British Drug and Alcohol Policy, Coda: Question Time

My last post in this series brought to an end my extended discussion of six particular issues facing drug and alcohol policymakers in the UK. I am grateful for the many people who posted thoughtful critiques and commentary on this series, as well as those who did so privately in email. In this final post, I respond to 12 questions raised to me over the course of the series. I edited the questions for brevity and removed personal information from those that were emailed.

1. You seem to be enthusiastic about the 24/7 Sobriety Program for drink driving offenders in South Dakota and I have heard the UK may adopt that, is that true?

I am happy and excited to say the answer to this question appears to be yes. London’s Deputy Mayor for Policing, Kit Malthouse, heard about 24/7 and has expressed publicly his intention to explore its potential applications in London. England isn’t South Dakota of course, if you can drive 80 miles an hour (while intoxicated or not) through the streets of London you deserve a knighthood, not a sanction. But London does have extensive problems with binge drinking and associated violence within families as well as in the streets (e.g., Leicester Square on a weekend night is truly dangerous). There are a lot of details to work out before 24/7 can be attempted in London, including figuring out what is allowable under British sentencing law, but I am impressed with Kit and his team and their willingness to try something new.

2. Why bother with something as rococo as minimum pricing of alcohol when it would be simpler to just slap an excise tax on alcoholic drinks based on their potency?

This question from a business school professor reflects what many economists would say. The approach he proposes is employed in some parts of the world, such that for example, a 2.2% alcohol beer has a tax advantage over a 4% or 6% alcohol beer. Sometimes this can be done in such a fashion that total taxation (i.e., aggregate government revenue from all sales) doesn’t even change. I don’t think there is any head on head comparison of this approach to minimum pricing so I can’t make any empirical judgments of which is better. The argument for minimum pricing comes more from political economy than straight economics. It’s not a tax so it can garner support more easily from elected officials and alcohol retailers.

3. You only wrote about Labour and Conservative Politicians. Those aren’t the only political parties we have over here: the Liberal Democrats don’t agree with the Tories on drug policy and you didn’t address their role.

As a rule I meet with any elected official who wants to discuss the policy areas in which I work. But as fate would have it, I have only met two UK politicians outside the two main parties who were interested in drug policy, and both of them lost their seats in 2010 (Dai Davies and Lembit Opik). On election night, seeing Mr. Opik’s shocked face on BBC television as he stood in his empty-as-a-graveyard campaign headquarters made me again sympathetic to all elected officials. They live out their careers in front of a firing squad with itchy and unpredictable fingers, and the end can come without warning. I see that Mr. Opik has turned to stand-up comedy, which presents the same risks. Brave fellow. Godspeed.

But back to the LibDems: Speaking with zero personal knowledge I would say that if I were Nick Clegg, I would realize that after what it has to be said was a disappointing showing on election night, my party nonetheless bagged a nice clutch of plum jobs in the new government. I would therefore pick my policy fights carefully. As yet, I haven’t seen any sign that one of those fights will be over drug policy, so the Tories will probably continue to be the leaders in that area.

4. The new government is thinking of eliminating intermediate jail sentences of less than a year, which would affect many offenders who are addicted to drugs and alcohol. Is this a good idea?

With respect to Secretary Clarke and Minister Blunt, the problem with intermediate sentences isn’t that they are too short, but that they are not short enough. Instead of receiving sentences of 3, 6 or 9 months many serial offenders who have drug and alcohol problems should be put in programs like HOPE and 24/7 where the maximum sentence is a few days. This would achieve the desired reduction in overall incarceration, keep the community safer and help more offenders turn their lives around.

5. Are you trying to signal something about the Obama Administration’s views in these posts?

Absolutely not. I saw in one of the tweets that I was called “ONDCP’s Humphreys”. I am proud of my year as senior policy advisor at ONDCP but I am a university professor now. As my bio on this site indicates, nothing I say at RBC necessarily represents the official Obama Administration view of drug policy (or anything else, for that matter).

6. This series was helpful to my understanding, but I don’t exactly have time to go tramping through Parliament trying to keep up on HMG drug and alcohol policy from here on out…is there any regular source of information you can recommend?

A simple and I think quite enjoyable way to get a crash course on UK drug and alcohol issues is to visit FEAD, the Film Exchange on Alcohol and Drugs. Many of the players in the UK scene (including a number who posted comments to RBC during this series of articles) are interviewed or are shown giving presentations. You will get every view and significant debate on this website, and its all very smoothly produced by the FEAD team.

7. What is the future of the British pub?

Actually, no one asked me this personally, but it was raised in the issue of the Economist I read on the plane back from London last week. Pubs in the U.K. are hurting economically and losing business year on year. Because I oppose the legalization of any more addictive substances, I suspect some readers of this site put me down as a wowser, but the truth is I think a good pub is a wonderful thing. When a pub is a place that families go, where neighbors know each other, and where pints are nursed and not gulped, they create a setting to enjoy what is good about beer without the damage that comes from excessive drinking.

My advice to publicans and their political advocates is to drop all opposition to minimum pricing. The supermarkets are underselling the pubs and hurting their business, and minimum pricing will raise supermarket alcohol prices while not even being noticed by most pub patrons. With that policy in place, there is clearly a good living to made by publicans. There is also I believe a profitable market available for pubs that strongly enforce safe serving practices. Just as some people have returned to bars now that smoking is banned, there are people who will return to pubs that are not operated as taverns for lager louts.

