1. Beyond drug criminalisation: Why, what and how?
Prof. Alex Stevens
University of Kent
Beyond drug criminalisation: Why, what and how?

2. Why end the criminalisation of people who use drugs?
A discussion in three sections
Why end the criminalisation of people who use drugs?
What alternatives policies exist?
How do they work?

3. The Misuse of Drugs Act 1971
Separates drugs into three classes, based on their supposed harmfulness, with different penalties for each.
Class A (possession - up to 7 years, supply – up to life)
Heroin, cocaine, LSD, MDMA/ecstasy, psilocybin mushrooms, amphetamines (prepared for injection).
Class B (possession – up to 5 years, supply - up to 14 years)
Cannabis, amphetamines, mephedrone, ketamine
Class C (possession – up to 2 years, supply up to 14 years)
Benzodiazepines (e.g. Valium), GHB, BZP.

4. Critics of classification
Source: Nutt et al 2007

5. The purported aims of criminalisation
Law enforcement is supposed to reduce drug use and related harms by:
‘Sending a message’ that drug use is not acceptable
Deterring drug use through the threat of punishment
Limiting availability and increasing price of illicit drugs.
Theresa May, MP (2018):
“It is right that we continue to fight the war against drugs.” 5

6. In Europe Does criminalisation reduce levels of drug use? 6
Source: EMCDDA 2017 6

7. Does criminalisation reduce levels of use?
In Australia
Source: Moxham-Hall et al 2017 7

8. Does criminalisation increase harms?
106 studies that examined criminalisation and health behaviours/outcomes for people who inject drugs (PWID)
Indicators of criminalisation:
E.g. Incarceration, Street-level policing
Indicators of harms:
E.g. Injecting, Syringe sharing, prevalence of HIV among PWID
Results
85 studies (80%) suggest negative effect of criminalisation on HIV
10 studies (9%) suggest no association
5 studies (5%) suggest null and negative effects
5 studies (5%) suggest beneficial effect of criminalisation on HIV
DeBeck et al 2017 8

9. Criminalisation: an initial summary
Imposes harms and costs:
Arrests and criminal convictions
Increases risks of drug use
Uses up a lot of police time
Imprisonment very expensive
Although numbers imprisoned for simple possession are small
Very little evidence of effectiveness
People don’t respond to ‘sending messages’
People not aware of what the actual penalties are
Very low proportion of people who use drugs can be caught and punished 9

10. 2. What alternatives exist?

11. Alternative policies for regulating drugs
The status quo
Prohibition/criminalisation of both possession and supply
Alternatives for dealing with possession
Depenalisation
Diversion
Decriminalisation
Alternatives for dealing with supply
Prescription by doctors
Legalisation of sale

12. Classifying alternatives for possession

13. Depenalisation
Use of discretion within existing laws to avoid arrests and convictions
E.g: Denmark, 1969 – 2004, England & Wales since 2004 (cannabis warnings)

14. Police diversion
Police use their discretion to divert low level offenders to education/treatment
E.g. several Australian states, Seattle. Also Durham, West Midlands, Bristol.
Reduction in arrests and costs
Less damage to job prospects and relationships

15. De jure diversion
Police use new legal powers to divert low level offenders to education/treatment
E.g. some Australian states
Reduction in arrests and costs
Less damage to job prospects and relationships
But with less police discretion.

16. Decriminalisation with diversion
Drug possession no longer a criminal offence
Criminal sanctions replaced by civil sanctions
Plus use of administrative law to divert drug possessors to assessment/education/treatment
E.g. Portugal

17. Decriminalisation with civil sanctions
Drug possession no longer a criminal offence
Criminal sanctions replaced by civil sanctions
Without use of administrative law to divert drug possessors to assessment/education/treatment
E.g. Italy, several US states

18. Decriminalisation with no sanctions
Drug possession no longer a criminal offence
No alternative sanctions
E.g. Germany since 1994, Vermont since 2018

19. Summary on alternatives
Several alternatives exist:
Depenalisation
Diversion
Decriminalisation
In several countries:
Including the UK
Provisional evidence of effects:
Reduction in harms and costs of criminalisation
No consistent increase in drug use
Some reductions in health harms (when combined with health and social services) 19

20. 2. How do alternatives to criminalisation work?

21. A ‘realist programme theory’ of alternative measures

22. Contexts

23. Causal pathway 1: normative

24. Causal pathway 2: criminal justice

25. Causal pathway 3: health and social services

26. Potential outcomes

27. Summary: It’s time to move beyond criminalisation
Why: Because criminalisation imposes harms/costs without producing benefits.
What: We can choose between various alternatives: depenalisation, diversion, decriminalisation.
How: By paying attention to the complex combinations of contexts, mechanisms and outcomes.