Police Foundation/Runciman & Government reply
Drugs and the law: independent inquiry into the Misuse of Drugs Act [2000]
.
 

Overview:

2 In the course of our Inquiry it has become inescapably clear to us that the eradication of drug use is not achievable and is not therefore either a realistic or a sensible goal of public policy. The main aim of the law must be to control and limit the demand for and the supply of illicit drugs in order to minimise the serious individual and social harms caused by their use. At the same time, the law must enable the United Kingdom to fulfil its international obligations.The law should be based on the following principles and purposes:

(i) as a means of reducing demand, the law is only one aspect of a broader agenda of health, prevention and education. It should not undermine other elements of that agenda – indeed, it should be able to support them;
(ii) it should reflect the latest scientific understanding and the social and cultural attitudes of modern British society;
(iii) it should be realistically enforceable;
(iv) it should infringe personal freedom only to the degree necessary to restrain serious levels of harm to users or others;
(v) it should target the drugs that cause the most harm;
(vi) it should reflect the relative harmfulness of activities connected with each illicit drug or category of drugs, and provide for sanctions proportionate to that harm;
(vii) in its operation, the law should be accepted by the public as fair, consistent, enforceable, flexible and just. The proper exercise of discretion may be an important means of achieving this.

5 In this report we use the terms ‘problem’ and ‘casual’ drug use in their now commonly accepted senses. By ‘problem drug use’ we mean use whose features include dependence, regular excessive use and serious health and other social consequences; it will typically involve the use of opiates, particularly heroin, cocaine or other stimulants, often as part of a pattern of polydrug use. We use ‘casual’ in its dictionary definition of ‘not regular or permanent or calculable, varying with circumstances’. In distinguishing between problem and casual drug use, we do not imply that the latter is problem free or does not involve a variety of risks. We only consider that objective terminology is required to distinguish between those with serious drug problems and others who use drugs.

8 The evidence that we have collected on public attitudes shows that the public sees the health-related dangers of drugs as much more of a deterrent to use than their illegality, the fear of being caught and punished, availability, or price. There are also significant differences in public attitudes to cannabis compared to other drugs.

10 All the evidence suggests to us that the law plays a minor part in deterring demand. It is of prime importance, therefore, that the law should accurately reflect relative harm in terms of current knowledge and experience. Only then can it support a public health agenda of education and prevention.

11 The law is and must remain the principal means through which supply is curtailed. But we see no evidence that severe custodial penalties are deterring traffickers, or that enforcement, however vigorous, is having a significant effect on supply.

12 In considering possible changes to the law in the light of this evidence, we have been very conscious that the Misuse of Drugs Act 1971 reflects a long historical process of international agreements on drug control in which the United Kingdom has been a major participant. As such, one of its objectives is to implement this country’s obligations under the three current international conventions.

13 It is in the area of drug use, possession and related acts that the scope left by the international conventions for different approaches is widest. We have found that it is not well understood that for such offences there is express provision for imposing measures such as treatment, education, rehabilitation or social reintegration. These measures may be imposed either in addition or, more importantly, as an alternative to conviction or punishment.

16 The United Kingdom is unique in Europe in having a three-tier classification system by which the law ranks drugs according to their relative harmfulness and attaches penalties to the class in which a drug is placed. We have concluded that this classification is useful and should be retained. It enables the relative risks of different drugs to be more accurately distinguished in terms of current scientific and sociological knowledge. It also allows sanctions to be applied which are proportionate to the harms of the drugs and the activities related to them.

17 However, the criteria by which drugs are classified have never been clearly described. We believe that they should be. We have undertaken this exercise as best we could within the time, resources, and expertise available to us, and we hope it will be built upon. It has led us to conclude that some drugs should be reclassified so that the classes provide a more accurate hierarchy of harm and commensurate sanctions. We recommend the following transfers between classes:
(i) cannabis from B to C (a recommendation first made in 1979 by the Advisory Council on the Misuse of Drugs);
(iii) ecstasy from A to B (a recommendation made to us by the Association of Chief Police Officers among others);
(iv) LSD from A to B;

18 ... the changes will enable the law to reflect more accurately the risks attached to different drugs. This will enhance the law’s credibility and the support it can offer to education and prevention. When young people know from their own experience that part of the message is either exaggerated or untrue, there is a serious risk that they will discount all of the rest.

