Policy paper

2010 to 2015 government policy: drug misuse and dependency

Updated 8 May 2015

This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government

Applies to England

• Publication for Northern Ireland
• Publication for Scotland
• Publication for Wales

This is a copy of a document that stated a policy of the 2010 to 2015 Conservative and Liberal Democrat coalition government. The previous URL of this page was https://www.gov.uk/government/policies/reducing-drugs-misuse-and-dependence Current policies can be found at the GOV.UK policies list.

Issue

Between 2011 and 2012, an estimated 8.9% of adults used an illegal drug. For young people aged between 16 and 24, the figure was 19.3%. Although this is the lowest level of drug use since we started collecting figures in 1996, drug misuse continues to have a negative effect on the health, wellbeing and quality of life of too many people.

It also drains public resources. For example, crimes related to drugs cost the UK £13.3 billion every year.

Actions

We want to reduce the number of people misusing illegal drugs and other harmful drugs and increase the number of people who successfully recover from dependence on these drugs. We also want to restrict the supply of drugs and identify and prosecute those involved in the drug trade.

We also have plans for reducing harmful drinking.

Preventing young people from becoming drug misusers

It is important that we encourage young people to live healthy lives and that they know the dangers of misusing drugs. We also need drug services to help young people as soon as possible if they have a problem with drugs.

We are:

• supporting children in the first years of their life so that we reduce the risk of them engaging in risky behaviour (like misusing drugs) later in life
• providing accurate information on drugs and alcohol through drug education and the FRANK service
• making it easier for headteachers to take action against pupils who are found dealing drugs in school
• through the Business Rates Retention Scheme (which includes what was the Early Intervention Grant), giving £2 billion to local councils, between 2014 and 2015, which they can use to create programmes to help prevent young people misusing drugs in the first place
• helping young people who have problems with drugs by giving them treatment and support, including supporting them in other areas of their life (for example with housing or mental health problems), so that they don’t return to drug use as a way of coping with these problems

Helping people recover from drug dependence

We want people who are dependent on drugs to be free of drugs for good. We also want treatment to include help with problems that might encourage people to start misusing drugs again after they are drug free.

We’re testing a new way of commissioning treatment services that for the first time involves ‘payment by results’ - paying treatment providers for getting 3 types of results:

• services users become free from dependence on drugs and/or alcohol
• reduced re-offending or continued non-offending
• improved health and wellbeing

We are piloting this approach in 8 areas over 2 years, and it will be independently evaluated.

Helping offenders who misuse drugs get treatment

Prison isn’t always the best place for offenders who misuse drugs. Our Drugs Intervention Programme refers offenders to treatment services as early as possible in their contact with the criminal justice system.

We are:

• making the programme more flexible, so that local areas can adapt it to suit their local communities
• launching new ‘recovery wings’ in prison, to help prisoners become drug free before they move back into the community
• funding a programme to support prisoners who have recovered from drug dependence when they move back into the community, so that they are less likely to go back to misusing drugs

Providing information on what works best

From April 2013, local councils, supported by Public Health England (PHE), will have responsibility for helping people to live a drug-free life. They will be able to create information, support and treatment services that meet the needs of their local communities.

We will continue to fund research into what works best – and we will share that information with PHE, local councils and other relevant organisations to use in their services.

Restricting the supply of illegal drugs

We restrict the supply of illegal drugs by classifying and controlling drugs, including new psychoactive substances (known as ‘legal highs’).

The establishment of the National Crime Agency will help us co-ordinate national and international efforts to reduce the supply of drugs.

Background

In 2010, we published the national drug strategy for England. The strategy sets out our plans for helping people to live a drug free life.

We publish annual reviews of the strategy reporting on the progress we have made and our priorities for the coming year. The second annual review of the strategy was published in December 2013.

Positive trends in a number of areas include:

• drug use is at its lowest level since measurement began in 1996, across all age ranges (children and young people as well as adults)
• the number of people completing drug treatment free of dependence is at record levels
• drug-related deaths in England and Wales have fallen over the last 3 years

Alongside the second annual review, we also published the Drug strategy evaluation framework outlining our planned approach to evaluating the effectiveness and value for money of the 2010 Drug strategy.

Who we’re working with

The Advisory Council on the Misuse of Drugs is an independent expert body that advises government on drug-related issues in the UK.

The Home Secretary and the Advisory Council on the Misuse of Drugs work to a joint working protocol. This covers their roles and responsibilities in commissioning and receiving drug-related advice, as well as the membership of the Advisory Council and processes for temporary class drug orders.

