Implementing Effective Drug PolicyCourtesy Transform - Working for an effective drug policy
(This page is taken from a talk given by Danny Kushlick, director of Transform, at the European Cities on Drug Policy Conference in Halle, Germany, in June 1999. The title of the talk was 'Forming successful multi-agency drug policy using effectiveness as an indicator'.)
The idea behind this page is to provide a framework for producing drug policy that is both simple and effective. One that is applicable on both a large and small scale - from global policy to individual agency.
It will also look at some of the issues that relate to commissioning services in a multi-agency setting.
We hope that it points the way toward producing successful social policy so as to meet the needs of the majority - one that is both inclusive and transparent. We recognise the difficulty that organisations and particularly multi-agency partnerships have in changing their practices. And therefore we want to outline a common-sense approach that is simple and unthreatening.
1 Who is concerned about drugs?
So, who isn't? But we must begin by identifying those groups who have a legitimate concern and get them involved in the formulation process early on. It has been the statutory agencies that have historically had the largest say in this part of the process - social services, health, police, local councillors etc. If community groups are involved at all, they often have a much less significant voice.
2 What are their concerns?
A simple enough question but unless excluded communities (drug users, residents representatives etc.) are invited to play a part in the first place, all kinds of assumptions are made on their behalf. It is crucial at this point that no judgements are made about the relative merits of the concerns that are raised by these groups.
3 Who sets the priorities?
Now this is the really tricky part. As we all know there are vested and historical interests at stake here. Some agencies command power and others have virtually none. Then there are the value systems of the various parties, their budgets (or lack of them), their willingness to share budgets and contracts and their willingness to share information. In the UK the key phrase is 'Joined up government'. At present it is still just that - a phrase. It is very important that this part of the process is transparent.
4 What are the indicators that will show that these priorities are being addressed?
These indicators need to be defined by the group that has identified the concern, in conjunction with the other agencies. Historically these issues have been handed over to policy makers who often miss the point of the exercise to the extent that the original concern is not addressed at all.
5 Which strategies will show the best results on these indicators?
Here there is a great need to follow tried and tested best practice from a similar setting. This is where cost/benefit analysis comes in. It means that police, health and drug services will have to subject themselves to severe scrutiny - particularly on measuring successful outcomes against cost.
6 What are the means of monitoring and evaluating these strategies?
Longitudinal follow-up must be included as part of the project to assess the relative merits of different initiatives. These must include measurements that take in a wide range of needs including individual, community and state. All these needs will require constant re-evaluation in the light of the prioritisation process.
1 The police are a concerned group.
2 They have identified a concern - property crime related to fund-raising to support a heroin habit.
4 The indicator would be reduction in the proportion of property crime committed by heroin users.
5 From the available evidence (Switzerland in particular) prescribing heroin to addicts significantly reduces property crime committed by them.
So, we have a concerned group, a clear concern, an indicator and a strategy leading to clear benefits to a large group of people. (Obviously steps 3 and 6 have been omitted here. This particular strategy would need to be seen within a broader context of the needs of health officials and other concerned groups. It would also require a system of monitoring and review to be put in place.)
The consequence of a large-scale heroin prescribing programme has other benefits to the police including a reduction in street dealers and gang violence related to heroin dealing.
Heroin prescribing would also show effectiveness on a number of indicators relating to the concerns of heroin users: a reduction in the need to offend and consequent lack of contact with criminal justice system, pharmaceutical quality drugs, contact with health services, etc.
Benefits to the community include: reduction in street dealing, reduction in property crime.
Benefits for politicians include: reduction in property crime, reduction in criminal justice expenditure, community safety and consequently voter satisfaction.
Issues arising from this model
Often the communities suffering the most from drug use and misuse are excluded from this process. They must be brought in and given a seat at the table.
It means agency representatives will first and foremost have to listen to the concerns of people they may never have spoken to before. These previously disenfranchised groups will need to be offered a significant role in helping to develop this policy.
One issue that we must take into account is how the disparate concerns are prioritised. Most agencies have a long history of their particular method of working. The process of inter-agency partnership is relatively new, both locally and nationally. Agencies have some resistance to taking an objective and dispassionate view to identifying problems, prioritising them and then working together to allocate resources. This could mean the terrifying prospect of re-allocating budgets between local and national government departments.
It is crucial that this process of identifying priorities is totally transparent. The great failings up to now have been the exclusion of ordinary people from the prioritisation process. And the unwillingness of agencies to step out of their traditionally defined roles. For instance in the UK we have just had the results of a long-term study into the effectiveness of treatment for drug users. We did not have a parallel study into the effectiveness of enforcement as a response to drug use and misuse. We need to level the playing field and apply all initiatives to stringent analysis.
Transparency and ownership of the process of development by a wide range of groups is the key to successful policy implementation.
Suggestions for groups to include in consultation
Young People, Tenants Associations, Drug users, Black groups, Prostitutes, Police officers, Probation officers, Solicitors, Magistrates, Prison officers, Joe and Mary public, Health officials, Prisoners, Parents, Teachers.
For more information visit Transform