22 ... imprisonment is neither a proportionate response to the vast majority of possession offences nor an effective response where the offence is related to problem drug use.

29 ... we have encountered no sense that the legislation on drugs overall needs radical change, we have encountered much unease and scepticism about the law and its operation in relation to cannabis. Cannabis is not a harmless drug. But by any of the main criteria of harm – mortality, morbidity, toxicity, addictiveness, and relationship with crime – it is less harmful to the individual and society than any of the other major illicit drugs, or than alcohol and tobacco.

30 Our conclusion is that the present law on cannabis produces more harm than it prevents. ... it inhibits accurate education about the relative risks of different drugs including the risks of cannabis itself.

35 Our overall conclusion is that demand will only be significantly reduced by education and treatment, not by the deterrent effect of the law. What is needed is a less punitive approach to possession offences at the same time as a more effectively punitive approach to supply. We see no inconsistency in this. If the harm caused by drugs is to be significantly reduced, long custodial sentences for supply are clearly not a sufficient deterrent. It must be made much more difficult for traffickers to profit from supplying drugs.

36 We have also considered the issue of the therapeutic use of cannabis. We have nothing to add to the detail of the Report of the House of Lords Select Committee on Science and Technology. We are particularly surprised that one of the grounds for the Government’s summary rejection of its recommendations should be anxiety about the capacity of GPs to withstand pressure for the prescription of cannabis when they have always been able to prescribe heroin for pain without any apparent problem.

40 Drug laws in all countries reflect the tension between cultural history and changing attitudes and practice.

41 Any law must win the consent of the majority in a democracy. Attitudes to drugs, across all age groups, have shifted and will continue to shift. We believe we are moving with the grain of that consent, especially with regard to cannabis. Our proposed changes ... bring the law into line with public opinion and its most loyal ally, common sense.

 

Report:

Chapter 2

32 In England and Wales recorded deaths associated with drug dependence, non-dependent abuse, or poisoning by controlled drugs rose from about 1,800 to 2,100 between 1979 and 1997 [Office of National Statistics Mortality Statistics].

Public attitudes

55 As part of our work, we felt that it was important to try and learn something about public attitudes towards drugs, the harms associated with them, and the role of the law. A survey was commissioned from MORI which provided some surprising responses and proved particularly revealing about attitudes towards drugs in contemporary Britain.

56 The surveys were conducted among adults and school students, and asked a range of questions concerning the perceived harmfulness of different drugs. The adult survey involved face-to-face interviews with 1,645 people aged 16 and 59 years between 9 – 13 April 1999. The schools survey was conducted between 18 January and 12 February 1999, and collected completed questionnaires from 3,529 pupils aged 11-16 years.

57 One key question was how people assessed the relative harmfulness of different drugs. Where adults were concerned, substantial majorities of 90 per cent or so across all age ranges – from 16 to 59 years, judged heroin, cocaine, ecstasy and amphetamines to be either very or fairly harmful. By contrast, only one-third judged cannabis to be as harmful, and again this judgement hardly varied with age. Attitudes tended to vary with age where alcohol and tobacco were concerned, with a marked tendency to see these substances as increasingly harmful with increasing age. Among adults from 18 to 59 years, cannabis was seen as by far the least harmful of all these drugs.

58 Public attitudes, therefore, do not lump all drugs together, but adopt a more considered view of the harmfulness of different substances; a view, moreover, which tends to conform with medical and scientific opinion (see Chapter Three, paragraphs 23 and 24). The one exception to this is that people judge ecstasy to be almost as harmful as heroin and cocaine, whereas scientific opinion tends to judge ecstasy as considerably less harmful.

