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A focus on harm

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Mark Easton | 14:31 UK time, Thursday, 14 May 2009

The Home Office tells me that a "data lag" explains why ministers continue to quote hopelessly out-of-date figures to prove they are winning the war on drugs.

Not just a bit of a lag - they trumpet data which are four years old. Since that time, the government has spent more than £5bn on the drugs strategy in England and Wales.

And yet, only last February, Alan Campbell, Home Office minister responsible for crime reduction, used the ancient data to claim success in the House of Commons. He told Parliament:

"A key indicator of the effectiveness of measures to combat drug-related crime is the Drug Harm Index; since 2002 this has fallen 28%, representing a substantial fall in drug-related crime types."

What he didn't say is that that 28% fall reflects almost nothing that has happened since the last election.

His source (Measuring the harm from illegal drugs: the Drug Harm Index 2005 [94.3KB PDF]) is a graph published two years ago and which only incorporates data up to 2005. After that we simply have white space:

Graph showing drug harm index and trajectory

It is a small point, perhaps, but it leads me to what I really wanted to write about - the shift in emphasis from "crime reduction" to "harm reduction".

The Drug Harm Index (DHI) was introduced as a way of trying to measure how well the Home Office was doing in its key objective to "reduce the harm caused by drugs".

So it includes measures such as drug deaths, mental health problems stemming from drug misuse, HIV and hepatitis infections as well as figures on a range of crimes associated with drugs.

This table shows how it works - you can see how the picture of harm is dominated by crime, notably burglary and theft.

Table showing drivers of change in harm (2004-2005)

The index has its critics who argue that it conflates two different types of harm: the harms from using drugs and the harms from a policy of prohibition. The campaigning Transform Drug Policy Foundation puts it this way (A Comparison of the Cost-effectiveness of the Prohibition and Regulation of Drugs 2005 [444 KB PDF]):

"The failure to disaggregate drug use harms from drug policy harms or, specifically, prohibition harms, is a major obstacle to meaningful evaluation of existing policy and consequently, to the rational development of potentially more effective policy responses."

Nevertheless, the idea that we should focus on reducing "harm" rather than simply "crime" is increasingly embedded in Whitehall thinking - and the implications could be far-reaching.

This week's annual report from the Serious Organised Crime Agency (Soca) reveals that a Harm Framework "was used to underpin all SOCA operational and project-based work from November 2008". The Framework is attached as an Appendix to the report (Serious Organised Crime Agency annual report 2008/9 [6.10MB PDF]).

(You may recall that I referred to the agency's harm reduction "imperative" in a post earlier this week.)

Soca's definition of "harm" goes beyond illegal drug running and the economic costs of crime - this is a complex measure by which the agency pursues all its activities. Physical, social, environmental, economic and structural harms are considered at every level - from the personal to the international:

"SOCA's focus is not solely on the criminals and the offences they are committing" the agency explains, adding that their "operational business now focuses more sharply on the question of what will make a tangible and lasting difference for those who are being adversely affected".

Looking at crime through the harm prism may make us reconsider priorities.

An attempt by the Home Office to quantify the physical and emotional harms associated with violent offences took them on an interesting journey a few years ago (The economic and social costs of crime against individuals and households 2003/04 [337KB PDF]).

When they first put a financial cost on wounding for example, they assumed that the physical and emotional impact was equivalent to a sexual offence: calculated at £13,219. But after further research, they found that victims took far longer to recover from a rape or sexual assault while victims of a wounding were less affected than they had thought. The physical and emotional "cost" of a wounding was reduced to just £4,554 while a sexual offence "cost" was increased to £23,015.

Table showing comparison of the consequential cost of violent crime 200 and 2003/4

We see this attempt to quantify "harm" in many areas. The Advisory Council on the Misuse of Drugs recently went on a couple of "away days" to try to establish a new formula for weighing up the comparative harms of different illegal drugs.

You will remember how the home secretary rejected their advice on the classification of cannabis and ecstasy.

Well, I am told the ACMD were lectured by a man who works out the least harmful way to get rid of nuclear waste.

An interesting choice of speaker, I think, given the growing argument within criminology to weigh up "social harms" alongside the costs of crime. Consider this argument from an essay entitled Criminal obsessions: Why harm matters more than crime [1.5MB PDF].

"The police record the detail of over 1,000 different criminal events, most of which create little physical or even financial harm and often involve no victim", the authors argue. Meanwhile, "many events and incidents which cause serious harm are either not part of the criminal law or, if they could be dealt with by it, are either ignored or handled outside of it."

What do they mean? "For example, in the context of 'safety crimes', recorded occupational injury amounts to over one million workplace injuries per year in Britain; but restriction to the term 'crimes' means making reference to just 1,000 or so successfully prosecuted health and safety offences."

Suddenly the concept of "harm" takes on a political dimension. Academics, particularly on the left, use it to reflect on the impact of taxation and welfare policies. "Widening the notion of financial or economic harm would involve recognising the personal and social effects of poverty, unemployment, and so on."

The Home Office tells me the Drug Harm Index is not dead - the graph will be updated later this year. It will be interesting to see whether the methodology reflects an increasingly sophisticated debate about what "harm" actually means.


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