on the Westminster Council website as saying:
"The Westminster cathedral piazza and surrounding area has been the focus for soup run activity and rough sleeping for many years and this has inevitably had a detrimental impact on the lives of people living and working in the immediate vicinity.
“It is reasonable that the council should seek to introduce a bye-law covering this specific area whilst at the same time continuing to commit resources towards ending rough sleeping in the borough."

It is not clear from this statement if Mr. Swain is endorsing both the criminalisation of soup runs and the further criminalisation of rough sleeping. So far he has not deigned to cover the issue in his Blog. In the Guardian he is quoted as defending the proposal, but with the caveat "This is not a borough-wide ban, which I would oppose." We look forward to Mr Swain joining the protests when such a borough-wide extension takes place as it surely will if this initial bye-law is passed.

Nor is it entirely clear how fining people who sleep rough helps anyone. Unable to pay fines, people will be required to beg more or face short prison sentences for unpaid fines - which will simply eat in to Police and court time and increase the isolation and stigma faced by people who are homeless or vulnerably housed.

But in truth there are others whose stated stance (or lack thereof) in relation to this legislation is more craven. Of these the most notable must be Westminster Cathedral. The deafening silence from this quarter, other than to lament:
"Of those homeless people who congregate in the area, there is a minority of hard drinkers and drug takers who cause residents and visitors distress, which I have witnessed and been told about," a Westminster cathedral representative told the council. "During the day they can often be seen in groups of up to 15, and this can dramatically increase in the evenings with the soup runs."

Given such an abandonment of the poor and huddled masses of South Westminster, it is hard to read the Westminster Cathedral website without astonishment at the hypocrisy therein.

In the news section, Father Witon happily burbles:
"CAFOD believes that all human beings have a right to dignity and respect, and that the world's resources are a gift to be shared equally by all men and women, whatever their race, nationality or religion”.
One of the saints said: “the best place to keep your money safe is in the stomachs of the poor”. It is in this spirit that we are all invited to be generous with those who can never say that they have too much on their plate ."

Clearly this sentiment doesn't extend to the poor of South Westminster.

This is perhaps where localism and the Big Society have their first head-on clash: the Big Society expects people to give their time and their energy to take on rolls which the state is increasingly unable or unwilling to fund - like care of the poor and the homeless. But on a local basis residents and businesses want to see action against the same poor and the homeless. And it seems that when it comes to South Westminster, localism trumps Big Society.

In truth the legislation as it currently stands is probably unworkable - and certainly would end up being enforced in a partial and selective manner. There are some exemptions proposed in the legislation: so for example sporting events would be exempt, which will be a relief to marathon runners. And while it will be an offence to give people who are starving food, it will remain acceptable to give out promotional nibbles to encourage people to eat in local premises. Heaven's forbid local businesses should be further inconvenienced! But in the event of a Police kettling operation, they wouldn't be able to give out water to people. And as an aside, the right to peaceful protest would be curtailed by this legislation as lieing down - as a form of protest for example - would be illegal under this legislation.

But beyond these legal concerns and the attitudes of Jeremy Swain and The Westminster Cathedral there is a bigger issue here - and that is the ongoing and accelerated cleansing of the poor and homeless from the streets of the Capital. A process that has included the introduction of ASBOs, the hosing down of rough sleepers and sleeping spots by Council street cleaners, the deliberate under-counting strategies endorsed by the Rough Sleepers Unit and now culminating in a proposal to make such the act of sleeping rough an offence.

The idea that this will be restricted to one area of Westminster seems naive. Should this piece of legislation be successful, then a rapid extension across Westminster is inevitable. And then, in the run up to the Olympics, seeing am extension to other London Boroughs as the City is cleansed for the marketing jamboree of the Olympics. Westminster proposes, Boris disposes and streets cleared of "huddled masses" for a tourist-friendly Olympics.

Consultation on the proposed legislation closes on the 25th March 2011.

Bulletins from the front: deep cuts, unplanned cuts, malicious cuts?

2011-02-14T20:44:00.000Z

Services being cut…the vulnerable becoming yet more vulnerable…..those who work in public services nervously eyeing the post for the ‘your job is at risk’ notification. Oh, and one public toilet in Manchester. We live in times of concern, worry and uncertainty – well, we do if we are concerned with the welfare of others.

But we knew this was coming; the swing away from investing in the population was going to come at some point (I still haven’t made my mind up if all that spending was ok, being as it came at the apparent cost of letting the City do whatever it pretty much fancied for over a decade).

The decisions and beliefs lieing behind the reductions in public spending are surely more ideological than practical, despite the protestations to the contrary. I can live with that. Some of us have seen the swing from investment in the population, via increases in spend on hospitals, schools, housing – well, social housing services if not bricks and mortar – and the swing back to cuts, cuts, cuts. What does appall me is the subsequent response from the public sector itself.

Working in the world of Supporting People I’ve seen the budget swell larger each year – until this year, with massive cuts apparently required, a series of reductions now have to be made. From the apparent top to bottom of the local government I can see in action the rationale behind what goes and what stays is and, ….well, frankly, the playground can see more sophisticated decision making processes.

We have a reduction in the number of staff in the team – but is this based on any kind of reasoned approach, a setting of priorities for the programme that needs a particular set of individuals with the right skills, expertise and knowledge to make the best use of limited resources?

Guessing you know the answer to that. No, of course not. The whole element of measuring service quality, the staff that actually have contact with the people who use services and those who work every day in those services – looks like its going to be gone baby, gone.

We’ll still be counting numbers though. We’ll be able to tell you how many,and where. Just not what’s actually going on for people, whether the service is actually making a difference or, worse, whether the service is safe or not.

It just gets better. In my naïve reasonings (hah!), I had considered that a thoughtful and planned approach to cutting Housing Support Services would be adopted, with thought about which service for which individuals would have the most consequences if they were reduced – or, in many floating support services in our County, gone altogether.

But again – no. Actually cuts are being made with no rationale and reason. Except that sometimes it seems to take the form of malice. A sense of old scores being settled prevails at times. And I am all too aware that any discussion about the people living in these services, those who are being supported in situations where there is no other support available – there is no thought for them, none that I have seen. I just see a ruthlessness by some to keep their own jobs intact, at any cost. This isn’t what I came in for.

Reporting in - News from the South West

2011-02-08T21:49:00.002Z

I have maintained radio silence for the last couple of months watching how things unravel, but now it is time to break cover.

Between now and the end of February councils will be setting their budgets for next year and then we will have a much better idea of the fate in store for some of the most vulnerable members of our society.

It seems that unitary authorities are being as short sighted as the executive councils when it comes to removing the funding for a whole swathe of services which currently provide a safety net for those people with multiple vulnerabilities, none of which hit a threshold for a statutory service. Admittedly a lot of the statutory services are being cut too probably by setting the priority criteria even higher.

A colleague of mine who works for a district housing department bemoaned that it is as if this government have decided on a full on attack on housing;

The grant given to Housing Associations to build new social and affordable housing has been completely cut, but they are still supposed to deliver new housing stock, how? by taking out loans - but how will they repay the loan I hear you ask - through the rent they charge. "affordable" rent = 80% of the market rent, social rent can be whatever (interestingly, I saw a bedsit for rent from a housing association for £103. per week today how affordable is that!!).

The bottom line is with loans to repay the Housing Associations are going to take less risks on who they give a tenancy to; the young and upwardly mobile for "affordable" housing or those on 100% benefit (social housing).

Already the place of last resort social housing will become the sole residence for the sick, unemployable and the dispossessed with that social calamity of the sink estate making an unwelcome reappearance.

Changes to housing benefit will shut yet another escape route for those trying to dig themselves out of the poverty hole. Changes to the Local Housing Allowance will mean that those receiving Housing benefit will only be able to afford property with a market rent that falls in to the lowest 30% (so that will be all the crap accommodation then). but if you are under 35 and single then you will only qualify for the rent for a single room in a shared house.

All is not doom and gloom. If there is a will there is a way.

In the face of cuts to the Supporting People budget Exeter City Council are looking at innovative and cost effective ways to maintain some housing in the city for non priority homeless. The STAR scheme which has been running for 2 years can offer a temporary flat to someone rough sleeping giving them among other things a reference for a rent deposit scheme. This scheme uses part of the housing act which says a council can house someone without accepting a duty toward them, it counts as temporary accommodation so the council can claim top rate housing benefit and the excess is then used to buy in a bit of floating support. Any local authority could do this even if they don't own their housing stock.

I guess what I am trying to say is things are bad, the outlook for the year ahead is grim, but there are ways to keep on ensuring that there is some support available for those people who traditionally slip through the net and we have to keep trying.
The time for moaning is over, the time for action is now

Over and out.

Omissions, Contradictions, and Confusion: The 2010 Government Drug Strategy reviewed

2011-01-10T16:15:00.004Z

“Gone are the days,” reads the introduction of the new drug strategy “when central Government tells communities and the public what to do.” (p2). Yet a mere seven pages later the Government does exactly that, saying “People should not start taking drugs and those who do should stop.” (p9).

Such contradictions are a recurring theme within the 2010 Government Drug Strategy. Given such contradictions and the serious omissions within the Strategy, it’s a shame that the Strategy received such an uncritical response from the drugs field. The sense of agencies keen in a time of austerity to make nice rather than challenging the Strategy was palpable.

Vanishing Harm Reduction: In a Stalinesque linguistic purge, the terms “harm reduction,” “risk reduction” or “reducing harm” have been wholly expunged from the Strategy. I wonder to what extent this wanton abandonment of the term “harm reduction” is as much a rejection of the terminology of the previous drug strategies as an ideological rejection of harm reduction by the current Government. But whatever the rationale there is precious little space within the Strategy for pragmatic harm reduction with on-going users. The approaches are supply and demand reduction to prevent use, and abstinence-focussed treatment to end dependent use. But between these two poles there is a gaping void where effective harm reduction measures would have sat.

The sole reference to harm minimization is on page 29 where, in somewhat garbled terms the strategy says:
“We will achieve better outcomes for those entering treatment by:…continuing to promote harm minimization measures including needle exchange and drug-assisted treatments that encourage drug users to enter treatment, in order to reduce the risk of overdose for drug users and the risk of infection for the wider community…”

It’s not entirely clear from this wording if “drug assisted treatment” has now been demoted to an intervention “that encourages drug users to enter treatment” rather than being a treatment in its own right. But the overwhelming sense I get from the amount of space and time given to NSP in the document is that it is not considered a priority within the Strategy. The fear must be that this reduction in priority will give commissioners and fund-holders the green light to cut spending on this area to the bone.

Recreational users: Whilst this (limited) acknowledgement of the role of needle exchange is welcome, and the implied retention of overdose-prevention strategies is also welcome, this still leaves a substantial population with their needs wholly unmet: non-problematic, non-dependent users. This group, the largest proportion of people within the drug using population don’t seem to be effectively considered within the drug strategy – certainly not from a harm-reduction point of view.

The Government drugs information service “FRANK,” is presented in the strategy less as a way of making people “aware of the consequences of their actions” and as a way of providing “accurate and reliable information on the effects and harms of drugs…” Whilst it will be a welcome development of Frank succeeds in providing “accurate and reliable information” it seems likely that Frank will be required to become much more partisan – promoting behavior change and stressing risks much more than providing any harm reduction information in literature or on the phone.

This development is certainly in keeping with the expectations of the Centre for Social Justice who demanded reform of Frank saying that this was "imperative if we are to prevent young people from engaging in drug and alcohol abuse so we urgently call for wholesale reform of Talk To Frank and the messaging within it." (ref)

With the Release drugs helpline facing closure, and Frank heading more firmly in a “drugs are dangerous, don’t do them” direction, it becomes harder to see where accurate, pragmatic harm reduction information for the vast majority of recreational users is going to come from.

Power of evidence – or just power? Given that the Conservatives now form part of the coalition Government, it’s interesting to see how the Government’s strategy on drugs has abandoned some of the measures that the Home Affairs Select Committee recommended in 2002. Back then, a more-radical, not-in-power-at-the-moment David Cameron advocated, with the committee, several things, including:

· "We recommend that an evaluated pilot programme of safe injecting houses for heroin users is established without delay and that if...this is successful, the programme is extended across the country"

· We recommend that a target is added to the National Strategy explicitly aimed at harm reduction and public health;

"· We recommend that Section 8 of the Misuse of Drugs Act 1971 is amended to ensure that drugs agencies can conduct harm reduction work and provide safe injecting areas for users without fear of being prosecuted;" (ref)

It is a shame that none of these worthy interventions survived Cameron’s journey from opposition to Prime Minister and that have not featured in the new Strategy.

While these evidence-based interventions have not survived to see inclusion in the Strategy, some interventions which have no evidence base have been included. So for example the strategy exhorts a return to the days of ex-users going in to schools to do prevention work. It has been reframed as “Community Recovery Champions – people who are already in recovery…who will be encouraged to…contribute to prevention in communities and schools.” (p21)

This is a real retrograde step and one for which there is no evidence base of effectiveness.It is effectively a return to the old-days of ex-users telling young people "not to do what I did," but presupposes (I hope) that people in recovery will be slightly more subtle than some of the shock tactics that were used in the past. It was always a useful tool against those who were not going to use anyway, but short of simply rescreening "Better Off Dead" (which was the sum total of my own drugs education at school) the Strategy couldn't be much less use than those already using or inclined towards use.

Contradicted and Confused:

Behind the scenes, when the Strategy was being drafted, there must have been some serious horse-trading going on as various factions tried to get their perspectives incorporated. The Lib-Dems appear to have sacrificed any hope of liberalisation of the drug laws as the price of becoming “coalition prank monkey.” Certainly the Lib-Dem manifesto aim to “ensure that financial resources, and police and court time, are not wasted on the unnecessary prosecution and imprisonment of drug users and addicts” has vanished and instead the Strategy promises that this will be decided locally by Police and Crime Commissioners and that drug possession will appear on Crime Maps. “Drug dealing and drug possession,” the Strategy ominously (and ungrammatically) warns “is a crime.”

The other key area of tension that was played out behind the scenes was the turf war between Ian Duncan Smith who has had a longstanding interest in drugs and wanted to see the DWP take a leading role in drug strategy, and the Home Office with whom drug strategy has typically rested. Others lobbying hard to influence drug strategy was the Centre for Policy Studies the Conservative think-tank where Kathy Gyngell gave the Strategy the most luke-warm of receptions saying “Fair words about recovery are just not enough. Nor is hope of a ‘recovery contagion’ unless many, many more people are paid for to go into abstinence based therapeutic programmes like those run by The Providence Project and the Ley Community, unless methadone prescribing is capped.” (ref)

The manifestation of these tensions is apparent within the strategy, and when the Drug Strategy is considered in context of the wider policy picture, these contradictions and confusion become all the more apparent and concerning.

Contradiction 1: “commitment to an evidence-based approach.”
Page 9 of the strategy affirms that the Government “values the work and the independent advice of the ACMD, which has experts from fields that include science, medicine, law enforcement and social policy. We are committed to both maintaining this expertise and ensuring the ACMD’s membership has the flexibility to respond to the accelerating pace of change.”

These are fine words, but the stated commitment rings hollow when considered alongside clause 150 of the Police Reform Bill (ref) which would remove the obligation to maintain those representatives from medicine from the ACMD.

Contradiction 2: “vulnerable young people”
The strategy highlights that “vulnerable groups – such as those who are truanting or excluded from school” face increased risks in relation to drugs. Reducing school exclusion should therefore be a critical aim of any intervention to support vulnerable young people.

It will be interesting to see how the needs of vulnerable children and the need to reduce school exclusion sits alongside proposed powers discussed on Page 10 of the strategy to “tackle problem behaviour in schools, with wider powers of search and confiscation. We will make it easier for head teachers to take action against pupils who are found to be dealing in drugs…”

The proposed White Paper on Schools, The Importance of Teaching proposes increasing the authority of Heads to exclude, but at the same time increasing their obligation to take responsibility for excluded pupils.

Contradiction 3: “rehabilitiation in a Payback Jacket.”

On the one hand, there is a clear desire stated within the strategy to use community interventions such as Drug Rehabilitation Requirements, to help move people away from dependency and offending. However, this desire is at odds with the Government’s desire to ensure that justice is seen to be done – and so the Strategy proposes “combining drug and alcohol requirements with other sentencing options, such as Community Payback, to make sentences more robust and ensure that punishment is visible to the community.”

Whilst some form of reparation and payback is clearly essential, the priority surely must be to address drug dependency first and foremost. And it is hard to see how a day of highly visible “community payback” in a fluorescent jacket will represent a contribution towards recovery capital.

Contradiction 4: “forensics”

As part of its response to ‘legal highs’ the Strategy says the Government will “improve the forensic analytical capability for new psychoactive substances and will establish an effective forensic early warning system.” (p15)

Such a system would be very welcome indeed – and would be better still if it would also provide early warning of contaminants in heroin and such like. Unfortunately, however, since the Drug Strategy was published, the BBC reported that the UK Forensic Science Service would be wound up from 2012. It is not clear, therefore where a forensic early warning system of the type proposed in the Strategy would come from, and if indeed it can ever happen now. With Forensic analysis shifted to either cash-strapped police forces or private enterprises it is hard to see where the money for such a scheme would come from.

Contradiction 5: “housing need”

The recognition of housing need from page 22 of the Strategy is very welcome, and the report stresses “the importance of providing accommodation for these people.” The importance of Supporting People in this context is noted and the strategy mentions that the Programme will have £6.5 billion investment over the next four years.

What the strategy doesn’t mention is that this money represents a 11.5% reduction in SP money, is not drug-specific and is not ringfenced (ref). So in some areas of the UK we have already seen swingeing cuts to SP funding and provision with budget cuts of 40-50% being announced in some areas and entire services being culled. So the proposal in the strategy and the reality on the ground are substantially at odds.

The Great Unresolved Issue:
At the heart of the Strategy is a commitment to “recovery.” The strategy title includes “building recovery.” But within the addiction field the term “recovery” is argued over and defined in various ways, so within the Strategy too the term “recovery” is subjected to various interpretations and indeed it is hard to find two consecutive sentences where “recovery” has the same meaning in both.

A clue to the Government’s interpretation of “recovery” is the subtitle to the strategy – “supporting people to live a drug free life.” So here the aim of recovery is equated with abstinence.

But the Strategy seems unwilling to commit to this interpretation. On page 18 of the Strategy the ambition is for “individuals to leave treatment free of their drug or alcohol dependence so they can recover fully.” This would mean that the result of treatment is an end to dependence, but not necessarily abstinent. And “recover fully?” Well in the next paragraph this is expanded on with the words “into full recovery and off drugs and alcohol for good. It is only through this permanent change that individuals will cease offending, stop harming themselves and their communities and successfully contribute to society.” [emphasis added].

So within this interpretation, full abstinence is the only solution. Not managed use, controlled use, or substitution. Ironically this interpretation of “recovery” is at odds with many recovery advocates who would argue that abstinence alone does not equate – or even lead to full recovery and the sense of personal and spiritual wholeness is an essential component of true recovery, not mere abstinence.

In the next paragraph, the Strategy offers a different interpretation: “wellbeing, citizenship and freedom from dependence.” So abstinence is not essential here. And a sentence later the definition has shifted again: “it is an individual, person-centred journey, as opposed to an end state, and one that will mean different things to different people.”

So in the space of six lines the Strategy has veered from a position that expounded that the only outcome should be “off drugs and alcohol for good,” and moved to a “person centred journey as opposed to an end state.”

A couple of sentences later the Strategy changes course again and defines an end-state saying “our ultimate goal is to to enable individuals to become free from their dependence.” All crystal clear then except that, a sentence later the ground has shifted again. “Supporting people to live a drug-free life is at the heart of our recovery ambition.”

Such confusion and ambiguity at the heart of the drug strategy should be a cause of huge concern. As we move towards payment by results, the interpretation of a successful result becomes more and more important. Is the successful result complete abstinence? Or is it an end to dependency? These are not the same and, if the past is anything to go by, can become the source of huge controversy.

Certainly in her ongoing battle against the NTA, Deirdre Boyd of Addiction Today has repeatedly argued for abstinence as a core feature of recovery and so is unlikely to settle for less as a “success” for the new strategy.

Recovered enough to work? The definition applied to “recovery” is not, however, merely of ideological importance or for providers who will be paid by results.

It is also critically important in terms of eligibility to benefits and readiness for work. So, for example, on page 23 of the strategy, the document says “we will offer claimants who are dependent on drugs or alcohol a choice between rigorous enforcement of the normal conditions and sanctions where they are not engaged in structured recovery activity, or building appropriately tailored conditionality for those that are.” [emphasis added]

There are two phrases here to which are hard to decipher. “Structured recovery activity” is a loaded phrase. It hinges in part on what interpretation is being applied to “recovery.” And the idea of “structured activity” begs the question “what activity?” and “whose structure?” It suggests that someone who is starting to engage in recovery-oriented interventions (such as, for example, starting to attend a self-help group on a sporadic basis) would not be involved in “structured recovery activity” and so would be subject to “rigorous enforcement of normal…sanctions.” But if the definition of “recovery” is not defined, then how can job centre staff be clear if a claimant is involved in “structured activity?” Elsewhere it is accepted that substitute prescribing is both an aspect of recovery and structured. So would this measure mean that someone was engaged in “structured recovery activity?” Given that on such questions a person’s receipt of benefit and in turn things like housing may hinge, it is a critical question.

It seems inevitably that, without very explicit clarification for job-centre staff here, claimants will be exposed to local and arbitrary interpretation of what level of compliance is required – meaning that people engaged in the “wrong” kind of recovery, or taking too long to recover in the “right” way will be removed from the benefit system.

Challenge Now!

So that’s our muddled, contradictory, drugs strategy. Maybe it’s no bad thing. Maybe the fact that it is in a state of flux – even though it has now been published – means that it is more malleable and can be more easily challenged, refined, adjusted and improved. Because at the moment it is contradictory, muddled and confused. It is more of an optimistic wish list – where the Government wished to get to, rather than a map of how to get there. But it will require a great deal more critical analysis rather than the warm words of endorsement from the field if the Strategy is to resolve the issues that are currently unresolved.

Council Cuts Cornwall

2010-12-23T14:18:00.001Z

Reports in the media suggest that at Cornwall Councils emergency budget meeting, today, the Supporting People budget could be cut by £5.6m - around 40% of their budget. The Government have cut the grant to the Council by a much smaller 12%.

Regardless of the reports and today's meeting, it has already been decided that there will be no more funding for the Floating Support service provided accross Cornwall by Stonham Housing after 31st march. Thats a quick saving of £3m, about 100 redundancies and huge numbers of vulnerable clients left without vital support to enable them to maintain their tennancies.

No other services do this same job in Cornwall, and being surrounded on three sides by the sea, there are no similar services in neighbouring areas.

The client group is wide ranging but includes drug users. The Government's Drug Stategy acknowledges the important role Supporting People services play with this group, but this important Floating Support service can be wiped out locally in one hit.

Its clear that this quick saving will be a short term gain to the local authority and will probably cost them (or the tax payer) dearly over time, and cost other services like the NHS etc..

Other Supporting People services have yet to decided on but face 're-stucturing' at best.

Things seem to go from bad to worse and can't even be entirely blamed on our new coalition government!

If you are running winter provision for the Homeless - assess for overdose risk

2010-12-15T21:11:00.000Z

It's going to be a very cold winter and, mercifully, emergency cold weather provision will be opened up around the UK to provide much needed respite for people who are homeless this winter. Such provision is, of course, a life saving intervention and is often provided on a shoe-string by voluntary organisations and faith-groups.

In order to make the provision still more safe and life-preserving, organisers should be able to assess and respond to people who are at risk of overdose. Early identification of people at risk, and intervening with education, support and staff awareness can help reduce the incidence of overdose, and reduce the risk of fatality in the event of overdose.

To assist this process, KFx developed the Housing Opiate Overdose Risk Assessment Tool (HOORAT). It is a simple assessment tool which can be completed with a resident to assess level of opiate-related overdose risk. The tool was originally developed a couple of years ago. Thanks to the support of Homelesslink it has been slightly ammended and the supporting notes have been expanded to make it more self-explanatory. It is being jointly promoted by KFx and Homelesslink as part of their Evictions and Abandonments project.

The tool will take less than five minutes to administer and can help identify residents most at risk of overdose. The document explores strategies for reducing this risk and how housing providers can ensure that they have interventions in place to address this risk.

HOORAT can be downloaded free of charge from the KFx-run Drugs and Housing Website

Why the Release Helpline is still essential!

2010-11-28T14:27:00.001Z

It's depressing news that the Release helpline is facing a funding crisis and faces closure imminently if funding can't be secured.

It can't really be stressed how unique and essential the Release Helpline is. From an outside perspective, Government and funders may well think that the Release helpline is no longer required due to the presence of Frank, the Government-funded helpline. But in practice, Frank is only able to provide a superficial service, skimming across the top of key issues and providing a basic level of information to children and young people. Anyone requiring anything more complex needs to be referred - and all too often the Frank helpline operator will redirect the person to Release.

Frank has been a huge money-pit. Between 2006 and 2008 Frank blew more than £3.5m in advertising alone - more than Release's income for the entire period 2005 through 2009. And it is an ongoing scandal that the rebranded service has had so much money lavished on it and yet cannot deliver a proper telephone help service for drug users. In a situation where the state-funded drugs helpline is unable to manage complex calls, and indeed acknowledges this by referring such calls, it seems only fair that proportion of the money lavished on it are diverted to fund helplines capable of delivering such work.

Sadly, this situation is not new, and while it is to be hoped Frank's funding and running will be reviewed, any such review is likely to come too late for the Release helpline.

In the months and years to come, the Release helpline will be needed more than any time since its inception in the late Sixties. Changes to prescribing practice are likely to see patients on opiate substitutes having to fight for treatment, especially as time-limits on prescribing become more wideplace and prescribers become more rigid in relation to use on top. Changes to welfare rules and housing strategy will also see more drug users seeking help as they encounter benefit or housing problems. While local services such as CAB offer an indispensable service (but are themselves terribly over stretched) callers desperately need a service that understands drugs,treatment, law, housing, benefits, employment and is able to access this service for free and by phone.

Release has had a number of funding scares and but this one, coming as it does at a time of increased need and huge austerity is the worst for a long time. It is imperative that the Helpline survives this crisis.

Support Release here

Dopey Journalism # 1: The Price of A Plant

2010-11-14T14:26:00.000Z

There's been a lot of cannabis "factory" raids of late which has given journalists and the police the chance to go wild with their estimates of the relative value of the crops seized:

So for example the Belfast Telegraph reported a raid in which sixty plants were seized: stated value: £30,000 or £500/plant.

This figure is presumably based on each plant producing a notional 5oz per plant, with a (cheap) street value of £100/oz
Compare this, though, the a reported raid in Essex, reported in the Mirror: 8,000 plants seized with a stated value of £2m. So the value of these plants has dropped to a mere £250/plant. In nearby Cambridge, 1,300 plants were reported to have a street value of £750,000 or almost £600/plant according to the BBC.

In Liverpool, the media stated the value of plants at almost three times this; the Liverpool Daily Post cited the value of 275 seized cannabis plants at an amazing £223,000 - or £810/plant.

It's fortunate then that the same valuation wasn't applied to a Wolverhampton man reported in the Stourbridge News (in a piece of journalism which is odious in its own right) who had two plants in a wardrobe with a reported value of £300.

So from £150/plant up to £800/plant, it seems that dopey hacks will report any figure given to them by the Police. But in turn the risk is that the courts will be equally credulous of inflated figures.

If you spot a reported figure for a plant of higher than £800/plant let us know!

Ashes to Ashes

2010-11-02T21:28:00.004Z

I am sure that I am not the only person who suspects that they have been involved in some horrific accident and have somehow woken up in the 1980's just like that programme on the TV. I constantly have to scan for modern cultural references to reassure myself. Only the other week when I was confronted with a picture of La Snatch - aka Maggie Thatcher milk snatcher (ask your parents) on the front page of a newspaper I thought; 'It's ok I am in a Cafe Nero - we didn't have coffee shop chains in the 80's'.

But seriously we are hurtling back to the values and attitudes of that decade; the 'rolling back of the state' with the most vulnerable in society being cast out, where not for profit is is being replaced by run for profit.

My most immediate concern is for those people who are currently rough sleeping and those being supported either in hostel accommodation or self contained via Supporting People money.

For those of you who don't know Supporting People funds all supported accommodation to a number of vulnerable groups; Learning Difficulties, Physical & Sensory Disabled, Mental Health, Older People and Homelessness, which in itself encompasses offenders, substance misuse etc.

Supporting People was comprised by amalgamating a lot of disparate streams of funding in to one central pot to be administered by the Local Authority and this pot of money was ring - fenced.

There had always been a bit of tension as being in a 2 tier authority area the county council controlled the pot of money, but despite this a lot of good work was done especially in improving access to a range of accommodation options for drug users at all stages of their recovery, including actively using. (Of course all this was helped by the great resource that is the KFX Housing and Drugs Website sample drugs policies and other materials, but I digress).

Last year the ring fence was removed, but the grant was protected albeit a 10% cut. This coming year the grant will not be protected and will make up part of the Area Based Grant. Therefore we always knew that we were in for a rocky ride especially as the county council were proposing a move away from block contract agreements with accommodation/ support providers to 'variable volume contracts' (Newspeak for Spot Contracts). However this was always discussed as an incremental change and there was an understanding that some providers would still need an element of a block contract. Indeed there were proposals for some joint commissioning between SP the DAAT Probation and Mental Health, change was in the air but there were proposals to manage it.

Meanwhile in the background, trouble was looming; 2008 had seen a change in administration at the County Council with the Tories taking overall control. At first, nothing much happened; like when a nuclear bomb is dropped - first silence then a blast followed by fallout.

