Devising Effective Drug PolicyCourtesy Transform
- Working for an effective drug policy
The idea behind this briefing is to suggest a methodology for
assessing the effectiveness of various policy alternatives.
This methodology is based around the concept of effectiveness,
using specified aims and key performance indicators to provide its
analytical framework. Whilst many of these indicators have not been
finalised, we have come up with a series of questions to aid their
development. This methodology is constantly evolving and we welcome
input and feedback from interested parties.
Drug policy, like any social policy, should be designed to meet
the needs of the majority. It is of supreme importance to remember
that drug policy is only one inter-linked part of a wider social
policy, and as such needs to be considered in a range of contexts.
Crucially, any policy should seek to address the social factors
that underlie both the use and misuse of all drugs, legal or otherwise.
UK drug policy has historically been driven by political imperatives,
misplaced ideological crusades and characterised by an absence of
evidence, evaluation or pragmatism. Whilst the UK Government has
introduced an evidence base as part of its 10 year drug strategy
Transform believes that the indicators chosen are wrong and the
targets for these indicators unrealistic.
The four key targets in the strategy are:
Target 1: Halve the number of young people using illegal
drugs, especially heroin and cocaine.
Target 2: Halve the levels of re-offending by drug misusing
offenders to protect communities from drug-related and anti-social
Target 3: Double the number of drug misusers in treatment.
Target 4: Halve the availability of drugs, especially heroin
and cocaine on UK streets by 2008.
(For a more detailed analysis see Transform briefing on drugs
Criticism of these indicators and targets is widely shared across
the drug field, in particular the lack of health and harm reduction
indicators. The Association of Chief Police Officers' written submission
to the Home Affairs Select Committee inquiry into drug policy reform
contained the following analysis of the indicators and targets:
"The absence of any baseline data means that the targets
set in the strategy were unrealistic and are now demoralising."
"The objectives lack credibility, which deters agencies
from channelling their efforts towards targets that they know
are impossible to achieve."
"In the case of the police service, there is an additional
frustration in that Home Office performance indicators do not
measure outcomes and are open to manipulation."
When the committee asked former Drug Tsar Keith Hellawell what
the targets were based on, he answered: "Where did the actual
figures come from? There was no statistical analysis."
The methodology presented here is a response to these obvious shortcomings
and is, in essence, a call to apply a more rigorous evidence based
analysis and evaluation process to UK drug policy. Only then can
we expect genuinely workable solutions to the drug related problems
Part 1 outlines the suggested aims of an effective
Part 2 looks at performance indicators for
evaluating if these aims are being achieved.
Part 3 looks at the available options for
regulating the production and supply of drugs.
Part 1: Aims
These are the suggested aims of an effective drug policy:
- To Increase regulation and control of drugs trade
- To Reduce drug related ill health
- To Reduce drug related crime
- To Extend provision of honest and effective drug education
- To Maximise effectiveness of drug-related expenditure and taxation
of drug trade
- To Protect civil rights of drug users and non-users
- To Encourage inclusion of communities in drug policy formation
Part 2 Key Performance Indicators (KPIs)
In this section we have produced a series of questions linked
to each of the aims outlined above. Answering these questions will
give an indication of how effective the policy is at achieving the
given aim. Some of the answers will be a simple yes or no, others
will provide quantitative or qualitative data that can display trends.
Under some questions we suggest specific quantitative indicators
that will show whether a drug policy is effective or not.
Drugs are an international as well as a local and national issue
and to reflect this we have divided the questions accordingly. This
analysis has been devised with UK drug policy in mind but is adaptable
to different locations and scales by incorporating relevant questions
Main aim: To provide effective regulation and control of the drugs
- Who is in over all control of the market? Organised crime or
- Are fair trade agreements in place?
- Is there an international regulatory body overseeing drug production
- Is there government regulation of production?
- What is the percentage of drug control spending in producer
countries going to: military / crop substitution / crop eradication
/ prevention / poverty reduction.
- Is there control over drug availability and points of sale?
- Are drug vendors licensed?
- Can the price of drugs be controlled?
- Is there quality control of drugs?
- Are there controls on advertising and promotion of drugs?
- Are there health warnings and ingredients listing?
- Is there a national regulatory body?
- How expensive is a daily habit for dependent users? Average
- Is there a public perception that drugs are under control? poll
Main aim: To reduce drug related ill health
- Do medical researchers have access to drugs?
- What safeguards are in place to protect 'vulnerable' individuals?
(e.g. young people, mentally ill)
- Is there consistency between health authorities in how problem
drug users are dealt with? (e.g availability of substitute prescribing)
- Is drugs health education having a positive impact? Controlled
- What are rates of newly diagnosed cases of HIV/ Hep C amongst
injecting drug users?
- How many 'dual diagnosis' clients are presenting for treatment?
- What is the average age of problematic users?
- What is the average age of first drug use?
- What is the level of mortality associated with drug use?
- How available are different types of drug treatment? (Treatment
options, waiting times)
Main aim: To reduce drug related crime
- Are international movements of drugs monitored and regulated?
- Is drug control policy linked to military spending in regions
- Is there corruption associated with drug trade?
- Does the trade offer opportunities for organised crime?
- How many driving accidents occur under the influence?
- Is there proportionality in sentencing for drug offences?
- Is there consistency in sentencing between regions?
