Tag Archives: cannabis policy

Drugs, Prisons and ‘Unintended Consequences’ – Does drug interdiction drive drug-related harms?

Rick Lines, Olivia Howells and Daniel Webb*


The availability of drugs in prisons around the world is well documented. In Europe alone, up to seventy percent of people in prison have used an illicit drug. In Canada, forty-eight percent of prisoners in federal correctional institutions have had ‘problems’ with drugs. In Australia, one in six people discharged reported using illicit drugs during their sentence.

The 2018-19 Annual Report of HM Chief Inspector of Prisons for England and Wales stated, ‘we are regularly told how easy it is to get hold of illicit drugs in prisons, and of the shockingly high numbers who acquire a drug habit while they are detained’. The Chief Inspector was ‘particularly concerned by the high number of prisoners who said they had developed a problem while in prison – 13% of adult men in our survey reported that they had developed a problem with illicit drugs since they had arrived’. Here in Wales, a Cardiff prison survey found that fifty-two percent of prisoners said it was easy to get illegal drugs into the prison.

The availability and use of drugs in prisons cannot be separated from wider drug policy. The criminalisation of drugs and the people who use or sell them fuels mass incarceration in many countries, and in doing so creates large profitable markets for drugs behind bars. To counter this, prison systems around the world have deployed a wide range of supply reduction and drug interdiction measures – from searches to sniffer dogs to drug testing – to try to stop drugs entering prisons, and to disrupt internal markets.

Are these measures effective at deterring drug use or shrinking illicit markets? The high levels of drug use in prison cited above suggest the impacts are limited at best, and that despite the efforts of prison security, drugs continue to flow into places of detention with relative ease.

Photo by Matthew Ansley on Unsplash

Although supply reduction efforts in prisons may be ineffective overall at eliminating drug markets, that does not mean they do not have an impact on drug consumption. As noted in 2008 by Antonio Maria Costa, former Executive Director of the UN Office on Drugs and Crime, efforts to control illicit drugs often have negative ‘unintended consequences’ not considered at the time they were implemented. In other words, drug enforcement efforts often have the effect of creating problems worse than those they were intended to solve. In prisons, one of these ‘unintended consequences’ is increased drug-related risk and drug-related harms.

One widely used measure to deter drug use in prisons is mandatory drug testing (MDT). The UK Ministry of Justice states that 67% of prisoners surveyed in 2014/15 had participated in some form of MDT. While the UK government states that MDT is intended to ‘deter prisoners from misusing drugs’ and to ‘contribute to drug supply reduction, and contribute to prisoner safety, violence reduction, order and control’, the evidence suggests that random drug testing may actually undermine all of those objectives.

Cannabis is the most commonly used drug by people in prison in the UK, with a reported 79% lifetime prevalence of use. It is also a drug that remains highly detectable in the body for long periods after use. As such, cannabis users in prison have a ‘high risk of detection through mandatory drug tests’. One of the ‘unintended consequences’ of MDT in prisons is therefore a switch from cannabis use to heroin use among prisoners. As heroin is undetectable via MDT after only two to three days, heroin use becomes a logical choice for people who want to use drugs and minimise their risk of being caught. This switch to heroin use can also lead to a switch from smoking to injecting as a route of administration, with the attendant risks of blood-borne virus transmission and vein damage from sharing and reusing scarce injecting equipment in prisons.

There are also increasing indications that drug interdiction activities in prisons are driving the availability and use of new psychoactive substances (NPS), with mandatory drug testing again playing a role. Many varieties of NPS are not detectable by drug testing, creating an incentive to choose new psychoactives as a way to minimise risk of detection. As noted by one observer, ‘due to testing…cannabis, which is argued to be a lower risk substance, has been replaced by spice – a substance perceived to have more dangerous health implications’. A study commissioned for the National Offender Management Service found that prevalence of synthetic cannabinoids was twice as high among prisoners at time of release than at the time of admission. In that study, synthetic cannabinoids were the only substance for which a higher prevalence was detected upon release than upon admission, suggesting a statistically significant uptake of use of NPS by people in detention.