I can't remember the exact order of things but it happened something like this; first the portfolio holder for Adult and Community Services disbanded the Joint Commissioning Body (made up of representatives of the District Councils and Partner Agencies such as the DAAT, Probation etc), he also disbanded the next tier down. Then all work-streams were cancelled such as the review of Women's Hostels. Money pledged from an underspend to support accredited training in complex needs and work with Rough Sleepers was withdrawn without any notice or discussion. The proposed JSNA for Homelessness was also postponed.

Next we were informed that Supporting People would cease to exist after March 2011. The monies would be subsumed into Adult Social Care and a framework agreement and Pathway would be set up. No discussion. No debate.

The problem with SP being controlled by County Council is that, of course they have no statutory duty towards preventing or dealing with homelessness, that is the duty of district councils, so once the ring- fence is off there is absolutely no onus upon them to spend it on what was intended. Another 'worry' is the money moving into Adult Social Care; anyone who works with people who are homeless know how difficult it is to get adult social care to accept a duty to their clients, especially if (god forbid) they take drugs or are non compliant, indeed social services are often referred to as the 'empty chair' at Multi Agency Meetings.

If the situation wasn't dire enough we then had the General Election and the Con-dems with their attack on the Public Sector. This gave the County Council the excuse to cut (sorry prioritise) 50% of current SP services by March 2011 all this before George Osborne uttered a word on the 20th October. Of course Tory central are saying that they have limited cuts to SP budgets and they are committed to ending rough sleeping BUT THEY HAVEN'T RING FENCED ANY OF THE MONEY!!!!!! so Local Authorities faced with an overall cut of 25% of their budget will spend as they see fit on and guess who will be at the back of the queue, the homeless the already chronically excluded. We can't even offset some of the losses by getting creative with Housing Benefit because they are cutting that as well.

I was told yesterday that the County Councils' 'Corporate Leadership Team'. Will be meeting to discuss budget levels in November and that it will be possible to watch this live on the internet.
Is this an example of local democracy - We have access so that we can passively observe the decisions they will make.

Any way enough for now - next time Framework Agreements - the truth

Penelope P-S

KFx Regional Bloggers

2010-11-02T21:17:00.002Z

As drugs and housing care in the UK looks like it's on a fast rewind to the early eighties, it was clearly time to revert to time honoured approaches to activism. So we have been recruiting regional bloggers to provide news and commentary about relevant regional developments which are having a real effect on the ground.

All the regional bloggers are people who have been approached to take part because of their integrity, passion and belief in the need for high quality interventions for people affected by drugs and/or in housing need.

Our first regional bulletin is going up now.

Knowledge is Power.

6-APB Briefing

2010-10-31T11:33:00.004Z

Although you won’t know it from visiting Frank, Drug Discussion forums and on-line drug retailers have been a-buzz since the Summer, excitedly discussing and promoting the latest “legal high” – 6-APB. As with Mephedrone before it, the lack of reliable and factual information, especially analysis, is once again creating a hugely unsafe environment. This briefing attempts to summarise the current confused situation.
Names:
6-APB is short for 1-benzofuran-6-ylpropan-2-amine or 6-(2-aminopropyl)benzofuran. Unfortunately, due to the drug containing the benzofuran molecular ring, some on-line retailers decided to give it the name benzo-fury. This is confusing as 6-APB is not an benzodiazepine, and shares none of the effects of a benzodiazepine. So the slang name is deeply unhelpful. The more sensible of the drugs discussions forums have tried have some influence here by refusing to use the term ‘benzo fury,’ but despite this it is listed for sale on many sites by this name. There is no relationship between “benzo-fury” and the (currently) unrestricted benzodiazepine phenazepam which is being flogged on some sites. The latter is really a benzo and 6-APB isn't!

There is a molecularly very similar product 6-APDB or 6-(2-Aminopropyl)-2,3-dihydrobenzofuran. This product has been offered for sale by vendors aswell as or instead of 6-APB. In the absence of laboratory analysis it is not possible to say which of these products has been actually sold – or in truth it is either of these products.

Early suggestions are that retailers initially may have believed that they were selling 6-APDB but early forum discussion raised concerns about the legality of 6-APDB and the suggestion that many people experience severe nausea when coming up on 6-APDB. This may have led to the conclusion that marketing 6-APB was an easier proposition.

Routes and Effects:
The very few credible trip reports for 6-APB suggest that the drug is a relatively powerful psychedelic drug causing significant visual distortion. It has been described as more MDA-like than MDMA – so less energetic and more trippy. Users also report MDMA-type effects such as gurning and urine-retention.

It has been snorted and swallowed; some reports suggest that swallowing is more effective. Dose ranges have been at around the 100mg mark.

The available evidence suggests the drug causes elevation of serotonin levels (probably by blocking reuptake) with low levels of impact on nor-adrenaline and dopamine levels.

The early reports indicated effects from 4-6 hours with little urge to redose during or afterwards.

The early users who wrote trip reports were very positive about their experience.

Availability and Supply:
These early reports, dating back to July triggered a significant interest in 6-APB and attention turned to a number of on-line vendors who claimed that they would have the drug in stock shortly, some of whom were taking advanced orders. As has become more common with some of the on-line vendors, some distributed samples, especially to those people who were writing trip-reports or would otherwise promote the drug.

Since then a number of companies have offered to supply a range of products, under the name 6-APB. A quick trawl suggests between 10 and 20 online vendors all offering products of different appearance. It is not clear how many, if any of these contain 6-APB.

User reports of many of the products being sold range from non-active products, through those which have a low level of potency, up to reports of people being sold very long-lasting stimulants with unpleasant side effects. There is little consistency either in terms of the products sold or reported effects.

Appearance of 6-APB:
Early supplies of drugs reported to be 6-APB and used in early trip reports discussed a tan-coloured powder. However, later on this was replaced by an off-white, creamy coloured powder. None of the early reports described a crystalline white powder.

After the initial availability of powder, the products that came to market were either “pellet” form or capsule form. And at this point the supply side and the discussion side both seemed to go in to what can only be described as melt-down.

Discussions, partly it seems fed by vendors, talked about “official” 6-APB supply chain and so a distinction started to emerge between “official -6-APB” and other stuff. It should be stressed at this point that the idea of “official” or “authorized retailers” in the context of any so-called legal high is bogus. There is no quality control or monitoring body. It’s all equally unofficial.

The pellet forms of 6-APB sold in a professionally produced foil bag were orange in colour; some had a chemical, TCP-esque smell. The alleged dose range was 100mg. Pelletised drugs bring a couple of new challenges – they make it harder to take an initial “allergy test” sample to check for bad reactions. And they increase the chances that people will take several pills in a sitting, and thus increase dosing in 100mg increments, increasing the risks of overdose.

Since then a large range of capsules have been marketed and sold as 6-APB. These have included red capsules, blue capsules, translucent capsules, orange ones and so on. The early availability of red and blue capsules and fierce arguments about which were better led to some commentators referencing the Matrix. Either way, the consensus was that the capsules did not contain 6-APB and the actual contents were unknown. There is at least one trip-report of a person who, taking white capsules containing a white powder sold as 6-APB had very negative, long acting effects off it more akin to a strong stimulant than 6-APB.

The bottom line at present has to be the vast majority of compounds being sold as 6-APB do not contain this drug. There is no evidence that any of the capsules being sold contain this drug. The odds are that if you go to an on-line vendor and attempt to buy this drug you will not receive 6-APB.

What is being sold as 6-APB:
Quite simply, we don’t know. A report in August 2010 published in Drug Testing and Analysis titled “Analyses of second-generation ‘legal highs’ in the UK: Initial findings“ analysed a range of products being sold by online retailers and found that the majority contained now-banned compounds such as mephedrone or relatively low-acting stimulants such as caffeine. Unfortunately this research was conducted before the upsurge in sales of 6-APB so these were not analysed.

So we cannot be certain what is in any product being sold as 6-APB including those tested early on and described as more MDMA-esque.

Reducing Harm:
It is difficult to offer harm reduction information when we know so little about what is being sold, or the risks attached to that substance. So harm reduction information needs to be loosely couched to ensure it is relevant not just to the substance allegedly being sold, but also likely substances being sold in its place.
• If using powders swallow rather than snorting;
• If using a new substance take a small amount first. Take a very small amount (e.g. no more than 10mg) as an “allergy test” to check for unexpected adverse reactions; wait at least an hour. If there are no adverse effects use a larger dose if you are still convinced you want to.
• You should use on-line forums to assess the range of doses being sampled and start at the low end of this range. And then half this. So for example if people are using a substance at the 100-150mg range start at 50mg. Wait at least an hour. Then and only then increase dose cautiously and not exceeding the upper dose range.
•Don't use if you are prone to poor mental health, especially depression or psychosis.
• Don’t use on top of other substances including alcohol. Don’t mix with other stimulants or anti-depressants
• Seek medical help if you experience serious unpleasant symptoms.

Legal Status:At present 6-APB is not believed to be covered by the Misuse of Drugs Act 1971. Sale for human consumption would probably put it within the terms of the Medicines Act hence being sold once again labelled as "plant food" or "for technical use." As with MMCAT before this is not a plant food. Some commentators suggest that the decision to sell it in pelletised form (and to call it pellets, not pills) is to further reinforce the illusion that it is a plant food, and not for human consumption.

The situation regarding 6-APDB is more confusing with a number of sources suggesting it may fall under the Misuse of Drugs Act, but in lieu of a ruling from a court or the Home Office this is mere speculation.

It is likely that some of the compounds sold as 6-APB are, in fact, Controlled Drugs, and possession of them will be illegal.

To summarise:
• Compounds sold as 6-APB could contain a range of different chemicals. The one thing you can be reasonably certain of is that it won’t contain 6-APB;
• We do not categorically know that any 6-APB has been sold in the UK at all; early samples could have been any of a range of compounds;
• The products sold as 6-APB may contain hazardous substances which may also be controlled drugs;
• It is possible to be prosecuted for possession of a Controlled Drug even if you bought it believing it to be legal;
• A flashy website does not ensure they sell what they claim to sell; what they claim to sell may not be safe.

Sources for this article include but are not limited to:
Drugs Forum, Bluelight, Partyvibe, Legal Highs Forum
Liverpool John Moore University
Wikipedia
Frank

Training: If you need a workshop or training on new, legal or herbal highs get in touch to discuss our course "Cats Bees and Dragonflies." Can be delivered anywhere in the UK.
To download this blog as a PDF for reproduction and distribution click here www.ixion.demon.co.uk/6apb.pdf

Project Prevention: Beams and Motes

2010-10-24T19:01:00.007+01:00

“We now have such a crisis…that we ought to give active consideration to paying female drug users to take long-term contraception.”

Ah-ha! You think – another diatribe against Project Prevention.

Sections of the drugs support and treatment community have been up in arms as Barbara Harris came to the UK and used her model of cash incentives to promote long-term contraception and sterilisation for drug users.
Nowhere was this state of high dudgeon more apparent than on the pages of the Wired In community where diatribe after diatribe has appeared. Which is ironic as the quote at the top of this article is not from Project Prevention but from the UK’s own Professor Neil McKeganey in an article from the BBC in 2004. And Professor McKeganey is also one of the Advisory Board of Wired In.
Despite the Professor’s apparent support for at least some of the measures promoted by Project Prevention, he doesn’t seem keen to step in to the current fray and defend the idea of incentivised long term contraception to Wired In members or the wider public. Conversely, despite McKeganey’s stated views on the subject, Wired In don’t seem to have any problem with him being on their Advisory Board.

There are of course significant differences between the views espoused by McKeganey and Project Prevention. McKeganey drew the line at long term contraception while Harris goes further and promotes these measures and sterilisation. And to my knowledge McKeganey only promoted measures for women, not for men.

Of course he is not the only person to make such proposals in recent times: a Greenock MSP made suggested adding oral contraceptives to methadone .

The approach and measures suggested by Barbara Harris are odious and the promotion and incentivisation of non-reversible or permanent sterilisation, to a client group ill-equipped to make such a fundamental decision, is ethically and morally repugnant. It is right that her appearance in the UK has attracted such a wide range of condemnation.

But mere condemnation of Project Prevention is not, in itself, an adequate response. We need to look at some of the failings of interventions in the UK which have created fertile ground for the sterilisation policies of Project Prevention. The wider social picture is one where drugs users are demonised and denigrated in the media. Judgemental and stigmatising language is routinely used and the type of language and attitude which is now unacceptable when discussing mental health, ethnicity or sexuality is commonplace when considering drug use.

This stigmatisation helps foster a climate where measures that would be unacceptable if promoted for any other social group become more acceptable when applied to drug users.

The wider social context is important, but beyond this, the issue of contraception and family planning for drug users in chaos is something that does warrant proper and detailed discussion. It is a serious and sensitive subject, and one of the tragedies of the Project Prevention backlash is that it will be harder to have this discussion now without people resorting to end-arguments like “Hitler” and “Eugenics.”

It is also a subject that has been considered before, most sensibly in the 2003 ACMD report Hidden Harm, which advocated:

“Contraceptive services should be provided through specialist drug agencies including methadone clinics and needle exchanges. Preferably these should be linked to specialist family planning services able to advise on and administer long-acting injectable contraceptives, contraceptive coils and implants.”

This is an eminently sensible proposal – and one that most right-thinking people would have little problem with. A “belts and braces” approach – temporary barrier contraception (i.e. condoms) to address the risk of STDs combined with effective long acting contraception seems like a balanced approach provided that it is undertaken with the patient’s informed consent and there is sufficient consideration for follow up and referral and support in to drug treatment.

But we haven’t really done this properly. Too much contraception is delivered in a half-hearted way – a couple of condoms given out with a bag of needles, the basket of condoms in the reception of a drugs project – rather than a proper assessment and contraception care plan.

If this were done, and were done properly then the number of unplanned and unwanted pregnancies amongst drug users in chaos could be addressed. And by doing so we can demonstrate there is no place for the bribed sterilisation of Project Prevention. Just as badly delivered needle exchange or badly executed drugs education helps create a climate which embraces “just say no” or “abstinence” models so a failure to adequately address family planning with drug users creates a climate which is ready for Project Prevention.

So instead of just sending off angry letters about how wrong Project Prevention is (and it is very wrong) it is equally important that the field engages with a sensible discussion about how to ensure that the contraception – effective and reversible – is made accessible to drug users, especially those in chaos.

So This is What a Sucessful Policy on Cannabis Looks Like!

2010-08-25T15:58:00.004+01:00

The ACPO report on Cannabis Policing "Three Years On" makes depressing reading. It looks at the way that the UK cultivation of cannabis has changed over the past three years and should represent compulsory reading for anyone who believes that the prohibition of cannabis has been a success. These developments over the past three years, considered alongside the developments over the past thirty plus years, highlight just what a disaster the prohibition of cannabis within the Misuse of Drugs Act (and before that the Dangerous Drugs Act) has been. The policy has seen:

between 1974 and 2002 there was a ten-fold increase in people found guilty or cautioned for cannabis offences (1)
increase in levels of cannabis use in the UK which have only recently dropped off slightly since their reported peak in the mid 90s;(2)
a drop in the age of onset of cannabis use; (3)
increased potency in terms of THC levels (4)
the emergence of imbalanced forms of cannabis containing high levels of THC and minimal levels of CBD (5)
concentration of cannabis production in the hands of criminal gangs who are also involved in other drugs, people traficking, weapons, counterfeiting and other offences;
yearly increases in number and quantity of cannabis seizures but without a significant impact on the availability of cannabis in the UK (6)

By any measure, it is hard to view as a success a strategy of prohibition that has seen the substance being controlled become more potent and less safe, be used more widely, by younger people, despite a non-stop policy of crop and drug seizure, arrest and criminalisation of users and producers.

The evidence from the ACPO report on cannabis production is the latest evidence that in addition to prohibition acting as a driver for less safe, unregulated cannabis markets, prohibition and the profits associated with it have concentrated the production and distribution of cannabis in the hands of a smaller number of large producers, controlling the market with increased force, and with crossover to other offending.

Historically, before gaining power, both David Cameron and the Liberal Democrats wanted to reform the law on cannabis. David Cameron, who it is widely accepted had dalliances with at least one controlled drug when younger, endorsed the moving of cannabis from Class B to Class C. Once elected leader of the conservative party is belief in evidence based policy seemed to evaporate and argued instead for Cannabis to return to Class B.

The Liberal Democrat policy historically was for radical reform of drugs legislation, and in terms of cannabis proposed "adopting a policy of not prosecuting possession for own use, social supply to adults or cultivation of cannabis plants for own use." (7)

However, since entering the ConDem coallition, the Liberal Democrats have been silent on this subject, and it will not be a suprise if, when the Government drug strategy is published in October, all mention of cannabis reform is lost.

But even the Liberal Democrat's old, relatively progressive stance is inadequate and by leaving production and supply in an unregulated market, perpetuates the problems in terms of criminal production, unregulated strength and unmanaged supply.

Given the ongoing disaster of cannabis prohibition the need for Government to fully revise the laws on cannabis are long overdue. Cannabis needs to be licensed and regulated to make it safer. Features of a regulated cannabis market would include:

licensed, registered outlets with staff who receive training on cannabis use and risks
age-restricted sales to people aged over 18 only
sliding bracket of taxation on retailed cannabis with higher strength products being taxed at a higher level;
products labelled to indicate THC and CBD content, with appropriate health messages
taxation from cannabis sales ring-fenced to fund awareness and treatment interventions
personal possession of up to three cannabis plants, by persons over 18 no longer a criminal offence
licence production in UK and overseas, to encourage (for example) Afghani opium producers to produce hashish not heroin.

Given the current resurgent abstentionist climate, the puritanical approach of the Conservatives to drugs, and the apparent willingness of the Liberal Democrats to trade belief for power, it is vanishingly unlikely that any changes will be forthcoming. So in the meantime, it is back to the prohibition hole and time to keep digging. Sanity, anyone?

The Straw Man of Recovery

2010-08-23T12:05:00.003+01:00

The Times today reports that The Home Office will be pushing ahead with a drug strategy focussed on achieving abstinence from both illicit controlled drugs and prescribed substitutes. The article also reinforces the impression that the strategy will include payment by results and that it may include coercive measures like removal of benefits.

The Times' article doesn't offer any substantive new evidence for this. There has already been a significant amount of information (e.g. the NTA business plan, comments from Cameron et al, and the consultation on the Drug Strategy) which strongly indicate the direction of travel.

The Conservative predilection for abstinence-based interventions should come as no suprise. Nor should the threat of coercive measures.

The real icing on the cake though, has been the idea that abstinence is readily achievable. This is where the newly vocal and high profile neo-abstentionists in the Recovery movement have been so successful. A core message that has been promulgated in a number of forums is the idea that the treatment of people with drug dependency is a conspiracy primarily cooked up by pharmaceutical companies and drugs workers out of some sort of self interest. This straw man, as repeatedly offered on recovery forums suggests:

- that a key driver for the ongoing prescribing of methadone is the financial interests of the manufacturers of methadone;

- that drugs workers don't really want to assist people to end their drug use because either (a) they don't believe people can stop or (b) they don't want people to stop because they will lose their jobs

- that the combination of medical dogma, professional self interest and big-pharma is active in keeping people in addiction.

Having created this simplistic model, the argument seems to then extend - these services and structures are a barrier to recovery and by sweeping these away and replacing them with user-led, recovery focussed projects drug users will see the recovery of others, be "infected" by the contagion of recovery and then learn from others how to live productive drug free lives.

It's a very simple and very seductive message. And it has found a ready ear with the Conservatives who are using the recovery mood music to say that the previous Government merely offered substitution not freedom and for the first time this Government will offer true Recovery.

Ignore the history - that the earliest drug treatment services in the UK were mostly established by ex-users in recovery themselves - and while they successfully helped some people they were not a panacea for all. Ignore the fact that the UK drug field has a significant number of people with histories of dependency who can and do believe and know that people can achieve lasting recovery, sometimes with medication, sometimes without. The idea that drugs workers want to keep people addicted for their salary is a vicious lie.

Ignore the practicalities - that payment by results will disadvantage small and independent charities and start ups who can't afford the overheads.

Ignore the safety considerations - that supervisory frameworks from, for example the Care Standards Commission helped ensure minimum levels of safety in residential treatment. Remember that not every residential drug service offers or offered a safe, therapeutic or high quality service and stripping away safeguards leaves the most vulnerable at risk;

Ignore the casualties - that on the one hand reduced, time-limited abstinence driven models will assuredly deliver a larger number of people who are drug free at the end of treatment (and this will be the measured success) but there will be the people who are driven out of or drop out of treatment, some of whom will die. They will not be a measure of success.

Ignore the lost - the people who will lose their benefit, lose their housing, their medical care and their toe-hold in society. Forget that the route back to recovery for these people will be that much harder and some won't make it. Except of course unless you believe in a Jellinek-type model where people have to hit rock-bottom before they will turn to recovery;

Ignore the inconsistencies: that some people will consider Treatment a "failure" if the person has stopped using heroin and crack but continues to use cannabis, even if this is under control. Abstinent from what - and by whose standards? Addiction Today's?

Ignore the cost: the DCLG proposes cutting costs by up to 40% and this will affect budgets including Supporting People - which does a huge amount to help people with drug and alcohol problems secure housing and sustain independent living. The work of some residential social landlords to support people with drug problems has been a shuge success story in some parts of the country. The feared cuts to SP money will destroy this work. And trying to help people with drug problems sustain change without housing is a fools errand.

But hey, who needs these petty problems. Just bathe in the mood music from the Recovery Community and ignore the real-politick of the situation. and when it all comes crashing down make sure that the people who are held to account are not just the policiticians who introduced the policy, but also the neo-abstentionists whose evangelism is rapidly becoming the new dogma.

Something wicked this way comes…

2010-08-20T08:30:00.003+01:00

The proposals by Kit Malthouse, Deputy Mayor of London for a new and robust approach to sobriety enforcement for problem drinkers was reported in the media but has received little comment.

The model promoted by Malthouse is based on a scheme in the States. I remember first becoming aware of it during an episode of CSI Miami which featured an alcohol-detecting leg bracelet, which would identify if the wearer had consumed alcohol, and automatically send a message (e.g. to a Blackberry) informing authorities that the wearer had consumed alcohol, where, and when.

A quick search highlighted that not only did the technology exist, but it was being used extensively. The SCRAM system States including Florida, South Dakota and Michigan were amongst those in the US adopting the technology which came to market in 2003.

Malthouse proposed a system of punitive enforcement of abstinence. His model included:
- a sobriety requirement
- 24 hour incarceration for people breaching the requirement, as evidenced by the detection tag
- self-financing by people required to take part in the scheme.

The proposals as outlined by Malthouse couldn’t come in to power as outlined – they would need legislative changes that, fortunately, fall outside the powers of either the London Assembly or the Metropolitan Police. While ‘alcohol asbos’ introduced in August 2009 can impose restrictions on buying alcohol or drinking in public, they don’t enforce sobriety and as such wouldn’t as they currently stand be suitable for Malthouse’s plans.

Likewise Drug Abstinence orders, as they currently stand, relate only to Class A drugs and so wouldn’t fit with Kit’s ideas.

The use of alcohol-detection bracelet systems in the UK hasn’t yet been approved. This, however, is probably less of an obstacle. The use of drug-testing equipment is a growing and hugely lucrative business and there is every reason to believe that a constant testing system which is worn by users will be adopted at some stage in the UK.

At this stage, the system detects ethanol excreted through the skin, but does not work with other drugs. The Guardian article reports “The structure of the programme is being adapted to include drug abusers,” but at this time there have been no announcements that the technology has been successfully adapted to detect drugs of abuse transdermally. While ion-track technology (e.g. Itemizer machines) can indicate contact with controlled drugs, this is markedly different to proving intake, which, at this time requires more invasive procedures such as oral swabs, blood or urine testing. Even the most recent developments, such as proposed roadside drug-driving tests are based on saliva testing.

But it is the third aspect of Malthouse’s proposals which are the most interesting and should ring the most alarm bells – the adoption of “offender pay” systems in the UK. A number of US states, including Indiana, Oregon and Texas have adopted some elements of an “offender pays” system whereby a proportion of the subjects earnings are deducted to pay for the cost of alcohol monitoring units, and associated staff costs.

The costs of these are typically applied on a sliding scale depending on earnings, but in most situations allow the scheme not only to break even, but even generate a small return.

And this is the point where the schemes become most worrying – because they create an incentive firstly to get more people on the scheme and secondly to keep them on the scheme. One hundred people on the scheme, each generating a $5 surplus per day for the scheme - $182,000 a year.

It is easy to see the appeal of introducing offender-pay schemes in the UK – especially when we have seen proposed cuts to the Department of Justice which will radically affect the management of offenders in the community.

Although Malthouse may be keen to take forward measures such as these radical plans for tackling alcohol-related disorder, he can’t do it without the support of the Government. While Boris and Malthouse may have effectively gained political control over the Metropolitan Police, even this won’t give them the resources and legal powers required for such a change of offender management. What will be critical is how much power and influence Boris and Malthouse have within the coalition Government and the extent to which policies which fall further to the right will find a willing ear at least for pilot programmes within the capital.

If I can’t dance I don’t want to be in your Big Society.

2010-08-17T12:05:00.002+01:00

This blog probably shouldn’t really start with a misquote of something that Emma Goldman never said. Instead it would have been better to start with Milan Kundera from the Unbearable Lightness of Being: “The struggle of man against power is the struggle of memory against forgetting.”Since the advent of the Coalition Government the media and numerous groups and individuals seem to be engaged in an orgy of forgetting, especially when it comes to the analysis of the putative “Big Society.”

Roll back twenty years when to the advent of John Major’s Conservative Government. We saw the development of an astonishing array of small, grass-roots initiatives set up. There was creative use of abandoned buildings. Land that had been abandoned by industry was used for cultivation, to produce locally grown vegetables for communities. Initiatives to protect local assets such as woodland gained profile. Self managed, self-funded and self-policed recreational activities became more widespread across the UK.

But these initiatives were not heralded as an example of an embryonic “Big Society.” It became known as DIY-culture and unfortunately it did not fit with other aspects of Conservative Ideology.The use of derelict land or empty buildings ran counter to Conservative views of land and property ownership and so they passed laws to make it easier to clear the occupiers off that land and from those buildings. Autonomous cafes, galleries and community spaces were established and briefly thrived, then closed by Police and Bailiffs.

The importance of industry and cars was rated higher at a national level was considered far more important than the views of local residents and communities, so bypasses were authorised by the Government despite local opinion and protests. The Government purchased an independent, unaccountable security force using commercial agencies such as Reliance to deliver this agenda.

The proliferation of the “Free-party” movement, its association with controlled drug use and the non-approved use of land for such parties again ran counter to Conservative values and culminated in the end in the much-loathed Police and Criminal Justice Act being passed in 1994. It was the death knell of this period of DIY-culture in the UK.

So does Cameron’s much-discussed “Big Society” share common cause with DIY culture? The answer to this has to be a resounding “no!” The Big Society is a straight Thatcherite agenda presaged in Thatcher’s much misquoted line saying “there is no such thing as society.” Her wider comment at the time shows the continuity from her views to those of Cameron: “There is no such thing as society. There is living tapestry of men and women and people and the beauty of that tapestry and the quality of our lives will depend upon how much each of us is prepared to take responsibility for ourselves and each of us prepared to turn round and help by our own efforts those who are unfortunate.” http://www.margaretthatcher.org/document/106689

And herein lies the problem; the Big Society as proposed is inherently Conservative. It is attempting to create and engender a conservative model of society, seed-funded and driven from the top and delivered from the bottom.

Provided that the hopes, dreams and aspirations of a community fit in to this Conservative ideological world-view, then the Big Society will serve you well. But for those who fall outside it, then there’s no place for you in this Society.Look at some of the examples that have been cited as examples of the “Big Society.” The reduction in sex work in Birmingham’s Balsall Heath is held up as one such example.

What the example as cited neglects to mention is that alongside the passive recording of kerb-crawlers, local activists also allegedly threatened and harassed women involved in sex work – a house was fire-bombed, windows had bricks thrown through them, and women believed to be prostitutes were sent poison pen letters by local activists. So it’s a Big Society that fetes you if you want to set up a self-policing vigilante movement that removes kerb-crawlers and sex work from a community. But take this specific issue a little further. What if a local community, in a fit of pragmatic liberalism, decided that the best way forward was rather than simply trying to wish the problem away. If this grassroots, locally agreed, locally relevant initiative approach were mooted, what would Cameron say then? Would it be embraced within the Big Society as an example of local empowerment. Or would it be stamped out as not really the sort of Big Society we want. There is evidence, such as models of tolerance that were trialled in Edinburgh, that show tolerance models can result in a marked reduction in attacks on sex workers.

David Cameron signalled a desire to review the laws around prostitution in the UK, following the murder of three women in Bradford. But if he decided against full legalisation or tolerance zones, what then for a local community wanted to pursue such a route?

And what of drugs (for this is, if nothing else, a drug-focussed blogging site)? What would the Government do if a local authority, in conjunction with the local police and local community, decided that a supervised drug consumption room was the most sensible response to the issue of public drug use? Would this be something that would be resourced and funded by the Big Society Bank? Would it receive the endorsement of the Government as an example of local solutions for local problems. Or will it be given a firm “red light” from Number 10, as has previously been the case. This is an especially loaded issue as, when he was part of the 2002 Home Affairs Select Committee, Cameron came out in favour of drug consumption rooms. The report unequivocally demanded that “…an evaluated pilot programme of safe injecting houses for [illicit] heroin users is established without delay…”

It would be an interesting test of integrity to see what would happen if a local area trialled such an approach now. Would David Cameron support such a move in practice, as he did in theory in 2002. And would such a thing be tolerated within the Big Society.If it does then the Big Society could genuinely be something inclusive. It could represent a tolerant, informed, flexible and liberal model of community empowerment. But if this isn’t the case, and such approaches are blocked by Central Government then this isn’t such a big society after all. It’s the same conservative view of Society that crushed the DIY Culture almost twenty years ago. It’s learned a new language and it’s changed its clothes, but it still won’t be a revolution that everyone can dance to.