- How much police time/resources spent on drug-related crime?
- How much of police corruption is related to illegal drugs?
- What is the % of property crime (by number and value) related
to fund-raising to support an illegal/legal drug habit?
- What is the % of street robberies (by number and value) related
to fund-raising to support a illegal/legal drug habit?
- What is the proportion of prison population convicted as a
result of offending to support an illegal/legal drug habit?
- What % arrested/convicted/imprisoned under drug laws are from
- How much crime is committed under the influence?
- How many convictions are there for personal possession?
- What is the value of illegal drug market?
- Are turf wars and gang violence associated with the drug trade?
- Is there property crime/robbery associated with drug use?
- What is the focus of enforcement - users, dealers, traffickers,
- What is the level of enforcement resources directed toward
- How much prostitution is related to illegal drug use?
EDUCATION AND INFORMATION
Main aims: Increase knowledge and understanding of drugs and drugs
- Is there an understanding of drug using lifestyle?
- Is there acknowledgement positive aspects of drug use as well
- Are illegal drug users stigmatised?
- Is there a reduction of taboo around drugs?
- Are young people satisfied with drugs education?
- How is drugs information produced and by whom?
- Is a distinction made between use and misuse?
- What proportion of the drugs budget is spent on education?
- Is the effectiveness of drugs education monitored?
- Is there targeted community education?
- Is there access to truthful drugs information and education?
MEETING THE NEEDS OF LOCAL COMMUNITIES
Main aim: Encourage inclusion of communities in drug policy formation
- Does policy promote good relations/ cause conflict with other
- Does policy promote political autonomy in developing/producer
- Do drug control policies damage the environment in producer
- Do drug control policies routinely require military support/intervention?
- Are international drug control sensitive to local cultures and
- Is there acknowledgement of the religious/spiritual use of
- Has drug crop production displaced food production?
- What is the proportion of the drugs budget spent on criminal
justice interventions compared to health initiatives?
- Is there transparency in policy making process?
- Does policy engender social inclusion?
- Do drug laws engender confidence and trust in police and law-makers?
- Has community safety increased/decreased? (see crime indicators)
- Is there a public perception that community safety has increased/decreased?
- Do local community representatives have access to policy-making
- Does policy engender confidence in local police?
- Does policy engender confidence in young people?
- Is there support for local policies?
- Does the policy help to address the underlying causes of misuse?
- Does policy exacerbate or relieve problems associated with poverty
and social exclusion?
- How is the policy impacting on prevalence of drug use/misuse
in local areas.
Main aim: Increase revenue and maximise effectiveness of drug related
- Does policy stand up to independent audit or cost/benefit analysis?
- Does policy support fair trade or encourage restrictive practices?
- What is the value of tax revenue lost because of international
illicit drug trading?
- What is the proportion of drug related expenditure going on
health/ prevention/ enforcement?
- Should sales raise revenue through taxation?
- What is the value of tax revenue lost because of illicit drug
- Does policy enable price regulation?
- Can the policy stand up to an independent audit of cost effectiveness?
- Do public have confidence in policy makers expenditure of their
Main aim: Protect civil rights of drug users and non-users
- To what extent are civil rights abuses linked to military support
for international drug control initiatives.
- To what extent are civil rights abuses linked to compliance
to international drug control treaties
- Do drug policies have the support of international human rights
- Does policy infringe users rights to privacy?
- Does policy infringe users rights to freedom of belief and
- Does policy have the support of civil rights organisations
- Is there consistency in law between the way users of different
drugs are treated?
- Does policy protect dignity of users?
- Does policy protect confidentiality of users?
- Are certain social groups, communities targeted by enforcement
- Does policy facilitate those who choose to use drugs, to do
so responsibly and safely?
There is a choice of regimes for controlling and regulating
the production, supply and use of drugs. There are six basic models
for distribution of drugs:
1) No regulation
Examples: raw magic mushrooms, poppies, fly agaric toadstools, datura,
morning glory seeds.
Controls: no controls, legal or otherwise
2 Over the counter sales - supermarkets, grocers, health food shops
Examples: aspirin, paracetamol, poppers, glue, St John's Wort, tea,
Controls: Controls over production, limited controls at point of
3) Licensed sales
Examples: beer, spirits, tobacco.
Controls: Strict controls over licencee and purchaser e.g. age,
state of intoxication
4) Pharmacy sales
Examples: Kaolin and morphine, codeine linctus, amphetamine-like
decongestants, Dual products aspirin/paracetamol with dihydrocodeine.
Controls: Controls over pharmacist
5) Doctor's prescription
Examples: tranquillisers, anti-depressants, methadone, chlorpromazine,
anti-psychotics, thalidomide, diamorphine.
Controls: Strict controls over doctor
6) Criminal marketplace (Prohibition)
Examples: LSD, heroin, cannabis, speed, crack.
Controls: Legal bans on production, supply and possession. Illegal
production, supply and use in practice have almost no controls.
Putting this methodology into operation
Having set out the aims, methods of distribution, and indicators
for measuring effectiveness we are able to undertake an informed
assessment of current policy, as well as evaluate the potential
effectiveness of policy alternatives.
We can take each drug in turn and analyse what is likely to happen
with each system of distribution. With this information to hand
the choice and responsibility over the direction of future policy
For more information visit Transform