59 In the schools survey, attitudes towards the perceived harmfulness of drugs were different in important ways. Children aged 11-12 years offered a much simpler testimony, seeing all illicit drugs (including cannabis) as more or less equally harmful. In contrast, 11 to 12 year-olds see alcohol and tobacco as relatively much less harmful, and this view does not change with age among 11-16 year-olds. Attitudes towards cannabis change considerably as young people grow older – so that by age 15-16 years they see cannabis in the same way as adults, that is as among the least harmful of drugs.

60 Young people also reported increasingly with age that they knew someone of their own age who had smoked cannabis. By age 15-16 years, only about one in ten said that they did not know someone who had used cannabis. Young people of all ages, as with adults, see heroin, cocaine, amphetamines and ecstasy as very harmful.

61 Between the ages of 11 and 16 years the perceptions of children as they grow older gradually move to approximate the views of adults. The exception is attitude to alcohol and tobacco: only adults see these substances as particularly harmful. The most frequent reasons given by both children and adults for people not taking drugs were ‘health reason’ (33% and 51%) and ‘just don’t want to take drugs’ (27% and 56%). By comparison only 19% of children and 30% of adults mentioned ‘illegality’ and 12% of children and 17% of adults cited ‘fear of being caught by the police’.

62 People did nevertheless want to see strong and effective drug laws. Two-thirds of adults thought that the law against drugs ‘is not tough enough’, and tended not to agree that the use of drugs was merely a matter of personal choice. Once again, views differed sharply between different drugs. Whereas two-thirds expressed the view that drug laws should be tougher, approximately one-half of all adults felt that the law should be changed so that the use of cannabis was no longer illegal. In the schools survey a higher number of children and young people said that fear of being caught by their parents (21%) was more of an influence than fear of being caught by the police. The latter view was held a little more strongly among younger age groups, although in all age groups a clear majority of those who expressed a view felt that the law with regard to cannabis should be changed.

63 The MORI survey evidence suggests that people view the health consequences of drug use as a more important deterrent than legal controls. They do want strong and effective drug controls, but do not believe that the police alone can be effective in curbing the damage caused by drug misuse. When asked to state what priority the police should give to a variety of different offences, heroin dealing and sexual assaults were seen as by far the most important. They were mentioned by two-thirds of respondents. Assault, racial violence and drink-driving were mentioned by one-third, with burglary and muggings mentioned by one in five. At the lower end of the spectrum heroin users (as opposed to dealers) were mentioned by only 8%, and cannabis dealers by 9%. Cannabis users, on the other hand, were hardly mentioned at all as a police priority – by less than half of one per cent of respondents.

64 It is clear on this evidence that cannabis stands out as a special case in public attitudes towards drugs in modern Britain. It is seen by adults as by far the least harmful of all drugs, including alcohol and tobacco. The possession of cannabis is seen as the very lowest of priorities for the allocation of police resources. A majority of adults, young and old, even feel that its use should be legalised. Where other drugs are concerned, public opinion fully supports strong drug laws, while emphasising concern with the health risks resulting from drug use. We were particularly impressed by the uniformity of these attitudes towards cannabis and other drugs across different social groups and age groups. Perhaps most surprisingly in terms of the way in which public debate is often constructed, there was no evidence of a ‘generation gap’ in public attitudes towards the use of cannabis.

65 This last point perhaps indicates as well as anything how far public attitudes towards drug use may have changed in the past thirty years. Unfortunately, there are no directly similar surveys from the past to compare with our own findings. The MORI poll which we commissioned is undoubtedly the most comprehensive survey of its type to be as yet conducted in Britain. Even so, we can offer some idea of how attitudes seem to have changed on some questions, although unfortunately most of these relate only to the legal status of cannabis.

Chapter 3

1 In introducing the legislation in 1970 [the MDA], the Home Secretary, Mr. Callaghan, said ‘The object here is to make, so far as possible, a more sensible differentiation between drugs. It will divide them according to their accepted dangers and harmfulness in the light of current knowledge and it will provide for changes to be made in the classification in the light of new scientific knowledge.’

