US President Barak Obama’s 5-year National Drug Control Strategy, which takes a more balanced approach to the challenges, and stresses prevention and treatment as well as law enforcement is welcomed in an Editorial in this week’s Lancet (a peer-reviewed academic medical journal).

In linked Correspondence, UK experts from the Drug Policy Commission (UK) summarize what they propose is needed to repair UK drug policy after the recent sacking of chief drug advisor David Nutt and the mephedrone affair.

The Editorial highlights the US plan’s ambitious aims, including:

  • A 15% reduction in the rate of youth drug use and the number of chronic drug users
  • A target in the first year to focus on preventing:
    • drug use
    • driving under the influence of drugs
    • prescription drug abuse

The Editorial says:

These are well chosen priorities since those who reach 21 years without developing an addiction are less likely to do so afterwards, driving under the influence of illegal drugs is now more common than drunk driving in the USA, and the abuse of prescription drugs is the country’s most rapidly growing drug problem, with over 6 million Americans currently using prescription drugs for non-medical reasons.

The Editorial concludes:

Obama’s new plan is a welcome departure from the ideologically driven measures of previous administrations and from other countries such as the UK, which have failed on several occasions to use evidence as the basis of drugs policy.

The Correspondence addresses the situation in the UK and is written by Ruth Runciman, Colin Blakemore and Tracey Brown, all of the UK Drug Policy Commission, London, UK.

The authors write:

We have seen drug policy increasingly affected by media pressure, sometimes hysteria, and by the ideological and polarised opinions of campaigning organisations and others, often based on flimsy evidence. Successive governments have tacitly acquiesced to this shift from evidence to opinion by not building an adequate evidence base along with suitable machinery and structures for independent scrutiny and evaluation. This point has been commented on by the National Audit Office and the Public Accounts Committee. This changing pattern of influence has eroded the provision of objective advice for the development and implementation of drug policy.

The authors outline that, over the next 18 months, their Commission will undertake a serious review of drug policy governance and stewardship in the UK. Their initial view of what is required to deliver a suitable system for better and effective drug policy and governance is:

  • Comprehensive investment in developing the evidence base to inform drug policy analysis and decision making.
  • An independent mechanism and body for the evaluation and scrutiny of policies.
  • Inclusive and transparent methods, machinery, and structures to take account of public opinion and “political” considerations, against a background of the best scientific evidence and expert advice.
  • Enhanced political accountability through parliament and devolved bodies.
  • Clear and open reasoning that people can understand and hold to account.

The authors conclude:

The new government will now have an opportunity to reflect on recent events and make a fresh start in strengthening the overall governance of drug policy, rebuilding the processes, structures, and practices, so that a new consensus about the aims and directions of drug policy can be created. We hope that the work of the UK Drug Policy Commission can facilitate this much-needed review.

“A new dawn for drug policy in the USA”
The Lancet, Volume 375, Issue 9728, Page 1754, 22 May 2010
doi:10.1016/S0140-6736(10)60787-8

“Time for a fresh look at drug policy governance”
Ruth Runciman, Colin Blakemore, Tracey Brown
The Lancet, Volume 375, Issue 9728, Page 1777, 22 May 2010
doi:10.1016/S0140-6736(10)60796-9

Written by Christian Noqvist