The drug consumption rooms that Brighton’s committed drug legalising Green MP, Caroline Lucas, proposes, risk inflating the very public health and social problems she claims they would mitigate, writes Kathy Gyngell.
Brighton has an acute drug problem. But the much media-hyped ‘independent’ report laid before Brighton Council today offers no analysis of it at all. Nor does it investigate how this parlous state of affairs came about.
As far as this depressingly negative report is concerned the problem is here to stay. All that can be done is to mitigate its worst consequence – drug deaths.
Poor Brighton, should it follow this advice.
The self-styled ‘Independent Commission for Brighton and Hove’ was commissioned by pro-drugs legalisation Green MP, Caroline Lucas.
Its most commented on recommendation is that Brighton should trial euphemistically described ‘safe’ injecting sites, otherwise known as shooting galleries; their purpose being to reduce Brighton’s high level of drug deaths.
At the helm of the Commission is its Vice Chair, Mike Trace. Trace is the former deputy British Drug Czar (the first Blair Government) who was later forced to resign from a key role as Head of Demand Reduction at the United Nations Office for Drug Control and Crime, after the Daily Mail exposed his role at the centre of a network to subvert UN drug control laws. Like Caroline Lucas he is a long term and committed ‘drugs legaliser’.
Lucas’s and Trace’s stance on drugs underlay the report’s curious choice of ‘solution’ to Brighton’s chronic and acute drug problems.
It also explains the report’s three glaring omissions.
The first is omission of any analysis of what Andy Winter (the chief executive of the Brighton Housing Trust which runs the city's largest drug and alcohol treatment service) has described as Brighton’s 'anything goes night time culture.'
For there is no doubt at all that this once elegant south coast resort, famed for the Prince Regent, its Pavilion and fabulous Regency architecture, today is better known for ‘this awful tag’, as he describes it.
Today no one in Brighton would dispute the scale and impact of its drug use problem. Two per cent of the adult population are chronic problem users and four per cent are regular users; numbers that might sound small but which are double the national average. In light of the disproportionately damaging effect of drug using behaviour, such numbers are near catastrophic in their impact on the social and economic fabric of the city.
Yet anyone reading this report would be forgiven for believing that Brighton’s clubbing and drugging culture has nothing to do with the drug problem it outlines. Nowhere is it mentioned as a reason for the particular attraction of this city to dealers and users.
Nor would it occur to the naïve reader that the choices Brighton, as a city, has made over the years, have any bearing on its problems.
But the ‘anything goes’ culture Brighton sanctions is, arguably, one that its Council has actively chosen, and then tolerated, over the years. From licensing hours to the choices of establishments it allows to operate on Brighton’s premises, these are all optional – ones that the city can influence or change if it wishes.
Brighton residents know this. One of my acquaintances – a resident for all the 25 years I have known him - said to me:
“Yes, illegal drugs figure largely in the local landscape; yes, Brighton and Hove has a high death rate of illegal users and that’s tangible evidence. But incredibly despite this there seems to be a feeling that drugs are somehow OK - despite the social and personal harm they cause. There is a collective ‘fingers in ears’ approach to the real nature of the problem.”
He is not the only one to be far from convinced that shooting galleries would help address Brighton’s toleration of risky behaviour or for that matter stem drug deaths. Yet this is the one recommendation, naively endorsed by an addict’s mother on the Commission, in the name of, ‘doing something positive’, that The Brighton Argos has reported, “will rid the City of its unenviable reputation”.
Perhaps I should not be surprised. Like many journalists, they appear to have been brainwashed about the virtues of injecting rooms, described as safe despite the very unsafe street drugs used in them, and despite the intrinsic risk of addicts continuing to inject drugs at all – illicit or prescribed.
More than one newspaper report has uncritically relayed the ‘fact’ they have been fed that, ‘drug consumption rooms have seen overwhelmingly positive results operating in more than 90 of countries around the world”.
But the truth is they haven’t and they remain deeply controversial.
The positive spin on them stems from the published evaluations of Vancouver’s Insite, North America's first medically supervised injection site. Hot on the heels of their publication followed equally glowing reports of Insite in the popular media. All overstated the findings; downplaying or ignoring negative findings and reporting meaningless findings.
Overall, they gave, “an impression the facility is successful, when in fact the research clearly shows a lack of program impact and success,” Doctor Colin Mangham wrote in the Journal of Global Drug Policy afterwards – a conclusion he arrived at after analysing the base data of 13 evaluations.
His analysis revealed:
Of these, he said, the most under reported finding was that only a small percentage of IV drug users used INSITE for the majority of their injections. Most drug users used it only some of the time or not at all.
