Illicit drug use should not be a crime, says Royal College of Physicians
BMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k1832 (Published 25 April 2018) Cite this as: BMJ 2018;361:k1832
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Perhaps physicians don’t see the pernicious effects of cannabis cocaine heroin etc as most members are spared the Acute Psychoses, the family breakdown, the personality and behaviour damage that these drugs cause. Ask a GP or a psychiatrist. Nowhere in the world has legalising addictive drugs led to a reduction in their use or harm. I have been a Fellow of the RCP for 25 years and I would like to know how this view can claim to be the College’s view. I couldn’t be more opposed.
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Dr Adrian James, Royal College of Psychiatrists' Registrar, said: “We are not calling for decriminalisation in these circumstances. The mental health side effects of illegal drugs can be very harmful. We need to look at the wider drugs policy to weigh up the risks and benefits of other options. We support a broad review, and would be delighted to contribute to that within our area of expertise.”
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Professor Helen Stokes-Lampard, Chair of the Royal College of GPs, told The BMJ: “We respect the Royal College of Physician’s new stance on this issue. However, this is not an issue on which the RCGP currently plans to debate.”
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Re: Illicit drug use should not be a crime, says Royal College of Physicians. Drugs policy will not change or progress as long as Government refuses to acknowledge the need for change.
Perhaps emblematic of current Westminster drugs policy is the recent response from the Home Office to the Government’s own advisory committee bluntly refusing to contemplate the introduction of safe injecting environments for the most damaging drug use (1). As well as relying only on criminal justice information and in the absence of acknowledgement of the medical and social consequences of drug use, the Ministerial response is confident and robust in the refusal to contemplate an intervention which has been shown to work in many European countries, Australia and Canada.
This might be more understandable if it wasn’t against the background of a decade of deteriorating drug problems across the UK. An on-going outbreak of HIV in Glasgow among vulnerable inner city drug injectors, increased cocaine use, escalating numbers of drug related deaths and internet access of waves of toxic drugs all indicate a policy failure on a large scale and an urgent need to innovate and modernise.
Government’s response has been characterised by a return to a policy reminiscent of the 1980s. A policy of neglect of this patient group, which lead to epidemics of HIV/AIDS and hepatitis C, both of which resulted in a revolution in drug treatment and harm reduction policy but cost the country and a generation of young people a legacy of harm.
Evidence of the profound dangers lurking when seriously at risk groups are neglected is evident for drug users (2) and analysis of policy history can clearly relate a cause and effect from neglect to crisis (3).
The Government’s own advisory committee has a clear vision of the response need to address the drug related deaths problem and the four UK Departments of Health have sponsored an evidence-based guideline for treatment of the contemporary drug problem (4,5). There can be no other area of public health or medical practice that would allow institutional and prejudicial neglect on this scale.
1.https://assets.publishing.service.gov.uk/government/uploads/system/uploa...
2. Kalk, N. J., Robertson, J. R., Kidd, B., Day, E., Kelleher, M. J., Gilvarry, E., & Strang, J. (2017). Treatment and Intervention for Opiate Dependence in the United Kingdom: Lessons from Triumph and Failure.. DOI: 10.1007/s10610-017-9364-z
3. Minton J, et al. J Epidemiol Community Health 2017; 71:461–467. doi:10.1136/jech-2016-207379
4. Reducing opioid related deaths in the UK. Report from the Advisory Council on the Misuse of Drugs. December 2016. Home Office
https://www.gov.uk/government/publications/reducing-opioid-related-death...
5. Drug misuse and dependence: UK guidelines on clinical management. Recommended citation: Clinical Guidelines on Drug Misuse and Dependence Update 2017. Independent Expert Working Group (2017) Drug misuse and dependence: UK guidelines on clinical management. London: Department of Health.
Competing interests: No competing interests