The use and abuse of evidence in drug policy

Alex Stevens The use and abuse of evidence in drug policy

Evidence versus ideology • “New Labour is a party of ideas and ideals but not of outdated ideology. What counts is what works” (Labour Party Manifesto, 1997: 1). • “Evidence remains the cornerstone of government policy” (Robert Street, Home Office, 1st May 2008). Use and abuse of evidence in drug policy

What is the role of evidence in UK drug policy? • Models of the link between evidence and policy • Developing an ideological model of this link • Testing the use of evidence on drugs and crime • Drugs cause half of crime? • The Drug Treatment and Testing Order • The recent cannabis kerfuffle Use and abuse of evidence in drug policy

Models of the evidence-policy link • Linear • Fails to describe most uses of evidence • Enlightenment (Weiss, 1976) • Fails to predict selective filtering in use of evidence • Tactical/political (Young et al 2002) • Does not predict systematic bias in selection of evidence • Ideological Use and abuse of evidence in drug policy

Evidence and ideology • Two conceptions of ideology: • Broad • Ideology as an internally coherent set of political ideas. • Narrow • Ideology as symbolic forms which sustain “systematically asymmetrical relations of power” (Thompson, 1990) Use and abuse of evidence in drug policy

The modus operandi of ideology • Legitimation • rationalising and reinforcing existing order. • Dissimulation • domination concealed, denied or obscured. • Unification • creation of false unity. • Fragmentation • creation of threatening outsider groups. • Reification • representation of time-specific states as never-ending and inevitable. Use and abuse of evidence in drug policy

An ideological model of the use of evidence • Powerful participants in discursive struggles around policy issues will make selective use of the available evidence. • They will tend to select evidence that promotes/does not challenge the legitimacy of their current power. • This leads to the reproduction and use of evidence in ways which sustain power asymmetry between participants in the debate. • “Survival of the ideas that fit”. Use and abuse of evidence in drug policy

Evidence for policy – “drugs cause crime” • Estimates of the proportion of crime that is caused/driven/motivated by crime in policy debates: • Vary from 20% to 70% • Have settled at about a half. • Estimated cost of “drug-related crime” • £13.9 billion per year (Gordon et al 2006). • Based on misinterpretation of “pathologising studies” of arrestees and drug users in treatment. Use and abuse of evidence in drug policy

Overestimating proportions from arrestees Use and abuse of evidence in drug policy

Drug users over-represented in arrestee samples Logistic regression of data from Offending, Crime and Justice Survey showing predictors of reported arrest among self-reported offenders, aged 10-25 (n=1,370). Use and abuse of evidence in drug policy

Drug user reports of police supervision • Rhodes et al 2007: qualitative study of drug injecting in South Wales • ‘Homeless injectors spoke of police being “on your case everyday, even if you’ve done nothing wrong”, of being “constantly hassled”, of police who “won’t leave you alone”’. • “They [the police] know every smackhead in Merthyr. That's why they are always on our cases, searching us and this and that.” • Also indicates extra likelihood of police arresting drug users when they offend. Use and abuse of evidence in drug policy

Overestimating costs from drug users in treatment • The estimate of £13.9 billion in annual crime costs from problematic drug users rests on the National Treatment Outcome Research Study • Asked questions of 1,075 drug users at entry to treatment about offending in previous three months • extrapolates from them to estimated 327,466 problematic drug users. • Assumes that: • Offending is accurately reported. • Offending is the same in the entire year as the three months previous to treatment. • PDUs in treatment offend at the same rate as all PDUs. Use and abuse of evidence in drug policy

Offending peaks before treatment entry Source: adapted from Gossop et al 2006 Use and abuse of evidence in drug policy

Summary on drugs and crime • Proportion of crime by drug users likely to be less than estimated. • Value of crime by drug users likely to be less than estimated. • Plus, doubts that the relationship between drug use and crime is causal • Search for the “third variable”. Use and abuse of evidence in drug policy

Use of evidence in drug policy:1.The DTTO • The available evidence: • High correlation between drug use and crime • Debate about the proportions, costs and the causal mechanism. • Possibility that this link may be due to prohibition. • Possibility that it may be due to social inequality. • Treatment works in reducing drug use and offending. • Debate about the effectiveness of court-ordered treatment (e.g. US Drug Courts). Use and abuse of evidence in drug policy

Coding the DTTO discourse Crime prevention Use and abuse of evidence in drug policy

DTTO discourse: the unused codes Ideological EBP Crime and inequality Use and abuse of evidence in drug policy

Ideological use of evidence? • “Dissimulation” • By hiding the failure of prohibition to stop drug use. • By concealing the role of inequality in the link between drug use and crime. • “Unification” and “Fragmentation” • By identifying and targeting an “other” group of prolific criminals. • As opposed to an imaginary, law-abiding majority. • “Legitimation” • By rationalising the projection of power on to the bodies of this “other” group and presenting this as “the” solution to drug-related crime. • Supporting power asymmetry by extending the scope of drug prohibition. Use and abuse of evidence in drug policy

Mary Douglas on unification/fragmentation • Both consumption and its regulation are forms of communication. • Identified social dangers = “weapons… in the struggle for ideological domination” • Separation of the dirty from the pure is not rational but about order maintenance. • We create categories (and stick to them) as a form of “mutual coercion” • Dirt = “matter out of place” • Anomalous substances must be pushed back into one category or another • Dirty or pure Use and abuse of evidence in drug policy

The UK cannabis kerfuffle: 2004-2008 • 2004: In response to various reports (including ACMD 2002), govt’ reclassifies to class C. • Max’ sentence for supply of class C increased to 14 years. • Police introduce presumption of non-arrest of adult cannabis possessors. • 2005: In run-up to election, Charles Clarke refers decision back to ACMD. • 2006: ACMD reaffirms class C and is accepted. • 2007: Brown refers decision back again to ACMD • 2008: ACMD re-reaffirms class C, but cannabis re-reclassified to class B. • Police continue presumption of non-arrest for first offences. • Meanwhile, cannabis use continues to fall. Use and abuse of evidence in drug policy

Cannabis: The evidence • No risk of fatal overdose • Cannabis (even skunk) is not “lethal”. • Significant association with schizophrenia • Ongoing debate on causality • Some evidence of association with cancer and heart disease. • UK market becoming dominated by stronger forms of domestically cultivated skunk • 10% average THC content, compared to 6% THC in cannabis resin. • No evidence that legal changes affect patterns of use. Use and abuse of evidence in drug policy

Cannabis: the debate • Cannabis is dangerous because it’s stronger • Than when “we” took it. • Cannabis causes mental illness • Drug classification “sends out signals” to young people • So – “ignore the experts”. Use and abuse of evidence in drug policy

Cannabis: the ideology • Drug users (i.e. very nearly all of us) separate “my” drugs, from “your” drugs. • “Your” drugs seen as dirt • “matter out of place”. • “Your” drugs further stigmatised by association with threatening groups; • Young, unemployed (black) men. • Normalisation of cannabis makes it anomalous • So it has to be pushed back into the dirty category. • Leading to calls to expurgate cannabis and its users: • Unification (of non cannabis users) • Fragmentation (against cannabis users) • Legitimation (penal sanctions against some drug users) Use and abuse of evidence in drug policy

Conclusions • Evidence is not necessary for the penalisation of drug users. • Evidence is used selectively to bolster political positions. • This selective use of evidence tends to support inequality. • Drug policy is about “sending messages” • Policy as symbolic form. • These messages must be contested at the level of evidence, but also at the level of the values and power asymmetry that underpin them. Use and abuse of evidence in drug policy

The use and abuse of evidence in drug policy