We have given considerable attention to this area because of the importance of getting it right if the law is to be credible, proportionate and just and if it is to be able to support accurate education in the harmfulness of drugs.

4 Transfers between Classes on the other hand have occurred only twice. The first occasion was the transfer of nicodicodine from Class A to Class B in 1973. The second followed the only full review of the Classes carried out since 1971 by the Advisory Council on the Misuse of Drugs [1979]. The Council was broadly satisfied with the classification of controlled drugs. It made only two recommendations: that cannabis and cannabis resin be transferred from Class B to Class C, which was not implemented, and that methaqualone (a sedative) be moved from Class C to Class B, which was.

Criteria for classifying drugs

5 The explicit criteria in section 1 (2) of the MDA are (1) whether the drug is being misused or (2) whether it is likely to be misused and (3) whether the misuse in either case is having or could have harmful effects sufficient to constitute a social problem. There appears to be no explicit criterion for deciding which drugs are more harmful than others and so should go in Class A rather than B or C. The Council, however, deduced that the nature of the mischief to which misuse might give rise was a criterion implicit in the threefold classification and its link to penalties.

7 We believe that the present classification of drugs in the MDA should be reviewed to take account of modern developments in medical, scientific and sociological knowledge. The main criterion should continue to be that of dangerousness but the criteria should be made clear. The relative dangerousness of drugs is determined by a number of factors, some applying to the individual, others to society. The main justification for controlling drugs lies in the harm that their use causes to society. However, we should make it clear that, as a matter of principle, it is right for the law to take into account harm that drugs cause to users themselves, as well as to other people affected by users or to the community at large. It is widely agreed that there are cases in which the law may properly try to protect people from harming themselves. These are cases – seatbelts and motorcyclists’ helmets are examples – in which the damage is serious, almost always comes about unintentionally, and is hard to reverse. This is the kind of risk that is associated in varying degrees with dangerous drugs, and the case is even stronger to the extent that they take away the power of choice. For these reasons, we think, as most people do, that the law should take into account the harms that drugs do to the people who use them. In any case, it is impossible in fact to separate harms to users from harms to others; self-inflicted damage usually results in costs to others. The harm to the individual as a consequence of the pharmacological effects of a drug lends itself best to objective evaluation. Initially at least, this harm is likely to be the best indicator of how strictly a drug needs to be controlled.

8 Personal harm may be assessed on the basis of four factors:

i) risks of the drug itself: acute (short-term) and chronic (long-term) toxicity;
ii) risks due to the route of use;
iii) extent to which the drug controls behaviour (addictiveness/dependency);
iv) ease of stopping.

The relative dangers of each factor vary from drug to drug. For example, heroin is highly toxic acutely but may cause little chronic toxicity provided it is used in a sterile fashion. The benzodiazepines have relatively little acute toxicity but may be difficult to stop taking after long-term use.

Social risks

19 Some forms of social harm are a direct consequence of intoxication, for example road traffic accidents. Others come from addiction and dependence: the drug controls behaviour to an extent that has detrimental effects on all aspects of social functioning. In severe cases this can lead to complete personal collapse with loss of job, family and ability to look after oneself. It may also lead to acquisitive crime in order to obtain the funds to buy further supplies of the drug. A third area relates to the medical complications and the costs of treating drug use and dependence.

20 Social harm is hard to quantify. The health care impact is difficult to estimate because the costs of treating addiction are fixed arbitrarily by the availability of treatment resources. Also they are only a fraction of the full medical costs. Unknown extra costs include those due to accidents, infections and mental illness. Other social costs, for example from crime, are hard to measure because it may not always be the drug use that leads to the commission of criminal offences. It is, however, possible to reach a reasoned assessment of relative social harm without precisely quantified estimates. The addictive and dependency potential of a drug can be used to a large extent as a proxy for the social risks - a highly addictive drug will lead to a great deal of social harm.

