Drug policies are a popular topic for the medical research nowadays all over the world. Statistical data shows that some of these policies have already had positive results and impact on the drug taking within the society. In general, development of effective drug policies has an immense potential. The availability of various drug policies in many countries of the world proves the fact that the topic of the drug use is a serious problem of the mankind. Despite the number of institutions and the involvement of government in certain cases, drug policies are in most cases ineffective and are based on wrong assumptions.
This paper is aimed at analysing the existing UK drug policy, which has been developed and introduced by the UK Drug Policy Commission in early 2007. Together with other documents and publications prepared by the UK Drug Policy Commission and other institutions of the same category, the analysis presents the assessment of various factors affecting the implementation of the policy.
Key points of the policy are discussed throughout the paper. Together with the overall objectives of the policy, the key concepts are examined in order to provide the evidence for the facilitation of models of implementation. The comparison to other policies helps in seeing similarities and differences among the UK drug policy and those of other countries such as Sweden, India, the US, Germany and the Netherlands.
Problems for the policy implementation affect policy results to a large extent. In general, the way models of implementation are assessed, the success of the policy is provided. In the case of the UK drug policy, the analysis of the policy implementation and results helps in revealing potential problems of the policy and understanding how these problems can be avoided in the future.
The members of the UK Drug Policy Commission believe that their ‘aim has been to show how independent scrutiny of evidence can produce both better results and value for money in drug policy and practice’ (Casey 2012, p. 8). All recommendations developed by the institution address the problem of the drug use for those who do not stop using drugs when becoming older and for whom drugs are much more serious problem than for teenagers trying drugs for fun reasons only (Parker, Aldridge & Egginton 2001; Reuter & Stevens 2007; Monaghan 2011; Casey 2012; Howard 2013).
In general, the actions of the UK Drug Policy Commission are based on the fact that the UK has the largest number of drug users among all European countries (Reuter & Stevens 2007; Casey 2012; Howard 2013). According to Reuter and Stevens (2007), “the UK has the second-highest rate of drug-related death in Europe, at about 34 per million population aged 16 or over” (p. 7).
However, the problem of drug taking is not solely the problem of those people using such drugs as heroin or cocaine. In the UK, as much as in many other countries, the drug use is related to crime commitment. As Reuter and Stevens (2007) point out, “illicit drugs may also be linked to violent crime through the direct effects of stimulants, such as crack cocaine, on aggression and through the operation of the illegal market, which is regulated by violence and fear” (p. 8). For this reason, it would be reasonable to conclude that drug policies introduced in various countries usually address other problems affected by the drug use such as crime, mental illnesses, drug dependency and death rate caused by the drug use (Reuter & Stevens 2007; Monaghan 2011).
It is also necessary to differentiate the meaning of drug dependency and drug-related death. Not all teenagers, who die from drugs, are drug dependent on a regular basis, and not all drug dependant people are dying from drugs (Boyum & Reuter 2005; Rosmarin & Eastwood 2012; Howard 2013). As many of the latter are criminals, they also die from aggressive and violent actions of other people (Reuters & Stevens 2007; Casey 2012).
In some cases, criminals are arrested and sent to medical institutions for the rehabilitation (Kleiman, Caulkins & Hawken 2001; Casey 2012). Therefore, drug dependency and drug-related death are the two most widely discussed concepts in most of drug policies (Reuter & Stevens 2007; Trace 2011; Brownstein 2013). However, these concepts have differences and cannot be judged in the same way as similar issues or problems.
One of the key thoughts also developed by the UK Drug Policy Commission is that socially successful people rarely become drug users. As Reuter and Stevens (2007) mention, ‘drug problems are disproportionately concentrated in areas of disadvantage’ and are related to crime, mental illness, poverty, aggression, abnormal social behaviour in public areas and other forms demonstrating that an individual does not allow accepting help from the society and environment around him, when being drug dependent.
This is one of the key problems that have become a challenge for all those involved in fighting with drug problems. In most cases, the success of the given drug policy is fully dependent on the way policy makers understand the way drug users think. Otherwise, the drug policy becomes a paper with lots of analytics, but without the practical implementation. Developing models for the drug policy implementation is mentioned as the most difficult issue for all drug policy makers and institutions (Trace 2011; Monaghan 2012; Casey 2012; Hallam et al. 2012; Howard 2013).
Casey (2012) points out that the numbers of drug users have stabilized over the past ten years all over the UK. At the same time, Reuter & Stevens (2007) report that the number of drug users even increased since the beginning of the 21st century. As the problem continues to progress, the primary challenges for the UK drug policy are the following as Reuter & Stevens (2007) point out:
- the overall reduction of drug users for the drugs of Class A in the groups of young people under the age of 25;
- the reduction of health impact of drugs and drug-related substances that are measured by the Drug Harm Index;
- the overall increase of the aggressive drug users under treatment by Criminal Justice System of the UK;
- a 100% increase of drug users under treatment by 2008 together with the increase of those drug users, who have already completed the treatment (p. 8).
