HASC, Clegg and drug policy reform

The publication of the Home Affairs Select Committee report on drug policy, followed by Nick Clegg’s intervention on the matter, raised a huge amount of interest in the field, prompting a flurry of media appearances, tweets, blogs and the like. My own response was more muted than all that and I couldn’t think of anything very constructive to say about it. And then I remembered a ‘Dear Minister…’ letter I was invited to write for Criminal Justice Matters in the run-up to the 2010 General Election, and realised this still pretty much said it all for me. So, I’ve reproduced it below…

 ‘What is to be done?’ Lenin once famously asked in his blueprint for a revolution. Some of this radical spirit will be needed by the new government if it is to get to grips with a key challenge for the coming decade: the problem of alcohol and other drugs.

 A Saturday-night tour of any police station or hospital A&E department teaches us a sharp lesson about the domestic failures of our current approach; whilst the violence and corruption in places like Afghanistan and Colombia remind us that this is a problem with a global span. How have we got things so wrong? And how can we put them right?

 There is no easy answer. We know that the old solutions do not work. Any politician who claims that the way forward lies in reviewing drug classifications or tightening supply controls or any of the other stock responses, is either misguided or dishonest. We desperately need fresh thinking.

 This will be difficult. It involves removing the comfort blanket of some of our moral, cultural and political certainties. Specifically, three habits of thought need to be overturned before we can make progress:

 1)      We must look beyond the law. Regulation scholars have taught us that the law is not the only game in town when it comes to regulating markets and human behaviour. The construction of a new legal framework is not a magic bullet.

2)      We must look beyond the state. State institutions, and supranational bodies like the UN, are only one set of actors in the field, and it is myopic to see them as the sole or even primary agencies involved.

3)      We must have an integrated approach. We should not assume that existing legal categorisations reflect actual differences between substances.

 The new government has the opportunity to be in the vanguard of a radical new approach. Will it have the courage and imagination to start a revolution?

 

Postscript. Two further thoughts about HASC/Clegg. First, calls for a Royal Commission are misguided, in my view. What is it about drug policy that we don’t already know? A Royal Commission would simply be an elaborate and expensive way of kicking the issue into the long grass. Second, a few days after Clegg’s statement, I heard a political commentator describing how the new LibDem political strategy involves disagreeing with their coalition partners as often as possible, as part of an attempt to avoid electoral meltdown in 2015. It’s hard to avoid the conclusion that Clegg’s intervention on drug policy is driven by rather more calculating and self-interested motives than some have suggested.

Posted in Uncategorized | Leave a comment

More politics, less evidence!

A familiar trope in drug policy debates is the idea that policy-makers should pay closer attention to research and that there is a choice to be made between, on one side, ‘science’ and ‘evidence’, and on the other, ‘dogma’ and ‘politics’. And we are usually left in little doubt about which side the angels lie on!

Drug policy researchers and campaigners often appear to believe that if only they can make the evidence a bit more compelling or authoritative then they’ll eventually win the policy argument. But I’ve observed over many years that that just isn’t the case. There are many ‘controversial’ drug policy questions where the evidence is reasonably settled and clear – e.g. heroin prescription, needle exchanges – but which remain hotly contested. In fact, I would say it’s actually quite rarely the problem that the evidence base is lacking. So why is evidence not enough? One answer is that policy-makers simply find the lure of ‘playing politics’ too powerful to resist. Perhaps that’s partly true. But I’ve come to think that it’s actually misguided to believe that drug policy questions are always capable of being resolved by appeal to ‘science’. There are (at least) two reasons why this is the case.

The first involves thinking about what ‘playing politics’ really means in this context. Usually, we say this when we believe policy has departed from rationality because populist politicians are ‘playing to the gallery’. But this, it seems to me, is a caricature. Politics, at least in part, is about attempting to engage with the social and cultural anxieties and preoccupations of the time. It can be messy, even ugly sometimes, but it requires excessively narrow vision to see it solely as vote-grubbing behaviour by politicians. And this helps to explain why often we can’t rely on science to adjudicate for us between contested policy options. Drug policy isn’t a purely technical exercise – there are other matters in play and it’s a mistake to treat them as somehow inferior or illegitimate concerns.