The European Monitoring Centre on Drugs and Drug Addiction (EMCDDA) has noted that ‘the avoidance of positive drug tests has been suggested as motivation for drug users to switch to NPS while in prison’ and that ‘increases in NPS use in prisons may therefore, arguably, be an unintended negative consequence of random mandatory drug testing programmes in some European prisons’.

While the UK and Germany have recently incorporated detection of synthetic cannabinoids into its MDT programme, this ultimately will not address the issues of drugs in prisons, or the creation of risk. As noted by EMCDDA, ‘One possible outcome…is that there may be displacement from use of synthetic cannabinoids to other substances, such as synthetic opioids, which may also be extremely harmful.’ Indeed, the EMCDDA notes that the use of synthetic opioids in Latvian prisons ‘has been accompanied by more overdoses and an increase in injecting, including needle-sharing’.

The UK Prison Inspectorate has stated that ‘NPS have created significant additional harm and are now the most serious threat to the safety and security of the prison system’. The widespread use of NPS, driven in part by random drug testing, suggests that the MDT is having the opposite effect of that intended by the government. In 2005, MDT was withdrawn from Scottish prisons as it was deemed a waste of funds that had little effective impact on drug use amongst prisoners.

Such negative ‘unintended consequences’ can also be identified from other supply reduction efforts. Drug detecting sniffer dogs are widely used throughout the UK prison regime. A 2014 review of supply reduction activities in Australian prisons described the impact of sniffer dogs as ‘modest’. However, even this ‘modest’ success is undermined in the case of new psychoactives. The EMCDDA, for example, cautions that, ‘Sniffer dogs are not trained to recognise the many different types of NPS.’ The UK Prison Inspectorate has noted that ‘Synthetic cannabis has no distinctive odour and is therefore harder to detect than non-synthetic cannabis, making it more attractive to smuggle in’. Even where dogs are trained specifically to identify one type of NPS, such as ‘Spice’, the longer-term effectiveness of this is made difficult by ‘the ever-changing composition’ of new psychoactives, making the programmes ‘ineffectual’.

Drug use is as much a part of the prison environment as it is the outside community. Overall, the supply reduction activities of prison regimes fuel drug-related risk and drug-related harms among people in detention. The advent of NPS only exacerbates this, creating an environment in which use of new psychoactive substances, substances often more dangerous than the traditional drugs they are created to mimic, are the easiest to smuggle in, and the most logical to use if wishing to avoid detection.

If governments are truly serious about addressing drug use and reducing drug-related harm, they must move away from enforcement-focussed responses, and instead implement laws and policies that reduce the number of people in prison for drug-related offences, and to provide comprehensive harm reduction programmes for people in detention.


*Dr Rick Lines is Associate Professor of Criminology and Human Rights at the School of Law, Swansea University. He is also a Senior Research Associate with the Global Drug Policy Observatory. Olivia Howells is a Law and Criminology student at Swansea University and Daniel Webb  is a Criminology and Criminal Justice student at Swansea University.

This research was conducted as part of the Swansea Paid Internship Network programme, a scheme enabling School of Law students to obtain experience working on an active research project under the guidance of an academic supervisor.

British System, American Century: A short case study

British System, American Century: A short case study

Chris Hallam

This blog shows the intimate ties between the international and domestic domains of drug control. This is a well-known phenomenon; however, it involves considerable complexity. The lengths to which governments will go to reduce potential tension at the international level are apparent. This is especially so when states – as in the following case – are wary of the US position. At the same time, powerful domestic forces can counteract the influence of international powers, even when the United States is concerned, as in the aftermath of the Second World War.
The blog selects the example of Britain during that period in which the negotiations leading to the Single Convention were taking place. The then-famous ‘British System’ of drug treatment was a key aspect of Britain’s drug policy relationships; stemming from Sir Humphrey Rolleston’s inquiry into addiction that reported in 1926, the ‘British System’ permitted any doctor to supplyheroin, morphine, cocaine and other drugs to those who were dependent upon them. Unlike the present mode of ‘Heroin Assisted Treatment (HAT), the British System imposed few requirements on patients, who could take their prescription to a pharmacy, collect their drugs and consume them more or less at will. This depended on the regulatory context, the liberal views and the largesse of the doctor, but these were generally forthcoming.
Both the international and the domestic domains played a part in the changes that overtook the British regulatory framework in the 1950s and 60s, leading to the demise of the ‘British system’ of prescribing and its replacement with a much more restrictive ‘clinic’ system in 1968. The international dimension was always important, but in the period preceding the agreement of the 1961 Single Convention, it was especially significant as countries sought to shape the draft treaty to suit their national interests, or (less rationalistically) to forge the global order of intoxication according to their mythological image.