Cannabis: B but no PND says the Met PC

2010-08-10T12:47:00.003+01:00

It's just got more confusing on the cannabis front. The Metropolitan Police is reported to be abandoning the use of Penalty Notices for Disorder (PNDs) in a number of London Boroughs. This was reported in the Evening Standard and then on the BBC.

These powers had been used for a number of offences such as shoplifting and drunken behaviour. But the use with which we are interested here is there use for second offences for cannabis possession.

The current ACPO guidelines on handling cannabis possession, since cannabis moved back to Class B, was that for a first offence, the person should be given a "cannabis warning." As part of an escalating series of responses, second cannabis offences aren't meant to be given a cannabis warning but should have resulted in a Penalty Notice for Disorder. A third offence would then mean arrest and charge, and a resultant criminal record.

It is not immediately clear if the decision to abandon PNDs will extend to cannabis enforcement. If it does, the decision could be good news or bad news as regards cannabis enforcement (depending of course on your point of view).

The BBC reported a Met Police spokersperson as saying "We are seeing if there is a more effective way to deal with them, such as through cautions, through the courts or, in minor cases, words of advice."

Given that cannabis users already receive "words of advice" in the form of cannabis warnings already, it doesn't seem likely that further "words of advice" will be offered to people repeatedly found with cannabis. So it seems more than likely that for second and subsequent offences, arrest and charge, and court action look more likely.

We have written to ACPO to seek clarification on this important issue. more news as it happens

Please look after these drug services!

2010-08-08T14:06:00.006+01:00

With the LibCons embarked on a whole scale razing of 'that which went before,' huge swathes of health-care are set to be restructured. Proposals in the White Paper have already been made including proposals to:

dismantle Primary Care Trusts (PCTs) and Strategic Health Authorities (SHAs)
abolish the National Treatment Agency
abolish the Health Promotion Agency
establish a national Public Health Service, with Local Authority planning and delivery under local Directors of Public Health
Increase the role of GP Consortia in commissioning services.

At this stage, details are scanty. Details, for example, of the structure and role of the Public Health Service are yet to be published, and the NTA business plan, published at the start of October, can't yet reflect changes that have yet to be announced.

This lack of detail hasn't (of course) stopped charities welcoming the changes. Addaction for example endorsed the White Paper on NHS reform straightaway, and likewise endorsed proposals for time-limits on methadone prescribing. Given the profile of Michael Howards wife Sandra Howard on their board of trustees, one must suspect that Chief Exec Simon Antrobus is playing nice to the Conservative top brass.

It will be a while before more details emerge. But a key concern in all this is where services for drug users will end up. And this includes the full spectrum of drug services from education and prevention initiatives for young people and non-users through to substitute prescribing, counselling and residential treatment options. It includes harm reduction interventions like needle exchange and longer term interventions that support the journey from problematic use to recovery for dependent use.

Some aspects of service, such as Needle Exchange, will most likely fall within the remit of the Public Health Service and be delivered via local authorities. One worries that in areas with small budgets and high demand, this will result in an increase in delivery via Pharmacy Needle Exchange as the lowest-cost option. Needle exchange has been over-stretched, underfunded and lacked a coherent set of quality standards. It will be incumbent on the new Public Health Service, in conjunction with bodies such as the National Needle Exchange Forum, to develop minimum standards for Needle Exchange in England and Wales in much the same way that Scottish Needle Exchanges are being reshaped thanks to the Guidelines on Injecting Equipment Provision in Scotland.

It's less clear where non-treatment initiatives, especially education and prevention, will come from. Where will Frank end up for example? Will he be run straight from the Departments of Health and the Home office (as is currently the case) or will he find a new home at the Public Health Service. That is of course if he survives at all. Frank could be culled as well - it would be a suprise if he survived unchanged and unscathed.

But the most vexed question is to where drug treatment services will be located. Will they be something that is commissioned and contracted by GP consortia? Or will they be one of the few aspects of patient care deemed not suitable for this model and an alternative will be developed. Almost certainly, Cameron's Big Society will be expected to play a role. This will certainly be of huge benefit in terms of involving peer support groups, mentoring and mutual aid. But it is of less use when it comes to the vexed issues of prescribing and residential treatment. Prescribing, time limited or otherwise, demands the involvement of Doctors in some capacity and so can't be done by a willing army of volunteers. Not that, on the whole, this army of volunteers would have much to do with prescribing, especially methadone.

We don't know at this stage if the funds for treating drug users (or "Problem Drug Users") and distributed as the "Pooled Treatment Budget" will be retained or not. Let us assume for a moment that such a budget is, for now, retained though possibly subjected to the same cuts being made elsewhere in the budget.

While the budget may be retained, it won't continue to be distributed or spent via PCTs as is currently the case. So where would it go? Would it go directly to GP consortia? This would be as close as one can envisage to actually putting control of the budget in the hands of the actual patient. But as some of this would need to be spent on prescribing (something currently done by GPs) there is something of a conflict of interest here - giving the GP Consortia a budget for drug treatment and then expecting them not to spend a large chunk of it on continuing to dispense methadone.

Or would the money end up being controlled by the new Directors of Public Health. And would the budget for treatment for drugs then end up as a ring-fenced fund within the wider Public Health Service budget. Were this not the case, drugs money would end up being spent on other aspects of Public Health - including prevention, smoking cessation and obesity.

Wherever the money ends up, and whoever controls it, part of the expectation at least on the Government's part, is that payment will be made by results. But this creates something of a dilemma. If as seems likely the money which was previously in the Pooled Treatment Budget is transferred across to the control of the Public Health Service, it would then end up being distributed to local authorities according to need based on the scale of the drug problem in that area. It would then need to be used to pay for drug treatment services of whatever persuasion as is the case now. The only big difference is that in theory the treatment provider would be paid by results - which using the current yardstick being brandished by the Government, would be abstinence and getting a job.

This then seems a far cry from a personal health budget which patients can use to purchase whatever treatment they want, where they want, provided it is evidence based. It will be easy for the motivated, for the "ready to quit" to access treatment - they will be manna for the "payment by result" services. Indeed the development of screening tools and profiling (or segmenting as it's now being called) will make all the difference to the profitability of these services. But for the most vulnerable, those with the most complex needs, the most entrenched habits, the risk is that they are more likely to be written off than before. Because the services that are paid by results don't want people on their books that make them look less than successful. And prescribers won't want to be drawn in to a constant battle to justify (or not, as the case may be) long term prescribing even where it may have been beneficial.

How it would be spent - and how this will be directed - may come from within the Public Health Service. But its ideological basis - that may come from another source. Some will hopefully come from evidence-based research, rather than whatever whimsical notion is currently flavour of the month on a discussion forum. But it may end up coming from just such a quarter, given shape and form by a "Addiction Recovery Board." Such a body was proposed by the Tory "Centre for Social Justice" think-tank, the brain-child of Ian Duncan Smith. So while coordination in the short term will be taken within the new Public Health Service it may well be that within this an Addiction Recovery Board will be formed to supervise and direct how money is spent and shape policy. The ideology of this post will be critical - a rigorous abstentionist in this position would have a huge impact on treatment models.

The next few months will be an interesting time. An awful lot of services are petrified that they will be decomissioned and will be jockying for position to ensure that they don't lose favour at the LibCon court. The vocal neo-abstentionists already have a ready ear in the Conservative party. They are likely to receive only muted complaints from a field that looks set to be swept away.

But these plaudits from the neo-abstentionists and quiescence from the mainstream drugs field should not be taken as a sign that all is well. There is no clear structure and the ideology is still being fought-over. It's early days and the feathers in the wind do not bode well.

be careful what you wish for...

2010-08-06T15:42:00.005+01:00

The new NTA business plan was published today and one can see the tensions between the old and new guard being played out between the lines of the document. Though in truth this document is going to be less significant than the changes that it heralds - and the structures in which they will be implemented.

There are three things that leap out at a quick initial reading:
- the priority given to abstinence is very obvious: the word is used twenty times, and most strikingly in the line "New clinical protocols will focus practitioners and clients on abstinence as the desired outcome of treatment." But desired by whom? And what of those people who wish to stop using the drug on which they are dependent, but not other substances? "Harm reduction," by comparison warrants only three mentions, one in the budget, one in relation to young people and a generic mention. "Reducing harm" has gone.

- Payment by results: the Business Plan says "We will continue to drive unit costs down by a combination of matching resource allocation to performance, progressive implementation of
payment by results..."

This throws up two substantial challenges. The first - what is the "result." Given the priority given to "abstinence" one must suspect that payment by result will be tied to abstinence as an outcome.

The second is that payment by results can result in very long timescales for payment. They tend to work in the favour of large corporate bodies who can afford the up-front costs of treatment and can await later payments. They don't work so well for small third sector organisations with limited cash flow and small reserves.

Time-limits on substitute prescribing: The business plan stresses that open-ended prescribing will not be an option most of the time and the presumption is against it. The Plan says "substitute prescribing is planned to be a time limited intervention." What the stated time limits will be are not yet clear and guidance has still to be issued.

There is at least grudging acknowledgement that some people will warrant and benefit from long-term prescribing. The Plan says "Those who need substitute prescribing beyond an initial time limit should, in turn, be reassured that it is only on the basis of a rigorous, multidisciplinary review of their ongoing needs." Reassurance really depends on your perspective. For those who argue that it is too easy for people to be left on methadone without other interventions, this review and reassessment is welcome. But for others, "reassurance" will mean a three-monthly battle to justify ongoing prescribing because they are not yet ready to reduce or stop - irrespective of the other interventions being offered to them.

In a lot of respects the Business Plan will get cautious approval from a lot of people who will see what they want in it: mutual aid groups get a mention and will be more involved; abstinence is reprioritised; there's mention of residential rehab than before though probably not as much as this Sector would have liked. But there'll also be bouquets for the mentions of time-limiting substitute prescribing and some will even cheer for payment by results.

But at the heart of this a couple of unresolved issues still remain, potent and toxic. The first is the remaining tension as to what "recovery" really means. And the Plan doesn't resolve this. On the one hand it says that "treatment gives individuals the opportunity to overcome their dependency and achieve abstinence" suggesting that it's all about abstinence.

The other says "The purpose of treatment is to enable individuals to overcome addiction. This is fully achieved when someone has completed treatment and been rehabilitated back into their community as an economically active contributing citizen." And given that we are entering terrain which will include payment by results, the definitions are all important.

Ultimately it won't be the NTA who ends up resolving these questions: but some of the voices that will be shouting loudest will be the ones who tie it to abstinence for ideological, not evidentiary reasons.

One of our Drugs Acts is Missing!

2010-07-29T18:37:00.003+01:00

It's strange, that, if you try finding a complete list of drugs which are 'controlled' under the Misuse of Drugs Act, it simply doesn't seem to exist on line.

It's a broken up, jumbled mess spread across numerous websites and documents. It's not of course helped that The Misuse of Drugs Act 1971 is interlinked with the Misuse of Drugs Regulations (2001) which in turn were an update an consolidation of the Misuse of Drugs Regulations (1985). So there are two primary pieces of legislation. When drugs have been added, removed, moved down, or, as is more likely moved up the categories, parliamentary "Statutory Instruments" have been used to insert the changes.

But unfortunately these changes haven't been consolidated in the main legislation, and so to get a complete list of all the drugs you have to trawl across numerous pieces of legislation.

So look, for example at the Misuse of Drugs Act 1971 as posted on the Statute Law Database, Thi, unfortunately hasn't incorporated changes since 2003.

Or the Misuse of Drugs Regulations 2001 on the Office of Public Sector Information - none of the numerous changes to the Regulations obvious here either.

Most of them took place through Statutory Instruments - a directory of these can be found on the OPSI website too, but searching within these for "Misuse of Drugs Act 1971" throws up some 720 results which can, with a bit of filtering be reduced to some 35 or so SIs.

There's another list which is a bit more accessible on the Home Office website which is snappily titled "List of Drugs Currently Controlled under the Misuse of Drugs Legislation" which is almost up to date (it ends at March 2010) and is fairly comprehensive - but doesn't include all the various analogue clauses.

But if you want a list of all the drugs, with all the analogue clauses, which reflects all the changes - well there isn't one officially available.

This strikes me as fairly shoddy. People should at least be able to find out which substances are currently legal or illegal in a relatively straightforward way. If people are to make informed choices, a key choice is to know if what they are going to do is illegal or not. After all, possession of these substances can carry a long custodial sentence. And ignorance of the law is no defence.

So, for want of anything better to do I spent a couple of days cutting and pasting the list of drugs together from the two base lists of the Misuse of Drugs Act 1971 and the Misuse of Drugs Legislation 2001. I went through all the Statutory Instruments and inserted the relevant additions and ammendments in the right places. And to finish off I colour coded the additions to the Statutory Instrument which introduced them, so you can see which changes were introduced by which legislation.

I don't know how useful it is but it's certainly very pretty now. And I thought that,somewhere on the Net there should be a complete list of the Controlled drugs in the UK by Class and Schedule.

I'm going to update the version off the Home Office website next (with some better annotation) but first I need to get rid of the splitting headache that this has given me.

Enjoy the full colurful list here on the KFx Website.

The Most Expensive Weed in The World...

2010-07-28T14:38:00.003+01:00

With the price of cannabis, especially herbal cannabis, hurtling upwards people are starting to pay silly prices for cannabis - prices of £250+ per ounce are being quoted. In these desperate financial times it seems that cannabis dealers are determined not to succumb to austerity measures.

But their inflated prices are nothing compared to the prices being charged by GW Pharmaceuticals and Bayer - who were recently granted a licence for their cannabis spray, Sativex. The price to the NHS of this new drug will be £125 for a 10ml vial. Sativex contains THC at a level of 27mg/ml. So a 10ml vial would contain 270mg. Or £125 for just over a quarter of a gram of THC. Or £600 per gram for THC.

Now compare this to an ounce of herbal cannabis. For the sake of argument (and easy maths) think about an ounce (28g) of strong skunk (say 25% THC). That's 7g of THC - probably selling at around £250/ounce. Or £35/g for this THC. Which is a fair bit cheaper.

Of course, there's GW Pharmaceuticals R+D costs to cover - although the original plants were bought from Dutch growers, and Bayers shareholders to pay. And there's the perks for the board.

But when the NHS is so strapped for cash, surely every little helps!

THC and CBD to be Rescheduled - Home Office confirms

2010-07-28T12:19:00.002+01:00

In June 2010 the cannabis-derived medicine Sativex received its licence in the UK. This meant that it had received approval to be used as a medicine. The active compounds in Sativex are THC and CBD.

This is problematic from a legal point of view. Cannabinol and its derivatives are currently Schedule 1 drugs under the Misuse of Drugs Regulations 2001. Drugs under Schedule 1 are generally cannot be prescribed and their possession, supply or administration is not permitted without a licence being granted by the Secretary of State.

This put THC and CBD in a somewhat invidious position. Licensed as a medicine but still in the most restrictive category of the Misuse of Drugs Regulations.

At present the Home Office has adopted a work-around. The Secretary of State has granted an open general licence to allow this specific medicine to be prescribed. This an interesting work-around, of dubious legality. It probably doesn't extend to all the other parties who need to be able to handle the drug - such as pharmacists for example. This would require more substantial revision of the legislation.

And indeed the Home Office has confirmed to us that it intends to undertake just such a revision - to move THC and CBD from Schedule 1 to a lower schedule which would allow it to be lawfully prescribed at a POM (prescription only medicine) and CD (controlled drug). This would probably mean it moving to Schedule 2 (same Schedule as Methadone) or Schedule 3 (the same as Buprenorphine).

But the really interesting part of this is that the legislation will not be able to specify the brand "Sativex." It would have to specify the specific compounds THC and CBD. Which means that the key active ingredients of cannabis will be recognised as having a legitimate medical use.

This doesn't mean a huge cause for celebration. It doesn't mean that herbal cannabis or cannabis resin will also change schedule. It will be very easy to specify that herbal cannabis and resin stay in Schedule 1 while certain cannabinoids drop down to Schedule 2.

But why it is so interesting is the issues of patent and trademark this throws up.
GW Pharmaceuticals coined the terms Tetranabinex and Nabidiolex and registered these as Trademarks. So these names, along with Sativex are protected. Similarly, the specific strains of cannabis hybridised by GW Pharmaceuticals are also Patented in some countries. So growing these specific strains without licence would be illegal.

But the underlying compounds - THC and CBD are not patented. And so while GW and Bayer now have a patent, license and trademark for Sativex, this is not in itself an obstacle to other producers developing their own products which are based around finding an effective balance of THC and CBD in an effective delivery mechanism.

It is to be hoped that, when THC and CBD are rescheduled, as they inevitably will be, this will open up the scope for more groups to explore the medical uses of cannabinoids, rather than them being consolidated in the hands of a big pharmaceutical giant like Bayer.

NRG -1: analysis indicates batches contain MDPV

2010-06-22T07:11:00.003+01:00

Thanks to the previous Governments rush to prohibit MMCAT and MDPV manufacturers were left holding stockpiles of their now-illegal drugs. What to do? Emerging test results suggest that they are repackagaging and relabelling it as NRG-1 and passing it off as the still-legal drug Naphyrone.

Reports that batches of "NRG-1" in Scotland had been analysed an found to contain MDPV were reported at the start of June by ACPOS.

Further and more detailed work was undertaken by Drugs-Forum who confirmed and expanded on Police reports.

Drugs Forum have once again been outstanding. There is a detailed report and recommendations on the website, a stark difference to FRANK's somewhat anodyne observation "it is likely that substances sold as naphyrone or “NRG-1” actually contain one or more Class B cathinone derivatives, the most well known one of which is mephedrone.

It is not clear who in the supply chain knows that drugs being passed off as legal Naphyrone are in fact illegal MDPV. The suspicion is that dealers left holding stock of MDPV are passing it down to smaller retailers as NRG-1, who then sell it under the misaprehension that it is lawful NRG-1. ALternatively it could be that the smaller internet retailers are aware that they are selling end users MDPV under the guise of NRG-1, to get rid of old stock.

At this stage it is not clear how much "real" Naphyrone is on the market; user reports as to the appearance and effect of substances sold as NRG-1 vary widely and little consistency has emerged. With the summer festival season on us, this is a dangerous situation.

Two key pieces of advice must get out to end users:

1: any substance containing MDPV or MMCAT can result in action being taken for possession of a Class B drug; people in possession of large quantities could be charged with Supply.

Ignorance or confusion as to the nature of the substance will not be a defence and so anyone in possession of a compound that they bought in the belief that it was legal NRG-1 and in practice turns out to be MDPV could be prosecuted.

2: The dose ranges for NRG-1 are far smaller than those for MDPV. The size of a dose of MDPV that would provide a reasonable effect would be far too strong if the batch contained Naphyrone. A normal MDPV dose would be probably ten times the range suitable for naphyrone.

Conversely, the low doses advised for taking NRG-1 would not provide an effect if it were actually Naphyrone.

So anyone offered or buying white powder should exercise extreme care regardless of the label on the packet. The best advice is to stay away from any compounds unless you are certain of the composition and strength, and how to take it with as much safety as possible.

Remember: a 'normal' size dose of powders such as ketamine, speed, coke, mmcat or mdpv could be fatal if the powder in question contains naphyrone.

If you are uncertain of the constituents of a powder, or think you have bought NRG-1 take a tiny dose first - a dose about the size of a grain of rice AT MOST. It would be safer to use a professionaly-calibrated set of scales but this will not be feasible for most people. The cheap scales you bought of E-bay are not accurate for this sort of thing and won't be callibrated properly so don't leave you in a safe position.

Keep up to date with news on NRG-1 at Drugs Forum.

The Perfect Storm will engulf the Drugs Field: expect casualties

2010-06-21T07:41:00.002+01:00

The UK drugs field is about to be engulfed by a collection of circumstances which have come together at the same time. The net result of these will lead to seismic shifts within the field. Whilst some changes are undoubtedly needed, the net result is likely to be a disaster for those dependent on substances.

The first key element is of course the change of Government, and the extent to which this will in itself herald a change in drugs policy.

Almost inevitably, not least so that the Conservatives can portray the previous Government as profligate and incompetent, the National Treatment Agency is almost certain to be an early victim of change.

The change of Government and inevitable change of policy is going to take place against a backdrop of swingeing financial cuts. These two issues coming together possibly facilitate more dramatic interventions than would otherwise have been feasible, especially early in a parliament. Politically and ideologically motivated changes can be passed off or pushed forward under the guise of financial necessity. Some of the financial cuts will take place centrally. But most of them will trickle down to the drugs field via more general cuts – to local authority and health service budgets.

There’s a third factor that will facilitate dramatic change alongside the change of Government and the new climate of austerity. The increasingly vocal Recovery movement is likely to provide the public support for many of the changes likely to be proposed. And while the Recovery movement is ostensibly a broad church which welcomes a complete spectrum of interventions, some of the loudest voices therein are less pragmatic. For them the advent of a new Government is the chance to sweep away substitute prescribing and promote abstinence-based models instead.

Allied to this is the likely willingness of peer and mentor-led recovery organisations who profess to be able to offer the wholly grail of abstinence-based recovery at a lower cost than current treatment modalities. Such promise will be manna to the new Government, keen to deliver abstinence at low cost within the paradigm of the “big society.”

The next concern is the lack of any concerted opposition to dramatic and potentially damaging changes in provision. Historically, there had been a reasonably loud and organised range of drugs services who had lobbied, with varying degrees of success, to maintain balance within drug strategy. The number and stridency of these voices has been hugely reduced over the past few years. Some of the largest drug treatment providers, all too conscious of where their contracts have come from, have been hugely reticent of speaking out. Some of the largest, while assiduously securing contracts, have been far from keen on commenting on the politics of the drugs field.

In the meantime, the Advisory Council on the Misuse of Drugs, which demonstrated a new ability to deliver recommendations in a manner to the liking of their political masters, seem unlikely to suddenly demonstrate their mettle and act as a bulwark against Government excess.

With organisations like Drugscope still relying significantly on support from Government, it is placed in an awkward position when it comes to robustly defending the needs and interests of its members. And with the number of independent drugs services dwindling as tenders are increasingly won by a small number of organisations, criticism of strategy is not likely to come from this quarter either.

The next aspect is the wider economic and political situation affecting the UK as it attempts to escape recession. With cuts in public spending imminent, both an increase in unemployment and a reduction is spending on support services is inevitable. And on the back of this there is every likelihood of an increase in substance use and therefore a need for these self-same support services. This scenario could be worsened if the draw-down in UK and US troops from Afghanistan results in an increase in opium production and distribution. Levels of heroin use had been stable and probably reducing in the UK over the past few years – increased availability and reduced cost at a time of increased unemployment and reduced services would be a disastrous cocktail.

Each of these factors alone could have a dramatic effect on drug strategy and services in the UK – put them all together and the consequences are likely to be dramatic – and fills us at KFx Towers with trepidation.

The most obvious and significant change is of course a change of Government. The advent of the Conservative/Liberal Democrat coalition inevitably heralds a change in drugs policy. To date, little has been announced as to Conservative policy on drugs.

The only concrete proposal, in “The Coalition: our programme for Government” is the following:

We will introduce a system of temporary bans on new ‘legal highs’ while health issues are considered by independent experts. We will not permanently ban a substance without receiving full advice from the Advisory Council on the Misuse of Drugs.

However, it doesn’t seem likely that this is where matters will rest.
The Conservative Party manifesto prior to the election announced that “abstinence-based Drug rehabilitation orders” would be introduced. Likewise, the Conservative strategy paper “A Healthier Nation” lacks any concrete proposals relating to Drug Strategy.

James Brokenshire MP, the Home Office Minister with responsibility for crime reduction, is the minister with responsibility for drugs. A couple of key proposals he intends to take forward include changes to the drugs legislation to allow for a 12 month ban on new substances to allow for full assessment of risk, and widening of categories to allow chemical analogues to be controlled more easily.

Of greater interest is his views on treatment and abstinence. In January 2010 on his blog he noted that the NDTMS had a classification of “'Treatment completed free of dependency (occasional use)” for people who completed treatment, were no longer using heroin or crack, but still used other substances on an non-dependent basis such as cannabis or cocaine powder.

Brokenshire railed against this in his blog, lamenting that “it's astonishing that someone can complete drug treatment apparently free of dependency even though they may be … still taking cannabis or cocaine, provided it's not crack cocaine. Sadly, it underlines just how far adrift the Government has become in getting to grips with the problems of addiction.
It's a failure for society, to which drugs do so much damage and a failure to the individuals, who are clearly not getting the help they need to beat their drug problems. We can't carry on like this and we need a change of approach with much greater emphasis on abstinence based rehab to get more people drug free - and mean it.”

This provides a very clear indication of where the strategic vision for drug treatment lies in the eyes of this Minister. This approach was also being promoted by David Cameron immediately before the Election. In a written reply to a drug treatment service, reported on UKHRA and vouched for by a number of posters, Cameron’s office said:
“A Conservative government will send an absolutely clear message on drugs. We
will take concerted action to tackle the scourge of drugs on our streets.
We would introduce an abstinence-based Drug Rehabilitation Order to break the cycle of addiction and offending. The focus on abstinence is a fundamental distinction between Labour's approach of maintenance and management, which has failed, and ours.”

Future direction is also clearly signposted on the Addiction Today website where Ian Duncan Smith, in his role as Founder of the Centre for Social Justice, made a speech in January to the CSJ regarding addiction policy – including scrapping the NTA and proposals for reforming the ACMD.

These measures have been heartily endorsed by Deirdre Boyd of Addiction Today who has led vigorous campaign against the NTA – drawing on a range of eclectic bedfellows to support her case.

Boyd in turn is closely involved not just with Addiction Today but also the Centre for Policy Studies. This group is described by Boyd as an “apolitical” think-tank. Even by Boyd’s standards this is a stretch, given that the CPS would probably be far more proud of its political Conservatism. They highlight their history thus: 1974: CPS established by Keith Joseph to "convert the Tory Party" to economic liberalism. Margaret Thatcher joined the Centre as Deputy Chairman. Given nine Conservative MPs on their Council, and the presence of Tim Montgomery, former Tory Chief of Staff, claims of being apolitical or independence from Political parties seems a bit of a stretch.

The CPS also published Kathy Gyngell’s widely distributed paper “The Phoney War on Drugs.” It seems very likely that the CPS and the CSJ will have play a critical role in influencing future drug strategy. And in turn these organisations will be influenced by the organisations with which they are inter-twined: the Addicition Recovery Foundation, Europe Against Drugs (EURAD) et al.

So far these measures haven’t yet materialised in Coalition proposals. The rationale for the non-appearance of such measures may be that Conservative abstinence-based doctrine has been attenuated by the counsel of Lib-dems. Or it may be that such measures have merely been postponed in the current financial climate. We will have to wait and see.

Prior to entering a coalition with the Conservatives, some relatively radical proposals had been included in the Liberal Democrat manifesto, including the following:
• Ensure that financial resources, and police and court time, are not wasted on the unnecessary prosecution and imprisonment of drug users and addicts; the focus instead should be on getting addicts the treatment they need. Police should concentrate their efforts on organised drug pushers and gangs.
• Always base drugs policy on independent scientific advice, including making the Advisory Council on the Misuse of Drugs completely independent of government...
• Move offenders who are drug addicts or mentally ill into more appropriate secure accommodation.

Just as some of the Tory policies seem to have gone in to hiding, there’s little evidence that the Lib-Dem’s ideas have been advanced. We will have to wait and see if any of the Lib-Dem proposals see the light of day from their second-rate position within the coalition. The second proposal, to provide the ACMD with greater autonomy is almost certainly a non-starter. The Conservative position on this may partially have emerged in a series of questions asked of the Conservative party by the Guardian newspaper; in response to David Nutt’s question on the subject, Conservative science spokesman Adam Afriyie said “Drugs policy, like all policies, should have a basis in evidence. We have no desire or intention of ignoring scientific advice. There may be times when ministers decide to take account of other considerations.”

This certainly suggests that while the Conservatives are keen to put scrutiny of the economy beyond the meddling hands of politicians, they don’t wish to extend such independence to the world of drugs.

So all the pieces are in place: right wing think tanks providing the theoretical models, the burgeoning Recovery movement who will become the cheer-leaders for the new regime, a bought third-sector, unable and unwilling to effectively challenge the changes that will come, a new Government, keen to sweep away what went before, all against a back-drop of austerity and rising joblessness. This is the worst of times.

meow!

2010-04-15T20:33:00.008+01:00

Only the most optimistic (or intoxicated) observer could have expected a different outcome, but in a very short period of time, mephedrone (MMCAT, Meow, Bubble etc) will have been added to the rapidly expanding list of "Controlled Drugs." The only thing that may have been a suprise was the speed with which the Government managed to push through legislation in the Parliamentary 'wash-up' period. That, and, perhaps the spineless compliance of the ACMD and a collection of Politicians who saw fit to rubber-stamp the whole process in the hope that they may garner a few votes on the back of this prohibition.

Having driven itself in to a full state of rabid, indignant, hysterical and ill-informed froth over Mephedrone, (see previous post MMCAT Madness) the media calls for it to be banned "immediately" were clearly being heard loud and clear within Government. But what could the Government do? With a Statutory obligation to consult the ACMD, the Government could not simply legislate. And the recent travails at the ACMD would normally have slowed the process a little. But the timescales here were tight and critical: receive advice from the ACMD AND put legislation before the Commons and then the Lords and then secure an Order in Council, all before the Prorogation of Parliament on the 8th April 2010.

