In 2021, there were more than 1,300 drug-related deaths in Scotland – the second-highest figure ever recorded (Picture: Getty Images)
All Professor Angela Thomas wants is a proper, grown-up discussion about the benefits of decriminalising drugs.
The haematologist, who has been a fellow of the Royal College of Physicians of Edinburgh (RCPE) for almost 30 years, understands it’s not the most popular position in the country – a poll last year found a healthy majority of Brits opposed the decriminalisation of all drugs except cannabis – but she believes minds can be changed with evidence.
When the Scottish Government endorsed drug decriminalisation in a major policy paper last week, the RCPE quickly came out in favour. So did the Faculty of Public Health.
And when the Royal Society for Public Health released a paper recommending the same move in 2018, the 500-year-old Royal College of Physicians of London declared their support for it too.
It is rare for such prestigious organisations to find themselves at odds with the public to such a degree. So what is going on? What are they thinking?
First, an essential piece of context.
Here are a few quotes from respondents in the aforementioned YouGov poll, when asked to give the reasoning for their opposition:
‘Because they’re banned for good reason’
‘Because no drugs should be legal’
‘Drugs should not be legal, there are no good points to taking them’
They’re all fair and understandable points, but all make the same mistake: decriminalisation doesn’t mean legalisation.
In the world envisioned by most proponents of drug decriminalisation, it’s still illegal to make and sell drugs. The difference is that if someone is caught in possession of a small amount of drugs, they won’t end up landing in court and getting slapped with a criminal record.
Professor Angela Thomas, with a photograph of the first female RCPE Fellow Isabella Pringle (Picture: Royal College of Physicians of Edinburgh)
‘We need to encourage people who are addicted to drugs to come forward, and one of those ways of doing that is to not make them into criminals if they do that,’ said Professor Thomas, who was awarded an OBE for her services to the regulation of public health in the 2018 New Year’s Honours List.
‘Allow them to present themselves as people who are addicted to drugs, as patients, so that they can actually receive the care they need to improve their health and wellbeing.’
She believes people are afraid to seek help with their drug addictions because they’re worried that a criminal record would ruin their lives, and in Scotland, this situation is leading to deaths – many, many deaths.
In 2013, the National Records for Scotland documented 527 drug-related deaths. That figure has increased almost every year since, reaching a staggering peak of 1,339 deaths in 2020 before falling slightly to 1,330 the following year.
Comparisons make the figures even starker. In 2020, the rate of drug misuse deaths per million population for the UK as a whole was 67. The rate for Scotland on its own was 245.
Under the different definition used by the European Monitoring Centre for Drugs and Drug Addiction in their 2021 report, Scotland had a drug-death rate of 327 per million population aged 15 to 64. The next highest European country was Norway, with a rate of 85 per million.
‘Despite the criminalisation of drugs and the prevention – or trying to prevent – of drugs being used illegally, the deaths have risen,’ said Professor Thomas.
The number of drug misuse deaths in Scotland in 2021 was more than five times the figure in 1996 (Picture: Metro/Getty)
Medical experts like Professor Thomas and campaigners like Meg Jones, a director at drug support charity Cranstoun, have looked to Europe for potential solutions – specifically Portugal, which decriminalised possession of drugs for personal use in 2001 after the country was devastated by high rates of heroin addiction in the nineties. Instead of criminal penalties, civil sanctions such as fines were enforced, an approach the Scottish Government confirmed it was exploring.
‘What Portugal found very quickly was that numbers of drug-related deaths dropped dramatically and remained very low – especially in comparison to other places around Europe,’ said Meg.
The number of deaths from overdose each year fell from hundreds in the mid-nineties to just 30 a decade later. Money was redistributed from police enforcement to healthcare, and the number of addicts in the country fell from 100,000 in 1995 to 50,000 in 2019 – of whom 30,000 were in treatment programmes. Research shows there has not been a significant rise in drug use.
In Scotland, decriminalisation would also allow for the creation of supervised drug consumption facilities and drug checking facilities, which Professor Thomas says would bring deaths down in the short term while longer-term factors such as housing quality and employment opportunities are dealt with.
In its policy paper, released on July 7, the Scottish Government said: ‘In calling for decriminalisation for personal use, we recognise that it would not solve our drug crisis by itself. But it could provide a framework within which we can better pursue our existing policies to help, treat and support people rather than criminalise, stigmatise and fail them.’
Drug consumption facilities allow people with addictions to take drugs under the supervision of doctors, meaning they are far less likely to come to harm (Picture: AFP via Getty Images)
The response from Westminster was swift – and dismissive. A spokesman for Prime Minister Rishi Sunak said: ‘Whilst I haven’t seen those reports, I think I’m confident enough to say there are no plans to alter our tough stance on drugs.’
Shadow Chancellor Rachel Reeves, meanwhile, told journalists: ‘The short answer is no, I don’t think this sounds like a good policy.’
For Professor Thomas, the speed of the reactions – and the impression they were based on instinct rather than a close reading of the policy or the reports it was based upon – hurt as much as the rejection.
She asked: ‘Why doesn’t it sound like a good policy? What is the problem, what is it that you don’t like about it? What is it you’re finding difficult?
‘Because to say, we just mustn’t have drugs out there, anybody who has them must be prosecuted, it’s not helped. It overburdens the criminal justice system, and it doesn’t help those people who are addicted to drugs. There needs to be other ways of taking this argument, taking these discussions forward.’
‘Instead of creating a space to be able to have that conversation, people have just gone down the gut instinct route,’ said Meg Jones, the director at Cranstoun.
‘Let’s bring people into a room, let’s have a sensible, grown-up conversation about this, because actually, what we’re doing right now is not working. It’s never worked. So why would we carry on doing something the same way if it doesn’t work?’
A spokesperson for the UK Government said its current approach is a response to the two-part independent review of drugs, which was led by Dame Carol Black and published between 2020 and 2021.
They added: ‘Illegal drugs destroy lives and devastate communities. We are committed to preventing drug use by supporting people through treatment and recovery and tackling the supply of illegal drugs, as set out in our 10-year Drugs Strategy.
‘We have no plans to decriminalise drugs given the associated harms, including the risks posed by organised criminals, who will use any opportunity to operate an exploitative and violent business model.’
The Labour Party declined to comment for this article.
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Drug decriminalisation is endorsed by at least four of the UK’s top public health groups.
