Select Committee on Home Affairs Third Report



196.  While the Committee has focussed mainly on legislative change as offering solutions to the drugs problem in Britain, we have also looked at other issues. In Tackling Drugs to Build a Better Britain, Mr Hellawell said that "we must now shift our emphasis from reacting to the consequences of drug misuse to tackling its root causes".[185] In his First Annual Report and National Plan he reiterated this sentiment: "the overall aim of the ten-year strategy is to shift the emphasis away from dealing with the consequences of the problem, to actively preventing it happening in the first place".[186] Prevention is better than cure. It is also far cheaper, both in terms of cost to the individual and to society as a whole.

197.  We have heard that the causes of damaging drug use include underlying mental health problems, social exclusion, deprivation and abuse, which are also implicated in drug-related crime committed by users. A combination of education, social interventions and treatment, alongside enforcement will be required to tackle these causes. A recent report by the Advisory Council on the Misuse of Drugs observed that:

    "On strong balance of probability, deprivation is today in Britain likely often to make a significant causal contribution to the cause, complication and intractability of damaging kinds of drug misuse...We want now and in the future to see deprivation given its full and proper place in all considerations of drug prevention policy".[187]


198.  Many witnesses have stressed to us the importance of preventive work with young people designed to discourage them from starting to take drugs. In fact this forms an important strand of the National Strategy, under the Young People target. The Home Office have told us how they are approaching this issue with a plethora of initiatives including the Personal, Social and Health Education curriculum, the National Healthy School Standard, the National Drugs Helpline, the new cross-departmental Children and Young People's Unit, Positive Futures, Connexions, Health Action Zones projects, Youth Offending Teams, and Young People's Substance Misuse Plans.

199.  However, the Home Office has not presented us with any evidence of the effectiveness of this work. The Health Development Agency told us in evidence that:

200.  Mr Mike Trace told the Committee:

    "It was suggested in the strategy that a concerted programme of education in schools, backed up by more intensive programmes targeted at socially excluded children and adolescents, would achieve these targets [relating to reducing young people's drug use]. The evidence base for this hope was thin at the time and looks thinner now. While good drug education in schools, and investments in programmes for marginalised kids may be a good thing in their own right, they are unlikely to have an impact on the overall prevalence of young drug use, and will certainly not get anywhere near the target of a 50 per cent reduction".[189]

201.  We are also concerned about the quality of drugs education material, and the possibility of ambiguous messages contained within it. We accept Mr Ainsworth's recognition that "preaching at young people is not going to work".[190] However, we believe that all drugs education material should be based on the premise that any drug use can be harmful and should be discouraged.

202.  Our attention was drawn to two leaflets. The first was produced by DrugScope and entitled What and why?: Cannabis. This document explains in some detail what cannabis is, how it is taken, and some of the effects which may be expected. While the leaflet explains that cannabis may have unpleasant effects upon the user, it also lists some perceived pleasurable effects:

    "cannabis alters perception. The sensation is usually a pleasant one of general relaxation, a sense of being on the same wavelength as others who are 'stoned', and heightened sensitivity to colour and sound. Also common are the urge to eat ('the munchies') and fits of giggles as ordinary things become very funny".

203.  The leaflet goes on to state that "Cannabis is usually smoked by people who are part of a social group that sees cannabis use as acceptable (or even normal) and who want to relax and enjoy the company of others". DrugScope told us that this leaflet is not aimed at children but at parents and drugs workers.

204.  When we asked for further clarification of their philosophy, we were told that DrugScope "as an organisation prides itself on providing balanced, accurate drug information to professionals and the public". They went on:

    "whether we like it or not, drugs are part of most young people's lives. It is from this premise that DrugScope believes young people should be given balanced, accurate information about drugs...A 'just say no approach' or shock tactics do not connect with young people's reality; they are not credible with young people who may think the message, in their experience, does not reflect the whole truth. The approach may also make young people seek information elsewhere, from friends, for example, which may not be accurate".[191]

205.  The second leaflet given to us was produced by Lifeline and entitled How to survive your parents discovering you're a drug user. This leaflet includes a comic strip and some advice which includes:

    "Don't get caught in the first place. Don't be blatant or obvious and remember: parents search bedrooms and coat pockets...If you do get caught, don't expect your parents to understand".

206.  In response to our request for further information, Lifeline told us:

    "Education and prevention are often confused, an assumption is made that drug education prevents people from taking drugs. There is no evidence that will stand up to serious scrutiny that supports this from anywhere in the world...In the mid 1980s when faced with the threat of AIDS amongst injecting drug users, Lifeline looked at the available evidence and spoke to drug users. Our conclusion was that we did not know how to stop people taking drugs...we therefore decided to look at what was possible. We believed that preventing HIV among injecting drug users was both a more serious threat and preventable...we are trying to reduce the harm from drugs by telling the truth; the lies and exaggerations of primary prevention campaigns just make our job harder".[192]

207.  We acknowledge the need to provide realistic drugs education, but we believe that examples such as the Lifeline leaflet cross the line between providing accurate information and encouraging young people to experiment with illegal drugs. We believe that publicly funded organisations involved in educating impressionable young people about drugs should take care not to stray across this line.