But the Government appears to have done it. The Home Office widely announced that the prohibition of Mephedrone and related compounds would come in to force on the 16th April 2010. This announcement, made on the 29th March, was two days before the ACMD Published their reccomendations, and a week before the matter went before Parliament. It was very clear at this stage that the matter was a "done deal" and that Parliamentary approval was a mere formality.

The ACMD appears to have dutifully played their part. Interim Chair, Les Iversen, formally wrote to the Home Office on the 31st March 2010 to offer the ACMD's consideration and on Mephedrone. It had presumably been offered to the Home Office, privately, sometime before this.

The drafted legislation was put before the House of Commons on the 7th April (see HANSARD) and a Motion to approve it was passed; then it went before the Lords, and was briefly discussed (Hansard record) where it was similarly rubber-stamped.

Contributions from Victor Adebowale, a member of the ACMD, Chief Executive of Turning Point and a member of the Lords were noticeable by their absence. One would hope that his reticence was a reflection of his shame at having been a part of this wholesale abandonment of evidence-based legislation and policy making.

The whole process, and the media storm that has driven it, is deeply depressing and distasteful. It may well be that Mephedrone will ultimately prove to be a harmful and dangerous substance. But at the time of the drug being added to the list of Controlled Drugs, not one fatality in the UK had been conclusively attributed solely to Mephedrone. The jury was still out on how risky the drug was, and how to manage this risk. But the Government clearly felt that, with a close-fought general election looming, they could not allow for the perception of being soft on drugs to offer a soft target for electoral attacks. And likewise, the Conservatives and Liberal Party could equally not appear to oppose legislation that would prohibit Mephedrone. So all three parties signed up to a process that abandoned an evidence base and proceeded on the basis of supposition and assumption.

The complicity of the ACMD, with the notable exceptions of Eric Carlin and Polly Taylor who resigned rather than participate in the charade is disappointing. It does not bode well for the future if the Interim Chair and remaining members feel sufficiently cowed by an outgoing Goverment at the end of a Parliament that they need to rush through their recommendations - without them being put to the full Council. In the end only the Technical Group of the ACMD looked at the drug.

This matter was forcefully brought home by LD MP Dr Evan Harris who, along with Dr Brian Iddon are the only politicians to appear to have come out of this with any integrity. Harris stressed the extent to which the rules on consultation had been disregarded and warned of possible consequences, saying "the Government, who acted not just without considering the report-which they were bound to consider under the Government principles issued on Budget day-but before it had even been published. In fact, according to Eric Carlin, who resigned last week, when the chair of the ACMD left to brief the Home Secretary for a press conference the ACMD had not even finished the report. The Government responded to the press not only on a report that had not been considered, that had not been published and would not be published for three days, but on a report that had not yet been completed. That makes a travesty of the advisory process.

If, as a result of that, this statutory instrument, if-or rather, I suspect, when-it is passed by both Houses-is challenged in the courts as being ultra vires and the Government lose the case, something which, as has been said, should have been done much earlier, will be delayed by months." (Hansard)

Ironically, in the small window between deciding to prohibit Mephedrone, and being able to enact legislation, the Government suddenly found a collection of measures that they could use to restrict and reduce availability without needing to Schedule the drug. They could stop the compound being imported outright; Trading Standards could act where the drug was being "mis-sold" as Plant Food or Bath Salts; Frank could be used to provide more awareness and publicity rather than whittering on about Pablo the Drug Mule Dog. Further, schools could confiscate the drug if pupils brought it in; head-shops could be visited and warned. So without any changes to the MDA 1971, measures could be taken.

It's a worry that almost a year after Mephedrone became an issue, the Government only now arrives at these measures. None of them require ACMD guidance; none required Parliamentary time. All that was required was the imagination and will to act, which seems to have emerged late in the day and coincidentally close to an Election.

Historically, when the Government wants to add or reschedule drugs, there is a period of consultation prior to legislation being passed. While the Government has a statutory obligation to consult the ACMD, the wider public consultation is not mandatory, but has happened with all previous drugs legislation. Most recently, when the Government was considering adding GBL and synthetic cannabinoids to the list of Controlled Drugs, public consultation took place. Ironically, even though the drug has been conclusively attributed to at least one fatality, the demands of Industry were held of greater importance than the risk to users. Although a decision was made to make GBL a controlled drug (Class C) because of its uses by industry a decision was made to make it "illegal to possess, supply, produce and import/export GBL and 1,4-BD for purposes of personal ingestion." http://www.opsi.gov.uk/si/si2009/em/uksiem_20093209_en.pdf

The irony of this outcome cannot be under-played. In order to protect jobs, industry and the economy, GBL is added to the list of controlled drugs but provided it is not supplied for human consumption, such supply will remain lawful. In this regard, the Government has created a "plant-food" model akin to the Mephedrone situation. Supply GBL "not for human consumption" and require people to sign some sort of statement and it would be difficult, if not impossible, to prosecute suppliers for selling GBL. Prosecuting users for possession is also well-nigh impossible, as any savvy user will know to say that their possession is for alloy cleaning, nail-polish removing or some other purpose and the onus is on the CPS to prove that the purpose of possession was ingestion.

The "mephedrone as plant-food" problem contributed directly to the risk and lack of information relating to the drug. The situation arose thanks to the MHRA's "borderline products" category which created and caused the problem.

Products which may contain pharmacologically active substances, but are not intended for medicinal use may fall in to this category of Borderline Products, which the MHRA assesses on a case by case basis. They take in to account "any information which may have a bearing on the product's status, for example, the claims made for the product, the pharmacological properties of the ingredients, whether there are any similar licensed products on the market, and how it is presented to the public through labelling, packaging, promotional literature and advertisements."

Selling a medicine which has not been approved can carry a two year sentence. But by ensuring a product is not labelled or sold or promoted for ingestion, this problem can be avoided. Hence the "plant food" or "bath salts" labelling.

But the problem that came on the back of it was that the dodge of labelling effectively prevented retailers from providing dosing or harm reduction information. With a licensed product, information about not mixing with other drugs, hydration or health risks could have been provided. But having been boxed in to a position of selling it as "plant food" no chance of providing dosing information was possible.

It's worth contrasting this with how magic mushrooms were sold prior to them being made illegal. Then, information about the relative potency of mushrooms could be offered, and guidance on dose ranges was offered. Instead the MHRA creates an incentive to "prove" a substance is not a medicine, and hence create increased risk when such substances are used as intoxicants. Strange then that the Home Office should endorse exactly the same model for GBL control. Money talks - money walks.

The GBL situation emerged in part thanks to lobbying by Industry during a consultation period before the legislation being drafted. The ACMD recommended consultation, and the Government, without the incentive of an election, consulted over a three month period. However, with Mephedrone (callow ACMD, media storm, election) the Home Office felt that there was such danger that "in light of the urgent need to act to protect public health, no public consultation has been carried out prior to the laying of this Order. In providing its advice, the ACMD consulted a range of experts in this field and concluded that the drugs subject to this Order have no legitimate use (ref)

But the story doesn't wholly end with the passing of the legislation. Buried in all the papers that have started to come out from the ACMD, from the Home Office and the Parliamentary Stationery office, a few little gems have come out which are worthy of further comment.
The first is the significant amounts of Revenue that the Government has received from what Gordon Brown described as "evil" drug.
A Written Question from Mr Burrowes MP on the 7th April 2010 asked "how much has been collected in import duty on mephedrone in each of the last three years."

The figure for 2009 was just over £250,000 - representing a taxation at a rate of 6.5%. This means that the minimum declared value over Mephedrone imported in 2009 must have been in the region of £4m.

The figures for 2010 haven't been made available yet, and will obviously be incomplete as will only be for the first three months of the year until imports were banned. But it will be interesting to learn the 2010 figure, as it will indicate how much volume of imported mephedrone changed. Interestingly, The amounts collected in 2007 and 2008 were also significant - between £150-170,000.

It will be more interesting still to learn if the Treasury will take the £1m plus earned from Import duties, and the income from VAT received from Mephedrone sales, and will be donating that money to drugs education or treatment. Given the swingeing cuts faced by drug services in the coming financial year, such a modest windfall could be highly useful.

Alternatively the money could be refunded to the numerous retailers who paid the money to the Government in Import Duty. Given the news that the Local Government Association is trying to impound remaining stocks prior to a ban coming in to force, it would seem only reasonable that import duty paid on a legitimate product should be refunded if the state arbitrarily deems the substance illegal, especially without a reasonable notice period,

The other paper which is worthy of comment is the appalling Explanatory Memorandum and Equality Impact Assessment which the Home Office was required to carry out prior to putting the Legislation before Parliament. This document recaps the legislative proposals and looks at the potential impact of them. The document is dated March 2010. Importantly it is signed off by the Minister David Hanson on the 30th March 2010. This is the day before the ACMD published their advice on Mephedrone, which were dated 31st March 2010. Given the content of the Equality Impact Assessment, and the drafting time required, it is obvious that the Home Office received the ACMD reccomendations in a draft form prior to their official publication - in order presumably to prepare the required legislative paperwork within the tight timeframe of the dissolution of Parliament.

A close look at the Explanatory Memorandum and Equality impact assessment highlights how quickly and badly this piece of legislation has been prepared, and with how little consideration.

The first thing that is woefully apparent is the extent to which this is legislating without a clear idea of the scale of the problem, or the impact of the solution; so the report says "Any real costs associated with [prohbition] cannot be predicted. Not only is the scale of the availability of mephedrone and other cathinone derivatives unknown, but the impact on the police and consequently the CJS is dependent on the policing response to its control as Class B drugs." So in short we don't know how many people use mephedrone, how it should be policed post prohibition, and how many people, especially young people will be criminalised as a result.
The report admits that "there is no current direct evidence that mephedrone cause any significant social harms such as acquisitive crime and anti-social behaviour."

The Equality Impact Assessment is meant to look at if any particular population is disproportionately affected by the legislation. The only group noted is young people; the EIA says "Age Indications: from small-scale surveys (e.g.Mixmag, Frank Website) and anecdotally suggest young people are the largest consumers of these substances. The change in policy will protect the huge number of young people currently using these substances or intending to do so fromthe harms caused by these substances."

This is a very loaded assertion. Having already acknowledged that we have no evidence of the scale of mephedrone use, the EIA makes the unwarranted assertion that there are "huge numbers" currently using the drug, and that prohibition will protect them from harm. There is no acknowledgement that prohibition may criminalise young people, drive up the price, or bring young people in to contact with other controlled drugs. Indeed the evidence that was available suggested that the biggest user groups were young adults with a mean age of use of 23, and the biggest group contacting helplines about Mephedrone were 19-25 year olds. So the primary user group were young adults. It's probably one of the benefits of products primarily sold to people who hold credit or debit cards, or PayPal accounts. It makes it that much harder for young people to access.

The EIA goes on to say "It is not anticipated that the change in policy will have any significant adverse impact on this group of users." Which given that some young people will receive criminal records as a result of the change is hard to fathom. Maybe this isn't counted as an "adverse impact."

One of the areas where the EIA is most misleading is in the section entitled "How did your engagement exercise highlight positive and negativeimpacts on different communities?" This section says, in the age section "No concern expressed in response to the public consultation over the impact of controlling these drugs on age." This is a complete misrepresentation. There was no Public Consultation, and so it is disingenuous to say that no concern was expressed.

The deliberately misleading statements continue, in the section asking "What were the main findings of the engagement exercise and what weight should they carry?" The answer given is "The engagement exercise showed support for control measures for these drugs, but did not raise any findings associated with equality issues." Again, a lie. There was no "engagement exercise." So to claim that is showed support for the measures is not true.

And while no consideration has been given to the direct impact of prohibition there was no awareness or consideration of the indirect impact - that as a controlled drug the cost of mephedrone will go up, quality will drop, and trade will switch to people prepared to take the risks of dealing in controlled drugs. Mephedrone won't go away; it will shift to a different market. And as availability drops, we will probably see a switch back to cocaine. The cartels will be celebrating even while a credulous media congratulate themselves on bumping a Government in to action.

This isn't the first time that rushed drugs legislation has been pushed through prior to an election: the proposed revision to Section 8 of the MDA was squeezed through in the wash-up period, and later revoked. Likewise, the Drugs Act 2005 received assent in April 2005, the month before the General Election. Much of it has never been used since, or was since abandoned.

The only thing robustly evidenced base is that the Government has a poor track-record of passing drugs legislation prior to elections. They've done it again with mephedrone. And, sadly, will not be in office in a month's time to be held to account for it.

MMCAT Madness

2009-11-29T13:52:00.003Z

The bulletin boards of the UK drug scene, the media and drug agencies are all talking about the same drug MMCAT (also known as mephedrone). For those readers unfamilar with this drug there's a briefing on the KFx website at http://www.kfx.org.uk/mmcat2009.pdf

MMCAT is a relative newcomer to the drugs scene and is probably one of the best examples of a true designer drug that has gone global in a couple of years. Developed and marketed in Israel in 2007, it started to crop up in the UK early 2008 and by late 2009 has reached a high level of market penetration.

Drug discussion boards, music and party sites are full of mephedrone discussion. It's become an increasingly popular stimulant, lawful to possess, Ecstasy-like effects and perceived safety all make it a drug likely to be the must-have as the festive season approaches.

The emergence of MMCAT highlights the inadequacies of current Government drugs policy and strategy. Despite the fact that MMCAT has been available for over two years, it has not been the subject to any assessment of risk, review, or any efforts made to regulate or control the trade.

In March 2009 the ACMD wrote to the Home Office http://drugs.homeoffice.gov.uk/ACMD_Letter_to_Home_Secreta1.pdf partly to tellthe Home Secretary that they had an Early Warning system to provide information about trends. On this occasion the system appears to be sadly lacking as, while the letter speaks of looking at Spice, it doesn't mention Mephedrone at all.

However, prodded in to action by a recent flurry of media interest, the Home Office was reported on Sky as saying "The ACMD are looking into it as a priority as part of their review into legal highs....they will report back next year and their advice will inform our response to these substances." http://news.sky.com/skynews/Home/UK-News/Party-Drug-Meow-Meow-Sold-Online-As-Mephedrone-Teenager-Gabi-Prices-Dies-After-Taking-Legal-High/Article/200911415468664?lpos=UK_News_First_Home_Article_Teaser_Region_7&lid=ARTICLE_15468664_Party_Drug_Meow_Meow_Sold_Online_As_Mephedrone%3A_Teenager_Gabi_Prices_Dies_After_Taking_Legal_High

However, with the ACMD currently without Chair, following the Home Office intemperate decision to sack Professor David Nutt, the festive season approaching and a general election after this, the odds are that it will be a good six months before any legislation can be put before Parliament.

The legislation alone could prove challenging. The UK has relatively wide ranging catch-all drug clauses within the Misuse Of Drugs Act, which covers many of the Phenylethylamine family of drugs. This legislation, widened after Ecstasy (MDMA) became popular, was intended to ensure drugs based around the same 'parent' as Ecstasy would also be illegal, even if they had molecular differences.

Now MMCAT is built on a cathinone base; this is the same compound present in Catha Edulis, the African plant Khat which is widely used in Sub-Saharan Africa. While Khat is currently legal in the UK, specific components and related compounds are not: so cathinone and methcathinone are controlled drugs. But compounds built on this base are not controlled. So chemists have been exploring a whole family of drugs - the beta ketones, which are not currently as tightly controlled as the Phenylethylamines.

So any legislative changes would need to be drafted carefully to ensure that they didn't simply create lots of new loopholes.

But this isn't really about legislation to 'control' MMCAT. More than anything MMCAT (and Spice before it) highlight the complete failure of the current control systems. The speed and development of new synthetics will continue to outpace the lumbering progress of Academics, media and politicians. Even if MMCAT is added to the list of controlled drugs, new products will not be far behind. The spread of knowledge, tools, markets and producer countries far outstrips the ability of States to control and remove them.

So for example, although precursor chemicals for many drugs (like Ecstasy and Amphetamine) are closely watched, the precursors for MMCAT are not, making it a relatively easy product to synthesise.

The extent to which producers and users are ahead of the curve, and the researchers and enforcement behind it is well illustrated by a look at some websites. So, for example the site Drugs Forum (http://www.drugs-forum.com/) has a massive compilation of user reports, product descriptions, advice, harm-reduction and dangers. It runs to several hundred pages of resources. In comparison there's a single page on the Government funded Frank website. In comparison you could probably count the number of academic texts or journal articles on one hand without using your thumb.

The inadequacies of the current system are also exemplified by the "no man's land" in which MMCAT suppliers find themselves. It's not a controlled drug so it can be lawfully supplied BUT it can't be supplied for consumption as it runs the risks of falling foul of the regulations relating to the supply of medicine. But the work-around - of labelling the products as "bath salts" or "plant food" and marking them "not for Human consumption" leaves users at greater risk. Rather than being able to accurately label products with dosage information and risks, suppliers use code to suggest how to use the substance. But this leaves much confusion.

Further, as the substances are not sold for "human consumption" there's no protection for consumers - and no holding suppliers to account. So we end up with the worst of all worlds: an unregulated market, no clear information on harm reduction, no consumer protection and a grey area that is in no-ones interest.

But if Government and the ACMD have acquitted themselved badly in the face of Mephedrone, little could be worse than some of the hyperbolic, inaccurate and hysterical media reporting over the past few weeks. Given a new drug, some linked fatalities and an absence of "authoritative information" the media has gone in to overdrive.

So for example the "Sun" reported that "Legal Drug Teen Ripped His Scrotum Off"

but the article backs this up by quoting the police who in turn support their claim, rather than through toxicology reports but through website chatter. So we don't know for example if another drug (e.g. Ketamine) was involved.

The Daily Mail have been worse still. When reporting the tragic death of 14-year old Gabrielle Price they reported that she had taken "plant fertiliser Mephedrone." It may be many things to many people, and although sold as a plant food is not any such thing.

But the Daily Mail is a shining light of journalistic excellence compared to the Evening Telegraph and Post

It quotes local councillor Bill Sangster who flies in the face of Police and Home Office opinion and says "It is illegal, harmful and can become addictive.” Well, two out of three ain't bad.

More ludicrous are the claims "According to the Levenmouth-based Drug and Alcohol Project Ltd., the mixture in the capsules is produced in varying colours to signify its composition and strength, although cocaine is believed to be the main ingredient.
Capsules are broken and the contents are snorted, placed on to the eyeball, or swallowed by the user, who experiences an immediate high described as mix between ecstasy and LSD."

This is either the most ill-informed drug service in the UK or the worst journalism, possibly both.

The article goes on to report that the tested capsules contained a low dose (0.191g) of MMCAT but this fact seems to have escaped the sub-Editor who allowed the rest of the drivel to be printed.

So given an ill-informed media, an unregulated substance, an ill-prepared Government and an impending festive season, we have an almost perfect storm. In the aftermath, there will almost certainly be moves to make MMCAT a controlled drug. But the wider systemic changes that need to be made won't be forthcoming and so this situation will happen again and again and again.

Seeds of Destruction...

2009-10-20T17:24:00.002+01:00

Hemp seeds, THC, False Positive Tests and Intransigence.

This is sad, cautionary, true story. It is intended to highlight a little-known hazard of hemp-seed products. The names the people and organisations involved have been changed.

In March 2009, a woman called Anna got in touch. She had lost her job, she claimed, because she had failed a random urine test at work. She had tested positive for cannabis metabolites. Her employer, a large national company with a strict drugs policy and testing regime, had dismissed her. With the help of her Union Rep she planned to challenge the dismissal. Could, she asked, we help?

She was adamant that she had not used any illict forms of cannabis. She was however a regular user of Hemp Seed Oil, a legal and highly regarded dietary therapy. Hemp Seed Oil is reputedly high in Essential Fatty Acids and Omega 3,6 and 9 EFAs. Could this have been the cause of her positive test result?

Anna had been using Hemp Seed Oil from a reputable herbal therapies supplier. They said that the amount of THC in their product was 6 ppm (parts per million). This alone would come as a suprise to most people, who assume that there is simply no THC in seeds. However, in cropping and processing, resin can adhere to the outside of the seeds. While careful washing and processing will remove the majority of this THC, a small amount will survive the processing and get incorporated in to the final product, albeit at very low doses. However, the website of the Herbal Remedies supplier makes no mention of this, even after Anna's experience, of which the company are aware.

Anna was taking up to six table-spoons of Hemp Seed oil a day - some 60ml/day at 6ppm THC. This would mean she was consuming around .35mg THC/day. This is well below a psychoactive dose, but would it be enough to trigger a positive urine result.

There is very little robust research on the subject of THC levels from use of Hemp Seed. Much of the research has been funded by manufacturers of Hemp Seed Oil, keen to disprove that Hemp Seed Oil could result in positive THC results. Attendant negative publicity would have damaged the Hemp Seed Oil market, something manufacturers were keen to avoid.

Fortunately one piece of robust research had addressed this problem, in a paper snappily entitled "Urinary Cannabinoid Detection Times after Controlled Oral Administration of 9-Tetrahydrocannabinol to Humans" Clinical Chemistry. 2003;49:1114-1124.
This paper reported that "The 0.39 and 0.47 mg/day doses produced maximum urine THCCOOH concentrations (cmax) of 7.3–38.2 and 5.4–31 µg/L, respectively, with mean times to the highest THCCOOH concentration (tmax) of 99.9 and 85.9 h, respectively."
The cut-off for a positive result used by the Labs used by Anna, and by her employers, was 15 µg/L, a level that Anna had just exceeded. But based on the Journal of Clinical Chemistry, a dose range of 0.39mg/day (a fraction higher than Anna's 0.35mg/day) produced results that ranged from 7.3-38.3 µg/L. At the high end this means the results would be more than double the cut-off used by her employees.

Based on these results it seemed very apparent that the Hemp Seeds could well have caused the positive results, especially when at high doses for a sustained period of time. In Anna's case this was more than six months: far longer that the time frame used in the clinical trials.

These results were submitted to the Appeals Board on Anna's behalf. We were optimistic that the Appeal would be successful based on the evidence submitted which was robust and scientific.
Amazingly, the appeal was not allowed. Her Employees didn't reject the evidence about the test results. Instead the company used their policy demand that "any medication which may affect a persons ability to undertake their duties must be disclosed at the earliest oppertunity." Anna hadn't disclosed her use of Hemp Oil. Why should she have done so? Nothing she had been told by the herbal supplier suggested that it would produce a positive drug result. And the THC levels present in the Oil wouldn't have affected Anna's ability to undertake her duties. So there was no need and no reason for her to have notified her employee of her Hemp Seed Oil usage.

Unfortunately her employees didn't see it this way; they argued that the Hemp Seed Oil, which resulted in a positive drug test, may have affected her ability to do her job, and so should have been disclosed to her employees at the earliest opportunity. As this hadn't happened, the dismissal was upheld.

As a result the woman in question lost a job that she enjoyed, and entered unemployment thanks to a flawed drug testing regime and an inflexible drugs policy.

I was furious on Anna's behalf. Her employer's inflexibility was astounding and an appeal to an Industrial Tribunal for unfair dismissal seemed the only way forward.

And at this point Anna taught me an important lesson. She decided that she wasn't going to let battling with her former employees ruin her life. After deciding not to appeal she wrote saying "So, now I can concentrate on finding a wonderful new job and of course carry on enjoying the life of a lady of leisure going for long summer walks and sitting in the garden reading long novels!"

Frankly I was blown away by Anna's ability to overcome the injustice and move on. So following her lead I have tried to do the same rather than raging on. But her story still needs to be shared. Because there may be other people who are using Hemp Seed Oil at risk of false positives. And there are still manufacturers of Hemp Seed Oil that don't warn there products can cause a positive drug test result; and there are Testing Labs that will swear blind that the positive test results and cut-offs could only come from cannabis abuse when this is just not the case. And there may be other employers who share the inflexibility and intransigence of Anna's.

On which note if, perchance, Anna's former employeres read this article, I hope that they will spare a moment for the wonderful person that they sacked, and ponder the stupidity of a policy that can't flex enough to cope with an unforseen situation like this in a sensible and humane way.

First they came for the terrorists…

2009-06-15T17:02:00.003+01:00

The news that Police Officers in Enfield have been suspended while investigations take place in to allegations of assault, ‘torture’ and misappropriation of property has been widely reported in the press. Coming on the back of reported Police excesses at the G20 protests, it is all too likely that it will get dismissed as just another local example of poor policing, an ‘isolated incident,’ rather than viewed as more of a systemic problem.

Because there is a bigger problem here. It’s one that organisations such as Liberty constantly warn us about, but is too often dismissed as liberal softness. It’s the risk that when ill-treatment, brutality or a suspension of Human Rights is suspended in one context, it starts the process of legitimising the same abuses further away from the original case. So behaviour that has become increasingly acceptable to some in the “war” on “terror” seeps, inexorably into the “war” on “drugs.”

Of course, the constant demonisation of drug users by politicians and the media has contributed to this process. Legislation has eroded the legal rights of drugs users to a greater extent than any other group in society, apart, possibly, from terrorists. While the police have largely balked from setting up Itemisers at the door of McDonald’s to search for people who have had contact with explosives, there’s no such hesitation at setting up such testing points at pubs and clubs. Thanks to the power of Closure Orders, a person can be evicted from a house associated with nuisance and Class A drug activity although they have not personally used any drugs or convicted of any offences.

In a world where “Rat on a Rat” is an acceptable police campaign to encourage reporting drug suppliers, it can come as little surprise that some Police officers will reduce the rights of suppliers to a similar level.

There may also be another parallel here with the way that torture crept in to the war on terror. Commentators have highlighted how fictional torture (in, for example 24) may have inspired, legitimised and promoted the use of torture in extreme situations, justifying the ends against the means. Perhaps, in a similar way, fiction such as the Shield and, closer to home, Ashes to Ashes has inspired (or created nostalgia) for the torturing of suspects and profiting from the seizure of goods.

But in practice this is neither a nostalgic throwback to smoke-filled basements and giving the suspect a good going over, nor is it turning over the Armenian money-train. This what happens when the Government and successive mayors in London sanction brutality against protestors, strikers, demonstrators and suspected terrorists, and the media and politicians create a folk devil out of drugs and those who use them. You reap a whirlwind.

You wait for ages for a Drugs News service and then three come along at once!

2009-06-11T21:30:00.003+01:00

The strange saga of Daily Dose and DS Daily...

It’s been a funny few months for drug news services. For a long time the Daily Dose, established by David Clark, was the first daily Drugs News bulletin. Compiled by the industrious and diligent Jim Young, it built up a significant number of subscribers.

But, in April 2009, Jim Young left the Daily Dose. Editorials on the Daily Dose website suggested that attempts by the NTA to interfere with editorial content was the cause of this, a claim refuted by the NTA. The Daily Dose was briefly suspended, before reappearing with a new format at the end of April.All this must have been manna to Drink and Drug News who launched their own email Drug News service at the end of March. This subscription service (at http://www.drinkanddrugsnews.com/Register.aspx) is a relatively slim affair compared to Daily Dose, focussing as it does mainly on UK news services.

As if all this wasn’t enough, Drugscope then launched their own news service DS Daily – (http://www.dsdaily.org.uk/) in May 2009. Previously, their news had come from their regular Members Briefings but the DS Daily represented a new development, currently not dependent on Drugscope membership. But the biggest surprise of the launch was that Jim Young had moved across to Drugscope and was editing/running the DS Daily. First impressions of DS Daily is that it looks to be an excellent service, well-edited, and covering important stories. It is also much tidier and not overly cluttered either by advertising or by op-ed pieces.The launch of DS Daily, and the re-emergence of Mr Young within the Drugscope team, suggests an interesting back-story. The website name was only registered on the 7th May 2009, and the website was up and running a couple of weeks later. This all suggests some nimble footwork on the part of Harry S at Drugscope and some fast work by Jim. As an aside, site admin appears to have been done by Ash Whitney of Wired Up Wales, who had previously been the webmaster for Daily Dose!

However, three similar news aggregators would seem to be too many to be sustained. Few people are going to want to receive all bulletins as they will contain much duplication. Some will lose subscribers. This probably won’t be fatal. The bigger challenge will be funding, and which provider can garner sufficient funds and clout to survive.At present, Daily Dose has a far higher profile than DS Daily. But then it has been around since 2001, and so has a major headstart over the Drugscope upstart. And even if there is a drop off in subscriptions, the number of organisations linked to Daily Dose assures it a high search-engine rating for the foreseeable future. But it isn’t all about traffic. The funding is crucial and here, Daily Dose has probably shot itself in the foot.

Following their contre-temps with the NTA, Daily Dose decided to decline further funding from the NTA. We don’t know how much this was scheduled to be; in the year 07/08 it appears to be £50,000. For a charity that reported sponsorship of only £80,000 in financial year ending May ’08, such a drop off in funding could be catastrophic. Ominously, the NTA email hinted at the role that other could play, saying “However, the shut-down provoked some people to start asking questions, and others to suggest that they could step into the breach to provide an alternative”

Drugscope’s sponsorship of Daily Dose was scheduled to end anyway; the NTA’s has now gone, and it will be interesting to see how long sponsorship from the Home Office (which results in the FRANK logo and Tackling Drugs Changing Lives) remains.