The second reason is more fundamental. Drug policy and drug laws are, at root, about the relationship between the state and the individual. And this, in my view, makes them deeply political. Rather than shying away from this, we need to address the politics head on, with every bit the same rigour as we do other aspects of policy. And here we might ask where are the serious and penetrating analyses of the profound questions of power, authority and rights that underpin and run through drug policy? It’s a lamentable feature of much of the research literature that it focuses so much on investigating relatively minor issues, whilst, at the same time, pretending that it’s the big political questions that are trivial. In fact, I would go further and say that attempts to depoliticize drug policy are positively dangerous because they obscure what’s really at stake.                  

The title of this post is, of course, meant to be provocative and I’m not necessarily calling for less research to be done – this turkey is not quite ready to vote for Christmas just yet! – but I am arguing that we need to take the politics of drug control much more seriously, rather than seeing it as an unwelcome distraction. We need to understand that drug policy is politics.

[For further discussion of the politics of drug policy, see chapters 2 and 3 in Tough Choices]

Posted in Uncategorized | 3 Comments

The politics of recovery

There is a widely-held view that drug policy in Britain (and elsewhere) is in the throes of a major transformation. Whereas for the last decade or longer, the policy obsession seemed to be with crime and criminal justice, over the last year or two, this focus has ebbed somewhat, as a new recovery agenda has emerged and rapidly come to the forefront.

One way to read this shift is in ‘epochal’ terms: a ‘governing-through-crime’ strategy giving way to a recovery-oriented one. And for many in the drug field, it certainly feels as if big change is in the air. A noisy grassroots recovery movement even talks of a paradigm shift.

But I am not convinced. In my view, at a strategic level, continuity is much more apparent than change. As I noted in my last post, the new direction in drug policy retains much in common with the previous crime-focused strategy (and, indeed, the earlier harm reduction approach): the same problematization (heroin/crack users as sources of risk to the community); the same conception of drug users (rational calculating choice-makers); and the same strategic response (encouraging/cajoling responsible choice-making to reduce risk).

What has changed is that the most significant type of risk posed by drug users is now seen as being a burden on the public purse by drawing benefits and failing to contribute as a tax-payer. What we are seeing then is not so much a new era of drug policy but rather a new politics of drug policy. In a time of economic recession and public sector cuts, there is a novel set of social and cultural preoccupations and anxieties (coded in the language of ‘cuts’, ‘austerity’ and ‘efficiency’) which is shaping how we frame drug policy – and the emerging recovery agenda fits perfectly with this reframing. But underneath all that, I would suggest that the fundamental strategic pattern in fact remains pretty much the same as it has done for the last 30 years. Plus ça change…

[This post is an adaptation of pages 166-7 in this book]

Posted in Uncategorized | Leave a comment

Drug policy, prohibition and public health

Drug policy campaigners often call for policy to be re-oriented towards public health, as a more progressive and constructive approach than the criminalising strategy of prohibition. The broad thrust of this type of call is that we should be more concerned about helping sick people, preventing the spread of disease and enhancing well-being, rather than punishing individuals for supposed moral transgressions. On the face of it, who could argue against that? Indeed, last month, I even found myself enlisted as a signatory to a letter enjoining the Government to ‘put public health first’ in its drug policy. But when I look at the genealogy of drug control policy over the last 150 years, I start to feel a little queasy about this apparently ‘obvious’ proposal. Here, I point to three key moments in this history that prompt my uncertainty.

 

1. The very first regulatory controls on opium in Britain were contained in the Pharmacy Act of 1868. This was a landmark piece of legislation within the genealogy of prohibition as it arguably paved the way for the first modern drug laws in the early twentieth century. Yet one of the key drivers for the 1868 legislation was the emerging public health movement which had identified the problem of poisonings as a major concern. In this sense, the foundation for our contemporary approach to drug control itself has deep roots in public health.

 

2. One period that reformers often hark back to as a high-point of a progressive public health approach is the so-called ‘British System’ ushered in by the famous Rolleston Report of 1926, in which doctors were empowered to treat heroin addiction as a manifestation of a disease rather than as a vice, which could be managed by the prescribing of opiates to addicts. But again, as I have argued elsewhere, things are not quite what they seem here either. The ‘British System’ was built on the base of a strategic liaison between penal and welfarist approaches, rather than a medical approach triumphing over a criminalizing one.

