The Bristol Cable

The Bristol Cable spoke to Thangam Debbonaire about her critical views of the government’s Drug Strategy, the need for reform, and concrete solutions.



Series: What’s wrong with drugs?

Thangam Debbonaire has spent the last year talking to organisations and individuals in Bristol about how to reduce the harm that drugs cause, and has been filming a documentary with the BBC on the issue. The Cable spoke to Debbonaire about what she’s uncovered, her views on drug policies and why now is the time for people to ‘put their heads above the parapet’.

The Bristol Cable: As a resident of Bristol, what drug-related issues have you observed in the city?

Thangam Debbonaire: As a long-term resident, but also as an MP taking a particular interest in this, what I notice are the many ways in which drugs harm people. That includes not just the people taking drugs but also the people around them. Now that isn’t to say that there isn’t a social way of consuming alcohol and other drugs, but what I’ve noticed is that the harms that are caused aren’t just against the consumers.

We often think that drug addiction is the main harm, but there is also burglary for the purchasing of drugs, drugs litter, the impact on people who have consumed drugs giving them bad effects, the people around them, the cost to the health service, the costs to families and friends, people’s own employment if they have to miss days of work.

I include alcohol in the word drugs. I sometimes use the notion of ‘alcohol and other drugs’, because I want to make it clear that I take alcohol to be a drug. It is the most harmful drug and yet it is legal. I also want to make it clear that the evidence shows that there is no completely safe way of consuming any drug, including alcohol.

That’s why information is so important. I learned about the link between alcohol and breast and bowel cancers whilst I was having treatment for breast cancer, so it was an easy decision for me to decide not to drink alcohol – because I know doing that is reducing my chances of getting breast cancer again. But I can get information about the risks of alcohol and discuss these with my doctors without any worry about criminality, and I also know that if I do buy a bottle of wine, I can go into a shop and know that the seller is licensed, the alcohol is regulated and I am getting what I think I am getting.

Recently published statistics have showed a sharp increase in the rate of drug-related deaths in Bristol since 2012. In a speech to parliament in July, you mentioned having spoken to numerous organisations working on drug-related issues across the city. Could you highlight key takeaways from those exchanges?

Let’s take heroin-related deaths as an example. When I talked to Bristol Drugs Project (BDP) for instance, they talk about how they distribute naloxone, which is a substance that reverses the effects of an overdose. They know that they are not getting naloxone to everyone who’s consuming heroin. So there is an awful lot of people who are at risk of having an overdose with very little chance of being able to do anything about it.

Part of that is related to the illegal nature of drugs, it’s harder for people to get advice or to come receive help for something that technically is illegal and therefore makes them a criminal.

“UK [drug] deaths are one of the highest in Europe. We have a particularly punitive regime.”

Other people I talked to gave me light bulb moments. A clinical psychologist gave me the picture and said, ‘What would it look like if we had an entirely legal drugs shop?’, just like we have off licenses, or we buy alcohol from supermarkets. My first reaction, which is probably most people’s, was ‘I’m not really sure that is going to work’. And he pointed out there is already a drugs shop operating, it’s just an illegal one and a dangerous one. I just want to share this insight he gave me with everyone that I meet at the moment.

All around us we have the bad effects of an illegal drugs market. It’s a billions of pounds global market that is in the hands of nasty violent criminals and it’s unregulated, unsafe. It makes it harder for people to get access to treatment information.

I’d always had concerns about our drug laws. It’s evident that it’s not helping when you look around at heroin deaths. Heroin being illegal isn’t stopping people from taking it. UK deaths are one of the highest in Europe. We have a particularly punitive regime.

Another light bulb moment was years ago when I met Professor David Nutt. He was the chair of the Advisory Council on the Misuse of Drugs some years ago and was sacked for correctly saying that ecstasy was less risky than riding a horse if you look at it statistically. And it’s true.

It was a moment of clarity for me as a politician. It’s all very well saying I want evidence-based policy, and I do, but if you are trying to change public opinion at the same time, that is a tricky beast because people’s instinctive reaction very often is ‘those things are drugs, I know they do bad things, therefore we should keep them illegal’ rather than thinking through whether this actually helps. We need to ask of our drugs policies: does this help protect young people from harm? Does it help reduce risk and prevent harm?

“We need to ask of our drugs policies: does this help protect young people from harm? Does it help reduce risk and prevent harm?”

Now you have been an advocate of an evidence based strategy for rethinking drug policy reform. What do you think the drug strategy of the government focuses on and what are your concerns with it?

There are some good things in there. They recognise the need for treatment. They recognise the value of naloxone for reversing heroin overdoses, and they recognise the need for good education.

The concerns that I have are that they say they want an evidence-led approach, but they ignore their own evidence. So, the Home Office’s ‘Drugs: International Comparators’ paper, published in 2014, made clear that making a drug legal does not increase use, but it does increase the options for treatment, health and information. Yet the government ignored this.