It may well be that we end up with three distinct ‘products:’ the Wired-In community site which ends up primarily promoting a recovery model, Drink and Drug News bulletins, which includes some news stories and importantly recruitment opportunities and field-specific developments, and DS Daily, which will concentrate on the dissemination of news and bulletins. We will have to wait and see.The only thing that also remains unclear is what really went on behind the scenes in late April at Wired-In resulting in Jim’s departure and rapid reappearance at Drugscope. While the NTA’s email may have been significant, the developments point strongly to internal issues at Wired-In and the direction in which Daily Dose was going. But, as with which of the drug news services will survive this year, only time will tell.

Last twist of cannabis reclassification travesty

2009-02-10T22:57:00.004Z

In the last post on cannabis reclassification it appeared that there would be a delay before Penalty Notice Orders (PNDs) for cannabis possession were introduced.

The Statutory Instrument that would have brought PNDs in for a variety of offences had been scheduled for introduction on the 26th January 2009 but, faced with a rising chorus of opposition from bodies such as the Magistrates Association, the introduction was suspended.

This was to allow the Ministry of Justice to undertake a proper consultation with stakeholders about the offences covered, something that, up until this stage hadn't happened.

However, in their desire to introduce PNDs for Cannabis Possession, the Government then decided that consultaton on this specific PND was not actually required and asked the House of Lords to pass a motion introducing PNDs for Cannabis possession.

After a mere fifteen minute discussion on the subject (most of which was of little value) the Motion was passed and, it seems PNDs for cannabis came in to force. The passing of the Lords motion took place on the 26th January 2008 between 7.55 and 8.20pm. Two Lords spoke. The Motion was then passed. This it seems was all that was required to bring the PND in to force.

The record of the debate is here

Ironically, Lord Bach, proposing the Motion for the Ministry of Justice had the temerity to assert "The proposal that cannabis possession should be added to the penalty notice for disorder scheme was made public last October. We believe that there has been plenty of opportunity for people to comment on it."

This is a laughable assertion. There was no formal consultation on the subject despite the fact that Home Office had previously assured that there would be a consultation. There was a complete failure to consult. We asked the Ministry of Justice in November 2008 when the consultation would take place. In January 2009, two weeks before the motion was passed we finally received a reply from the Ministry of Justice, letting us know that no formal consultation would be taking place.

If Lord Bach therefore truly believes that this represented "plenty of opportunity for people to comment on it," then there is something truly rotten within the MoJ.

Further it seems that while other less serious offences being considered for PNDs are now on hold, pending consultation, one of the most serious, cannabis use, is not considered worthy of consultation or proper debate and has been fast-tracked for political expediency.

While it seems almost certain that PNDs for cannabis have come in to force, we are double checking this; while ACPO and the Home Office have released guidance, information and resources which state that PNDs can now be issued, there may still be some confusion. Certainly two days after the Lords Motion on the subject, Maria Eagle MP, providing a written answer said "When, penalty notices for disorder become available for the offence of possessing cannabis, my right hon. Friend the Secretary of State will issue guidance under section 6 of the Criminal Justice and Police Act 2001 about their issue." (ref)
Which certainly gives the impression that either the Parliamentary Secretary for the Government Equalities Office (!) doesn't have a clue what she is answering questions about OR further action needs to be taken before the PNDs come in to force.

Frankly, who knows? Maybe FRANK does? But in an interesting departure the new information leaflet on cannabis reclassification comes not with FRANK's usual happy banter and warm graphics. Instead there's a formal HM Government/ACPO document (see here) which explains the changes in fairly formal terms.

Given the millions being spent on Frank it seems a little strange that the vehicle for publicising the change would be such a utilitarian one. It could be that given that the move to reclassify cannabis is not popular with young people, there is an attempt to "insulate" Frank from negative associations by creating the illusion that this is something that the Government is doing and nothing to do with avuncular, independent Frank. Alternatively it could be that in the current financial climate there wasn't enough time or money for a swarm of designers to make the document look hip.

All this confusion should come as no suprise. It's the tail end of the actions of a home secretary who first decided to ignore the guidance of the ACMD and push ahead with reclassification, who decided to pursue PNDs for cannabis possession without consulting, and then decided to push through the required legislation by sidestepping the elected houe and getting the Lords to do it late in to the evening. So much for evidence based policy. So much for consultation. So much for democracy.

The ACPO guidance is here

The Home Office FAQs are here

To B or not to B - the chaos of Cannabis Re-reclassification

2009-01-26T10:54:00.003Z

Cannabis moves back to B while everyone tries to work out how policing will now work

On the 26/1/09 Cannabis moved back to Class B. To accompany this move, new policing strategy and guidelines should have also come in to force, which included a series of escalating penalties for cannabis possession. This should have included the introduction of Penalty Notice for Disorder (PNDs) for second offences of Cannabis Possession.

However, as with every other aspect of cannabis policy, the reclassification has ended in farce, confusion and recrimination.

As we previously reported, the proposal to introduce PNDs has had to be postponed as the spectrum of offences to be covered by PNDs has met with the disapproval of the Magistrates Association, amongst others.

So PNDs will not now be introduced until the Ministry of Justice has undertaken a proper consultation on the subject, something that as early as last week they maintained was neither required or possible.

As a result of this, PNDs for cannabis possession will not now come in to force at the same time as cannabis moves back to Class B.

At present, neither ACPO nor the Home Office has indicated how cannabis should be policed in the meantime. It is likely that the existing regime - of two cannabis warnings at most followed by arrest - is the most likely course of action. This would mean that, in the short term at least, the move back to Class B would have no meaningful impact on cannabis possession.

The media coverage of the reclassfication today has been as confused as the reclassification itself. Interviewed on the Today programme, John Fassenfelt of the Magistrates Association railed against the way reclassification had been conducted. He argued that cannabis was, illogically, being treated differently to other class B drugs and that the power of magistrates to look at cases was being circumvented by the decision to allow PNDs for cannabis possession. He somewhat undermined his case by being unable to think of another Class B drug, but the principle remains.

However, the most poor performance came from the woefully underprepared Home Office Minister Alan Campbell. He was challlenged on why cannabis should be treated differently to other Class B drugs - and be the subject of PNDs when other drugs weren't. One of the reasons he offered was that each drugs really should be treated on its own merits and that, even within Classes drugs should not be treated the same. Which, when you think about it, is a pretty damning indictment of the current classification system.

However, the most laughable suggestion as to why cannabis should be policed and treated differently was that cannabis was easier to identify in the street (unlike other Class B drugs such as Amphetamine) and so could be handled differently as nothing needed to be sent off for analysis. Presumably, the same bizarre logic could be applied to a host of other drugs, such as Magic Mushrooms.

Unfortunately, Campbell wasn't pushed as to why the Home Office and MoJ had botched the introduction of PNDs quite so badly. So instead he spent a lot of time stressing that the first option available to Police Officers was to arrest and charge, and that they had the discretion to use other interventions.

This was somewhat disingenuous as ACPO guidance on cannabis to date has stressed a presumption against arrest. Further, the onus has been on the police to demonstrate that an arrest was warranted as opposed to it being an approved intervention in all cases.

So at present, cannabis has moved from Class C to B, with no guidance to explain how it will be policed in the short term, and uncertainty as to how the rollout of PNDs will take place now. Now that's what you could call sending out clear messages about cannabis!

PNDs for Cannabis on Hold

2009-01-21T16:57:00.002Z

Cannabis back to Class B but PNDs will have to follow later

Hot on the heels of the last post, lamenting the Government's failure to consult properly on the introduction of PNDs, there has been a change of heart at the Ministry of Justice and there will now be a period of consultation.

However, this is not a cause for jubilation. Nor does it appear to be directly related to cannabis. Instead it seems to be a result of Magistrates raising objections to the PNDs on the grounds that many of the offences were considered by Magistrates too serious to be handled with PNDs. Their focus (according to the Daily Mail) was the addition of unlicensed cabs to the list of offences which could receive a PND.

As a result, the Ministry of Justice has now said "the government has listened to concerns about certain aspects of extending the penalty-notice-for-disorder-scheme and has decided to consult more widely on the new offences to be included."

So last week, according to the Ministry of Justice, a consultation had taken place, (albeit of a limited nature) and there was no scope for wider consultation, and a week later, a wider consultation is required.

Now, hopefully, this will be a proper, open, public consultation. Then again, who knows what will happen next week.

http://news.bbc.co.uk/1/hi/uk/7838928.stm

Cannabis Fines - Home Office Misleads regarding Consultation

2009-01-19T09:33:00.003Z

No Consultation on PNDs for Cannabis Possession despite Home Office Assurance.

In October 2008, in their press release entitled "Tougher Action on Cannabis" the Home Office said that prior to Penalty Notices For Disorder (PNDs) being introduced, consultation would take place.

They said "Under penalty notice for disorder proposals, on which the Ministry of Justice (new window) will shortly run a consultation."

We wrote to the Ministry of Justice in November asking when this consultation would be taking place. A long period of silence followed.

Last week we finally received a reply from the MoJ saying that no consultation would take place, and suggesting that responsibilty for this lay with the Home Office. They said:

"Possession of cannabis is included on a list of proposed new offences drawn from a longer list on which we consulted stakeholders in 2006. The Government decided that the PND should be available to officers, subject to Parliamentary approval, on re-classification of the drug to Class B on 26 January 2009. In the light of this decision, it has not been possible to carry out a full consultation."

This response is astonishing. The Home Office clearly stated a consultation would take place. This would have been an opportune time to explore how impractical the introduction of PNDs would be, what safeguards would need to be in place, and give stakeholders a chance to comment and critique the proposal.

In 2006, a small scale MoJ consultation looked at adding certain offences to those which could be dealt with by PNDs. However, this consultation was restricted to ACPO, Justices and Magistrates Associations but not the public.

In the Explanatory Notes which accompanied the Criminal Justice and Police Act Ammendment (2009) which included adding cannabis to the list of PND offences the MoJ said:

"More recently, Departments with substantive policy responsibility for the various offences now being added have conducted consultations with their own stakeholders Therefore, although
there has been no formal public consultation, all those most involved and affected have had ample opportunity to make their views known." http://www.opsi.gov.uk/si/si2009/draft/em/ukdsiem_9780111471876_en.pdf

So in effect the MoJ are saying that, as far as they are concerned, the Home Office consulted their Stakeholders regarding PNDs for Cannabis. And the Home Office said the MoJ would consult.

More worryingly, these proposals were never debated in Parliament. The Statement made by the Home Secretary on the 7th May 2008 made no mention of PNDs. They were mentioned in Written Answers in October 2008, and again they were mentioned in the Lord's Debate on the subject in November 2008.

Th upshot of this has been the introduction of PNDs never taken before the House of Commons, and no public consultation on the subject - just a RIA which was not available when the proposal went before the Commons.

Conspiracy or confusion? Who knows. The end result is the same.

January 2009

Eyes Wide Open Housing - Awards Not Courts

2008-11-16T13:01:00.006Z

Ten years after the first Eyes Wide Open housing was trialled in the UK, a hostel working with ongoing users has received national awards. It is long overdue. And now there can be no excuse for others not to follow suit

We are immensely pleased to report that the King Georges Hostel in London, part of ECHG, were the recipients of two awards at the Chartered Institute of Housing/Inside Housing Awards for Outstanding Achievement In Housing (England) and Meeting the Needs of Vulnerable People. King Georges are one of the growing number of housing providers who have adopted and adapted the “eyes wide open model” of housing provision that has been pioneered here for a number of years.

The Gateway Programme at King Georges Hostel is a pioneering initiative to provide housing, drugs education and harm reduction interventions to some of the most vulnerable dependent drug users in housing need.

The Programme takes in dependent drug users in housing need, provides housing in attend education and awareness sessions on injecting, overdose, and blood borne viruses. Despite the low level of obligations at admission, residents have been engaging with a wide range of initiatives, including Turning-Point provided drug treatment, nutrition and cooking programmes, outdoors fitness sessions and football clubs. The take up of interventions such as Hep b vaccinations is exemplary and despite the high-risk client group drug deaths have been prevented.

King Georges has made use of the resources, policies and guidance produced on the KFx website to help shape and develop this provision and we are pleased to have contributed in this small way to the establishment of the project.

Whilst offering King Georges staff and residents our congratulations for their win, this award is pleasing as it is, at last, recognition for a model of work which has been increasingly widely adopted or considered but has lacked the imprimatur of “official” recognition.

Ten years ago, Single Homeless Project (SHP) in London became the first housing provider in the UK to deliver inclusive housing to active drug users, where drug use was not only fully acknowledged, but fully engaged with, including access to sharps boxes, needle exchange, harm reduction services, and treatment modalities.

Whereas previously organisations had turned a blind eye or prevented drug use, SHP were early adopters of an “eyes wide open” model which they have used successfully used in their housing provision in several London Boroughs.

Since then a growing number of Housing Providers across the UK have been working within an “eyes wide open model.” Many have found marked benefits from this approach – better engagement, more openness, increased referral to treatment, reduction in public drug use, reduction in overdoses and drug deaths.

These agencies, including Brighton and Hove Housing Trust, Thamesreach, Look Ahead, Society of St James, Wallich Clifford Community, Manchester Methodist Housing Group, Foundation Housing, St Mungos and a number of others were courageous early adopters of such an approach.

It should be remembered that at this stage there was no official endorsement of such a model of work. Ten years ago, at a conference, it wasn’t even possible to get Ian Brady, then of the Rough Sleepers Unit, to publicly endorse the placing of sharps boxes in hostels! The Home Office was pursuing a policy of extending the Misuse of Drugs Act 1971 which would have made such provision illegal. And the repercussions of the Wintercomfort case made many housing providers wary of pursuing such an approach.

Since then there has been moderate progress. Norfolk DAAT embraced and endorsed an eyes wide open model in their superb document The Spectrum of Possibility. Research from Shelter demonstrated the benefits of the model in “Safe as Houses.” Papers from Cymforth Cymru reinforced the message that full spectrum, eyes wide open housing was a safe, lawful inclusive model of working with housing drug users.

Unfortunately, official recognition has been slow in coming. In 2006, an agency receiving a Housing Corporation Gold Award for Homelessness Strategies was pursuing a policy where suspicion of use (including drowsy symptoms or paraphernalia) was grounds for eviction – and this from an agency purporting to work with ongoing users.

But despite the absence of official endorsement, support or sanction, the work has crept on.

Even amongst organisations working in this way, all too often it has felt like a “dirty secret” where organsisations don’t explicitly acknowledge that they house ongoing users and manage use on site. All too often, the same organisations starting to undertake the work have to battle not just NIMBYism, public and political barriers but also too often their own organisational policy and hierarchies.

The decision by the DCLG to (quietly) endorse the “eyes wide open” model in their paper Improving Practice in Housing Drug Users was of course highly welcome, albeit that the paper fell short of an unequivocal statement acknowledging the importance of managed use on site.

So the presentation of two awards to King Georges Hostel is hugely welcome. It is not just an important acknowledgement of their work, and the progress that they have made in working with drug users.

It is also an endorsement of a model of work developed and pioneered here. From the early days, developing a model after leaving the Big Issue, through the time working and promoting it at Release, and over the past five years working with the growing number of organisations who took the work forwards, it has been a decade of change, innovation and progress.

For agencies thinking about adopting ‘eyes wide open’ models, the award to King Georges should provide the impetus to move from contemplation to decision. The resources on this site and the Drugs and Housing website provide some of the tools that such agencies will require to take this work forwards.

Eyes Wide Open housing has been a rare step change in the provision of services to drug users. In its own way it has proved as significant as the provision of needle exchange in representing a brave break with orthodoxy and the provision of pragmatic, life saving and life changing interventions.

One of the managers at King Georges got in touch a while after putting in place a lot of the changes and expressing thanks for the support and inspiration. He described what he’d got from here as “lighting the touch paper a few years ago that made me realise it could and should be done.” I am immensely pleased, proud and gratified that after ten years of work the “eyes wide open” approach is gaining acceptance and endorsement.

For myself, the drive to establish a new, inclusive model of housing which would take people who still used drugs and move them in to appropriate, supported housing began because of the tragic, senseless deaths of two young men on the streets of London, Chris Crowther and Chris Readman (aka Cockney Chris and Geordie Chris). They were murdered on Berwick St, London, on the 24th June 1997. Then, appropriate, suitable housing didn’t exist. They’d been routinely excluded from housing because of their drug use. They could and should have been housed in the right housing with the right support. There wasn’t anywhere for them then. Now there is. It’s a legacy worthy of them. And I wanted to make sure that amongst the awards, the professional congratulations and the backslapping, the small, personal tragedy that was the spark that lit the touchpaper is not forgotten.

More Hash Fudge!?

2008-11-11T21:29:00.009Z

As Jacqui Smith blunders on with her re-reclassification of cannabis we look at how she's managed to end up with a position which fails to meet the expectations of everyone with an interest in cannabis.

On the 7th May 2008, the Home Secretary, Jacquie Smith, acceded to the demands of the tabloid media and reactionary drug prohibitionists such as Talking About Cannabis. Despite recommendations from the Advisory Council on the Misuse of Drugs (ACMD), Smith decided to move cannabis from Class C back to Class B.

Five months later, Jacquie Smith release more details as to proposed policy and policing changes that would accompany this reclassification. These proposals added yet another layer of confusion and fudge to the ongoing mess of cannabis reclassification.

The Home Secretary faced something of a challenge. On the one hand, to satiate the media's demand for action, the decision was made to move cannabis back to Class B. This decision was reached despite the fact that the ACMD, whose opinion had been sought by the Home Office, recommended that cannabis should not be moved back to Class B. It was also despite a documented decline in cannabis use amongst young people, and no new evidence that cannabis was responsible for an increase in mental health problems.

Undaunted by an absence of evidence, she instead drew on various other evidence sources, saying "In reaching my decision, I have also taken into account the views of others, particularly those responsible for enforcing the law, and the public-58 per cent. of whom, according to a survey carried out for the council, favour upgrading cannabis from class C."
http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080507/debtext/80507-0004.htm

The ACMD commissioned a small piece of research to inform it's report. Amongst other things, the research showed how hopelessly confused and ill-informed about cannabis and the law respondents were.

Of those polled, 80% were aware that cannabis was an illegal drug, 4% thought it was legal and 16% "did not know".

Of those who knew that cannabis was illegal, 12% thought it was in Class A, 31% in Class B and 52% in Class C.
[Cannabis: Classification and Public Health: ACMD: 2008: p26]

So, of the sample of a thousand, only some 400 knew the current legal status of cannabis.

When asked about in what class cannabis ought to be,
32% considered that it should be in Class A, 26% Class B and 18% Class C, while 13% stated that they "did not know".

However, when they were asked to consider what penalties ought to be applied for possession, 11% considered seven years' imprisonment (equivalent to Class A), 13% five years (equivalent to Class B) and 41% two years (equivalent to Class C), and 27% considered that there should be no penalty [ibid: p27]

So while the ACMD's public survey did show that the majority thought cannabis should go up in class, the vast majority felt that the penalties should stay the same or go down.

Interestingly these results are the opposite of the Home Office's consultation on drugs which took place prior to the launch of the new Drug Strategy. This was also quoted in the ACMD report, which noted "Of the 639 individuals and organisations responding to these questions, 44% wished cannabis to remain Class C; 19% wished it to become a Class B substance; and 19% wished it to be legalised. One hundred and sixteen respondents were undecided." [ibid: p26]

It's a fine example of the selective use of consultations and research. The Home Office public consultation, which came down against cannabis reclassification, was disregarded, along with the ACMD's recommendation. The small sample of confused respondents which supported the Home Office's opinion is cited to bolster the Government's position.

Jacqui Smith went on to say "My decision takes into account issues such as public perception and the needs and consequences for policing priorities. There is a compelling case for us to act now rather than risk the future health of young people. Where there is a clear and serious problem, but doubt about the potential harm that will be caused, we must err on the side of caution and protect the public. I make no apology for that. I am not prepared to wait and see".
http://www.publications.parliament.uk/pa/cm200708/cmhansrd/cm080507/debtext/80507-0004.htm

Jacqui Smith goes on in her statement to outline how keen she is to see police enforcement increased, saying "To reflect the more serious status of cannabis as class B, I am clear that a strengthened enforcement approach for possession is required."

Five months later, the Home Office issued a Press Release "Next steps for tougher action on cannabis" http://nds.coi.gov.uk/Content/Detail.asp?ReleaseID=381162&NewsAreaID=2 which detailed the proposed enforcement measures that the Home Office wished to take forwards.

This included the introduction of Penalty Notices for Disorder for second offences. The press release proposed "those caught with cannabis on a first occasion could still get a cannabis warning, but on a second occasion are likely face a fine of £80 and arrest if caught for a third time."

The main body of the Press Release fails to mention (though it is included in the footnotes) that the policing situation for under 18s remains unchanged, with them being subject to the reprimand/final warning/charge system incorporated in the Crime And Disorder Act.

The idea of PNDs appealed to the Police because they allowed for enforcement action without the time consuming processes of arrest, charge, courts and suchlike. The appeal for the Home Office was that they provided an escalation after an initial warning, thus saving police time and ramping up the sanctions.

On the Home Office website the message was a bit bolder "Once that change takes effect, anyone caught in possession of cannabis will receive a penalty notice. If they're caught in possession on more than one occasion they could face an on-the-spot fine of £80. Those who are caught a third time, could go to jail." http://www.homeoffice.gov.uk/about-us/news/tougher-action-cannabis
It's not really clear what this reference to a "penalty notice" means. Presumably it is a "cannabis warning" renamed to make it sound stricter. Then there's the fine. The last bit is certainly true in theory, but as the full press release makes much clearer, a third time would mean arrest, followed by a range of outcomes including "release without charge, caution, conditional caution or prosecution."

Depending on their stance and their intelligence, various media outlets interpreted the news in different ways. Some (e.g the Telegraph) interpreted this as meaning that users couldn't be arrested until a third offence. http://www.telegraph.co.uk/news/newstopics/politics/lawandorder/3191025/Cannabis-users-will-have-to-be-caught-three-times-before-they-are-arrested.html

The Daily Mail, who had lobbied consistently for a reclassification of Cannabis, once again displayed their unerring love of a headline and failure to understand the law with their banner "Cannabis users face 'three strikes and you're jailed' http://www.mailonsunday.co.uk/news/article-1077254/Cannabis-users-face-strikes-youre-jailed.html

But as both the Mail and later the Times noted, there was a gaping problem with the Home Office's proposals.

The Times said "The approach was undermined immediately, however, when the Home Office said that warnings for a first offence would not be placed on the police national computer. This would make it difficult for police to check whether someone found with the drug was a first or second-time offender, particularly if the cannabis user was caught in a different police force area from where he or she lived." http://www.timesonline.co.uk/tol/news/politics/article4938527.ece
The proposals were that a first offence would only receive a reprimand but, unless this were recorded nationally, on the PNC, it would not be possible to implement a system of PNDs for second offences. If a PND could only be issued for a second offence, the Police would have to be certain that the person had previously received a cannabis caution.

At present, cannabis cautions are only recorded locally, not on the PNC and there is no requirement to verify the person's true identity or address.

The Home Office has said that it will look in to this issue, but it alone is unlikely to prevent the implementation of the proposed tiered sanctions sought by ACPO and the Home Secretary. However, in one of the rare glimmers of good news in the whole sorry proceedings, there should a be a consultation period at the Ministry of Justice on the implementation of PNDs for cannabis and this may allow a chance for saner heads to prevail.

It is hard to get a good sense of how many people would be affected by PNDs. The National Criminal Justice Board publishes figures as to how many people received PNDs and cannabis warnings over the past two years.

In the year ending March 2008, 102,467 cannabis warnings were issued. http://lcjb.cjsonline.gov.uk/ncjb/perfStats/pnd_formal-warnings.html

It is not clear how many of these warnings were for first or second cannabis offences, but based on these figures it's reasonable to assume some 50,000 people per year would receive these PNDs for cannabis. Outside of London, the police force issuing the greatest number of Cannabis Warnings was Merseyside, issuing some 7000 warnings. This is a little worrying, especially as the newly appointed Cannabis Coordinator was formerly a chief Superintendent on Merseyside, and one of the ACPO leads on cannabis.

It's also worth noting that an £80 PND cost £91 pounds to administer, and less than half of PNDs are paid in the required 21 day window - meaning that many still end up in arrest and court action. So if these procedures are followed we can expect more police and court time being tied up chasing up PNDs for cannabis.

In reality, the proposals surrounding the reclassification of cannabis are, once again pleasing no-one and Jacqui Smith must be questioning the wisdom of this fresh bodge job. In practice, little will change, and Smith has not received the plaudits that she must have hoped for in reclassifying cannabis.

In the list below, we highlight how very little will change when cannabis goes back to Class B. (click on the image to view at full size)

In practice, although cannabis will exist back in Class B, it will effectively be in a class of its own. The penalties and policing of cannabis will be unlike other class B drugs (such as amphetamines) or Class C drugs (such as benzodiazepines).

One could argue that as such, the Home Office is partly moving away from the Classification of system, designing a set of legal and policing responses on a drug by drug basis rather than on the widely discredited Classes of drugs. However, the Government has not had the courage to break fully from the sytem introduced in 1971.

In the meantime, adulterated, unmanaged cannabis will continue to be widely available in the UK and unfortunately, the latest Government fudge will only create more confusion, frustration and bafflement with this unworkable system.

“No-one Written Off” – The Perils of the DWP Green Paper

2008-09-03T10:03:00.004+01:00

First they came for the crack users…(part 4)

A long time ago, I used to work with the homeless people in Central London, back in the days of the “Cardboard Box City.” The vast majority of people with whom I worked had a range of factors that contributed to their exclusion: drug and alcohol dependency, mental health problems, basic skills needs, long offending histories and so on.

However, the initial biggest obstacle to helping these people re-integrate with any services, including housing, was the need for some identification and the need to start a claim.

For some clients, this initial hurdle was massive: a person had to regain their identity: their full name, date of birth, NI number and an address. For younger people this was easier, but for older people, and those with the most enduring health problems, this was a massive issue.

Many people needed some initial help to get a copy of their birth certificate, then support and encouragement to put in a first claim for benefit. This step was critical for so many reasons. Without it, securing stable housing was impossible. But it also represented a stepping stone away from begging, away from the street culture. For some people it also might mean “facing up” to the past. It might mean surrendering to an arrest warrant, to previous debts, or to previous failures.

Having secured the holistic trinity of ID, benefit and housing, the next step – access to treatment – became more realistic. Over the past ten years, there are only a very small number of people who are cut adrift – the massive visible street population has dwindled and the vast majority of people who are drug dependent are in some sort of housing, and have a greater level of stability than was hitherto the case.

The Department of Work and Pensions, with their Green Paper “No-one Written Off,” seems determined to reverse this process. They appear to believe, based on this paper, that mandatory referral and engagement with treatment, and the threat of benefit-related sanctions will act as a spur away from drugs and in to work. What it will do for most problematic drug users is push them away from benefits (as desired) but back to street-existences instead. The prospects of going full circle, back to the cardboard box cities of last century, are all too real.

The DWP Green Paper is a long document but the section related to drugs is in Chapter 2 The report claims that 75% of problematic drug users are in receipt of benefit (some 240,000 people) and of these some 100,000 are not currently engaged in treatment.

The report explores a number of proposals. The least tendentious of these is investing and promoting better joined up working between drugs services, benefit agencies, housing and employment. This would be a welcome development, and experience elsewhere shows that this can have a positive impact.

But the Paper doesn’t stop there and with a rallying cry of “we must go further” the report proceeds to outline the draconian sticks to get problem drug users off benefit.

These proposals include:
• Where claimants are identified as having a drug problem, they will be referred to a drug treatment provider. Failure to meet that provider could result in a benefit sanction.

This proposal is featured in the 2008 Drug Strategy and does not appear to be a “consultation item” but a firm Government commitment.

This proposal is very ambiguous in the paper. At some points the paper says that there should be a requirement to “meet that provider.” However, only a couple of lines later the paper goes further and says “where drug treatment is available and considered appropriate, then there should be an obligation that individuals will take it up.”

These two proposals are radically different: one requires a person to attend a meeting or an assessment; the other obliges the person to take up a treatment package, even if a local provider offered a limited range of treatment modalities.

In response to an article in the HSJ Paul Hayes wrote a letter (reposted in full on the NTA website here) that describes as misleading the assertion that the Government “intends to force people in to treatment.” It is hard to see how the line from the paper that “there should be an obligation that individuals will take [treatment] up” can be viewed as anything other than forcing people in to treatment.

The Paper then go further outlining how Job Centre Plus will be able to identify problematic drug users before imposing treatment requirements. Several approaches are mooted:

• A requirement to make all applicants for benefits declare whether they are “addicted to heroin or cocaine” and face sanctions or prosecution for a failure to disclose.

This wording deserves close attention. A willingness to admit to a drug problem is a huge problem for people with a drug dependency who are not engaged with treatment. As a group, they are one who are most likely to be unable to admit to having a drug problem. This problem or reticence is likely to be compounded in a Job Centre interview setting where the client has not had a chance to build up a trusting relationship with their interviewer yet is expected to disclose personal information of a deeply personal and illegal nature. The majority of Job Centre staff are still ill-trained to deal with problem drug users.

This proposal also becomes embroiled in a semantic argument about the definition of addiction, and the substances involved. If a person views themselves as being in control of their substance use, would it be feasible for them to be sanctioned for “misleading” the Job Centre if their assessor felt otherwise?

• Job Centre Plus to be notified of all cases where person has tested positive for heroin or cocaine and been referred for a Required Assessment, those who have agreed to a Drug Rehabilitation Requirement and those leaving prison who have an identified drug problem.

To make these information sharing schemes work, legislation would be required. While the DWP already leads the way in behind-the-scenes information sharing, substantial expansion of the existing databases would be required to store and process the 200,000 plus notifications per year that such a scheme would generate.