21 Such evidence as there is suggests that the health and other social costs attributable to illicit drugs are small compared with the health and social costs of alcohol and tobacco. A recent French study has estimated that 6% of the costs of responding to social problems caused by drugs are attributable to illicit drugs as compared with 40% to tobacco and 54% to alcohol.

31 The British Medical Association state ‘The acute toxicity of cannabinoids is extremely low: they are very safe drugs and no deaths have been directly attributed to their recreational or therapeutic use’.

34 Given the ranking that alcohol and tobacco have in the order of dangerous drugs, it is an obvious question why they and drugs controlled under the MDA should not be treated similarly: either alcohol and tobacco should be added to the appropriate Classes under the MDA or drugs that are no more dangerous than they should be treated as alcohol and tobacco are now treated. We resist this argument. In the first place, it is simply a fact that the use of alcohol and tobacco is so widespread and familiar that an attempt to prohibit their supply by law would lead to widespread resentment and law-breaking (as happened with the Prohibition experiment in the United States from 1920-33). Conversely, the present law against the drugs controlled by the MDA enjoys widespread public acceptance, with the exception of certain aspects of its operation against cannabis.

35 The cases of alcohol and tobacco are in any case not the same. Smoking tobacco is widely regarded as a bad and dangerous habit. Many who smoke wish that they could stop and measures are taken to prevent smoking in public places, to limit advertising and so on. It is a reasonable social aim that the use of tobacco should eventually disappear, even though that aim cannot appropriately be pursued by legal prohibition. Alcohol is a more complicated case. Although it is a dangerous drug and causes enormous social costs and harm, it is also used by many people moderately and non-destructively. It is strictly the misuse of alcohol that needs to be prevented, and while the ways in which this can best be done may be debated, control under the MDA is not one of them.

38 The assessment of some features must remain subjective but we believe that it is possible to reach an objective estimate of relative harmfulness by assessing drugs against the following factors (discussed in detail above):

i) their potential for leading to dependency and addiction;
ii) toxicity;
iii) risk of overdose;
iv) risk to life and health in longer term;
v) injectability;
vi) association with crime;
vii) association with problems for communities;
viii) public health costs.

40 To put the risks in context, if alcohol and tobacco were assessed for control under the MDA using these criteria, alcohol would be classed as B bordering on A, while cigarettes would probably be on the borderline between B and C.

Chapter 5: Non-trafficking Offences

2 Possession is the key issue. The United Nations conventions permit more latitude in this area than with trafficking offences. Parties are required under article 3, paragraph 2, of the 1988 convention to establish possession for personal consumption as a criminal offence under their domestic law. This requirement, unlike that for trafficking offences, is subject to a country’s ‘constitutional principles and the basic concepts of its legal system’. This is particularly relevant for those countries whose constitutions enshrine principles of personal freedom, including the freedom to harm oneself.

6 Whatever the penal sanctions provided, article 3, paragraph 4(d), of the 1988 convention permits measures for the treatment, education, aftercare, rehabilitation or social reintegration of the offender to be provided as alternatives to conviction or punishment.

Chapter 6: Cannabis

5 In their evidence to the House of Lords Select Committee on Science and Technology, the Department of Health said ‘cannabis is now the third most commonly consumed drug after alcohol and tobacco’.

6 Both our MORI surveys and our meetings with young people make it clear that there is no difficulty in obtaining the drug, nor is there any sense that the law is a deterrent for the majority. This is so despite record levels of seizures by police and customs.

8 There is no evidence that the presence of THC in higher concentrations leads to significantly higher health risks, just as it cannot be claimed that the risks would be eliminated if only lower-strength varieties of cannabis were available.

20 The British Medical Association has said ‘The acute toxicity of cannabinoids is extremely low: they are very safe drugs and no deaths have been directly attributed to their recreational or therapeutic use.’ The Lancet published an article summarising the evidence on the most probable adverse health and psychological consequences of acute and chronic use, and its editorial in the same issue comments that ‘...on the evidence summarised by Hall and Solowij, it would be reasonable to judge cannabis less of a threat than alcohol or tobacco....We...say that, on the medical evidence available, moderate indulgence in cannabis has little ill-effect on health, and that decisions to ban or legalise cannabis should be based on other considerations.’