Sir Humphrey Rolleston

Following the war and the continuing rise of the United States as an international military, political and economic superpower, there was friction between it and Britain over aspects of the latter’s drug policies. The 1955 American attempt to impose a global prohibition on heroin was eventually faced down by the British government after internal pressure from the medical profession in support of the drug’s retention in medical therapeutics, including in the treatment of drug dependence. The medical profession was a powerful force in British politics and culture, sufficient to bring the government to resist US pressure.
Britain’s representative at the Commission on Narcotic Drugs (CND), the policy-making body for the new UN international drug control system, was J.H. ‘Johnnie’ Walker. Bing Spear, the Home Office civil servant who had written extensively on UK drug policy, identified Walker as providing the initiative that led to the first Brain Committee, which, commencing its meetings in 1958, reviewed the British drug control system for the first time since Rolleston did so in the 1920s. Government documentation from the mid- to late-1950s supports this claim. The context for Walker’s views was largely international, with the British System undergoing criticism from a number of countries, particularly the United States, through the mechanism of the new United Nations drug control regime.
In 1955, Walker sent a lengthy and thoughtful memorandum to the Home Office suggesting that it was time to look again at the British drug control system. Despite the system’s smooth domestic running, said Walker: ‘It so happens that a number of problems have arisen, or are on the horizon, which indicate that this is a suitable moment to review the present system of control.’ These problems or potential problems included the proliferation of new synthetic drugs such as pethidine and methadone; the UK policy on addiction (by which was meant in particular the Rolleston-inspired regulations permitting the long term of maintenance of opiate habits and the belief in the ‘stabilised addict’); addict doctors; and improper prescribing and supplies to addicts (the issues surrounding ‘script doctors’). The memorandum paid the greatest attention to the second and the fourth of these categories, replicating the situation that obtained when the Rolleston Committee reported and showing that the issue of doctors prescribing dangerous drugs to addicts had remained at the heart of governmental anxieties. Walker claimed that the Rolleston Committee never intended the ‘lavish supply of dangerous drugs to addicts merely for the maintenance of addiction’. He then made reference to a ‘small but potentially dangerous group of drug addicts (mainly heroin addicts) in London at the present time’. This group was ‘disturbing’, as it represented ‘the first real sign of a significant increase in heroin addiction for very many years’. The group’s members had become addicted young and were mostly under thirty – often nearer twenty; many shared an involvement in one particular field of entertainment and therefore met socially at regular intervals – a reference to the jazz club scene. The social context of this drug use made it ripe for proselytism, contended Walker, ‘always one of the more dangerous features of drug addiction’.
He continued that many ‘appear to obtain supplies from a small number of doctors who make no attempt whatever at cure or even, so far as can be judged, at reduction of the dose. In other words, their addiction is deliberately fed, almost certainly in some instances for purposes of gain.’ Walker concluded that: ‘The “script doctor” who thus makes drugs freely available to addicts represents a special problem…’
Walker’s memorandum showed that the Home Office was by this time fully aware of the flourishing new London addict subculture, a full ten years before these facts were published in the Second Brain Report. As noted by Spear, the peculiar thing is that the first Brain Committee did not address it in their deliberations nor their report. At the Home Office, it was Tom Green (who succeeded Walker at the Drugs Branch) who led the drafting of the advice and information sent to the Ministry of Health, from which emerged the shape of the review. For ‘some inexplicable reason’, while drawing heavily on Walker, Green did not include evidence of the emergence of London’s expanding heroin subculture.