Before even contemplating the practicalities of such a scheme, it’s worth stressing the extension of State power and information sharing that this represents. At present, a positive drug test triggers a Required Assessment; it does not mandate an engagement with treatment. Only 35% of people tested received a Care Plan following an assessment within two months, and of those receiving a care plan 47% of people attending enter a treatment plan. (http://www.homeoffice.gov.uk/rds/pdfs07/horr02b.pdf) The green paper claims that “those who test positive (there are around 80,000 positive tests a year) are referred for a Required Assessment by a drugs worker which in nearly half of cases leads to an agreement to engage with drugs treatment and support.” This assertion is not evidence based and probably misinterprets the facts. The Paper purports that some 40,000 of the 80,000 positive tests engage with drug treatment. In fact it would probably be closer to 15,000, although no comprehensive assessment of Tough Choices is currently available to the public.

In this respect the Green Paper goes further than Tough Choices; a Required Assessment merely requires attendance at an assessment, not engagement. The Green Paper threatens benefit sanctions for a failure to engage with treatment.

The Paper makes no bones about this: it says “in return for this access to drug treatment and specialist employment support, there will be an obligation on individuals to take it up. Failure to do so without good cause would result in a referral back to Job Centre Plus and a potential benefits sanction.”

At present the proposals relate only to opiates and crack cocaine. While most of the text refers to heroin, the later reference to opiates could have implications for people who are dependent on prescription opiates. This is unclear. However, the paper ominously concludes that “over time we will consider the case for extending this approach to others – for example, those dependent on cannabis, powder cocaine, or dependent on alcohol.”

But ultimately, why stop there? Hampered from re-entering work by a weight problem? Why not sanction people who fail to join a dieting club and cut off benefit. Smoking-related respiratory problems contributing to worklessness? Get those nicotine patches on or lose benefit! This is a wonderfully clear example of “first they came for the crack users…”

Without any evidence, the authors of the paper seem to think that the threatened sanction of benefit removal will act as a spur to engaging with treatment. But as those who have had extensive contact with problem drug users will attest, the stick, all too often doesn’t work as hoped. Rather than driving people towards treatment it is more likely to drive people away from benefits. And while this may have some statistical appeal to the DWP it will bring with it a slew of attendant problems; increased homelessness, further distancing from treatment and increased offending. It is to be hoped that wiser heads and evidence will prevail in the face of these measures. But given the Home Office’s resistance to listening to the experts when reclassifying cannabis, one has little hope that they will do so in this case.

The green paper No-one Written Off is a consultation document and comments are invited until the 22nd October 2008. The body of the text invites comments on specific questions. It does not ask the question “should benefits be removed from people with drug problems who are not engaged with treatment?” Respondents will want to answer questions and pose challenges which are not currently invited by the (limited, specific) questions in the Paper.

The Paper can be viewed here. http://www.dwp.gov.uk/welfarereform/noonewrittenoff/

Playing House!

2008-08-28T10:12:00.002+01:00

A lukewarm welcome for new Paper on Housing Drug Users
August 2008

It can't have been easy for Gregory Green and Martin Nugent to write a paper on housing drug users which would satisfy the Home Office Drugs Intervention Project, Communities and Local Government, NOMS, The Housing Corporation, NTA and others. Nor can it have been easy to write the report with a single reference to the Misuse of Drugs Act, or Section 8 of the act. But in the 200 odd pagesof Improving Practice in Housing for Drug Users, there's not a mention of this legislation, or the antisocial behaviour act. In short, in this sprawling piece of work, there's not a single line that stresses the legality of working with use on site.

The paper is built around a series of case studies. These include a number of agencies working inclusively with ongoing drug use and injectors, including SHP, In Partnership Project, Norfolk Drug and Alcohol Partnership, New Steine Mews Brighton, and Thamesreach. These are fine projects, each doing innovative work with ongoing users, and who have done so for a number of years. It is highly welcome that there work is finally receiving a level of official recognition and endorsement. It is long overdue; these projects have developed and emerged despite a lack of Governmental backing or endorsement. Remember, this was a Government that sought to expand Section 8 of the Misuse of Drugs Act 1971 which would have ended this type of housing in the projects listed. As Deputy of the Rough Sleepers Unit, Ian Brady repeatedly refused to officially endorse the use of Sharps Boxes in hostel settings. So the Government embracing an "eyes wide open" model is to be welcomed.

Except that the Government doesn't appear to be embracing the report and its presentation and release seem intent on keeping the report out of sight. On the "Tackling Drugs Changing Lives" website, the report isn't mentioned on the "News and Events" sections, and even after going in to the DIP section there's no obvious link through to the paper. It is mentioned in the DIP August 2008 E-Bulletin which also mentions the National Seminar that took place the month before. The previous e-bulletins hadn't mentioned this seminar, making it rather difficult to know that it had happened. But, if you missed this E-bulletin, there's no other direct link to the Papers. The Papers themselves don't represent Government policy and there is a footnote disclaimer in the document to this effect.

The Paper itself is slanted heavily towards an organisational and strategic perspective. It stresses the need for a mult-disciplinary partnership approach, with key players involved and proper assessment of need, provision and outcomes. Search for the word "strategic" in the Paper and you get more than 100 uses of the word; look for references to "injector" and there's not a single use of the word. The report does stress the need, too, for a full spectrum of housing provision covering the full spectrum of drug use. The need for housing for ongoing users as well as for those in treatment, and those now abstinent is well made and welcome

What the Paper does not do is provide a clear vision or endorsement of how work with ongoing users on site can take place. This area feels fudged, and as it is the area which causes the most concern and confusion to providers, the police and commissioners, the lack of clarity here is damaging. Nor does it offset some of the concerns or direction that has been established by other, contrary, Governmental initiatives - most notably the Respect Standard for Housing Management. This model locates substance misuse firmly within a context of anti-social behaviour and primarily promotes an enforcement response to it, through use of demoted tenancies, ASBOs and injunctions, whilst paying lip-service to support and treatment interventions. Similarly, no mention is made in the Paper of the Antisocial Behaiour Act (Power to Close Premises) or its impact on housing drug users.

What there is, within the case studies is reference to "proactive harm reduction approach to managing drug use within premises that they manage." How you do this is not addressed by the paper, and the level of detail provided by the case studies is inadequate and vague. For example, the report says "the case studies have demonstrated that improving understanding, knowledge and skills of workers and service users were important elements of capacity building. This includes awareness and understanding of...drugs, housing and the law."

Ironically, despite asserting that this is an important element, the Paper does not make a single reference in all its pages to where this information could be obtained. No mention of the legislative framework, no mention of the resources available on this site or www.drugsandhousing.co.uk regarding lawful, safe, eyes wide open working. No mention of the Sample Drugs Policy or associated resources. This is not mere sour grapes. Of the projects mentioned in the report, nearly all the service providers mentioned drew significantly on the models that were outlined in Room for Drugs and the Sample Drugs Policy. Certainly, they have developed and evolved their own character, policy and practice since. But the kernel of these initiatives was built on working in an "eyes wide open" model as outlined in these and related papers. The decision by the report authors not to mention this, or to reference these resources is inexplicable.

One of the stragegic documents mentioned in the report is the "Safe Newcastle Policy on Drug Use Within Accommodation." This document has been reviewed previously (see Blog passim) and is at odds with a harm-reduction approach. It requires all known episodes of possession to be reported to the police, requires the removal of drugs and paraphernalia found in resident's rooms, and requires warnings to be issues for all suspected use on site. It would be interesting to know if one of the projects cited as a case-study, Tyneside Cyrenians, follows the Policy as written, because it would be hard to see how on-going use on site were managed in a harm-reduction manner where known use was automatically reported to the police, and rooms were searched on "strong suspicion of drug being used."

After a long wait for a Governmental report which embraced and endorsed full-spectrum, eyes wide open housing models for drug users, the Paper goes some way to fulfilling this need. On balance though, the Paper delivers a few crumbs of welcome recogntion for these models of housing. But buried as they are beneath reams of strategic vision, and obscured by a lack of clear illustration and clarity, it seems that we must wait longer for the report we had hoped for to arrive.

The complete set of papers for Improving Practice in Housing Drug Users - A Partnership Approach can be found here.

The complete Seminar notes are here.

Shelter have organised a Seminar on the back of the publication and details are here.

Cannabis Reclassification - a pawn in the Prohibition war?

2008-08-06T08:50:00.002+01:00

Back in May, we looked at how the reclassification of cannabis had become a political pawn. We reflected on how a Government under attack and with plummeting popularity used the decision to move cannabis back to Class B as a political tool in the face of expert evidence.

But above and beyond the UK Government, numerous other interest and lobby groups were promoting their viewpoints. And so while cannabis had become a pawn in the battleground of UK politics, it had also become a key piece in a conflict between the polarised camps of prohibitionists and legalisers.

When cannabis had been initially moved from Class B to Class C, it had been heralded by some as a first step in the liberalisation and reform of the drug laws. Given that it was the first time a drug had been reclassified down, it is understandable that some would view this as a sign of things to come.

Conversely, the move was viewed less positively by a range of prohibitionists. From the International Narcotics Control Board down through to the various pressure and lobbying groups such as Europe Against Drugs and the Drug Prevention Alliance, the downgrading of cannabis represented one of the biggest setbacks that they had experienced, and elicited howls of outrage.

So when the discussion about cannabis resumed and the Government contemplated a move back to Class B, the prohibitionists went to battle with a furore which had less to do with the case for cannabis per se but more to reassert the prominence of the prohibitionists’ message.

The final decision to move cannabis back from C to B was therefore welcomed by prohibitionist groups, less because of the fears about cannabis safety and more because it put (they believe) a prohibition tendency back in the ascendancy.

Unfortunately, truth was once again the first casualty of this drugs war, and the nuanced evidence and arguments relating to cannabis were lost within a slew of hyperbole, claims and counter-claims. Individual experience and small studies were cited as evidence of greater harm. The tabloid press, especially the Daily Mail, ran headline after headline citing the increased risks of strong cannabis.

Key progenitors of these hyperbolic arguments included Europe Against Drugs (EURAD) who have been vocal in their demands for cannabis to be reclassified. Key amongst these was Mary Brett, a former secondary school teacher from Amersham who now spends her time culling journals for negative cannabis stories, and promoting these as “facts” to support the prohibitionist arguments.

Her document, “Cannabis – The Facts” is in turn used by Debra Bell of “Talking About Cannabis.” TAC was initially set up by Bell, a journalist, as a way of exploring and discussing her family’s experience of cannabis. This role morphed in to a lobbying group demanding that cannabis be moved back to Class B and in an amazingly short time, TAC had face time with the ACMD and were being routinely cited by the media. TAC say that they are “currently preparing educational packs for schools with a strong prevention message, written by drug experts.” Presumably, with contributions by Brett, and following the line established by EURAD.

TAC are now members of EURAD, and as such presumably endorse EURAD’s other articles of faith, which include the abolition of needle exchange, and other harm reduction approaches.

Also beavering away at the cannabis issue, though less prominently than TAC, was the Drug Prevention Alliance, led by Peter Stoker with the assistance of former customs officer David “Claude” Raynes. Interestingly, these two well-established prohibitionists are now very active within the Foundation for a Drug Free Europe – a Scientology-derived campaign group which promotes Narconon treatment models and is staunchly prohibitionist. They are joined here by regular Drink and Drug News magazine contributor and long-standing Scientologist, Ken Eckersley.

Following the Home Office’s announcement regarding cannabis reclassification, a congratulatory letter in the Times was co-signed by, amongst others Bell, Brett, Raynes and Stoker, bringing together an alliance of Prohibitionists whose primary interest is not in Cannabis, but in wider prohibition.

The irony of all this is that it has been that cannabis has flourished and increased in potency under a regime of prohibition. Despite the fact that production and supply has consistently carried a maximum sentence of fourteen years in the UK since 1971, the sentence has not prevented first importation and then home-growing in the UK.

Cannabis became stronger and less safe within a prohibited, unregulated under-researched market. Just as under alcohol prohibition people were at risk through stronger, impure bootleg drink, so people were put at risk through illicit cannabis in the same way.

Producer countries such as Morocco and Algeria, who had historically produced cannabis resins with a good mix of THC and CBD saw home production curtailed to meet the demands of the INCB. Rather than risk importation, home-growing became the more profitable, lower risk alternative. And the end-product – high THC/low CBD herbal cannabis was the net result.

All this happened under prohibition – the stronger, imbalanced strains of cannabis that dominate the market were a result of an unlicensed, un-regulated market. The process of prohibition contributed to the increase in cannabis-related mental health problems.

It is only now, through legal research under Home Office licence, that researchers are becoming aware of how important the ratio of THC to CBD in cannabis is, and how CBD may cushion or protect against some of the negative effects of high THC levels in cannabis.

Left to an illicit market, the safety of a product will tend to take a secondary position to other factors such as potency or ease of production. Given a legitimate framework, it is feasible to produce a product with a lower risk profile.

Given, for example, licensing and regulation, it would be feasible to specify minimum CDB contents, maximum THC contents, and impose higher levels of excise duty on stronger strains.

By clear product labelling and allied information campaigns, the product available (age-restricted and licensed) would be the least hazardous option that could be made available.

By opposing this approach, and pushing the Government away from such a model, the Prohibitionists have ensured that the cannabis on the street will remain as unsafe as it can be, and exposed to risk the very young people that they claim so passionately to want to protect.

Brown v the ACMD - cannabis is the side show

2008-04-21T21:34:00.001+01:00

Within the next week, we can expect the Advisory Council on the Misuse of Drugs (ACMD) to publish their recommendations regarding cannabis. They have been asked to consider if, in light of existing research, they feel that it should remain in Class C or if it should be moved back to Class B. Following their report, the Government should make a decision as to whether it will follow or reject the ACMD’s recommendations.

According to media reports, both the Home Secretary and the Prime Minister have made it clear that they favour a move back from Class B to Class C. And media reports have also suggested that the ACMD is satisfied with cannabis in Class C. The truth of all these media assertions will, doubtless, be resolved very shortly.

What the ACMD actually decides is almost, now, a moot point. Thanks to the Home Office’s tinkering with the Classes when cannabis was reclassified, there is precious little difference between Class B and Class C anymore. They both carry a maximum sentence of fourteen years for supply (it used to be 14 for Class Bs and 5 for Cs) and possession of either Bs or Cs is an arrestable offence – previously possession of Class Cs was not an arrestable offence.

The only significant change with a move from C back to B would be an increase in the maximum penalty for possession increasing from two years to five years. But in practice these larger sentences would not be used for simple possession.

Everything else – how cannabis is policed, the awareness raising that accompanies it, the market that produces and supplies it – will remain the same.

The production and supply of cannabis can carry a maximum of fourteen years: this penalty will remain the same even if cannabis is reclassified. So there will be no increased deterrent by moving it from C to B as far as production is concerned. In a country now dominated by large-scale organised growers, reclassification will have no impact on the production end.

Use of cannabis has not increased in the past four years; indeed there is some evidence that it has declined, and there is no evidence that a move back to B would hasten this decline.

But really this is all a side argument. The real question should be whether the Prime Minister will follow the advice of the experts at the ACMD or for one of the handful of times in the past 30 years, he will ignore their advice and follow his own feelings on the matter.

In a field currently swamped by lobby and campaign groups with a variety of vested interests, the importance of the ACMD cannot be underestimated. Unlike the rest, this is not merely a lobbying group with a drum to beat. Established by Statute under the Misuse of Drugs Act, the ACMD is intended to provide a neutral, expert and influential body to advise Ministers. The drafters of the MDA clearly recognised that drugs policy was a political and moral hot potato. To avoid it being thrown around in the interests of political expediency, the ACMD provides expertise. Government has no obligation to follow this advice, but if they don’t they presume to know better than their own experts.

Given the current political climate, it has probably never been more important that there is an independent body to advise on drugs. We have the perfect storm of a party slumping in the polls, days before the local elections, and a leader who is unpopular and indecisive. How Brown must yearn to reclassify cannabis tomorrow – to garner some positive media coverage as a decisive protector of youth.

Unfortunately for him and fortunately for us, the ACMD report may only come out at the end of April. This will probably be late in the day for Brown to use any decision therein to bolster Labour’s political chances. Not that this will stop the leaks or media briefings that indicate Brown will reclassify regardless of the ACMDs stance. In the run up to the election this could be the ONLY comment emerging from Downing Street.

Post election, maybe, just maybe, cooler heads will prevail. Good or bad election result, the reclassifying of cannabis will be a moot point from an electoral point of view (unless the election result triggers a decision to call a snap general election – though this doesn’t seem likely.) In such a less fraught environment, Brown can side-step the controversy by following the ACMDs advice.

If the Home Secretary decides to disregard the ACMD the reaction of the ACMD is of critical importance. They cannot simply stand by and brief anonymously. There should instead be a whole-scale set of resignations by the Chair, and other members. This should send a clear message to the Government – the ACMD is there for a reason and it must be heeded.

Such a decision for mass resignations should not of course be taken lightly, and nor is it anything to do with cannabis. It must be done to highlight that when a Government decides to disregard the evidenced position of their own experts, then those experts should recognise that this Government considers them superfluous. If the Government would rather choose to listen to Daily Mail columnists, parent-activists and pollsters rather than a diverse panel of experts, then those experts should show their disdain for the process by resigning. To carry on without any such complaint would be to provide endorsement to this decision and facilitate the next decisions made in the face of the evidence.

In tendering their resignations, the ACMD can demonstrate just how critical it is that decisions on drugs policy are not left to politicians.

New Drug Strategy - Oh come on, what did you expect?

2008-02-27T19:37:00.003Z

We saw the launch today (27.2.08) of the new Ten Year Strategy. Predictably, there has been a sharp swing towards enforcement strategies including much touted proposals to increase confiscation powers, and coerce engagement with treatment via the benefit system.

Equally predictably, the Strategy has received a range of responses, from outright condemnation to mixed welcomes. The response so far has been muted. The responses over the next few weeks will be far more interesting.

But let's take a wider view. None of this should come as a surprise. Did anyone truly expect an embracing of true harm reduction, and admission of failures of past strategy, a consideration of wholescale review? Oh come on! Only the truly deluded could have envisaged anything other than more of the same, with bigger sticks and more mealy carrots.

Those who have predicted reform, or review of the drugs laws, or new developments have singularly failed to recognise that the "war on drugs" far from being over, is just gearing up for its next phase. Bigger powers, less rights, more enforcement, new weapons. This will only be the start. There will be more punitive measures to come.

I don't expect bravery and great things from the Home Office or the machine of Government. They are well past the stage of rational and balanced debate on drug strategy. But what amazes and depresses is the huge range of players who facillitate and legitimise the war on drugs while at the same time decrying its choice of weapons.

Take for example the much-derided "consultation" that led up to the new drugs strategy. Look at the energy that went in to it - Drugscope's series of regional events, the contributions from Transform, Release and others. Some of these organisations must have believed that their contributions would be read, evaluated, pored over. Others knew it was a sham. But still they participated.

In doing so they legitimised both the consultation and the resultant strategy. Rather than, en masse, boycotting the consultation as the farrago that they surely knew it was, they made their contribution. They had their say. Surely more powerful, more striking for a big group to withdraw from the process? But no. And so the new strategy, flaws and all, gains legitimacy from the consultation.

What if? What if as a group Addaction, Turning Point, CRI, Compass, RAPt, Drugscope, EATA, FDAP, Release and Transform had said NO! Said "we won't participate unless we are convinced that the resultant strategy will take real account of our views." They could have done. Once.

Now of course it becomes too dangerous for many of these bodies to bite the hand that feeds. Dependent on contracting culture, the good will of the Home Office, they can't and won't speak out significantly. A finacially weak Drugscope, other contract-dependent providers, political access achieved by compliance and silence.

Any new measure, punitive or otherwise, demands organisations to implement it. Look at the example of the threat to suspend benefit payments to clients who fail to attend an Assessment. This alone could be scuppered overnight if the big drugs agencies said, as a block, that they would not undertake assessments that were achieved at the threat of benefit suspension. So while we watch to see which agencies make the most show of condemning the measures in print, watch with equal care the number of agencies who refuse to take the contracts. No-one will refuse this dirty work because it pays, and refusal will result in decomissioning.

Historically the drug field was diverse, fractured and independent. This did result in a wide variance of provision. But it protected the field from the sort of Stalinist planning and control that we now see.

Having stripped away this independence, consolidated and centralised provision, agencies now have little choice but to comply with directives.

For drug policy to change the drugs field needs to change, and rediscover its voice and independence. This can only happen from the grass roots. We have ceased to be able to reply on the independence of the ACMD, or the representation of the field, to stem the political excesses of Government strategy. In the war on drugs, we have never, so badly, needed some effective resistance.

alcohol - short term memory loss?

2008-02-04T12:07:00.000Z

The BBC reported that the Government proposes to introduce new police powers to confiscate alcohol from young people found drinking in public.

Media, Police and groups such as Alcohol Concern all welcomed the measure.

Which is strange because, as far as we can see, the Home office is simply re-announcing a power created more than a decade ago, with the Confiscation of Alcohol (young Persons) Act 1997:
This empowers police to require under 18-s to hand over alcohol in a public place. Failure to do so (without reasonable cause) and to give a name and address when requested summary offence and carries power of arrest.

The Act was slightly amended in 2001 but, to our knowledge remains in force.

We are slightly concerned that Alcohol Concern's spokesman, who had done the media rounds the day before welcoming the new legislation was unaware of the old one. But we were far more concerned that the Home Office seems to have experienced total short term memory loss as to what legislation has already been enacted. Alternatively they may be hoping that the UK population is so stewed that they simply won't spot this blatant attempt at legislative recycling!

Drug Testing Times

2007-10-29T22:45:00.000Z

29.10.07

Another big merger in the drug testing market - and testing spreads in to more arenas. Is it time for clear legislation and policy to regulate this growing market?

At the end of September 2007, AIM listed company Concateno bought the drug testing company Cozart. Since 2006, and following a rapid spending spree, Concateno has acquired most of the drug-testing companies in the UK, and now controls a portfolio including Medscreen Ltd, Altrix HealthCare, Euromed, TrichoTech, Marconova, CPL, and Cozart Bioscience.

Part of the rationale for the acquisition of Cozart was to gain access to the Cozart Rapiscan technology which allows for portable drug testing in places such as road-side testing.

Concateno is now a hugely powerful player in the international drug-testing field, covering most aspects of testing (except Ion Scan technology). Having gained control over the key testing companies, logic suggests that we will now see an increase in lobbying to expand drug testing in a variety of settings. At present drug testing has been focussed on safety critical, criminal justice and drug treatment settings. The next expansion is likely to be in non-critical settings - general workplace, education and social settings.

We've already seen the start of this expansion - the random drug testing of school-children, for example. But this is only the start. At the moment, most of the testing technologies are, to a greater or lesser extent, invasive. The exception, and one of the companies not yet owned by Concateno is the Ion Scan.

It is this last technology, probably the most controversial of all the drug testing modalities, which is the greatest cause for concern. As the cost of Ion Scan technology has decreased, and as the availability of the equipment increases, we are seeing this technology being used in a range of settings.

Alongside the use of Ion-Scanners in school settings as part of so called "drugs awareness sessions" they are also increasingly being used in pub and club settings, random (consensual) testing of motorists and other public arenas.

Some police forces have even approached and 'encouraged' hostels and direct access services to allow the use of testing equipment on residents.

All this leads to a couple of inexorable conclusions: the first is that the use of the Ion Scan technology is going to increase and the second is that there is insufficient regulation or protection in place as to how and when it can be used. Given that results from Ion Trace technology are especially prone to generating "false positives" due to extraneous contamination, the unmoderated and unverified use of this technology has to be a cause for concern.

At present there is no obligation to consent to scanning with an Ion Trace detector in a public place. However, there is less clarity as to whether or not refusal to consent to a trace should be reasonable grounds for a stop and search. PACE needs to be amended to make it clear that refusal to be Scanned should not, of itself, be considered grounds for a search.

Likewise, to date much of the testing has taken place in semi-voluntary settings such as pubs and clubs. But its imposition in involuntary settings such as schools, or essential services such as hostels changes this dynamic. In these settings the 'choice' to be tested or not is severely restricted.

Finally, the status of Ion Scan test results are not well established in the UK. But given the rise and rise of this testing technology, we are long overdue legislation and guidance to manage this burgeoning technology.

Dr Kay Lumas' book "Drug Testing in the Workplace - A Pilot study on trace detection technology is now available. For information and review see here

Concateno buys Cozart: http://www.hemscott.com/news/latest-news/item.do?newsId=51002736731140

Can Frank still tell the Truth? - our lying drugs propaganda service

2007-10-18T00:30:00.000+01:00

Frank is starting to develop real problems with the truth. Frank has often been a stranger to accuracy in the past, but some of Frank’s recent pronouncements have seen Frank drift further from the world of drug facts and into the heady worlds of drug propaganda.

Before we go any further we should disabuse ourselves of the manufactured image of Frank being some kind of avuncular character who understands the foibles of youth but was old enough to impart sage advice. Frank is no such thing. Frank is a branding concept, developed by marketing consultants, tested in focus groups, assessed, reviewed, honed. The brief: hip, but not too hip; funny, but serious; accessible to the youth but don’t alienate the parents; understanding but not overly tolerant.

The evidence is that the marketing consultants succeeded in their aim. Brand Frank was created and supplanted the “National Drugs Helpline” with the Frank logo, website, helpline and campaigns.

Frank however, attempts to fulfil two very different roles. On the one hand, Frank is responsible for delivering the phone-service that was once the National Drugs Helpline. The Government has funded Essentia Group to the sum of £1.45 million in 2006-07 for FRANK (drugs), Sexual Health Line, Drinkline and Know The Score, the Scottish helpline on drugs. The Government can’t say how much Frank helpline actually costs specifically but estimates the cost at around £800,000 in 06-07. To put this spend in to some sort of context, the previous year the Home Office spent almost twice this amount (£1,588,007) in advertising FRANK http://www.publications.parliament.uk/pa/cm200506/cmhansrd/cm060911/text/60911w2347.htm

According to Government figures, and despite extensive advertising spending, the number of people accessing the Frank Helpline has not increased over the past three years, and the figures for 2006-07 are lower than the previous year, http://www.publications.parliament.uk/pa/cm200607/cmhansrd/cm070719/text/70719w0032.htm

Despite spending significant sums on advertising, only 4,444 under sixteens phoned Frank in 2006-07 – despite the fact that more that at least 40% of young people in this age bracket have experimented with drugs.

The Ask Frank service can deliver good quality information and does, at times, demonstrate a level of imagination and free-thinking. But, too often, Frank call handlers limit their responses to the on-screen information, referring anything more complicated to local drugs services. Frank really doesn’t want to get bogged down on a thirty minute call; Frank’s not set up for it. So Frank would rather signpost the caller on, send some information out or bring the call to an end, rather than undertake more open-ended telephone support.

Such a limited service would be just about acceptable were the Government still funding other services such as Release to undertake more in-depth, open-ended or longer interventions. Unfortunately the Government is no longer willing to do so. They claim that the funding mechanisms that hitherto supported Release no longer exist – and argue that there is no need to fund two drugs helplines. Either way, the Ask Frank service is now the lynchpin of low-level drugs advice to young people and their families in the UK.

But the Frank helpline is just once facet of Frank’s many faces. Because Frank also runs campaigns, places advertisements, and has the Ask Frank website. Frank also lends his name to any of a range of information, resources, materials or events produced locally or regionally.

Frank (the Helpline) and Frank (the advertising and campaign machine) are two very different beasts. Frank (the Campaign Machine) is effectively a manifestation of the Home Office’s drug strategy. Rather than branding resources with the Home Office logo, and making it clear that the information is prepared, vetted and distributed by the Home Office, the illusion is created that it is more independent, more free-thinking, less agenda driven.

But raise questions about content on the Frank Website, in adverts or in publications and all enquiries inexorably lead back to the Home Office. Some content has been externally commissioned; others has been drafted in house and then signed off by other bodies such as the Police or the Department of Health.

Take as an example the recent Frank Action Update, which focussed on Cannabis but was subsequently withdrawn due to serious factual errors. The legal sections (some of which were incorrect) were meant to have been produced by a senior police officer on Merseyside; the sections on reducing cannabis related harm were referred back to Health Advisors in the Home Office.

Ironically, the Frank phone advisors were unaware of the Action Update and, when it was brought their attention, disagreed with the content.

Does it matter that Frank has a Home Office run campaign arm? The answer to this should be a resounding “yes!” It is imperative that people who use drugs, especially young people, should have a source of information that is balanced, impartial, non-judgemental, and above all accurate. This may mean giving people information which is politically sensitive, which runs counter to Government policy, or which is in other respects controversial. Such an approach assists the credibility of the information, and the extent to which young people will retain – and act on this information. To do this information should not be slanted to serve a political agenda, or watered down to make it acceptable to Government.

The Frank branding exercise are intended to create the illusion of this credible, trustworthy and balanced information source. And certainly some call handlers at the Helpline work towards these standards where they can.

But, cynically, having created the illusion of Frank, the Home Office seeks to impart partial truths and untruths about drugs and bolster their credibility by putting Frank’s name on it.

This is a short-sighted approach and hugely damaging. Because as people become aware that the Frank adverts are simply the Home Office dressing up the Government’s messages in yoof clothes, why should anyone trust the Helpline? And if trust in the helpline is diminished, where can young people get this independent and impartial information?

Trust – in organisations like Release (for example) was cultivated over a number of years through action and words. Frank has attempted to nurture the same sort of trust in a fraction of the time through branding and image management.

Having done so, the Home Office seeks to use this trust to promote anti-drug messages, under the guise of the ersatz-honesty of Frank.

