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Drugs policy: The 'British system'

Mark Easton | 16:07 UK time, Wednesday, 18 August 2010

Sir Ian Gilmore's valedictory e-mail to colleagues at the Royal College of Physicians calling for laws to be "reconsidered with a view to decriminalising illicit drugs use" fits squarely in a British tradition which stretches back a century and more.

Writing in the Sun newspaper, Sir Ian said that:

"there will always be hard drug users but instead of treating them as criminals, we should treat them as patients".
 
"Heroin addiction is an illness and we should treat it as such, instead of acting on a knee-jerk reaction and putting people in prison."

This argument has been put forward by doctors ever since American campaigners started urging the UK government to ban recreational drugs at the beginning of the last century. Under increasing diplomatic pressure from the United States to honour various treaty obligations and toughen up our drug laws, in 1924 the UK government finally did what it usually does in such circumstances. It called in Sir Humphry.

Man holding syringe with heroinThe Rolleston Committee was set up under the chairmanship of Sir Humphry Rolleston, an eminent physician renowned for his book, Disease of the Liver, Gall-Bladder and Bile Ducts. The medical men around the table took a very medical view of the drugs problem, concluding after two years deliberation that addiction was a disease and an addict was ill.

The US saw drug abuse as a sin; the UK had decided it was a sickness. This therapeutic approach was seen as a direct challenge to the prohibitionists on the other side of the Atlantic, but it was also seen as a very British response to the problem.

In this country we are reluctant to ban things and the Rolleston doctrine became known internationally as the "British system". What it meant was that, while some patients were put on a withdrawal programmes in institutions, others were prescribed doses of pure heroin. It was a matter for doctors, not the police.

This philosophy shaped British drugs policy for 40 years until, in the mid-1960s, it was discovered that a handful of doctors were abusing the system. Well, not so much a handful as one doctor - Lady Isabella Frankau, wife of the venerated consultant surgeon Sir Claude, is said to have almost single-handedly sparked the 60s heroin epidemic. Records confirm that in 1962 alone she prescribed more than 600,000 heroin tablets to hundreds of users who flocked to her Wimpole Street consulting rooms.

Her patient list read like a Who's Who of 60s bohemian cool. Poets, actors, musicians, writers and refugees from the strict drug laws in the US and Canada knew that Lady F would not ask too many questions and, if you were a bit short of readies, might even waive her consultancy fee. American jazz trumpeter Chet Baker turned up at her door and has related how "she simply asked my name, my address and how much cocaine and heroin I wanted per day".

Lady Frankau's motivation was to heal, but what was later described as her "lunatic generosity", saw the end of the British system. As prescribing rules were tightened up, black-market Chinese heroin and other narcotics flooded in. Our relationship with drugs would never be the same again.

Between 1964 and 1968 the number of known teenage heroin addicts in Britain rose from 40 to 785. Criminal gangs had moved in to supply all manner of new substances to young thrill-seekers with money in their pockets.

The Home Secretary, James Callaghan, told Parliament how Britain faced a "pharmaceutical revolution" which presented such dangers that if the country was "supine in the face of them" it would quickly lead to "grave dangers to the whole structure of our society".

It was the beginning of the global "war on drugs". In 1971, US President Richard Nixon described drug abuse as "public enemy number one" as the United Nations passed a new convention on "psychotropic substances" which widened international controls to almost any mind-altering substance imaginable.

The same year, the British Parliament passed the Misuse of Drugs Act giving the home secretary direct authority to ban new drugs and increase the penalties associated with them. Political debate about the wisdom of prohibition was effectively closed down, the medical profession was side-lined and the criminal justice system became the main tool to fight drug abuse.

Forty years later and there are the first signs that the discussion is being re-opened. Even within the staunchly prohibitionist micro-climate of the United Nations, the weather is changing.

At the UN offices in Vienna last year, a meeting of academics and government representatives met ostensibly to discuss the relative merits of compulsory and voluntary drug treatment. What emerged was a discussion paper that recast the international debate along the lines of the long-forgotten British system [350KB PDF]. It stated:

"Drug dependence is a health disorder (a disease) that arises from the exposure to drugs in persons with these pre-existing psycho-biological vulnerabilities."
 
"Such an understanding of drug dependence, suggests that punishment is not the appropriate response to persons who are dependent on drugs. Indeed, imprisonment can be counterproductive."

With a foreword from the previously hawkish UN drugs chief Antonio Maria Costa, the paper proposes "moving from a sanction-oriented approach to a health-oriented one", reflecting how many countries were "looking for alternatives" to the expensive and ineffective criminal justice approach.

In Britain, the chairman of the UK Bar Council, Nicholas Green QC recently wrote in a report that "decriminalising personal use can have positive consequences; it can free up huge amounts of police resources, reduce crime and recidivism and improve public health".

There have been a number of reports from respected think tanks saying similar things and now we have Sir Ian Gilmore's intervention.

The Home Office has made it clear ministers remain opposed to such ideas.

"The government does not believe that decriminalisation is the right approach. Our priorities are clear; we want to reduce drug use, crack down on drug-related crime and disorder and help addicts come off drugs for good."

The British public is also largely unconvinced, although a poll conducted by Liberal Democrats for Drug Policy Reform recently tried to test the strength of feeling when offered a range of options. According to the survey, there was 70% support for legal regulation of cannabis and with magic mushrooms, amphetamines, and mephedrone there was a majority in favour of legalisation and regulation. Roughly three in 10 people said they would prefer the state to regulate rather than prohibit heroin supply.

It does seem that the assurance of the prohibitionists in Britain and across Europe, at the United Nations and even in the United States is under pressure. It may be that the British system is being slipped onto the table once again.

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