8. Will drug policy be affected if the hereditary peers are eliminated?

I assume this question means eliminated from Parliament and not executed like what happened under some of those medieval kings. I don’t think the remaining hereditary peers who sit in the House of Lords have a huge amount of political influence. People of great wealth and privilege are one sector of society in which drug legalization sentiments are stronger than in the rest of the population, and this is true of the UK hereditary peers in the Lords (Indeed, the two people who make the bluntest case for complete legalisation are in this group). If the hereditary peers lose their seats in Parliament, that would therefore produce a slight tilt away from drug legalization in UK political circles, but it would be slight because as I said the hereditary Lords don’t have huge sway anymore.

9. What is the future of the Serious Organized Crime Agency?

SOCA has gotten a lot of bad press and is apparently slated for re-organization or elimination or conversion into another agency. I am in the camp that considers the criticism of SOCA too harsh. They did introduce significant innovations in law enforcement using provision of information to criminals as a mode of deterrence (It is not every day that I sit down with law enforcement officials and hear them invoke Jeremy Bentham’s Panopticon, as one SOCA official did). Under Director-General Bill Hughes (who is retiring soon) SOCA has been laying the groundwork for a different model of law enforcement that has potential to increase public safety while better targeting criminal justice resources, and it would be a rotten shame if this approach were not carried forward in some form. Transnational organized crime is an extremely serious problem, and goes well beyond drugs to include human trafficking, weapons smuggling and a host of other nasty activities. Whatever the new UK anti-crime agency is called, something along the lines of SOCA is absolutely necessary.

10. What is the future of the Advisory Council on the Misuse of Drugs?

This question was implied in a comment on the first post of this series when James Wimberly made reference to the prior government’s falling out with David Nutt, the former head of ACMD. As part of that fracas, a number of members resigned and the continued viability of the council came into question. For the moment at least though, based on my recent meeting with an ACMD working group, it continues to be a place of lively intellectual exchange. Many qualified people applied to fill the vacant seats, resulting in a continued strong line up of talent and expertise.

There are proposals floating about to change ACMD’s remit, for example to convert it into a council on addiction or to make it cover legal drugs and not just illegal ones. I have no opinion on the first of these but the second I think is a good idea. Just as I favor the merger of the two U.S. National Institutes that address alcohol and other drugs, I favor policy advisory groups looking at all substances together rather than separating them into legal categories. This view by the way was most solidified for me by reading Mark Kleiman’s book, Against Excess.

11. You say that there are problems with the quality of U.K. addiction treatment services. Isn’t that really just political propaganda spread by the new government to discredit the old?

In comments on prior entries in this series, Professor Mike Farrell wrote that concerns about the quality of UK services were “bogus” and a “smokescreen” and Professor Susanne MacGregor averred that the prior government had already addressed quality. I also got some private emails saying that I was falling for government spin in believing there were any quality problems and that this was all just an attack on methadone. With respect, I don’t think complacency about the effectiveness of addiction treatment in the U.K. (or the U.S.) is warranted. There are many outstanding people providing, overseeing and evaluating services in the UK, Mike and Susanne among them. But complaints about quality of services come to me primarily from service users and service providers rather than politicians. If you gathered 50 service users who voted against the parties that now compose the coalition government (or didn’t vote at all) and asked them about their experiences, some would surely be positive but some would equally surely tell true tales of poor treatment. I recognize that criticism of one’s efforts to help is painful, but I think a hard listen to the service user community would reveal that whatever the political environment, some of the criticism is dead on target and needs to be taken seriously.

12.You made reference to “Yes, Minister” in your first post as well as in your Alcohol and Alcoholism article on minimum pricing. That show was funny but it’s not what UK politics is like any more, is it?

No, it isn’t. I belong to an informal klatch of public policy eggheads who got hooked on the show when it first came out and still find it painfully accurate and funny in capturing experiences we have had. But as one poster noted and I was emailed about as well, the all-powerful-civil-servant era in UK politics ended not long after the show did, with the rise of the special adviser class which is portrayed in The Thick of It. There has now been in turn some retreat from that model and what the new relationship between the senior civil service and politicians will be remains to be seen.

But I still cling to the show happily, and through great good fortune recently happened to be seated at a dinner next to the hilarious Kevin Grant, who contributed to the writing of the famous “who reads the newspapers?” sketch (“The Times is read by the people who run the country, the Daily Mail is read by the wives of the people who run the country…”). To close out on a light note this series of articles addressing some very painful human problems, I embed another great sketch below, which parodies with painful accuracy how bureaucrats talk

Author: Keith Humphreys

Keith Humphreys is the Esther Ting Memorial Professor of Psychiatry at Stanford University and an Honorary Professor of Psychiatry at Kings College London. His research, teaching and writing have focused on addictive disorders, self-help organizations (e.g., breast cancer support groups, Alcoholics Anonymous), evaluation research methods, and public policy related to health care, mental illness, veterans, drugs, crime and correctional systems. Professor Humphreys' over 300 scholarly articles, monographs and books have been cited over thirteen thousand times by scientific colleagues. He is a regular contributor to Washington Post and has also written for the New York Times, Wall Street Journal, Washington Monthly, San Francisco Chronicle, The Guardian (UK), The Telegraph (UK), Times Higher Education (UK), Crossbow (UK) and other media outlets.

4 thoughts on “British Drug and Alcohol Policy, Coda: Question Time”

  1. I give up, and have to ask you : what is the 24/7 plan? What does it do? I followed your link, which talked of implementation, I followed another two links beyond, and never got to what is the plan?

  2. I think what intrigues me most with this is the excise tax they are proposing .Such taxes have not been too successful with smokers and the cigarette excise tax which makes me wonder if it will work with substance abuse.

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