 

3. The British response to the threat of HIV in the mid to late 1980s has been seen as an exemplary public health approach to the drug problem which successfully averted a potential HIV epidemic. And I don’t question that success at all. Critics of the more recent obsession in drug policy with crime and criminal justice typically call for a return to the public health emphasis of the HIV era. But I am not convinced that the two strategies are in fact so different. Both are based on a shared view of the problem (drug users as threats to the community), a shared understanding of drug users (rational risk-takers and choice-makers) and a shared strategic response (urging and enabling responsible choice-making to reduce risk). (Incidentally, I see the current vogue for ‘recovery’ as essentially a variation on this same theme).

 

The idea then of a public health approach as a progressive alternative to a criminalizing penal one is problematic, as the two strategies have been closely intertwined over the last 150 years. It is difficult to sustain the idea that they are polar opposites or stark policy alternatives. I don’t mean by this that it is impossible, or undesirable, to emphasise or prioritise health concerns within drug policy. My point is rather that simple calls for a ‘public health drug policy’ ignore and gloss over this ambiguous and mixed lineage.

 

But I would also go further than this. Even if policy reformers eventually win the day and the entire existing prohibition regime is swept away, it is not clear to me that public health would or should necessarily emerge as the primary animating principle of any new approach. Other principles might stake an equal or greater claim to primacy, such as social justice, human rights, well-being or human security. Public health advocates would need very sharp elbows to emerge triumphant from that competition. 

[This post is a reworked version of pages 134-5 of this book]

Posted in Uncategorized | 3 Comments

The Contractual Governance of Drug Users in Treatment

Over the last year, I have been working with my colleague Matthew Bacon on an ESRC-funded project studying the growing use of contract-like agreements with drug users in treatment settings. It’s been one of the most fascinating studies I’ve ever been involved in, as it raises all kinds of theoretical, conceptual, empirical and ethical questions. There are intellectual puzzles and normative challenges all over the place!

We’re now starting to turn our attention to making sense of our data and publishing our findings. Our first scene-setting paper is currently in draft form and I thought I would share the draft introduction. Comments will be very welcome.

‘One of the abiding challenges for drug treatment services is how to engage drug users effectively: to identify and attract them, to keep them coming and to ensure they comply with what is required of them. Services which are unable to do this will obviously struggle to contribute to important drug policy objectives, such as, reducing mortality rates, curbing the spread of blood-borne viruses and supporting recovery. Effective engagement is the sine qua non of effective treatment.

 Over the years, many innovations have been introduced to deal with engagement and retention problems, including reducing access thresholds (Finch et al, 1995; Millson et al, 2006), establishing rapid prescribing services (Keene et al, 2007), rewarding attendance and compliance (Prendergast et al, 2006; Petry, 2012), developing outreach services (Needle et al, 2005) and making case management more ‘assertive’ (Vanderplasschen et al, 2007). In recent decades, for certain groups of drug users, there has been a particular emphasis on using the leverage of the criminal justice process to do this (Seddon, 2007; Seddon et al, 2012). Inevitably, there is a mixed picture of success from this diverse range of efforts and the challenge has far from disappeared. Indeed, to the contrary, in an ‘age of austerity’ with public spending budgets across Europe (and beyond) being squeezed tighter than for many decades, the problem has arguably become even more acute. The need for drug treatment to demonstrate that it can engage effectively with its target group is greater than ever.

 This paper examines one particular strategy or practice for enhancing engagement that appears to have spread quite rapidly in recent years: the use of contract-like written agreements between treatment service providers and users. Although, as we will see, these agreements can take on many different forms, typically they set out the responsibilities and requirements placed on users and, somewhat less frequently, what the service commits to providing for them. This novel practice of contractual governance of drug users in treatment may be viewed as having considerable potential, not only to address the engagement challenge we have described but also to underpin efforts to provide more personalised social and health care (HM Government, 2007). On the other hand, it may also be seen to raise serious ethical issues and concerns about human rights, as it appears based on a model of autonomy and responsibility that may seem at odds with conventional notions of addiction (West, 2006; cf Foddy and Savulescu, 2006).