21 New medical and scientific knowledge can still be expected to add to the evidence of long-term harm from cannabis, despite the length of time it has been available and the extent of its use. Nevertheless, as the House of Lords report remarks, the harms must not be overstated. When cannabis is systematically compared with other drugs against the main criteria of harm (mortality, morbidity, toxicity, addictiveness and relationship with crime), it is less harmful to the individual and society than any of the other major illicit drugs or than alcohol and tobacco. This is why our consideration of the relative harmfulness of drugs has led us to the conclusion that cannabis is wrongly placed in Class B of Schedule 2 to the MDA.

72 A primary concern of ours is minimising the adverse, unnecessary and disproportionate criminal consequences for very large numbers of otherwise law-abiding, usually young, people. Our recommendations are intended to support the education, prevention and treatment elements of a broader health agenda, which itself reflects the relative risks of different drugs including cannabis.

75 There can be no doubt that, in implementing the law, the present concentration on cannabis weakens respect for the law. We have encountered a wide sense of unease, indeed scepticism, about the present control regime in relation to cannabis. It inhibits accurate education about the relative risks of different drugs including the risks of cannabis itself. It gives large numbers of otherwise law-abiding people a criminal record. It inordinately penalises and marginalises young people for what might be little more than youthful experimentation. It bears most heavily on young people in the streets of inner cities who are also more likely to be poor and members of minority ethnic communites. The evidence strongly indicates that the current law and its operation creates more harm than the drug itself.

14 More far-reaching research is needed to provide a better understanding of the precise dynamics and causal links in the drugs-crime relationship, and better evidence about the factors that influence the effects of treatment. There is a particular need to evaluate the cost-effectiveness of different interventions, whether involving treatment or not. This is necessary to inform future decisions on what seems to us an unsatisfactory distribution of overall drugs expenditure, with 62% going on enforcement and only 13% on treatment services.

Recommendations:

1. The information and research base should be given renewed attention. In particular:

i) routine statistics should be improved to ensure that gaps in our understanding of the scale, nature and extent of drug use are reduced; and
ii) enforcement and treatment policies should be evaluated thoroughly.

2. The present classification of drugs in the MDA should be reviewed to take account of modern developments in medical, sociological and scientific knowledge.

3.The main classification criterion should continue to be that of dangerousness.

4. The chronic health risks from each drug should be kept under continuous review.

6. There should be clear criteria for the future to govern additions to, and transfers between, the classes.

14 The Advisory Council for the Misuse of Drugs should continue to be the body that has the statutory responsibility for considering and making recommendations to Ministers on the classification of new drugs and for keeping the existing classes under review.

15 Future reports from the Council should clearly state its methods and findings on such matters.

32 The law should take full advantage of the leeway left by the United Nations conventions to deal with the less serious situations in a non-punitive way.

64 The cultivation of small numbers of cannabis plants for personal use should be a separate offence from production and should be treated in the same way as possession of cannabis, being neither arrestable nor imprisonable and attracting the same range of sanctions.

72 More far-reaching research is needed to provide a better understanding of the precise dynamics and causal links in the drugs-crime relationship and better evidence about the factors that influence treatment effects. There is a particular need to evaluate the cost-effectiveness of different interventions, in order to inform future decisions on distribution of overall drugs expenditure.

 

Appendix 2

2 Terms of Reference

2.1 The Inquiry is asked to:

a. describe the purpose and intention behind the existing relevant legislation and place them in their historical context including the U.K. obligations under the United Nations drug conventions and to the European Union.

b. review and assess the current goals of drug misuse control.

c. assess the adequacy of the existing relevant legislation in meeting current needs.

d. compile a list of possible revisions to the existing relevant legislation pointing out agreement, conflicts and possible compromises if current legislation is found to be inadequate for some or all of the needs identified.

e. select the most cogent proposals for revision of the existing relevant legislation and examine the implications of their implementation.