Trust in services should be developed over time, through a framework that ensures integrity, accuracy and independence. Trust cannot and should not be manufactured by marketing consultants. Frank hasn’t earned out trust, and doesn’t have these hallmarks to ensure that further pronouncements reach the high standards of accuracy and impartiality we so badly need.

KFx: October 2007

War Amongst the Angels: How Caroline Coon's attack on Release is ill-judged and ill timed

2007-10-03T18:12:00.000+01:00

Caroline Coon launched a wordy and savage attack on Release, through the medium of her website. Entitled "the Plight of Release" she lays in to the organisation that she cofounded, describing it as "irrelevant," and accusing it of simply being an aspect of the "prohibition industry" She argues that the organisation should either close or substantially restructure to become viable and relevant.

Having worked for Release and having had contact with Caroline in the past, I certainly can't claim to be objective. But Coon's diatribe is ill-judged and had the potential to be hugely damaging.

Release was co-founded by Caroline Coon, but she has had little engagment with the organisation over the past couple of decades. It seems strange that she should choose to break her silence now, and in such a public and damaging way. Over the past forty years the organisation has had to evolve and change. It ceased to be a collective, had to fight harder for funding, needed to ensure that it operated within the contraints of charitable law.

Coon rails at the "ludicrously unambitious Directors" but her bile would have been better directed at previous Trustees, who undermined and hounded out former Director Mike Goodman, obstructed and hampered the refocussing of the organisation and, without discussion with existing staff imposed the ill-fated "Forward Thinking on Drugs" project on the organisation. Coon's opinion was that these Trustees operated with "wise discernment in the interests of the organisation." Nothing at this point could have been further from the truth.

Release is increasingly operating in a hostile environment, with Government policy moving further and further away from any revision to the drugs legislation. Funding of helplines has been focussed on Frank, which has become less independent and more a voice of Government strategy.

Revision and lobbying on drugs law has become equally competitive. There has been a recent proliferation of bodies lobbying for change. Whilst one would hope that this proliferation would result in more widespread and unified lobbying on legal change this has not happened. Instead, different fiefdoms, keen to garner profile and support, choose not to cooperate and stress difference from their peers, rather than working together. Release has suffered badly within this increasingly crowded field.

But (and this is the is a big but) Release is undoubtedly one of the "good guys." Profile may have dropped, it may not shout as loudly as it once did. But that is no reason to spuriously accuse it of being part of Prohibition industry. Such an accusation is deeply offensive, especially given the history of Release staffers such as Sebastian Saville and Gary Sutton.

Something has prompted Coon to think that Release should now be taken down. Perhaps it stems from conversations with Release staff. maybe she has been the subject of external pressure. Possibly, she thinks she is doing the best thing. She is not stupid. She may think that her contribution could be a needed kick up the behind. She should also be aware that it could be the knife in the back. If she is indeed trying to kill off the organisation that she co-founded, then she does the field a huge disservice.

If at first you don't succeed - have another go at cannabis reclassification until you get the result you want

2007-07-12T18:48:00.000+01:00

Gordon Brown announced today that he intends to review the reclassification of cannabis with a view to moving it back to Class B. This is purely political. Charles Clarke sought the same outcome, and referred the matter to the ACMD to do as he is required to do. The ACMD made their recommendations, which was that cannabis should remain a class C drug and the Home Secretary complied with their recommendations. So all Gordon Brown can do is refer the matter back to the ACMD. Will there be any substantial new evidence for them to consider? Will they be able to hold their nerve and not be browbeaten into acceding to the Government.

No suprise this; there's the draft drug strategy due out soon. But why wait on public consultation. Make policy on the hoof! Or as seems more likely make policy as a direct response to the conservatives newly published "Breakthrough Britain" strategy document. They wanted reclassification and by reviewing the issue again, the Government seeks to steal their thunder.

All this does not bode well for drug strategy. It looks like the issue will be as political and reactionary as ever.

KFx July 18 2007

First They came for the crack users..pt 2: Closure orders extension

2007-07-12T18:45:00.000+01:00

First they came for the crack users... pt 2

Brown announces intention to proceed with Criminal Justice and Immigration Bill 2007 - Measures to extend Closure Orders Proposed

Right at the very end, just before the demise of the old Goverment, the pulication of the Criminal Justice Bill 2007 was announced. Then the people behind it, John Reid at the Home Office and Tony Blair, stood down. Leaving the bill behind.

At the time the Bill didn't get a lot of attention. The section that received the most publicity was a section relating to prostitution. No-one seemed to mention the proposal to extend the power to close premises.

Any hope that Brown would drop the Bill was dashed on the 11th July when, in a speech describing the Government's business for the coming term, the Criminal Justice and Immigration Bill was included in the list.

The Section of the Bill of most interest to KFx is S.17 which extends closure orders to cover non-drug related premises.

The proposal is not dissimilar to the existing powers for closing houses associated with Class A drug activity.

A first striking difference is that the power to issue a Closure Notice and apply for a Closure Order is not limited to Police; it has been extended to Local Authorities too. This is a substantial change and should be the source of some concern. Given in many situations the Local Authority will be the Landlord, and the person seeking the Closure Order, this is likely to represent a conflict of interest for the Local Authority. Likewise, it means that the same workers who are providing support may also end up in court providing evidence of nuisance or disorder.

The power can be applied to premises as follows:

(1) This section applies to premises if a police officer not below the rank of superintendent (“the authorising officer”) or the local authority
has reasonable grounds for believing—
(a) that at any time during the relevant period a person has engaged in anti-social behaviour on the premises, and
(b) that the use of the premises is associated with significant and persistent disorder or persistent serious nuisance to members of the public

This bill, if enacted, would hugely undermine existing housing rights and laws. It undercuts licenses, tenancies and centuries of property ownership. It will result in exclusion from housing, increased homelessness and affect many families, including those struggling with drugs, alcohol, mental health problems, children with special needs and so on. It allows for a situation where the behaviour of a child with behaviour problems could see the family removed from their home, even though no offence has been caused.

This is hugely loose wording. "antisocial behaviour" is loosely defined, and so will affect numerous people where behaviour could have caused alarm or distress to another person. The words "persistent" will need to be further defined. But the "relevant period" will be activity that has taken place over the preceding three months. Defining significant and persistent nuisance will be a challenge!

The net effect of this, as with the Antisocial Behaviour Act (Power to close Premises) is that if the Magistrate's Court is satisfied that antisocial behaviour and nuisance is taking place, a Closure Order can be issued, and any body resident in the property will be required to leave, made homeless or face arrest if they refuse to leave.

Despite protestations in the past that this measure was to be used as a "last resort" where other measures had failed, this is not reflected in the legislation. The Magistrate is not required to consider if other measures have been used, or that they have failed. They are only required to consider if they think issuing an order: (c) the making of the order is necessary to prevent the occurrence of such disorder or nuisance for the period specified in the order.

This does leave some room to move for a magistrate and is probably a better wording than the one in the Antisocial Behaviour Act. A sensible magistrate could find that it was not "necessary" if there were other measures available which might work.

As before, the Closure Order doesn't determine a tenancy - it merely denies access. The Tenant has the choice of surrendering their Tenancy (and risking being found intentionally homeless) or refusing to surrender it, not being eligible for alternative housing, and challenging the order through the courts.

And as before, the status of those thus evicted is not clear - in many situations the people evicted will need further housing, and may well be in priority need. So the simple locking out of one house will be a fatuous gesture when the people in question will still need to be housed, probably by the same local authority.

When the Antisocial Behaviour Act was passed, there was hardly a mutter about it because it was aimed at "crack dens" the new bogey-men of UK society. They were considered fair-game and unworthy of rights afforded to the rest of society. This extension may prove more contentious - as people start to realise that what one person considers a normal lifestyle may, by a neighbour, be considered "significant and persistent nuisance." Repeated mowing of lawn in the morning? DIY in the evening? One barbecue too many when smoke blows over the neighbours fence?

This is an illiberal, draconian piece of law, and as before with the Antisocial Behaviour Act removes important protections from individuals and places huge powers in the hands of the State. This time, the legislation must be challenged and concerted lobbying by all agencies will be required to prevent the passage of this Bill. In theory and in practice it is too important to stay silent on this Bill.

To read the full text of the bill click here: http://www.publications.parliament.uk/pa/cm200607/cmbills/130/2007130.pdf

Speaking Frankly! - frank confused on cannabis

2007-07-12T18:42:00.000+01:00

At the end of May 2007 FRANK published their Action Update, "Cannabis Explained." It was made available as a hard copy, distributed to DATs and drugs services, and available as a download from the Home Office website.

At the end of June, a month later, the document was withdrawn from print and off the Government websites. This withdrawal was not accompanied by any notification or official explanation. Indeed, if you didn't know that the document existed, one might not have known that it had ever been there. But the short life of the "Action Update" and the tale of how it came to be removed from circulation raises some important questions about Quality Standards and accountability at Frank.

When the Action Update came out, KFx, alongside other organisations such as the UKCIA noticed some rather glaring errors. These are discussed here. Now while we would accept the interpretation put on Frank to be partisan and loaded, we don't expect it to be factually wrong. But on this occasion there were a number of errors and ommissions which were both obvious and serious. So for example, the document misrepresented the law on cannabis as applicable to under 18s; it said that smoking cannabis in a joint was the least hazardrous, and it didn't mention cannabis contamination at all.

We, alongside the UKCIA and others made representations to the Home Office about these errors and ommissions. And a long and fairly convoluted process began.

For the first couple of weeks, the document remained available on the Home Office website; although serious concerns about its accuracy had been raised, there was not attempt at this stage to suspend distribution while it was reviewed. Given that at least two of the errors were so obvious and so easy to check, this seemed inexcusable. All we got was reassurance that it was being looked at.

A phone call to Frank at this time was illuminating: The initial call handler referred the case swiftly to her senior call handler. The senior handler didn't know about the Frank Action Update, and was unaware of its content. He was suprised at what the action update said about spliff smoking and said that was different to the information on his screen. He said I should contact the Home Office to discuss this.

Frustrated by lack of action - and that the Home Office still hadn't retracted the document, we followed up the initial emails to the Home Office with a phone call. As a nice factual example of a serious inaccuracy, we used the coverage of under 18s and the legal process in relation to cannabis. This was a fairly charged discussion, with the contact at the Home Office not understanding the legislation and explaining that the relevant section had been "signed off" by a Senior Police officer and so had to be right.

Undaunted, emailed to the PA of the senior police officer in question; this email was forwarded to several officers in the relevant force until a helpful Officer emailed me back. after a couple of to-and-fro emails he emailed me back, confirming that he thought the position in the Frank document was wrong.

Back to the Home Office with this information, and after a short delay, they came back describing this information "of concern" and suspending distribution from the website. But in practice the update could still be found after a quick Google search.

A week later, the person in the Home Office wrote back again; this time, followig feedback from the Department of Health, they said

"In the interest of ensuring FRANK provides up-to-date and credible information, DH have recommended that some of the contents of the pack be amended or the issue explored further...As you are aware we have suspended distribution of the pack and removed it from the drugs.gov.uk website. We intend to re-issue the pack later in the year."

This was the right decision by Frank, and should be applauded. But it was a slow decision and an unpublicised one. While the LCA issued a press release about the withdrawal FRANK didn't. Unfortunately few agencies picked up on the LCA announcement. Unfortunately the Daily Dose, who now receive sponsorship from Frank, either didn't get it or didn't consider it sufficiently newsworthy.

There are a number of things about this story that cause concern. How did this flawed document slip through various proofing stages, why were the Home Office so slow to suspend distribution, and why was the suspension so low key when they did decide the document was flawed?

Authorship of the document is not clear; some of it appears to be cut and pasted from other sources. It has the same spellings (and even the same typo at one point) as other FRANK written documents so it suggests that some of the information has merely been recycled from other sources and not been reviewed.

One would hope that a final draft of the document would then be passed to others for scrutiny but clearly this didn't happen or if it did, the scrutiny was severely flawed. The information that we have gleaned suggests that the senior police officer would have understood and checked about the new ACPO guidance on cannabis - which was accurate, but wouldn't have checked the sections on Under 18s and processes under the Crime and Disorder Act, which were wrong.

But most worrying, we would hope that Frank would have a rapid and effective method of first suspending distribution and then informing readers of their errors. They were slow to do the first; they simply didn't bother to do the second.

Despite the branding and publicity material, FRANK is merely a vehicle to distribute drugs information. This epidode has demonstrated that the arbiters of this content are the Home Office. And on this occasion the Home Office have demonstrated their difficulty in commissioning and distributing accurate copy on an important subject.

And let's be clear, this is not the first time that FRANK's content has been found to be wanting. The initial content of the FRANK website was riddled with factual inaccuracies. The revised information still has many items which are of dubious accuracy. So, as one correspondent to KFx noted, if you go to DF118s you get taken to information on Methadone. Different compounds, different information?

FRANK urgently needs to review how it manages content. Remember that the FRANK image includes marketing and branding "experts" who know nothing about drugs. There's the call handling service, which knows something about drugs but has a tendency to regurgitate what is on the screen. And there's the Home Office and DoH which so far haven't managed to produce the level of accuracy that users and workers need.

Perhaps Frank would be best served bringing together an independent panel which could proof, review and advise on their output. That, and an improved system for responding to serious errors, would go some way to ensuring that they do not spend their million-pound budget distributing factually wrong information.

KFx: 12.7.06

Turkeys voting for Christmas

2007-05-01T20:11:00.000+01:00

How Region Wide Drugs Protocols are exceeding the law - and abandoning the gains of the past ten years.

Next year, it will be a decade since Ruth Wyner and John Brock were arrested and charged for offences under the Misuse of Drugs Act 1971.

During and after their case, many organisations and individuals worked long and hard to ensure that their dreadful experience would not result in the mass exclusion of drug users who were homeless from the limited provision available to them.

The ‘Wintercomfort’ case threw up some difficult challenges. Was it possible to have known drug users on site? To what extent could organisations preserve client confidentiality? Did all known suppliers need to be reported to the police? Was it legitimate to place sharps bins in hostels?

In the face of this uncertainty, the response from the Government and other key bodies was pitiful. Senior staff at the Rough Sleepers Unit refused to countenance the use of sharps boxes in hostels. Government advisors would not endorse models of working with ongoing users which would acknowledge use on site. And in 2001 the Government worsened the situation by passing the “Police and Criminal Justice Act” which extended Section 8(d) of the Misuse of Drugs Act 1971. This measure extended the obligation on occupiers and managers to stop the use of all controlled drugs on site rather than just the use of cannabis and opium.

In the face of unhelpful bureaucrats, intransigent Government ministers and voluntary sector workers turned Government lackeys, the situation for housing organisations working with drug users looked terrible.

But thanks to effective networking, proactive lobbying and dedication on the part of a small number of organisations, the legal and practice situation was salvaged,

• Thanks to campaigns of lobbying and letter writing, the amendment to Section 8 was suspended and ultimately repealed. It never came in to force;

• Thanks to the brave and innovative provision developed by a number of housing providers, a model of provision working in a “Eyes Wide Open” manner with active drug users;

• Thanks to resource development and training provision, a huge number of housing providers are aware of what they can and can’t legally do.

• Organisations can and have been able to work with ongoing drug users, whilst maintaining client confidentiality and maintaining good relationships with service users, the local community and the Police.

So where’s the problem?

Given the above battles that have been fought and the success of them, it seems inconceivable that organisations would voluntarily surrender these hard-won gains.

Yet they are.

The new and worrying development is where region-wide drugs protocols have been put in place. Several areas are in the throes of developing such a protocol. There is nothing intrinsically wrong with doing so. Indeed, such a Protocol can and should provide a safe umbrella under which all providers can legally and safely operate.

But at least one of these new Drugs Protocols imposes restrictions not currently required under the law. There is an expectation that local agencies sign up to the protocol. The requirements of the Protocol exceed the legislative requirements. And the Protocol restricts models of provision that other services have implemented lawfully and successfully.

A case in point is the Newcastle Temporary Accommodation Drug Management Protocol. Recently rolled out across all temporary housing providers, the protocol makes the following demands of signatories:

• Reporting all episodes of people possessing illicit drugs on site to the police;
• Confiscation and reporting of all paraphernalia to the police;
• Reporting any suspicion of supply to the police;
• Report use of any class A drugs to the Police

None of these requirements are current legal requirements and it is perfectly feasible to implement safe, lawful and effective drugs policy without such rules being in place.

If an individual organisation chooses to adopt a strict drugs policy, or exceed the demands of the law in terms of sharing information with the police, that is very much up to them. Some organisations do not wish to adopt more flexible and inclusive policy and that is their right. A good few of these have adopted exclusionary policies because it reflects the needs of their clients. They are seeking to work with people who are now drug free, usually after a period of dependency. Their policy and practice reflect the needs of their clients and rightly so. But this is not always the case. Other organisations have adopted harsh policies out of ignorance, others out of fear or prejudice. But to date it has primarily been on an organisation-by-organisation basis.

The idea that a City-wide or County-wide policy should turn its face on the gains of the past few years is deeply depressing. And it makes one wonder have the last few years all been in vain. So it seems now that the Government no longer needs to pass new, restrictive legislation – the turkeys are basting themselves and jumping in to the oven.

To view a copy of the Newcastle Temporary Accommodation Drug Management Protocol and supporting documents please click HERE.

To view a critique of this Protocol by Kevin Flemen/KFx click HERE and scroll down to the relevant policies.

Coming soon: a model sample drugs policy…details coming soon.

The Independent - shamefully wrong on cannabis

2007-03-26T22:46:00.000+01:00

The Independent is ill-informed, publicity hungry or utterly craven. Nothing else can explain their decision to abandon their ten-year campaign to legalise cannabis.

But, to be fair, their original rationale for legalisation was not especially well-thought out, so their retraction was never likely to be.

The Independent's old and new arguments seem to run as follows: ten years ago cannabis was not as dangerous as everyone thought, and so it was stupid that it was illegal. Now it's become more dangerous so it should be illegal.

Let's ignore, for now, the shaky evidence base that props up the claims that cannabis is ten, twenty, thirty times stronger than it was a decade, two decades or three decades ago. These arguments are not evidence based, and the relative strengths of available strains of cannabis have historically varied massively.

Let's also, for now, side-step the contested evidence that says THC 'causes' severe mental illness and, according to images offered up by the Indie, physical damage to the brain.

Even the statistics offered by the Independent on the number of young people "entering treatment" for cannabis are misleading. Yes, a significant proportion of young people "entering treatment" do so for cannabis. But let's not forget that more than a third of these young people are refered in to treatment via Youth Offending Teams. And that any young person receiving a "Final Warning" is referred to a Youth Offending Team. So thousands of children are receiving final warnings for cannabis use - thanks to an iniquitous policing system that means that they cannot receive "cannabis warnings" unlike adults. In turn they are refered to YOTs and then, on to drugs agencies so their cannabis use can be properly addressed. Each of these admissions is dutifully recorded as entering "treatment" for the purpose of the NDTMS, creating an illusion that thousands of young people are developing cannabis problems.

But even this isn't the worst aspect of the Independent's volte face.

Instead, let's look at the gaping philosophical flaw at the heart of the Indie's argument. The purport to be worried about the risks of 'new' 'strong' strains of cannabis. And these new, strong strains emerged within a period of prohibition. Cannabis they say, got stronger and more dangerous under prohibition. So what do they propose to deal with this? A continuation of prohibition.

As with alcohol in America during prohibition, so cannabis has become more hazardrous under prohibition, lacking as it does, any proper regulatory or scrutiny framework. We have ended up with contaminated resins, adulterated herbal cannabis; we have growing arenas which represent fire hazards, and we have cannabis of variable strengths which can be unpredictable.

Thanks to enforcement, relatively good quality, balanced compounds such as quality resins have been supplanted by skunk and soapbar.

And this is the stupidity of the Independent's new position. They should have continued to argue for legalisation. And probably argued more vociferously than ever before. Not because cannabis is a 'safe drug' which it patently is not. But because the best way to manage the hazards to bring it within a licensed and regulated framework. Concerned about the proliferation of super strength skunk? Then introduce a taxation system structured around potency, as we do with alcohol. Low strength products could be taxed at a lower rate, and higher strength products taxed at a punitively high rate. Suppliers would, as with alcohol sales, have to be trained and licensed. Products would need to be sampled, quality and strength assessed and properly distributed.

But the Independent cannot see this. They have abandoned their campaign. Not, to be honest that they had done anything with it in the past five years. In doing so, they have substantially boosted the cause of prohibitionists everywhere -as the comments of Antonia da Costa of the UNODC make all too clear.

Never has the phrase "yellow journalism" been so aposite. The Independent has really shown its true colours.

KFx March 2007

No Justice for Youth Justice - anyone but Louise Casey

2007-02-13T22:34:00.000Z

The Guardian has reported that Blair fancies Louise Casey to head up the Youth Justice Board - using it as a platform from which to take forward his Antisocial Behaviour Agenda after he is deposed in May.

This would be a worrying development - and one that everyonce concerned about youth justice should hope does not come to pass. Louise Casey has led something of a charmed life since leaving the world of the London homelessness sector. While she headed up the rough sleepers strategy, there were repeated, well substantiated allegations that rough sleeper counts were manipulated to 'prove' a reduction in rough sleepers. Approaches such as changing the count criteria, temporary opening of shelters on the nights before counts, food and quiz nights - all these and more were reported as ways of pushing the count down.

Unfortunately, few organisations had the confidence or resources to speak out: those that did were threatened with having their funding cut. those that made supportive comments and kept schtum about the manipulated counts were awarded new contracts.

Such strategies have endured since she moved on to the Antisocial Behaviour Unit. But rather than trying to reduce homelessness, Casey has done a 180 degree turn and is now endorsing policies that put people out of housing and on to the streets. In moves that would, one would hope, appall old stable mates at Shelter, Casey has taken forward an agenda which has seen people removed from housing and put directly on to the streets. Centuries of property right and hard-wons gains like tenancies have been overturned by new civil powers incorporated in to anti-social behaviour legislation.

If past experience is anything to go by, Casey, is appointed to the Youth Justice Board, would put punitive measures to the fore: in a 2004 interview she made her stance clear: "Not to challenge behaviour is a very British thing, and we have at times felt sorry for the minority of perpetrators. We think the way to deal with them is by feeling sorry for them and providing more and more services to them in the hope that maybe then their behaviour becomes checked. What is missing is the community saying we have had enough, we have rights too and we have a right to a decent honest way of life with our kids being able to be brought up in peace." [http://www.together.gov.uk/article.asp?c=32&aid=1093]

In the same interview, Casey dismissed concern about ASBOs, saying "I think the criticisms recently have been in the minority. If you read the newspaper coverage of ASBOs, it is immensely positive, and I now find it interesting that even publications like the Guardian are struggling to find holes in them."

This attitude sums up both the Government's and Casey's approach - that if it's well received by the media and popularist it should carry on. In practice there are far bigger holes - such as those reported by the Youth Justice Board:

"Nearly half of the young people whose case files were reviewed, and the vast majority of young people who were the subjects of
in-depth interviews, had been returned to court for failure to comply with their order. The majority had ‘breached’ their ASBO
on more than one occasion. Eighteen young people were sentenced for breach of an ASBO as the sole offence: for one young person,
the outcome was a custodial sentence." [http://www.yjb.gov.uk/publications/Scripts/fileDownload.asp?file=ASBO+Summary%2Epdf]

One suspects that, should she take over at the Youth Justice Board, such criticism would be a thing of the past.

More recently, the Runnymede trust noted that there had been a failing on the part of those delivering, enforcing and monitoring ASBOs to monitor ethnicity - as such this is a failing under the Race Relations Amendment Act and ultimately the responsibility of the Antisocial Behaviour Unit for failing to instruct that such monitoring should take place.
[ http://www.runnymedetrust.org/publications/pdfs/Final%20Report%20Equal%20Respect.pdf]

There has been a growing level of concern about the misuse of ASBOs, and the high breach rate. The Home Office has been reluctant to release accurate figures, despite requests under the Freedom of Information Act from Asboconcern and others.

But despite this we know that:

British Institute for Brain Injured Children (BIBIC) found that up to 35 percent of asbos imposed on young people are given to children with a diagnosed mental disorder or accepted learning difficulty. This represents approximately 1100 cases since asbos were introduced.

As at October 2006, the Home Office had still refused to release breach rates for ASBOs despite repeat requests. Figures up to the end of December 2004 showed a breach rate of 40%.

But reports from some councils (e.g. Westminster) showed a breach rate of 60%.

So despite the claims made for Antisocial Behaviour Orders and the Respect Agenda, they have, to date, been a collection of media friendly, populist measures. But the Home Office has obfuscated on the evidence, and failed to look beyond the headlines. It hasn't looked at the level of breaches for people receiving orders. It has stigmatised and criminalised children with mental disorders. It has legitimised "naming and shaming" of children as social policy. It has taken people with dependencies and made them homeless. And it has prohibited vulnerable people from carrying harm reduction equipment such as condoms.

Louise Casey has been the leading light and champion of these measures and as such is not fit to lead as essential a body as the Youth Justice Board.

Getting us hooked on Suboxone

2007-02-05T15:29:00.000Z

We at KFx Towers like a good pharmaceutical success story as much as the next person. So the news that Schering Plough received an EU-wide licence for Suboxone before Christmas must have been good news for the good people at said company. Indeed, so happy were they at their success, that they decided to make their new medicine available at knock-down prices, so that more people could start on this new treatment. We understand in some areas that Suboxone is being made available more cheaply than Subutex, which shows how much they care about the little people....

Only the truly and despicably cynical would think anything else, but we've had several emails about Suboxone so we thought an article would be in order.

Suboxone is a 'cocktail' of Buprenorphine (Subutex (r)) and Naloxone. The idea is that Naloxone is badly absorbed sublingually, but the amount reaching the brain is very high if the drug is taken intranasally or injected. 100% bioavailability is achieved if Naloxone is injected, and levels as high as 100% are claimed for snorting, but this may not be the same in street settings.

If a patient takes their suboxone sublingually, as directed, they should only get the subutex. But if they are tempted to snort or inject the tablets, then they will get the subutex, but also a dose of Naloxone. This should, the theory goes, act as an opiate blocker, making it ineffective to inject it.

The very pretty Suboxone website explains it thus:

"The naloxone component in SUBOXONE is included to help discourage diversion and misuse. Naloxone has very limited bioavailability when administered sublingually, as intended. However, if SUBOXONE is crushed and injected, the naloxone will precipitate opioid withdrawal. In the absence of an opioid, the antagonist has no effect."

But if we pause for attention and recap some important facts, the situation is less clear.

The NIDA took a leading role in the development of Suboxone: they reported
"the medication buprenorphine/naloxone (marketed as Suboxone), developed by NIDA in collaboration with the pharmaceutical industry for the treatment of opioid addiction..."1
1)

The US department of Justice goes further, explaining "In fact, Suboxone was designed specifically to meet FDA requirements for a more diversion-proof drug for use in opiate addiction therapy."2

But ironically the NDIC reports ongoing abuse of Suboxone, saying
"Suboxone also can be diverted and abused; however, it is more likely to be abused by individuals who are addicted to low doses of opiates since it can precipitate withdrawal symptoms in high doses. The naloxone in Suboxone guards against abuse by causing withdrawal symptoms in abusers who crush and either inject or snort the drug; however, law enforcement and pharmacist reporting indicates that Suboxone is being abused successfully when snorted.

Using buprenorphine and heroin in combination does not produce increased effects, but if buprenorphine and methadone are abused together, the effects of both drugs are enhanced. Consequently, diverted buprenorphine may be attractive to patients currently using methadone for opiate addiction therapy."3

All this talk of precipitating withdrawals can get confusing. So what's really going on?

1) the ratio of buprenorphine to Naloxone is 4:1 - a very low level of Naloxone.

2) Buprenorphine is a partial opiate antagonist - it will block heroin from reaching opiate receptors reasonably well. But it is a less effective antagonist than, for example, Naloxone

3) Buprenorphine can and does cause respiratory suppression; especially when injected in large doses, and especially if mixed with benzodiazepines.

4) If a user has heroin in their system, and they use a dose of buprenorphine, this may produce withdrawal symptoms. The severity of these symptoms will depend on the levels of heroin in the system, the amount of buprenorphine used and the quantity of buprenorphine used.

5) but if a person has no opiates in their system (i.e. in withdrawal) and they take buprenorphine, they will get the opiate agonist effects of the buprenorphine, as in relief from withdrawal and mild opiate effects.

6) Naloxone is less effective at blocking or reversing buprenorphine than it is heroin. The literature says that a higher dose of Naloxone will be required, and attention given to maintaining breathing as Naloxone alone might be inadequate.

7) the amount of buprenorphine reaching the brain via snorting is around 49% compared with 29% sublingually, meaning that if someone were titrated and tolerant to a sublingual dose, they would be getting almost a 1/5th more drug by snorting. The time to reach peak levels would also drop from around 200 mins sublingually, to 30mins nasally, according to sources at Schering Plough.

So let's put all these pieces together.

If crushed and snorted, the subutex in suboxone is reportedly still effective. It is possible that the low doses of Naloxone, combined with the higher effective dose of burprenorphine and the relative poor blockading of Naloxone against burprenorphine make snorting the drug effective.

Schering Plough say "Currently no studies have been carried out looking at the effects of nasal snorting of Suboxone tablets." So it would be curious for them to claim that it cannot be effectively snorted.

If injected then all the subutex and all the Naloxone reaches the brain. If the user has heroin still in the system this will precipitate rapid and marked withdrawal symptoms. In fairness, this is likely to have happened even if the naloxone was not present, as the buprenorphine alone would have precipitated withdrawal.

But if the user has no other opiates in their system and inject crushed suboxone, what happens? Well it won't precipitate withdrawal if there's no opiates in place, that's for sure. So for someone not dependent or already in withdrawal, there won't be a sudden reversal into unpleasant symptoms.