Each year, after consulting other relevant government departments, the Home Secretary writes to the Advisory Council on the Misuse of Drugs to set out the government’s drug priorities. The Advisory Council will include these in its work programme, along with the work it has chosen to consider.

Bills and legislation

Misuse of Drugs Act 1971

The Misuse of Drugs Act 1971 is the main law to control and classify drugs that are ‘dangerous or otherwise harmful’ when misused.

The act lists all illegal (or controlled) drugs in the UK and divides them into one of 3 ‘classes’ – A, B and C – based on the harm they cause to individuals and society. Class A drugs are considered the most harmful. This is commonly known as the drug classification system.

The act makes it illegal for people to:

• possess illegal drugs
• possess illegal drugs with intent to supply
• supply or offer to supply illegal drugs (including giving them away for free or sharing with others)
• produce illegal drugs
• import or export illegal drugs
• allow a house, flat or office to be used by people to undertake any of these unlawful activities

Illegal drugs can be added to the act by a parliamentary order after consultation with the Advisory Council on the Misuse of Drugs. The Secretary of State can temporarily add new drugs to the list of controlled substances until a decision is made about whether they should be permanently controlled.

The act provides the flexibility to control harmful drugs (including under a temporary class drug order) by:

• naming them or defining them by chemical name individually, such as cannabis and cocaine
• the use of generic definitions which capture families of drugs that are chemically related, or potential analogues and derivatives of, the main drug, for example, anabolic steroids, cathinones, piperazines, synthetic cannabinoid agonists, phenethylamines and tryptamines
• capturing simple derivatives, such as salts, esters or ethers, of the controlled drugs (whether these are defined individually or captured by generic definitions)

The act and its associated regulations also enable organisations to carry out legitimate activities involving controlled (illegal) drugs, many of which are used in healthcare.

Since 2010, the Misuse of Drugs Act 1971 has been amended to control new drugs, including a number of new psychoactive substances:

• a new range of synthetic cannabinoids, methoxetamine and other related compounds and O-desmethyltramadol
• desoxypipradrol (2-DPMP), its related compounds and phenazepam
• naphyrone and other synthetic cathinones, tapentadol and amineptine

On 10 June 2013, a temporary class drug order was made on two groups of new psychoactive substances (or ‘legal highs’) - NBOMe and benzofuran compounds - making them illegal for 12 months.

Misuse of Drugs Regulations 2001

The Misuse of Drugs Regulations 2001 allow for the lawful possession and supply of controlled (illegal) drugs for legitimate purposes.

They cover prescribing, administering, safe custody, dispensing, record keeping, destruction and disposal of controlled drugs to prevent diversion for misuse.

In 2012, we made a number of changes to the 2001 Regulations. The changes covered:

• nurse and pharmacist independent prescribers
• the mixing of medicines for administration to patients that include controlled (illegal) drugs
• possession authorities under patient group directions

Other regulations

The Misuse of Drugs (Safe Custody) Regulations 1973 set the minimum storage requirements for some illegal (or controlled) drugs. They apply to care homes and retail pharmacies, and are applied as minimum standards in other healthcare settings.

The Misuse of Drugs (Supply to Addicts) Regulations 1997 restrict the prescribing of cocaine, diamorphine and dipipanone for the treatment of addiction to doctors licensed by the Home Office (and in Scotland, by the Scottish government).

Appendix 1: classifying and controlling drugs

This was a supporting detail page of the main policy document.

Drug classification

The Misuse of Drugs Act 1971 lists controlled drugs in 1 of 3 classes – A, B and C. Class A drugs are considered the most harmful.

Each class attracts different levels of penalties for a range of unlawful activities including the possession, supply and production of a controlled drug. In 2012, the Sentencing Council issued a definitive guideline for drug offences.

The Home Office publishes a list of controlled drugs. It lists only the most commonly encountered drugs and is not exhaustive.

The drug control process

The government can add drugs to the Misuse of Drugs Act 1971 by making a parliamentary drug control order.

When deciding how a particular drug should be classified, we consider advice from the Advisory Council on the Misuse of Drugs (ACMD), and the need to protect the public.

The ACMD makes an assessment of a drug’s individual and societal harms based on the available evidence.

If the ACMD recommends a drug for control, it makes a recommendation for its classification (class A, B or C). It can also recommend that chemical compounds related to the drug are classified as well.