 

 

GOVERNMENT REPLY TO THE REPORT OF THE INDEPENDENT INQUIRY INTO THE MISUSE OF DRUGS ACT 1971

Recommendation 1. The information research base should be given renewed attention. In particular:
(i) Routine statistics should be improved to ensure that gaps in our understanding of the scale, nature and extent of drug use are reduced, and;
(ii) enforcement and treatment policies should be evaluated thoroughly.

6. The Police Foundation is quite right to identify the importance of a sound information and research base to inform the National Strategy [see reply to Recommendation 72 below].

Recommendation 2. The present classification of drugs in the Misuse of Drugs Act should be reviewed to take account of modern developments in medical, sociological and scientific knowledge.
Recommendation 3. The main classification criteria should continue to be that of dangerousness.
Recommendation 6. There should be clear criteria for the future to govern additions to, and transfers between, the classes.
Recommendation 14. The Advisory Council for the Misuse of Drugs should continue to be the body that has the statutory responsibility for considering and making recommendations to Ministers on the classification of new drugs and for keeping existing classes under review.
Recommendation 15. Future reports from the Council should clearly state its methods and findings on such matters.

8. The Police Foundation's recommendation that the Advisory Council for the Misuse of Drugs (ACMD) should retain the statutory responsibility for advising the Government on the classification of new drugs is very welcome. ACMD was established by the Misuse of Drugs Act 1971. It has served successive Governments well in the intervening period and its members, who give their time free of charge, bring an unrivalled depth of knowledge and experience to the Council.

9. It is part of ACMD's statutory remit to keep drug misuse under review and the Council has always been ready to look at individual drugs (e.g. ecstasy in 1997) on a more proactive basis when it believes this would be helpful.

10. The criteria for guiding the assessment of any given drug was set out in a 1996 protocol agreed by the two sub-groups of the Council that have responsibility for pharmacological and epidemiological assessment of specific drugs. This year, and very much in keeping with the Police Foundation thinking, ACMD has been reviewing this protocol and considering whether it might be improved, perhaps by drawing upon best practice elsewhere. A special joint meeting of these two sub-groups took place at the end of August and there were presentations from the European Monitoring Centre for Drugs and Drug Addictions (EMCDDA) and colleagues from Holland. Further meetings have trialed possible variants and have helped to developed thinking. It is hoped that proposals for a revised risk assessment protocol will be put to the full Council of the ACMD during 2001.

11. The Government agrees with the Police Foundation's conclusion that the main classification criteria should continue to be that of dangerousness. As the Police Foundation's report recognises, assessments of the sort that ACMD are required to make when considering the harmfulness of drugs must contain an element of subjectivity, but the Government and the Council agree that reports from the Council should clearly state methodology.

Recommendation 72. More far reaching research is needed to provide a better understanding of the precise dynamics and causal links in the drugs crime relationship and better evidence about the factors that influence treatment effects. There is a particular need to evaluate the cost effectiveness of different interventions, in order to inform future decisions on distribution of overall drugs expenditure.

56. As already mentioned, the Government recognises the importance of a sound research base and has made significant money available for research in support of the National Drugs Strategy. But the Inquiry is right to identify the importance of these specific areas, which are being addressed through the following pieces of research:

The drugs-crime relationship is being assessed through the NEW-ADAM programme. The latest report, Home Office Research Study 205, which was published in August 2000, included authoritative measurement over time of changes in drug use and offending, in two locations (Nottingham and Sunderland).

Evidence about treatment effects is being gathered through the NTORS research programme, which the Department of Health is continuing to support, and also through a study published by the Home Office in August, concerned with methadone maintenance (Home Office Research Findings No.120).

The cost effectiveness of different interventions is receiving heightened attention. For instance, the on-going evaluation of the effectiveness of arrest referral includes an economic component. Also, the study of methadone maintenance, just mentioned, included a cost effectiveness component.