It may be that nothing will happen - the naltrexone component will block the buprenorphine from working.

What could also happen is that the nNaloxone partially blocks the subutex - but not wholly. And so by taking a large dose of suboxone by injection, the person could still overdose, as the low dose of Naloxone would be a poor antagonist in such an overdose.7

The risk of buprenorphine-induced overdose would go up if use were taking place alongside benzo use.

So suboxone appears to be of limited value in preventing snorting, and of questionable benefit in preventing injecting. It will still be good for preventing use on top - but then if used properly no better than Subutex alone.

In which case why the big sell on Suboxone? If it isn't being driven by its clinical superiority, what's the appeal?

Firstly, this drug was developed to meet the demands of the US drug treatment and enforcement bodies. By complying with their demands, Schering Plough have a drugs which is the only one to receive federal approval for the treatment of heroin addiction - which is a huge cash-cow however you look at it;

But it should also be noted that away from the US, the patent period for Subutex has expired 4 leaving the way open for cheaper competitors.

To get an idea of the impact of this, the NHS pricing tariffs demonstrate the difference in costs between generic methadone, generic buprenorphine, and branded Subutex:

buprenorphine: 50x 20mg sublingual tablets £5.33
subutex 7 x 2mg £6.72
methadone 1 x 50mls 75p
5

Given these price differences it would be imperative that Schering Plough get a newer Patented product on the market and quickly - and the advent of Suboxone appears to meet that need.

Thanks to EU wide approval 6
Suboxone is now in a privileged position to become the prescribed drug of choice, regardless of cost or relative effectiveness. And by providing subsidised early "trials" which won't be randomised or controlled, Schering Plough can accrue claims to effectiveness which wouldn't survive rigorous academic scrutiny.

So on balance, and until we have independent and rigorous evidence to the contrary, Suboxone is more expensive than generic buprenorphine, can still be snorted, and won't induce withdrawal when injected unless the person already has opiates in their system. Further, it will still leave people at risk of overdose when injected, as the Naloxone won't effectively or fully reverse the buprenorphine.

Now why exactly is your rep pushing your patients on to Suboxone???
Don't you think you should ask?
Let us know what they say.

KFx 2007
[thanks to Kate for getting me started on this one]

DOI - Doh!

2007-02-05T14:30:00.000Z

New drug doing the rounds (again)

While the media was frothing over the reclassification of methamphetamine, four people were admitted to hospital in Bedfordshire following ingestion of an unknown substance.

The Media were quick to report this as being due to a "new drug" called DOI or D09.

The Beds police were a little more cautious saying "Speaking to other party-goers at the scene, officers were told that the two men may have taken a drug called DO1, DOI or DO9."

Importantly, it has not been verified that the people in question had indeed taken DOI, or what they believed to be DOI. No independent toxicology reports have been made available at this time, so the suggestion that the substance involved is DOI is highly speculative.

Having said that, other sources have noted some availability of DOI - especially amongst communities with a keen interest in hallucinogens and stimulants. These sources suggest that there is at least a batch of DOI doing the rounds. This, they speculate, may have been a UK based chemist who has cooked up this batch, or an imported batch from an overseas chemist. This would seem more credible than DOI becoming more popular as a rave drug.

DOI is short for 2,5-dimethoxy-4-iodoamphetamine

It was one of a number of compounds developed by Alexander Shulgin and listed in Pikhal. It binds strongly to various serotonin receptors and has been widely used as a research chemical to help identify the location of these receptors.

It is a powerful and long-lasting hallucinogen. Sources suggest periods of effect as long as sixteen hours, with a similar level of hallucinatory effect to LSD, but with the user also feeling more active.

It has not proved hugely popular as the hallucinogenic effects last a long time, and are not that good compared to other, shorter acting, more readily available compounds.

Dose ranges are small - 1-3mg. People undertaking experimental use in controlled conditions have typically had it in refined, powder form for carefull self-administration - e.g. snorting.

Generally such low-demand research chemicals would be in pure powder form for the user to dose at their own level, knowing exactly how much they were taking.

A source from Milton Keynes says that the DOI taken at these events was in tablet form,as E's would be.

no literature is clear on risks and none mention risk of convulsions, though, as this is an amphetamine-type compound this risk is not inconceivable. This would be especially hazardrous at high doses.

Suspicion is at this time that it could be (a) real DOI and some users have taken massive doses, not knowing its strength or (b) it's poorly made DOI with some additives of unknown type/action or (c) it's not really DOI at all but some unknown compound knocked up and flogged to users at a rave (d) it's MDMA or another E-type compound with DOI or something similar in their too, to increase the trippiness...

If you have anything to add please email so we can keep people informed...

Beds Police
BBC
Wikipedia on DOI
LEDA on DOI

[thanks to Carly for bringing this one to my attention]

Testing Times

2007-02-05T13:39:00.000Z

Consolidation of Drug Testing Companies - profit over privacy?

There's been a flurry of shopping activity in the world of Drug Testing - and it's not for testing on arrest!

Concateno PLC, an AIM listed company with no history in the field of Substance Misuse, has been buying up a motley collection of Drug testing companies. This has included Medscreen (November 2006) Altrix (January 2007) Trichotech (February 2007) effectively meaning that one company now owns the major urine, mouth swabbing and hair testing companies in the UK. Concateno PLC is a cash-shell company, headed by Keith Tozzi, former Group Technical Director of Southern Water, CEO of the British Standards Institute and former Chairman of Mid Kent Water...

Why does this matter? The risk is that, in a profit-driven market, the ethics of drug testing will gradually be eroded. To date, most UK testing companies have taken a responsible approach to drug testing by parents and carers. But the worry is that, as the need to create greater shareholder value grows, so the push towards large sales, more widespread testing and more frequent testing grows too.

Any one selling drug testing products has a vested interest in seeing them routinely rolled out in schools, the workplace, and other non-criminal justice settings. This is where the big money lies.

This is something Altrix has been especially keen on. They "passionately believe..." drug and alcohol misuse...are reaching epidemic proportions," and as such drug testing should be embraced to confront these "threats in society." Hence their willingness, enthusiasm and support for such initiatives as the Drug testing in schools rolled out in Kent. No evidence that it reduces use of course, but massive profits for companies.

It will be interesting to see how well these smaller companies can maintain any kind of ethical stance as they become just another part of a larger company.

As there is virtually a monopoly now on drug testing in the UK, it must surely be time for a review of these last purchases and ensure that they continue to act in the interest of the market and consumers.

BBC coverage of Tricho-tech buyout here

ACPO on Cannabis?!

2007-01-28T19:05:00.000Z

The Association of Chief Police Officers (ACPO) drew up new guidelines on the policing of cannabis in November 2006 which saw the light of day at the end of January.

This guidance was published following an ACPO review of cannabis policing. Hopefully it was also influenced by the recent JRF review of cannabis policing, but this is not necessarily borne out by the content of the revised guidance.

And if people were confused by the policing of cannabis before the review, the new guidance will convince people that they have toked on something especially potent.

One of the key changes is that the new guidance instructs a very clear "three strikes" policy. All 'cannabis warnings' issued are meant to be recorded on a force-wide basis. If a person has already received two 'cannabis warnings,' the ACPO guidance says that a third warning should not be given, but more formal action such as arrest and charge should be undertaken.

This change will be heavily dependent on accurate record keeping, and will require expenditure on record keeping. It will also mean that, unless police are able to verify a person's identity, it will a hit-and-miss process to enforce.

The other key change affects Under-18s. In the previous guidance, police had been instructed to arrest under-18s for cannabis possession. But in the revised guidance, this position has been reversed - police are now instructed NOT to arrest young people for cannabis offences unless there are other aggravating factors.

While, on the face of it, this represents a liberalisation of policing, it is in reality a cosmetic change. Young people will still be dealt with under the Crime and Disorder Legislation, resulting in a reprimand, warning or charge. This processing must take place at a Police Station so while the young person may not initially be arrested, subsquent action will take place in a Police Station.

It is essential that under 18s realise that while they will probably no longer be arrested, they will still end up engaged with the criminal justice system, and liable to getting a criminal record.

The release of the ACPO guidance coincides with publication of the Joseph Rowntree Foundation report on policing cannabis.

This piece of work reviewed the impact of cannabis reclassification on police and users.

It highlights that significant numbers of people are still being arrested for cannabis and that the policing of cannabis was variable - with street warning been used for betwen 22% and 42% of cannabis incidents. Given that the presumption should be against arrest, it is clear that arresting users is still the norm, not the exception.

The JRF report also notes that Black and other Minority Ethnic groups were more often given street warnings. This suggests that racial profiling plays a role both in who is searched, and also who is warned.

The report notes that almost half of police officers interviewed wanted to be able to give street warnings to Under-18s when the situation warranted it.

And finally the report notes that, as cannabis warnings could be counted as "sanction detections," there was evidence that senior police officers may use "street warnings" as a quick and easy way of bumping up detection figures.

The new ACPO guidance does address some of these concerns. Under 18s will not automatically be arrested, but they will still be criminalised; police officers are reminded not to arrest unless it is necessary, but this will still be at the discretion of officers; and police forces can count these as sanctions detected, although of course no force would be so craven as to use this as a way of improving crime figures for Home Office statistics.

Would they!

ACPO Guidance at:
http://www.acpo.police.uk/asp/policies/Data/ACPO%20Cannabis%20Guidelines.doc
JRF Report at:
http://www.jrf.org.uk/knowledge/findings/socialpolicy/1998.asp

Glass and Grass - The Sequel

2007-01-21T16:47:00.000Z

Back in November 2006 KFx reported that an increasing number of people were finding herbal cannabis which was being adulterated with glass. This adulteration came on the back of the ongoing police clampdown on cannabis-growing in the UK.

Two months later, the Daily Dose, Department of Health and Drugscope have also started to report this contamination - better late than never.

It was cannabis activists - not the Home Office or DoH that took a proactive lead, getting cannabis samples analysed by a friendly toxicologist. These reports were publicised by activists including UKCIA and Cannaprag

This supported the increasingly well-founded assertion that cannabis was being contaminated - probably by some sort of reflective glass beads in a solvent - based spray. It looks like this:

Belatedly, Department of Health realised that this was an issue and on the 16.1.07 released a bulletin. This was circulated to PCTs and others.

Unfortunatley, while this Bulletin highlighted the risk, it didn't see fit to propose suggest any harm reduction interventions.

Frank, the Government-run helpline recycles the same information and also fails to offer any harm reduction information.

So the outcome so far has been ACPO create a shortage of cannabis through operation Keymer. Growing and supply has been concentrated in the hands of a smaller number of illegal suppliers and, in turn they have started to bulk up supplies with contaminants, passing off lower grades of grass as being high in THC with adulterants.

This is a fine example of prohibition and its impact on health. So just as alcohol prohibition results in people choosing to drink toxic alcohol concoctions, so cannabis prohibition has resulted in an unregulated market and the increased availability of highly contaminated soap bar and now contaminated herbal cannabis.

For people left with contaminated cannabis to smoke, here's the choices:

- don't smoke or eat any contaminated drugs at all;
- if you really feel you have to, don't smoke in a straight spliff - use a water pipe, fine gauzes, filtered pipe or another method of smoking;
- don't take large lungfulls from any unfiltered sources such as chillums, pipes without filters, or spliffs;
- take more shallow puffs, don't such to hard - it increases the chance of glass being take deeper in to lungs.

and above all, remember that this situation arose out of prohibition...

Suffolk Murders - Tragedy, journos and ASBOs

2006-12-30T16:16:00.000Z

How the media handled death and sex
The tragic deaths of initially one woman, then a second were largely disregarded by the media. But as the number of deaths rose, so the media interest increased until Suffolk became the eye of a media storm.

The coverage of the media was, on the whole, insensitive, crass and at times downright offensive. In the face of the multiple strands of drugs, sex and death, many journalists used lurid, salacious and titillating coverage. Having sent so many journalists to Southwark, valuable police time was wasted feeding the media, even if there was no news to report.

As time went on, some media outlets started to revise their coverage, highlighting that the murdered women were, foremost, people - with families and friends who loved them and grieve for them. Some media commentators found themselves unable to do this, and could not get past the drugs and the sex-industry aspects of it. It was left to the commentators to explore the subject in more detail and to look at causes and solutions.

Inevitably, much of the editorial comment looked at how policy on drugs and/or prostitution could have made a difference. Some looked to greater prescribing of substitutes as a solution; others looked at the liberalisation of policy towards prostitution as a panacea.

In practice, there are no simple answers. As we see an increase in dual use of heroin and crack, the delivery of substitute prescribing practices is only a partial solution. Without high-quality, intensive interventions for stimulant users, many people will still find themselves engaged in dangerous activities like sex-work to fund habits.

Likewise, models of legalisation will aid those people engaged in sex work who can go 'legit.' This will primarily be those with minimal drug habits, and those in the UK legitimately. Those with the most complex problems - with violent or controlling pimps, those who have been traficked, and those with big habits, are as likely to be excluded from models of legalisation as they are now. So models of legalisation that create two-tier models cannot provide adequate protection.

There are severeal strands that need to be addressed simultanueosly. And fundamentally it requires rethinking not just of laws on drugs and prostitution, but the way we deal with perceived antisocial behaviour.

For it is the approaches to Antisocial Behaviour, as much as the dependency on drugs, that has increased the risk to people who undertake sex work. The way that the Antisocial Behaviour Act has been used effectively criminalised people engaged in prostitution - and mved people in to less visible, less safe arenas as a result.

The older prohibitions, for example on what could be considered a 'brothel' condemned people to working alone - or discretely in twos or threes.

Likewise, the restriction on the placing of cards in phone-boxes made it harder for people to advertise. Westminster council doing their bit to force people further in to the shadows!

But the provisions of the Antisocial Behaviour Act have had the most serious and far-reaching consequences. Prohibiting people from certain areas (e.g. known red-light areas) or times (e.g. after dark) or places (e.g. entering a car) or carrying items (e.g. a condom) has effectively made the trading of sex an imprisonable offence.

So the much touted Respect agenda has shown preciousl little respect for the vulnerable who are driven from the streets, away from lit areas, and in to greater risk.

For any intervention to work, we need a multi-stranded approach. Liberalisation of the laws on brothel-keeping and sex work to make small, well-run brothels wholly legal; increased tolerance of those who can't operate in such settings, to ensure that they are not further excluded and criminalised. And a full range of outreach and support services to address the multiple factors that have marginalised these people, so they can, if they wish, leave this hazardrous profession.

KFx
Dec 2006

THC4MS Case

2006-12-30T15:19:00.000Z

Prosecution, Pain and Pharmaceutical Profit

There is something obscene about the prosecution of Mark and Lezley Gibson, and their associate Marcus Davies. They are being prosecuted for supply of cannabis, supplied on a not-for-profit basis, in a therapeutic form, to people suffering from symptoms of MS.

Medical trials have demonstrated that a significant number of MS sufferers derive benefit from the use of cannabis. However, there is still no easy way for people to access a legitimate preparation containing cannabis. A small number of people have been able to receive Sativex, although this is not yet licensed in the UK. The rest must endure pain, use prescribed compounds which may be physically addictive or bring unpleasant side-effects, or break the law.

While there is a clear need for a legitimate product, this seems to be slow in coming. There is a growing sense that Pharmaceutical companies see a need to get a product on to the market - but one that they can control and profit from. Rather than allow any tolerance of self-produced cannabis for medical use, anyone seeking to use cannabis will be obliged to purchase it from drug monopolies.

So the defendants from THC4MS are on the wrong end of a tale of history and capitalism which, tragically, is likely to see them sent to prison. Cannabis was accepted as having a medical use for three millenia, and it is within the last century that it has fallen from favour. To be replaced, ironically, by new, 'safer' antibiotics, sedatives and analgesics - barbiturates, benzodiazepines, chlorpromazine et al. Shortly, new forms of the drug will be patented, marketed and controlled. But those who facillitated the process - medical users who were forced to break the law in the face of state and medical intransigence - will be rewarded by imprisonment, rather than the acknowledgement they deserve.

To find out more, or if you want to make your own views known on the THC4MS case you can use the following links:
http://www.thc4ms.org/ home page
http://www.lca-uk.org/

Off the Grass and on the Glass

2006-11-16T08:37:00.000Z

How Police and Home Office Strategy is increasing cannabis risks to young people

The ongoing police Operation Keymer has seen availability of homegrown cannabis drop to an unheard-of low. And there is growing evidence that this reduction in availability has meant new and potentially dangerous adulterants being used to bulk out dwindling stocks of herbal cannabis.

Cannabis users on UKCIA, and other young people are reporting cannabis being adulterated with bulking agents to either make low grade cannabis look like THC-rich skunk, or alternatively to increase weight.

Adulterants have included relatively low risk substances like sugar solution, or sand. But recent reports suggest an increased use of adulterants such as water-retention polymers - which may take the form of small yellow beads or (more frequently) white crystals.

Most worryingly, some users are reporting cannabis is being coated with ground glass, or sprayed with glass fibre. At this point, such rumours are apocryphal and cannot be substantiated. But there is good evidence that cannabis stocks are dropping in qualiy, prices are going up, and remaining stocks are being more widely adulterated.

Neither the Police nor Frank have raised awareness of these problems, leaving young people at high risk.

We would suggest the following harm reduction advice:

crunch test: if it's crunchy it's got adulterants such as sand or glass in it: put a small bit between teeth; if it's crunch spit it out;
rub test: rub a bit between fingers; if it's got a gritty feel - it's adulterated;
best thing to do, probably chuck it but as this isn't likely for most young people, we need to look at other strategies such as:

use in a water pipe
use pipes with screens
use a filter in place of a roach

Queens Bench Ruling highlights problems of Cannabis Policy

2006-11-07T17:43:00.000Z

The policing and policy towards cannabis received another blow when the Queens Bench Divisional Court refused a judicial review of a man cautioned for possession of cannabis in his own home. Norville Mondelly (The Times reported) was found in possession of cannabis when the police attended his property by mistake>

Although the aggravating factors that would normally have resulted in arrest were absence, the police initially decided to arrest under Section 8(d) (allowing premises to be used for smoking cannabis) before deciding that there was insufficient evidence to charge for this, and settling instead for a caution at the police station.

Mondelly sought to challenge this, as being contrary to the ACPO policy and guidance. But the court did not find in his favour, stressing that if the policy did constrain police action or make arrest or prosecution impossible, then such a policy would be unlawful.

The case really highlights the worthlessness of the current guidance, providing as it does no protection for individuals, who may believe that they would not be arrested for personal possession in their own home, as that is what the guidance led them to believe.

For the full Times coverage, click here

Keeping tabs on the Street-count

2006-11-01T23:02:00.000Z

The time for the annual street-count draws nearer. We have received emails from a number of workers with first hand experience of the count which provide evidence that local provision is adjusted on the run up to counts, to ensure numbers on the night of the count are kept low.

We are aware of one count area where the number of rough sleepers was brought down on the night of the count by the temporary opening of a shelter for a week; a rough sleeper count was brought down from fourteen to one, for the duration of the count.
Several workers are stressing that as more people are removed from city centres, or have ASBOs that restrict their access to City centres, more people are sleeping rough away from main count areas; they are certainly sleeping rough - but not necesarilly visible in street settings.

And there is a growing awareness of the number of economic migrants, and people seeking Asylum who may have had claims rejected who are now sleeping rough too. We are very aware that these groups, caught in a catch 22 where they cannot get benefit or access to many hostels, are especially vulnerable and are likely to be at risk during what looks like being a very cold winter.

If you are aware of any measures that have been used in your locality to push down the count in your locality, please write in and let us know; this may include sudden purges of rough sleepers the night of the count, emergency accommodation being opened.

We will make sure contributions are kept anonymous.

Some very selective hearing....How the Home Office, the ACMD, Science and Technology Committee and DfES all choose to hear only what they want to...

2006-11-01T22:57:00.000Z

A couple of years ago, the Home Affairs Select Committee recomended that cannabis be moved from Class to Class C. The Home Office rejected many of the Home Affairs Select Committee's recomendations, such as the unequivocal "injecting rooms should be piloted without hesitation."

But, perhaps sensing youth votes or for other reasons, the Home Secretary proceeded to move
cannabis to Class C.

However, daunted by the barrage of criticism from the police and the media, David Blunkett fudged the process of reclassification, changing PACE to make posssession of Class C drugs an arrestable offence and increasing the penalties for supplying Class Cs.

In effect, although Cannabis was reclassified, all the rules about class C drugs were so altered as to make the reclassification virtually meaningless. This confusion was then reinforced by the ill-advised and unevenly ACPO guidance on policing cannabis, soon to be the subject of judicial review.

Blunkett and subsequent Home Secretaries have since come under intense pressure to revise the classification of Cannabis.

Charles Clarke was asked to consider moving cannabis back to Class B. Although his personal opinion was apparently that it should be moved back, he instead put the matter in the hands of the ACMD, and asked if, in light of 'new' research evidence of its impact on mental health, cannabis should be moved back to class B.

If he hoped that the ACMD would give him the answer that he wanted, Clarke was to be dissappointed as the ACMD said that cannabis should remain as a Class C drug. In a clear shot across the bows of the Home Secretary, members of the ACMD made it known that there could be high profile resignations from the ACMD if the Home Secretary simply disregarded their recommendations.

Faced with this, Charles Clarke followed the ACMD's lead, and left cannabis in Class C, but decided that there should be a review of the whole classification system, to ensure that the penalties and restrictions were appropriate and commensurate with risk.

This review was undertaken, as instructed, by the Science and Technology Committee. It reported in October this year, in a report which was highly critical of both the drug classification system and the ACMD. It concluded that the current classification system was not 'fit for purpose' and castigated the ACMD for its failure to highlight the inadequacies of the system to successive ministers.

Perhaps unsurprisingly, the Home office and the ACMD didn't respond favourably to "Making a Hash of It." The Home Office rejected virtually all their recommendations; the ACMD issues a short, terse response using some very pointed language.

This spat reveals the very real problem at the heart of the UK's drugs policy. It lacks cohesion, direction or an evidence base. It is being pulled in different directions by various parties, rather than having the intellectual and policy foundations shaped by expertise and evidence.

The ACMD should be making recomendations to Ministers, and these should be put before Parliament. It is not for the Home Secretary to pick and choose what measures are, or are not taken forward. The ACMD for example said they recomended against the use of Sniffer Dogs or drug testing in schools. Yet the DfES are continuing to take forward a drug testing pilot in Kent - in direct contradiction of the ACMDs response.

Likewise, in their report on Drug Deaths, the ACMD called for a pilot for drug consumption rooms, a call echoed by the Home Affairs Select Committe and more recently by the Joseph Rowntree Foundation.

But despite evidence and recomendations from these respected bodies, the Home Office rejected these calls on the most cursory of grounds.

If we are truly to have an evidence-based drugs policy, we should be listening more closely to the ACMD. But in turn the independence of the ACMD should be more carefully protected. We grow more and more concerned that its composition will be more closely controlled and vetted by the Government of the day, and therefore more likely to produce "Government-friendly recommendations." This would be a disaster for policy and practice.

Making A Hash of It - report
ACMD response
Home Office Response

Heroin Chic: Kate Moss, Jane Henderson and Topshop

2006-10-23T18:34:00.000+01:00

It's not often that KFx dips it's toe into the heady world of fashion. But having had an insight into why former Topshop's fashion director recently quit, we felt obliged to share it.

As fashion followers will know, model Kate Moss was appointed as a fashion designer by the head of Topshop. This we learn was not the final straw for Ms Henderson.

What was, we understand, was that her initial offerings appeared to be some fairly 'distressed' clothes, which were somewhat ragged and (dare we say it) dirty.

We understand that being offered these as a design offering were a bridge too far, and this resulted in Ms Henderson's departure.

The only thing that remains unanswered is...were these products in fact Pete Doherty's unwashed clothes? We wait to learn more, avidly.

In the meantime, thoroughly ashamed of ourselves for running such superficial twaddle, we now resume normal service!

The Macho Rev Hargreaves and his Cannabis Campaign

2006-10-17T21:39:00.000+01:00

After the tragic stabbing of Stevens Nyembo-Ya-Muteba in Hackney in October, you could not avoid seeing or hearing George Hargreaves in the media afterwards.

It was widely alleged in the media that the boys who stabbed Mr. Muteba had been smoking cannabis before the attack. Hargreaves used this as the catalyst to launch a broadside against cannabis and to announce that thanks to an 'anonymous donor' he was going to court for a judicial review of the ACPO policy in relation to cannabis policing.

Hargreaves says that an anonymous donor has given him the required money to launch his High Court challenge. But in practice he could probably fund ths himself being a wealhy man. He earns, it is estimated, some £10k per month - from record royalties.

For the anti-Gay Hargreaves also wrote the Gay club anthem "So Macho," sung by Sinitta.

We discuss the review of policing cannabis in a separate article (see above.) Here, we want to set the record straight on Hargreaves and his campaign.

In the local press and on the Radio 4's Today programme, Hargreaves represented himself as a local pastor, dismayed at seeing 'his' community in Dalston torn apart by cannabis, and watching young people's mental health deteriorating.

In fact, the Reverend Hargreaves is a Christian Fundamentalist who established Operation Christian Vote and has parliamentary ambitions. He sees the purpose of Government "the purpose of government is the maintenance of freedom and justice solely in accordance with biblical principles."

He adds cannabis to his list of 'anti's' most notably anti-abortion and anti-gay. He believes that people should be arrested and charged for even small amounts of cannabis. Presumably he believes this would have a deterrent effect, or that a short spell in detention would correct wayward young people, rather than merely criminalising them at an early age.

In the sad case of Mr. Muteba, he didn't mention the lack of recreational facilities in Dalston for young people, the growth of gang culture, the lack of community policing on the Holly Estate. All he focussed on was cannabis.

And, like the Daily Mail and the other campaigners, Hargreaves likes to string together unproven and often incorrect statements to support his condemnation of cannabis.

He claims that use of cannabis has escalated; research shows that use of cannabis amongst 11-15 year olds, and 16-25 year olds has actually declined since 2003 [BCS, DoH].

He claims that use of skunk has escalated since reclassification; the widespread use and availability of skunk had been increasing over the past decade, and is not a reflection of reclassification. Indeed, the evidence is that a licensed and regulated market would ensure a wider range of strengths, rather than our current reliance on strong homegrown skunk'

he repeats the argument that cannabis causes schizophrenia, an assertion not borne out by the evidence. While there is clearly a relationship between cannabis and mental health, this has not be shown to be a causative link. It's tragic that anyone would want to exploit the tragic death of a person, to promote their own moral and political agenda. Something that the Reverend Hargreaves has no compunction about doing.

(17.10.06)

The End of the Road for the Cannabis Policing 'experiment?

2006-10-17T21:37:00.000+01:00

It seems likely that before the end of the year, the current cannabis policing policy will come to a grinding halt. Given a combination of factors, it seems almost inevitable that the current policy will be abandoned. This will not, unfortunately, be due to evidence that the policy has 'failed,' but rather due to a combination of media pressure, political ineptitude and circumstances.

The political climate:

The political demise of David Blunkett leaves the way clear for John Reid to change the way cannabis is policed. That Blunkett has now revealed the extent to which his performance was impaired by his social problems means that his decision making is now easy for others to question and overturn.

Likewise, Charles Clarke's decision to follow the ACMDs recomendations was a close run thing; it was made whilst the Home Secretary simultaneously promised a review of the whole classification system.

The Home Office's rejection of the review undertaken by the Science and Technology committee, which looked at the drugs classification system, suggests that the Home Office will not reclassify cannabis to B, but will also not change the overall classification system.

Media Pressure:

The media have frothed themselves in to a righteous indignation about cannabis and currently sense blood. The murder of Steven Nyembo-Ya-Muteba, the killing of Paul Butterworth in St Albans by Laurie Draper, the ongoing campaign against 'skunk farms' run by 'Vietnamese Gangs,' have all contributed to a febrile atmosphere and intense pressure on an underperforming Home Office. The Government needs a way out, and the media knows that they are kicking against a door which is ready to swing open.

Police Review:

ACPO is currently reviewing the policing of cannabis including the current guidance; this review (it is claimed) had been planned for a while and is not a response to current political or media pressure. But given current criticism pressure is going to be intense for a change to the current police guidance. Certainly, the outcome to date has been a lottery of enforcement and this has meant huge variation as to how cannabis has been policed.

Legal Review:

The Judicial Review, which has been sought by Christian fundamentalist George Hargreaves, is set to challenge the current ACPO guidance. He is not seeking (we understand) to review the reclassification of cannabis, rather the ACPO policing guidance. It has to be said that such a review may well find against the ACPO guidance, suggesting that the decision not to enforce the law as a matter of policy is ultra vires but this will remain to be seen. But it also increases the chances that ACPO and/or the Home Office may decide to change policy prior to a court result to avoid the embarassment of a court result going against ACPO.

In conclusion:

When cannabis was originally to be reclassified, it should have simply moved to class C, and as such the power of arrest would have been removed. Blunkett, in a furious backpedal under media and police pressure, had PACE amended to make sure that the power of arrest for cannabis was retained, and tried to fudge this decision by getting ACPO to draft guidance to ensure a presumption against arrest. This fudge, which was an inelegant and ill-considered approach, is now under review with ACPO, under sustained media pressure and the subject of judicial review. Blair, Reid, Clarke and others have already indicated that they would like to to see the reclassification reversed.

In light of this, it seems almost inevitable that the current policing arrangement will be ended. However, we do not think that cannabis will move back to Class B. To do so would be for the Home Office to reject outright the advice of the ACMD. This would be a huge step. But the need to re-reclassify would largely be irrelevant if the current policing policy were to be abandoned.

(17.10.06)