This document presents highlights from the Phase I report on drugs prepared in 2003, by the British Prime Minister’s Strategy Unit, but not published till it was leaked to the BBC in 2005. The Phase II report concerns policy & administrative recommendations.
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We start off with the prevalence of drug use in England and Wales..
Cannabis is the most popular illicit drug, no surprise there, but strongly ahead of all other illicit drugs. The curious thing is the Dependent Users tally: virtually no user of tobacco is not dependent on it; nearly one-third of cannabis users are claimed as dependent; Ecstasy (putatively MDMA), with 28.8% users dependent, is apparently a lot more addicting than cocaine, with 12.4% of users dependent. The definition of dependence is not forthcoming. These figures are in stark constrast with estimates from the 2004 US National Survey on Drug Use and Health. According to the NSDUH, 17.6% of cannabis users are abusers and/or dependents. Figures for dependence alone aren’t given. For cocaine, the figure is 27.8%. Ecstasy is classified as a hallucinogen, alongwith LSD, PCP, mescaline, psilocybin…etc. Of all hallucinogen users, 11.6% are dependent and/or abuse the drug. If you treat both efforts to be reporting the same thing, clearly, the UK team has a distinct unknown (& looser) conception of dependence.
Now, some slides about the properties of various common drugs..
What makes a drug addictive, and how do the common drugs measure up?
The above slide is very misleading because various factors other than the drug itself impact how addictive a drug is. To give an example, the route of administration of a drug can have a significant impact on its reinforcing power, with the same drug, taking, on average, either minute and a half to produce its peak effect (cocaine, smoked) or 14 minutes (cocaine, snorted). Accordingly, there is a significant difference in rates of addiction to cocaine, depending on how it’s typically used. In the slide above, the addictive potential of drugs, as they are currently being used, is presented as the fixed addictive potential of the drug, when this is not the case.
What about the other harms due to drugs, such as health and social harms?
A similar caveat as above, applies to this slide as well. As an example, the risks of contracting blood-borne diseases via shared (dirty) needles, contributes to the social harms due to drug use. However, they aren’t inherent to the drug, but due to the prevalence of injecting as a method combined with the lack of convenient access to clean needles.
How many people die due to acute drug use?
The heroin deaths among addicts could be largely avoided by the supervised prescription of pure, controlled dosage of heroin, as is the case with the Swiss & Dutch heroin maintenance programs, where a select number of addicts are provided heroin by the government. In fact, a wide expansion of this already-existing practice in the UK is one of the recommendations in the Phase II of the 10 Downing Street report. Heroin isn’t a magical poison that kills randomly. Unknown dosage due to varying purity, uncertainty about drug tolerance, polydrug use (especially alcohol and other depressants), and existing illness, like hepatitis (liver), are the important factors that can lead to an overdose. Another factor is that although a heroin overdose is reversible with administration of an opioid antagonist like naloxone, companion drug users often neglect to secure medical help due to the fear of legal repercussions. The deaths due to ecstasy (MDMA), again, are largely due to certain conditions, which are dangerous when someone is on Ecstasy and not inherent to the drug viz. prolonged physical exertion, high ambient temperatures (like in a crowded ‘rave’), excessive intake of water (overcompensation for dehydration due to the physical exertion), and as often, polydrug use, especially alcohol, GHB, cocaine or opiates like heroin.
There’s also the issue of diseases contracted due to injecting drugs.
How many drug users are admitted to hospitals for mental health conditions?
I suspect that most of the admissions for LSD, and perhaps, cannabis are for acute panic reactions to the effects of the drug. The term, mental health difficulties, implies chronic conditions, although the lack of details means I can’t confirm that.
How many deaths due to intoxicated driving?
A brief summary of drugs as per their harmfulness
Finally, a (simplistic) plotting of drugs, as per harmfulness
Next few slides deal with drug-related crime..
How much crime is drug-related?
What sorts of crime?
Interesting thing about the homicide pie-chart above, is that according to its source, of 118 homicides classified as crack-related, only 1 occurred under the influence, and 7% by users funding their habits. 85% were the outcomes of various disputes among drug-dealers.
On a cost-basis, most drug-related crime is committed by crack and/or heroin users.
Even within that group, it’s those who use both drugs that commit the bulk of the crime.
Among all heroin and/or crack users, it’s the top 10% of users who commit more than half of all drug-related crime, on a cost-basis.
Here’s a graph of the average costs due to crime incurred by subgroups among crack and heroin users.
Why do the users of these particular drugs commit so much crime? The cost of drugs may help explain the answer
And why are the costs so high?
How big are the markets for crack and heroin?
Finally, what’s being done about these users?
The next few slides deal with the supply side i.e. the producers, distributors and dealers.
The first slide summarizes the worldwide cocaine and heroin industries.
These two products - cocaine & heroin - are global commodities.
Some of the important drug trafficking groups are profiled below.
Contrary to popular perceptions, street dealers don’t make much profit, in terms of absolute currency. That’s reserved for the importers.
Till a few years ago, and to good extent even now, the drug war strategy has been to focus on supply. But this internal report lays bare the futiity of that approach.
Here’s a comparison of the profitability of drugs against luxury goods companies
These final set of slides deal with the big picture in the drug war and the road ahead.
One of the aims of the supply-focused drug war has been to raise prices. In this, it has failed.
Why don’t the prices rise due to the seizures?
If there is a drop in production, then wholesale prices do rise..
but the retail prices remain stable, due to the traffickers typically lowering the purity.
Similar to the first slide in this section, the long-term view broadcasts a dismal failure of the supply-side drug war.
Now, some estimation of what might result in success.
In recent years, the major drivers of the drug war, the US and UK have focused on crop eradication in the major producing countries. But such efforts lead, at most, to the ‘balloon effect‘, where suppression of crop cultivation in one region is compensated for by new cultivation elsewhere.
There are some root causes why drug eradication policies, as practiced so far, don’t work, and in fact, won’t work.
Finally, what about the road ahead?
Here’s an evaluation of the three broad strategies that can be pursued.
This concludes the presentation of the highlights of the Phase I report.