 It is significant that if we look beyond the drug policy field, the emergence of contractual governance is clearly part of a wider set of developments in the realm of politics and government at the turn of the twenty-first century. As we will show, in recent years, the use of contractual or quasi-contractual mechanisms to regulate behaviour has arisen in diverse domains, from school education to public housing to youth justice (see Crawford, 2003). A key part of our purpose in this paper will be to locate the contractual governance of drug users in treatment in this wider context of new social control strategies and practices. In particular, we will draw theoretical, conceptual and empirical insights from the largely socio-legal literature which has begun to examine this phenomenon.

 The paper is organised as follows. In the first section, we introduce some of the key conceptual building blocks for our enquiry: contracts, contracting and contractual governance. We then turn, in the second part, to a consideration of some of the specific issues that may arise in relation to the contractual governance of drug users in treatment settings and include a review of the small body of literature in this area. In the third section, we present some preliminary findings from the first stage of an empirical study we are currently conducting. Finally, in conclusion, we map out a research agenda to advance our understanding of what we believe to be a significant development in the field.’

Let me know what you think!

 

Posted in Uncategorized | 4 Comments

Visiting Oxford

Last month, I presented this paper at an All Souls Criminology Seminar in Oxford, at the kind invitation of Ian Loader. I promised those who were there that I’d blog about it and, although it’s taken a bit longer than I’d hoped, this is what I made of the experience.

The turnout was very good, with perhaps 40 or 50 people gathered in the rather austere Old Library. It’s always hard to tell but there looked to be lots of PhD and postgrad students there which was good to see. The paper seemed to go pretty well. As always with a first-time outing for new work, I discovered the usual things – some bits worked better than others, some of the sequencing of the argument was wrong etc. Most remarkably, I ran pretty much to time: Ian had asked for 45 minutes and I was wrapping up almost bang on that. This left a generous amount of time for questions, in fact, eventually running on for nearly 50 minutes.

The questions were the usual mixed bag (in terms of coverage, not quality!) and all of them were interesting or made me think. Two in particular stuck in my mind. One person asked the disarmingly direct question of whether I was optimistic about the prospects for radical drug policy change in the future. My answer was probably excessively equivocal and even-handed but I was still thinking the next day about what it really means to do critical social science. Before I entered academia, I spent 10 years in the voluntary sector doing research and policy work, so I’ve been grappling with this one for some time! The other question that I couldn’t stop thinking about afterwards was about how I saw my overall intellectual project in this area. I may write something about that in a future post but it was a great question to have provoked!

A very pleasant drink and dinner followed with Ian and some of his criminology colleagues, finished off by spending the night in a room in College. It’s a long time since I’ve stayed anywhere without its own toilet and on a mid-January night I found myself unexpectedly wishing I’d packed my slippers and dressing gown for that midnight walk down the corridor!

I’ll be giving the paper a second run-out in Sheffield at the end of the month. Watch this space to hear how that goes…

Posted in Uncategorized | Leave a comment

ManReg: The Manchester Centre for Regulation, Governance & Security

Last Wednesday, I spent a very enjoyable afternoon here with a group of my colleagues from the Law School. Sat around the table were several lawyers with expertise in different fields, an economist, some criminologists and a handful of socio-legal scholars. We were gathered to talk about a new research initiative – ManReg: The Manchester Centre for Regulation, Governance & Security.

You might wonder what such a diverse bunch of people could possibly have in common. What, for instance, would an environmental lawyer, a policing scholar and an intellectual property lawyer have to talk about? The basic premise of ManReg is that in fact, despite our widely differing expertise, our group actually shares some important things in common:

  • a concern with how rules and standards are made and developed;
  • an interest in understanding why rules and standards are followed or breached by different individuals, groups or institutions;
  • a focus on how different approaches to enforcement and compliance can vary significantly in effectiveness.

This common ground – the making, breaking and enforcement of rules and standards – is core territory for regulation scholars and it is under the sign of regulation that we have come together to form ManReg. We believe that our multi-disciplinarity and diversity will be one of our key strengths.

We hope to have a ManReg website up and running in the next few weeks, where you’ll be able to find out more about who we are, what we do and what our plans for the future are. Watch this space for details! In the meantime, if you want to make contact, please leave a comment below or, alternatively, email one of ManReg’s Co-Directors, Andrew Griffiths or David Williamson.

Posted in Uncategorized | Leave a comment