The objectives demonstrate the understanding of the current situation in the country in terms of drug-related issues. However, the purpose to increase drug users in treatment by 100% in only one year sounds unrealistic. It has been reported that drug users are very aggressive when treatment procedures are introduced (Casey 2012). Moreover, when dealing with the large criminal rates in the country, it is observed that many drug users are strongly hindering any forms of treatment (Trace 2011; Howard 2013; Brownstein 2013).
Additionally, the first objective of reducing the number of drug users among people under 25 is also a challenging task as most of them are not seriously offended by drugs due to their young age and are very difficult to reveal among other people. Sophisticated methods have to be developed in order to achieve this goal (Brownsberger & Heymann 2001). Nonetheless, the second and third objectives are derived from the first and fourth ones, and they are measurable and relatively easy to achieve.
The context of policy
Social policies are largely dependent on the subjective opinions of the policy makers. Moral values and the cultural background affect the perception of the environment, and policy makers are facing multiple choices, while designing policies for various population groups.
Despite the importance of the drug policy for the UK population and for the development and growth of a healthy society, the effect of most policies is usually hindered by the impact derived from the ‘large numbers of users remaining untreated, the high rate of relapse, the variable effectiveness of treatment and the continual influx of new users’ (Reuter & Stevens 2007, p. 9). Moreover, as Casey (2012) points out, “very aggressive stop and search tactics aimed at addressing drugs - employed by police in some places, and amongst certain ethnic groups - has had unintended negative consequences” (p. 12).
Therefore, it has been already recognized that the drug policy context needs to be well-planned in order not to scare most drug users and not to demonstrate the fact that drug taking is associated with the crime and mental illness (Howard 2013). However, at the same time, for those drug users, who are closely linked to a criminal behaviour and mental health problems, the treatment needs to be well-designed without harm to the future of an individual.
If these aspects are replenished by the traditional drug policy methods of ill informing and forceful actions towards drug takers, then the results will be far from achieving the goals. The context of a successful drug policy, therefore, involves methods that are oriented on informing individuals about the impact of drugs on health, which is especially effective for the population groups less than 25 years old (Monaghan 2011; McGregor 2012).
As Casey (2012) observes, the context of most drug policies, which are aimed at creating a responsible behaviour is based on “policies designed to prevent a range of harmful behaviours including truancy, offending and substance use, such as some early intervention programmes” (p. 13). Most drug policies have extensive time period and are oriented on the pre-policy period and post-policy period assessment (McKeganey 2011). It can be summarized that drug policies cannot be developed solely on the analysis of a current society situation assessment; they need to undertake a deeper analysis of all the drug-related issues within the population and environmental factors affecting them.
Situational factors analysis
According to the publications provided by various institutions on drug policies, the majority of existing drug policies within the UK are not effective (Parker, Aldridge & Egginton 2001; Reuter & Stevens 2007; Casey 2012; Seddon, Williams & Ralphs 2012; Howard 2013). Additionally, as Casey (2012) suggests, “the rapid creation of new drugs is changing the drugs market too quickly for the traditional methods we use to control drugs” (p. 8). Therefore, the overall assessment of the situation is favourable for the development of new approaches to drug policies. At the same time, the introduction and implementation of traditional policies at this period of time is not recommended due to the negative perception and negative impact of traditional approaches to drug taking.
Other situational factors that are mentioned in the policy include the growing street distribution of drugs and the growth of HIV infection across the UK, which is related to the drug injections. As Reuter & Stevens (2007) note, “despite substantial increases in drug seizures, street drug prices have gone down, with the price for a gram of heroin falling from £70 in 2000 to £54 in 2005” (p. 10). Therefore, it can be concluded that the situation challenging the circulation of Class A drugs is favourable for changing the scope of the whole drug dealer business within the UK.
The political support together with the strong position of the government towards eliminating the drug use in the country has supported the development of drug policies and provided a massive financial investment. At the same time, Reuter and Stevens (2007) stress the importance of the governmental support and financial investment as a part of the policy success in achieving the basic objectives.
In general, the situation with drug-related issues in the UK shows that policies which were implemented in the past did not show a substantial understanding of the issue. Most of them, as Monaghan (2012) suggests, doubt the basic “principles of patient consent and confidentiality which are the foundation stones on which treatment services have traditionally operated” (p. 33). However, the present growth of the amount of people using drugs of Class A and the growing number of the HIV infected due to drugs calls policy makers for action towards the reduction of drug users (Babor et al. 2010; Barrett 2011). At the same time, this action has to address the understanding of drug users and their perception of drug policies in order to minimize the harm for the mental health and personal treatment of drug users.
Structural factors analysis
Structural factors provide the foundation for a broader scope of the problem. As mentioned above, the drug use affects HIV indices and criminal rates. In addition, many drug users are people with a poor mental health and aggressive behaviour. It is a challenge for policy makers to comprehensively handle these issues without missing any sphere of the social life, which can be affected by drug taking.