If a drug is to be controlled permanently, the drug control order is prepared and laid before Parliament, where it is debated by both houses. If the drug control order is approved by the houses of Commons and Lords and also the Privy Council, the drug becomes a controlled drug – either class A, B or C.

Temporary class drug orders

The Home Secretary has the power to make a temporary class drug order (TCDO) for an emerging drug that is causing concern. A TCDO can be made within a matter of days and lasts for up to 12 months. This allows us to change the law quickly and temporarily, while the ACMD considers the harms further.

For example, the UK’s first TCDO on methoxetamine came into force in April 2012; it has now been permanently controlled as a Class B drug.

The process for making a temporary class drug order is slightly different, but follows similar principles to those described for permanent drug control under the act.

Controlled drugs regulations (Misuse of Drugs Regulations 2001)

Drugs controlled under the 1971 Act are placed in 1 of 5 schedules to the Misuse of Drugs Regulations 2001 based on:

• an assessment of their medicinal or therapeutic usefulness and the need for legitimate access
• their potential harms when misused

The more harmful a drug can be when misused, the higher the schedule and the stronger the regime around its availability.

Schedule 1 to the 2001 regulations covers drugs that have no therapeutic value and are usually used mainly in research under a Home Office licence. Examples include cannabis, MDMA (‘ecstasy’) and lysergamide.

Schedule 2 to the 2001 regulations covers drugs that have therapeutic value, but are highly addictive. These are strictly controlled and subject to special requirements relating to their prescription, dispensing, recording and safe custody. Examples include potent opiods, such as diamorphine and morphine.

Schedule 3 covers drugs that have therapeutic value, but have slightly lighter control, special requirements relating to their prescription, dispensing, recording and safe custody (where applicable). Examples include temazepam, midazolam and buprenorphine, and methylphenobarbitone.

Schedule 4 is divided in two parts. Part 1- benzodiazepines (examples include bromazepam, diazepam (‘Valium’) and triazolam) and Part 2 anabolic and androgenic steroids (examples include prasterone, testosterone, nandrolone and bolandiol), which is subject to lighter regulation with no possession offence.

Schedule 5 covers weaker preparations of Schedule 2 drugs that present little risk of misuse and can be sold over the counter as a pharmacy medicine (without prescription). Examples include codeine, medicinal opium or morphine (in less than 0.2% concentration).

Following the recommendations of the Shipman Inquiry in 2005, changes were made to the 2001 Regulations to strengthen the rules about the availability and use of controlled drugs in healthcare settings, specifically to improve the audit trail of controlled drugs in the community. The changes included:

• specific requirements for private prescriptions
• maximum validity periods for controlled drug prescriptions
• the requirement for certain healthcare professionals to provide specific details when making a request for the supply of controlled drug stock

The role of accountable officers, with duties to secure the safe management and use of controlled drugs within their area of responsibility, was also introduced through the 2001 Regulations made under the Health Act 2006.

Appendix 2: new psychoactive substances

This was a supporting detail page of the main policy document.

The pattern of drugs use is constantly evolving, and there are always new drug threats to consider. New psychoactive substances (so-called ‘legal highs’) frequently contain substances that are not legal and cannot be assumed safe.

New psychoactive substances have become a particular concern in recent years with supply and demand increasing. The availability of these substances, especially over the internet and in ‘head shops’, has radically changed the nature of the drugs market.

We have:

• published an action plan to combat new psychoactive substances, which sets out our approach to fighting the threat from emerging substances

• introduced the temporary class drug order, which bans newly identified harmful drugs within days- an order can last for up to 12 months and is implemented following initial advice from the Advisory Council on the Misuse of Drugs, and remains in place while the Advisory Council’s full report on the substance is prepared

• implemented a forensic early warning system, which detects new psychoactive substances in the UK - the forensic early warning system annual report describes the system and provides results on the analysis of samples tested

The drugs early warning system involves issuing alerts and receiving information from a wide variety of partners. It has provided valuable intelligence on the prevalence and harms associated with methoxetamine, synthetic cannabinoids and 5 and 6 APB.

Information sharing and collection

The UK has taken the opportunity of the G8 presidency to lead on tackling the threat of new psychoactive substances with other G8 member states, the UN and the EU. The sharing of information among international partners on the emergence of new substances, their impact on public health and the supply routes is invaluable in addressing the challenge.

The G8 have agreed a statement of intent to progress our close joint working on this.