Vancouver’s police chief of the time, on whom the burden of policing Insite fell, has since written in measured but less than glowing terms about the experiment. His concern is that whatever its possible virtues might be, the thinking behind it precluded other innovative approaches to the problem, such as the successful preventative measures adopted in Sweden.
Brighton’s public health director and their Community Safety team must note this before engaging on the risky and financially costly venture that is being proposed to them today; one that will put even more demands on local policing.
The shortcomings that Colin Mangham outlines are typical of all harm reduction measures. As Neil McKeganey, Professor of Drug Misuse Research at Glasgow University, has explained, they hinge on the ability of drug treatment agencies to control a free moving population of drug users sufficiently to control disease in the face of their continued use of drugs. The simple truth is they are unable to. Addicts are uncontrollable. So is addictive behaviour. This is something families of addicts find out to their cost.
But the harm reduction ethos, that Mike Trace and Caroline Lucas adhere to, is blind to the fact that addicts always want more than they are given; and if they can’t get the drug they love, they will get drug they are near. It is blind to why well intentioned harm reduction measures all too often keep addicts as addicts and undermine their chances of rehabilitation, much as Mike Trace tried to deny this on the Today Programme this morning.
A re-analysis of the Sydney’s King’s Cross drug consumption room points straight to this fatal conceptual flaw. Safety is the base rationale for drug consumption rooms, the expert authors of this report point out. By definition this demands that all injecting be done on site. But in Sydney, as at every other site around the world, this simply does not happen. Just one in every 35 injections is hosted there. If every time an addict shoots up may be his last time, how is it possible to justify these sites on the grounds of safety – let alone cost effectiveness?
Vancouver’s ratio is not a lot better. Only 11 out of 90 injections are ‘safely’ hosted there. Yet evaluations that ignored this data were instrumental in the Supreme Court of Canada’s decision in September 2011 decision to allow the Vancouver Drug Injection Site to remain open (after the Prime Minister Harper government declared it a failed experiment).
Brighton should note too, that just a year ago, Ontario, also in Canada, said an emphatic no to opening ‘safe injection sites’ there, in face of similar pressure on them to do so.
The third and final startling omission from this report is that drug consumption rooms are illegal in this country.
On Radio Five Live and the Today programme this morning Mike Trace blithely said he would advise Brighton Council on how to deal with this and implied this was not a fundamental problem. But it is, as he and Martin Barnes of Drugscope (who has publicly endorsed this recommendation) well know. Those they are seeking to influence may not, nor that the battle with the law that then ensues may add to the town’s dubious reputation.
The fact is that previous attempts to get the government to modify the law to allow them have failed. Dame Ruth Runciman’s (Rowntree funded) Working Group recommendations of 2006, which relied heavily on unreliable data from Sydney, fell on deaf ears.
Both political parties have, to date, turned their back on this spurious drugs solution ‘panacea’ – and quite rightly.
Mike Trace, Caroline Lucas and their supporters from the government funded Drugscope (Harry Shapiro from Drugscope is on the Commission) from Transform or the former United Kingdom Drug Policy Commission, chose to ignore this.
The fact is that efforts to control drug abuse in Brighton have strengthened recently and may be paying off. The drug death rate has fallen. The report applauds these measures - the targeting of arrests and prosecution, assessment and successful diversion of arrestees into treatment, and the gathering of intelligence and targeted intervention in local drug markets, which it says “all seem to be encouragingly based on careful analysis and strategic planning”.
But publicly Caroline Lucas has ‘dissed’ them. She says ‘prohibition’ has failed. Perversely she believes that only the further sanctioning of the most risky of drug use of all – injecting - will improve Brighton’s public health and safety.
None of this makes any sense unless the overriding objective in commissioning shooting galleries is a step change towards full blown legalisation. For as more parasite dealers are attracted to the new Brighton honeypots I predict that, once more, Lucas will be citing “prohibition” as the reason for the on-going problem - in order to justify her brave new world of fully sanctioned drug use.
Riven by internal contradiction and half-truths the report fails to address the question it asks on its first page: are any other strategies that the community could adopt to make for better outcomes? By framing their investigation in terms of harm reduction none of the best models for transforming lives and communities like Hawaii’s Hope Probation project are even mentioned, let alone explored. Yet there are many aspirational and positive City driven projects operating effectively around the world that Brighton should be looking at.
It is tragic that these have been excluded from discussion, and attention has centred on one narrow and highly questionable solution.
Details of many innovate projects are available on the World Federation Against Drugs website http://www.wfad.se/
I would invite concerned Brightonians to look carefully at them before investing in a policy of defeat as Lucas and Trace advise.