The implementation of the existing approaches to the drug policy design, which have been developed by policy makers during the last 50 years, demonstrate the need for structuring each case in order to find the best ‘match’ for the situation (Trace 2011; Monahgan 2012; Howard 2013). At the same time, as Trace (2011) believes, “the gaps in the evidence base, and complexity of the issues, mean that there can be no universally „correct” policy deduced from what we currently know” (p. 4).
The existing UK drug policy does not fully address the social life of an individual and his or her personal perceptions of family issues and his or her role in the society. As the majority of drug policies introduced in other countries, the UK drug policy lacks the understanding of how individuals recover from the drug use psychologically and how they can match the socially reasonable behaviour after the completion of the treatment (Higate, Hughes & Lart 2006).
The role of structural factors, which is stressed by most policy analysts, is reduced (Casey 2012; Rosmarin & Eastwood 2012; Seddon, Williams & Raphs 2012). Howard (2013) also mentions that drug policies are lacking new approaches directed towards the drug control. As the government does not allow full political involvement in terms of the issue, the drug circulation still exists as a major threat for any drug policy (MacGregor 2010; McKeganey 2011,).
Exogenous factors analysis
Howard (2013) mentions lifestyle risks that are present in the society that are likely to affect the development and implementation of the existing drug policies in the UK: gambling, criminal punishment, government funding and the lack of understanding the whole picture of drug-related issues. The lifestyle of the young people related to clubs and music can also be accounted as one of the exogenous factors for the existing drug policy.
As Reuter & Stevens (2007) suggest, the UK drug policy is set to create an environment, which facilitates the creation of a reasonable behaviour for all individuals. However, the creation of this environment is based on many factors besides drug-related issues. As Casey (2012) mentions, most drug policies are lacking the full vision of what the drug use can do to the modern culture and society. Trace (2011) also names such exogenous factors as the growth of the organized crime, marginalization of large groups of population in developed countries and human rights violations as critical exogenous factors affecting the development and growth of the drug user numbers worldwide. Wodak et al. (2011) conclude that the success of the majority of drug policies lies in understanding and evaluation of critical situational factors and the development of a full vision for all issues related to the drug use.
Comparison to other policies
The UK drug policy is derived from other drug policies worldwide. The approaches used in other countries are influenced by the situation actual for these locations and existing approaches applied towards drug taking problems. The design of the UK drug policy and the methods used by the UK Drug Policy Commission are influenced by the US drug policy, which has been largely criticized by researchers. According to Hakim (2011), “three out of four Americans now believe that the United States’ forty year “war against drugs” has failed” largely due to the lack of alternatives to support the existing drug policy in the US (p. 1). The government in the United States nowadays realizes the necessity of the situational analysis for the drug policy creation and modification (Reuter 2008, Hakim 2011, Zedillo & Wheeler 2012).
At the same time, Helfrich (2012) advises that the drug policy which has been so successfully implemented in the Netherlands does not relate to the other countries’ situation. The structure of drug-related issues is different in terms of their periodic frequencies and depth (Harris 2011; Jelsma 2011; Helfrich 2012). Charles (2005) finds that the drug policy development in India only affects some groups of the population, while missing the largest groups of drug users in the country due to its orientation on inappropriate social issues. Finally, the experience of Sweden shows the positive impact of a drug policy on the society, when policy makers introduce the vision of a reasonable social behaviour and the concept of ‘drug-free’ society through a well informed drug policy strategy (Hallam 2010).
Policy results analysis
According to Melis and Nougier (2010), drug-related issues are not a national, but a global issue, which requires a well-developed framework of strategies to be introduced on the global level. It is not possible to address drug related issues without the understanding of how they affect the global society and the most crucial world economic issues. In this respect, the drug circulation impact is the most important component for the global drug policy, which affects the results of the national drug policy implementation.
As Reuter and Stevens (2007) suggest in their analysis of the UK drug policy developed by the UK Drug Policy Commission, “there is little evidence from the UK, or any other country, that drug policy influences either the number of drug users or the share of users who are dependent” due to the fact that other social issues and exogenous factors are much more essential. The assessment of the successfully implemented drug policies in the Netherlands and Sweden demonstrates the significance of social implications over the number of drug users in the country (Reuter & Stevens 2007). Casey (2012) also believes that the policy results analysis requires the assessment of a social support, social assimilation of drug users, who passed the treatment and a number of other issues besides the number of drug users. As Stevenson (2011) believes, the medical programs introduction for the drug user treatment is a considerable step towards the implementation of the drug policy.
The overall assessment of the current UK drug policy shows that the meaning of the policy is not acknowledged fully by the society and medical professionals. The existence of factors that are beyond the number of drug users and the drug circulation in the country pushes the analysis of drug-related issues to a deeper level of assessment.
The successfully implemented policy within the UK as mentioned by most researchers requires a substantial financial and political support from the side of the government. The current UK drug policy lacks a well-informed strategy on the national level, which could drive the results of the drug policy and guarantee the positive impact of actions provided by the policy.