One possible reason for this startling omission lay in the international relations around the topic of drug control. Walker points out that US medical opinion was firmly against maintenance and the notion of the stable addict. The ‘strongly held’ view in the American medical profession was that it is ethically unacceptable to condemn a patient, especially a young patient, to perpetual addiction by offering this form of treatment. It was also remarked that the CND and World Health Organisation were highly critical of ambulatory treatment of the kind practiced in the UK. Indeed at its 10th session, the CND ‘expressed the view that ambulatory treatment (including the so-called “clinic” method) was not advisable and asked the World Health Organization to prepare a study on the appropriate methods of treatment.’ Furthermore, a clause had recently been inserted into the draft Single Convention which spoke of treatment being given on ‘a planned and compulsory basis, in properly conducted and duly authorised institutions’. However, by virtue of a qualifying clause that was initiated by the UK, such measures would be applicable only in those countries having a large addict population; it was this proviso that permitted the UK government to sign the 1961 treaty despite its differences with respect to drug treatment. Notwithstanding this, Walker expressed concern that the general trend at the CND was toward compulsion, and that there may in due course be concerted pressure for the removal of the UK clause. He added that, ‘it is unlikely that the United Kingdom could ever accept an obligation to require compulsory treatment of drug addicts in a closed institution’. In fact, Walker made it clear that such a measure could prevent the UK from signing the treaty, and would have been in conflict with the overall trend of mental health policies in Britain at this time, as expressed in Lord Percy’s 1957 Report of the Royal Commission on the Law relating to Mental Illness and Mental Deficiency. This optimistic document led the trend away from confinement, toward voluntary and community based mental health treatment, and fed into the 1959 Mental Health Act. In relation to addiction, Walker commented in closing that: ‘There is a limit to what the State should attempt, and the deprivation of personal liberty for medical reasons is far too serious a matter to contemplate unless there is overwhelming evidence of the need for it because of some widespread and particularly virulent social problem. This need does not exist in the United Kingdom’.
This last sentence is the key one. In order to fight its corner at the CND, the UK government needed powerful evidence that the domestic drug problem continued to be so small as to be negligible, a point which some other countries disputed. Consequently, ‘there would be much to be said from the point of view of strengthening our case in international circles for obtaining an authoritative opinion from a body of experts on the necessity for, and the feasibility of, providing special treatment for drug addicts in this country.’77 In other words, a Committee set up to review Britain’s arrangements could prove very useful in providing the government with ammunition which to fight its international drug policy corner, so long as this evidence indicated that the problem was tiny and relatively insignificant.
Although, as Spear claims, Walker’s superiors at the Home Office were initially unreceptive to his argument, the Brain Committee may well have been influenced by it at the meetings which produced the first report. Green led the way in producing the documentation for the Committee; mention of the expansion of the opiate subculture was entirely absent, and the growth in heroin addiction strongly downplayed. Accordingly, its Report was structured on precisely the lines that would support the government in its negotiations at the CND. It stated baldly: ‘After careful examination of all the data put before us we are of the opinion that in Great Britain the incidence of addiction to dangerous drugs… is still very small.’
This argument remains for the present a speculative one; nonetheless, the omission of the West End heroin subculture from the Home Office memorandum of evidence to the first Brain Committee, and the Report’s conclusion, which supports the UK’s requirements at CND in the run up to the 1961 Single Convention, are highly suggestive. Beyond this specific question, however, it is clear that the construction of international drug policy is a matter of both international and domestic (and transnational) domains, and that it is impossible to understand countries’ conduct in international fora without taking into account international politics and culture. And vice versa.