The government, in the publishing of its strategy and the debate that followed, said we need to keep these drugs illegal because they are dangerous. Well, that’s where we’ve been for the past 40 years since the Misuse of Drugs Act of 1971. That argument makes no sense and yet threads through the strategy. When you consider that alcohol and tobacco are two deadly drugs which are entirely legal and regulated, it makes no sense. My concern is they are ignoring evidence that doesn’t suit their current narrative.

They recognise the value of treatment, and recognise that for every £1 that you invest in treatment you get £2.5 back in saved costs further down the line, like saved healthcare and housing costs. But they don’t say at any point where they are going to get the money from. Where is BDP’s extra money going to come from over the next few years to deal with the increased rate of heroin deaths? There is no mention of that.

What kind of ideas for policy reform do you put forward? Could you point to more concrete projects that could move to resolve the issues?

Bristol already is pioneering and I would like it to continue to be pioneering about how it responds to the consumption of alcohol and other drugs, to be pioneering about how it supports the treatment for addicts but also regulation information that would help people who are not addicts. I would like there to be drug consumption rooms that are safe, where people have access to treatment, counselling and information.

“My concern is the government are ignoring evidence that doesn’t suit their current narrative.”

I’ve had to report drug litter from places close by my office, where there are blocks of council flats and people, parents, are worried about letting their kids playing outside because of the frequency with which we find drug litter there. So I would like there to be drug consumption rooms available for people to use, rather than the street, which puts us all in danger.

I would like drug testing facilities to be more widely available, not testing people who consume drugs but testing drugs for what they have in them. I met a woman in the last year who is involved in running a drug testing facility at various festivals. When she says to someone ‘actually this isn’t ecstasy, it’s something else’, like concrete, at least that gives people information and they can get rid of the unsafe drugs safely and without legal consequences.

That points to me to the need to reform the law. If we had safe drug consumption rooms for addicts, funding for treatment with testing available, and if we had regulation of and information about all drugs as well as alcohol, that would mean that casual users can consume their drugs socially in much greater safety, with greater knowledge. It also means that people who are addicted can get better help without fear of criminalisation.

Series: What’s wrong with drugs?

So, what of decriminalisation?

I haven’t yet said that we should make all drugs legal, though others have. At the moment I’m agnostic. I’m minded towards that argument because it’s patently obvious that keeping drugs illegal isn’t protecting people. The government’s argument that you should just have the laws that we have at the moment, that you should consume something that you can buy in Boots for instance – that’s what the minister said in the debate – is a ridiculous thing to say. Because of course, you can actually get medically prescribed heroin, or heroin substitute such as methadone, in Boots. You can also get opioids prescribed to you by your doctor to which you can become heavily addicted and can become dangerous for you. It’s just a ridiculous rule.

I want a drug policy that is informed by good evidence, and I also want our policy makers to be brave enough to say to the general public ‘I know that some of you will be anxious about the argument for legalising drugs, but we at least need to look at it’.

How much leverage do local authorities and various agencies, such as the NHS, have to tailor their response to drugs misuse? Away from the legislative framework where does the responsibility lie to implement new practices on the frontline?

That is both part of the problem and the solution, it’s a bit complicated. Public health lies with the council but other parts of health lie with the clinical commissioning groups (CCGs). So the funding for the liver ward in Bristol Royal Infirmary, for people who have diseases as a result of alcohol consumption, that is paid for by the clinical commissioning group. I visited it and spoke the clinicians there who said they badly wanted there to be better and more education about the harms of alcohol. Where does that responsibility lie? Probably with public health over at the council.

“I also want our policy makers to be brave enough to say to the general public, ‘I know that some of you will be anxious about the argument for legalising drugs, but we at least need to look at it’.”

Now, the two bits of the health service don’t really necessarily have time to communicate with each other. So everything is complicated by the fact that everybody is trying to get on with what they are doing at the moment with limited funds and try to make their own funds go further. Ironically, it would work better if people had the time to work better together, they could make it go further but it’s often very difficult for the people involved.

I’ve had conversations with various people in the last year involved in the commissioning and delivering of drug services, who would like there to be a safe drug consumption room and funding for drugs testing. And I know that there are conversations happening at the moment about whether the latter could be expanded to clubs in Bristol.

What can people do in Bristol to shift the debate? How can people do their bit if they are concerned about these issues and don’t work for an organisation and have written to you already? Is there anything else that people can get active around in order to make a change?

That’s interesting, the idea for there to be a campaign for drug law reform. There are already people campaigning for new drug laws, but it’s usually about specific drugs such as the medical use of cannabis. There are other campaigners such as the Bristol Cannabis Club who have a very sensible approach to campaigning on the legal framework around the consumption of cannabis generally. It’s difficult to say to someone reading this article exactly where can you go and get involved in a wider campaign.

I would like there to be one, because I think that the current framework harms us all. Ideally such a campaign should be co-led by people who have no interest in taking drugs themselves but think that the law is ridiculous and harming everyone, as well as by people who do want to consume substances but with greater knowledge and regulation.

I’m throwing that out there, not so much as a challenge but as a call to action in saying it’s about time that those of us who feels this way put all our heads above the parapet.

Series: What’s wrong with drugs?