Drugs and Crime

Lord Adebowale Excerpts

Tuesday 15th June 2010 Lords Chamber

[Lord Adebowale]

My Lords, after not speaking for some time in this House, I find myself on my feet twice in the same afternoon. It is a privilege to take part in this debate. I add my congratulations to the noble Baroness, Lady Meacher, on initiating it. This is a different debate from the usual one we have on substance misuse. It draws our attention to the discussion paper, which is a step forward—but only if we do more than just read it. We have to act on it, of course.

I declare two interests—first, as chief executive of Turning Point, which is probably one of the largest providers of substance misuse services outside the NHS, and as a member of the Government’s ACMD, the Advisory Council on the Misuse of Drugs.

Our current system is questionable; indeed, I think that it is broken. All the evidence points in the direction that substance misuse is best treated through health and social interventions. Substance misuse has roots in an individual’s psychosocial state. For treatment to be effective, the whole of the person needs to be the starting point of intervention. My organisation is incredibly ambitious for our substance misusers. It is a mistake to assume that providers of treatment for substance misusers allow them to languish on methadone without any intention of moving them towards work. That is wrong, certainly in the case of Turning Point and many of my fellow providers of treatment services, both within and outside the NHS.

We know the numbers, but it is worth repeating them. There are 400,000 problematic heroin and crack users in the UK, while 1.5 million people will be significantly affected by a family member’s drug use. I congratulate the noble and learned Baroness, Lady Butler-Sloss, on her remarks about children. About three years ago, Turning Point produced research showing that one in 11 children goes home to parents who are misusing alcohol. We must not forget the impact on children, as the problem is generational. We know that those children are more likely to fail in education and we know that failure to be educated thoroughly leads to low job attainment and a greater likelihood of ending up in the criminal justice system. The line that can be drawn between substance misuse, criminal justice, poverty and family breakdown is clear and well understood.

Recovery is dependent on the stability of the individual and is more likely if someone has a steady personal relationship, meaningful employment and stable housing. For me, the question has always been how to get people to the position of having the quality of life that makes recovery more likely.

The use of coercive techniques and prison to prevent substance misuse is questionable. When the noble Baroness, Lady Afshar, spoke about cannabis, we all laughed, but what she said was interesting. If you are caught with cannabis and happen to live in one of the 14 poorest boroughs, the chances of your ending up being able to give a speech in the House of Lords are severely limited, but if you are a member of the Royal Family or on the Front Bench of either party and you admit publicly that you have used cannabis, you will get off. It is an offence, but the impact is variable, depending on your status. That seems entirely unfair.

Leaving that to one side, I have yet to meet a substance misuser who has benefited from a spell in prison. Some might say it, but I have yet to meet anyone for whom prison as an intervention has been effective in removing their drug problem. Addiction is an irrational state. You can punish people until the cows come home, but you will not move them from their fundamentally irrational position. It does not work in that way.

Also, we are naive to think that prisons are drug free. They are not. As the noble Lord, Lord Thomas, said, prison imposes a stigma, but it also imposes a significant heroin problem. A number of clients whom I have known over the years have, immediately on moving out of prison, scored heroin and died, because their tolerance has been reduced by their spell in prison. They have been able to get hold of heroin in prison, but only in smaller amounts; when they come out of prison, they go back on to the dose that they were on before they went in and they die. In that respect, prison kills people.

The use of prison as a sanction for substance misuse is short-sighted and fails to acknowledge the nature of substance misuse. We should pay attention to the challenge not just of illegal drugs but of substance misuse generally. Many sufferers from substance misuse have dual diagnosis: they have mental health problems as well as substance misuse problems. It seems rather obvious that, if you decide to be in or are forced into a position where you are killing yourself through the misuse of any drug, you are probably challenged in terms of your mental health. The Royal College of Psychiatrists has suggested that approximately half of all clients in substance misuse services have some form of mental health condition, most commonly depression or a personality disorder. Prisons simply are not suitable places in which to manage personality or mental health disorders. Nevertheless, some people who misuse drugs will end up in prison because they commit heinous crimes. We must ensure that these people are given adequate support to address the root of their personal problems, and this means that health and social care interventions within prisons are a must.

My own organisation, Turning Point, was one of the first to pilot the drug courts programme in Wakefield. We campaigned for many years to get drug courts established because we saw the impact that they had on individuals and their ability to turn people away from substance misuse, and indeed the criminal justice system, towards work and a normal life.

The document that has been drawn to the attention of the House is not the only one that looks at drug treatment. My organisation has signed up to a drug treatment consensus, which has also been signed up to by many leading drug treatment providers. This consensus document encourages the coalition Government to remember that there is more to drug treatment than getting someone off drugs or stabilising them on methadone, which often ends up being the focus of the debate. Rather, we should consider the needs of the individual. Recovery from addiction is a journey on which there are different paths. However, when it comes to addressing their addiction, for some people it is better also to address what is influencing it in the first place. That is seen in the ambition of the signatories to the drug treatment consensus for those with substance misuse problems, although we acknowledge that methadone is a step on the journey towards recovery from heroin addiction.

Although it is an interesting issue, it is worth pointing out that I am not too concerned about having a debate on whether or not to legalise drugs. In a society with a system of legalised drug misuse, would we not have addicts? We would, and we would still be faced with the challenge of what to do with them. That is at the centre of this debate. However, let us move away from illegal substances and draw attention to the legal ones. Alcohol specialist treatment services are much needed.

Solutions to this problem do exist. Often they are denied not because of a lack of evidence—the evidence is there—but because of moral panic and a desire to play to the gallery. We have a once-in-a-lifetime opportunity to set aside moral relativity and to focus on the evidence and the interests of those who suffer from this terrible problem.