Dr John Petro

[1] Departmental Committee on Morphine and Heroin Addiction: Report (London: HMSO, 1926). (Rolleston Report)

[2] 59 D. R. Bewley Taylor, The United States and International Drug Control, 1909-1997 (London and New York: Continuum, 1999) p.141.

[3] Spear, H. B. & (ed) Mott, J. Heroin Addiction, Care and Control: The British System. London: Drugscope, 2002. Pp.65-89.

[4] Spear, H.B., Heroin Addiction, Care and Control p.90

[5] The National Archives HO 319/1 and MH 58/565.

[6] McAllister, W. B. Drug Diplomacy in the Twentieth Century: An international history. London and New York: Routledge, 2000. Pp.185- 211.

[7] TNA HO 319/1 ‘Dangerous Drugs Administration and Policy in the United Kingdom’ 25 October 1955.

[8] Ibid.

[9] Ibid.

[10] Ibid.

[11] Ibid.

[12] Ibid.

[13] Spear, H.B., Heroin Addiction, Care and Control, p.92.

[14] Ibid.

[15] The Tenth Session of the Commission on Narcotic Drugs, 1955. http://www.unodc.org/unodc/en/data-and-analysis/bulletin/bulletin_1955-01-01_2_page005.html Accessed 3rd September 2016

[16] TNA HO 319/1, ‘Dangerous Drugs Administration and Policy in the United Kingdom’ 25 October 1955. In this passage, Walker was quoting from a 1954 CND draft of the Single Convention.

[17] Ibid.

[18] E. Percy Baron of Newcastle Report of the Royal Commission on the Law relating to Mental Illness and Mental Deficiency (London: HMSO, 1957).

[19] TNA HO 319/1, ‘Dangerous Drugs Administration and Policy in the United Kingdom’ 25 October 1955.

[] Report of the Interdepartmental Committee on Drug Addiction 1961 London: HMSO. Paragraph 24.

The Beginning of the End for the Pot Prohibition

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The beginning of the end for the ‘war on weed’ in the US?

A new survey conducted by Rasmussen Reports in August 2013 shows that 82% of Americans think the US is losing the war on drugs. Only 4% of respondents believe the US is winning this war. This survey comes at a sensitive time for US commitment to the ‘war on drugs’ or the ‘war on weed’ at least.

In November 2012 two US states – Washington and Colorado – voted to tax and regulate recreational adult use of cannabis. Earlier this year Pew Research found a majority of the public – 52% – think the drug should be legal. The same poll also found that almost three quarters of Americans – 72% – think that efforts to enforce marijuana laws cost more than they are worth.

Now it seems that even the federal government is having doubts about the benefits of criminalising pot smokers. In August US Attorney General Eric Holder announced that low level, nonviolent drug offenders with no history of ties to gangs or organised crime shouldn’t be charged with offences that carry mandatory minimum sentences.

Also in August CNN’s Chief Medical Correspondent Sanjay Gupta (reportedly Obama’s choice for US Surgeon General, though Gupta turned the post down) made a documentary about the medical benefits of marijuana. Gupta argued that the DEA’s insistence that cannabis has “no accepted medicinal use and a high potential for abuse” has little scientific basis and that the American public has been “systematically misled” about cannabis and apologized for his role in this. The White House has refused to comment on Gupta’s documentary and in fact since Obama took office raids on medical marijuana dispensaries have increased.

On 29th of August 2013 the Department of Justice released a memorandum to US attorneys and law enforcement officials noting that whilst they should continue to enforce the federal government’s prohibition on marijuana the main focus in those states that allow some form of cannabis use – either for recreational purposes such as Washington and Colorado – or for medical use should be on eight key areas:

• Preventing the distribution of marijuana to minors;
• Preventing revenue from the sale of marijuana from going to criminal enterprises, gangs and cartels;
• Preventing the diversion of marijuana from states where it is legal under state law in some form to other states;
• Preventing state-authorized marijuana activity from being used as a cover or pretext for the trafficking of other illegal drugs or other illegal activity;
• Preventing drugged driving and the exacerbation of other adverse public health consequences associated with marijuana use;
• Preventing the growing of marijuana on public lands and the attendant public safety and environmental dangers posed by marijuana production on public lands; and
• Preventing marijuana possession or use on federal property

This guidance is an attempt to resolve the tensions between state laws and federal law with regards to cannabis. The commitment to maintaining the prohibition on pot is essential – not least because they are signed up to international treaties such as the 1961 UN Single Convention on Narcotic Drugs – however Obama has been open about his own weed smoking as a college student and must find it hard to ignore the shifting public opinion especially when more people voted to tax and regulate pot in Colorado than voted for him.

So the big question many drug law reformers in the US are asking is, ‘Is this the beginning of the end for pot prohibition?’