208.  The parents of one recent young casualty of a heroin overdose, Rachel Whitear, made the difficult decision to release police photographs of their daughter's body in the hope of preventing others from using drugs. We applaud them for courageously allowing their daughter's photograph to be. We do not share the view that confronting young people with shocking images of the harm caused by some drug use is counter productive.

209.  The initial memorandum from the Home Office to the Committee stated that:

    "Earlier this year [2001] the Government commissioned a long-term study on the impact of drug, alcohol and tobacco education in schools. This will be a joint project between the Department for Education and Skills, the Department of Health and the Home Office. The study will look at which types of educational input and other factors, such as socio-economic and cultural have most impact on influencing behaviour. The project will start in the autumn."[193]

210.  The study will conclude in 2007. We welcome the commissioning of this research, but until 2007, the Home Office must find other evidence on which to base policy. While we believe that drugs education and prevention work are desirable, we would be disappointed to see money being spent without evidence of effective outcomes from policy.

211.  We acknowledge the importance of educating all young people about the harmful effects of all drugs, legal and illegal. Nonetheless, we recommend that the Government conducts rigorous analysis of its drugs education and prevention work and only spends money on what works, focussing in particular on long term and problem drug use and the consequent harm.

212.  The point has also been made to the Committee that the young people most vulnerable to drug abuse are those excluded from school. It is therefore extremely important to aim drugs education programmes not only at those attending school, but, perhaps more importantly, at those who do not attend. The 1998/9 Youth Lifestyles Survey demonstrated that half of all truants and excluded children had used an illegal drug, as compared with 13% of school attenders. While only a tiny proportion of school attenders used Class A drugs regularly, 7% of excludees did so.[194] Mr Ainsworth told the Committee that:

    "the degree to which we focus on those groups and the degree to which we are going outside the young people's area and the degree to which we link up with Neighbourhood Renewal and Social Exclusion Programmes—because that is where the main impact of drug misuse is being inflicted on communities—are issues that we are trying to pick up in the stocktaking review".[195]

213.  We recommend that drugs prevention and education programmes are targeted towards particularly vulnerable groups of young people, such as truants, those excluded from school and children in care.


214.  The National Strategy contains a strong commitment to treatment for drug users. However, drug users not only require treatment for their drug problem; they also require general medical services, in common with the rest of the population.

215.  We were surprised and disappointed by the minimal response to our request for evidence from the British Medical Association on this issue. We have heard disturbing evidence that a large, albeit decreasing, proportion of GPs appears to be unwilling to treat drug users, with the effect that many users are without access to general medical services. Dr Claire Gerada of the Royal College of General Practitioners, told us that according to estimates made in the 1980s,

216.  Dr Gerada went on to tell us that a more recent, unpublished study suggested that GP involvement has risen since then:

    "50 per cent of a random sample of English GPs had seen a drug user in the last month and 25 per cent of the total...had prescribed methadone to a drug user...also the numbers of [drug-using] patients each GP is seeing...has doubled as well".[197]

217.  Dr Gerada pinpointed the minimal training of GPs in this area as the reason for any residual reluctance to treat drug users. She told the Committee that, in an average five year undergraduate training course, a medical student is given around thirty minutes training in drug misuse problems. She said that: "every single doctor wherever they practise, maybe in the Outer Hebrides, will see a drug user and yet there is virtually no training in it".[198] This lack of understanding "breeds prejudice, it breeds fear".[199] We were encouraged to hear, however, that the number of GPs interested in training was high.[200]

218.  We conclude that General Practitioners are, for the most part, inadequately trained to deal with drug misuse. We recommend that training in substance misuse is embedded in the undergraduate medical curriculum and postgraduate General Practice curriculum, as a problem which will arise with increasing frequency over the careers of all prospective doctors training today. We recommend that the Department of Health funds more training courses in substance misuse for existing General Practitioners.

219.  We would also expect the British Medical Association and the Royal College of General Practice to take a rather greater interest in this area than is evident so far. In particular we would expect these organisations to use their considerable influence to ensure that treatment of drug misuse is included in the medical curricula. We would also expect the professional bodies to encourage more of their members to take an interest in treating drug abusers so that a handful of dedicated General Practitioners are not left to shoulder the burden alone.

185   Tackling Drugs to Build a Better Britain, p. 8 Back

186   First Annual Report and National Plan,Cabinet Office 1999, p. 1. Back

187   Drug Misuse and the Environment, Advisory Council on the Misuse of Drugs, Home Office, 1998, pp. 113; 115. Back

188   Ev 104. Back

189   Ev 182. Back

190   Q. 1312. Back

191   Vol III, Ev 274. Back

192   Vol III, Ev 273-4. Back

193   Ev 2. Back

194   At the margins: drug use by vulnerable young people in the 1998/99 Youth Lifestyles Survey, Chris Goulden and Arun Sondhi, Home Office Research Study 228, 2001, p. vi.  Back

195   Q. 1313. Back

196   Vol III, Ev 242. Back

197   Q. 927. Back

198   Q. 941. Back

199   Q. 944. Back

200   Q. 927. Back

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