DRUGS, CRIME & COMMUNITY SAFETY

by Jacob Veale.

Introduction

In a paper published in 1991 Joy Mott, of the Home Office’s Research and Planning Unit, reported: "The evidence that the type of medical treatment offered to heroin users has implications for reducing and preventing crime cannot be ignored." This view is widely shared amongst crime prevention and community safety practitioners, but appears to have had little or no impact on the approach to treatment taken by medical practitioners. The main reasons for this are not difficult to identify they are common to interdisciplinary work in many contexts. Briefly, crime prevention and community safety practitioners have difficulty in addressing medical and pharmacological issues because they do not understand the terminology and jargon, and feel unqualified to comment on specific forms of medical treatment; medical practitioners meanwhile have similar difficulties with criminological jargon, and are understandably reluctant to adopt any approach which might erode their clinical independence.

However, the impact of both crime and drug use on individuals and communities can be profound. Opportunities to reduce crime should not be overlooked merely because effective interdisciplinary working is difficult to achieve. It is not impossible for a lay person to become conversant with the medical and pharmacological language and issues involved in treating drug users most drug ‘street agencies’ have staff with little or no formal training in medicine or pharmacology, but who have acquired very extensive and detailed knowledge of these subjects through their work.

Community safety is a new and wide ranging discipline which requires an unusual mixture of knowledge and skills from its generic practitioners, but is largely a matter of simple common sense in the context of any one specialised area of concern. It is usually understood to incorporate all aspects of crime prevention, victim support, and work aimed at reducing the fear of crime. Good practice in community safety frequently involves changing the way that organisations go about their work in order to obtain community safety ‘fringe benefits’ without reducing the organisation’s primary outputs, rather than developing entirely new services. For example, a local authority might decide to enhance the security of any of its residential properties that are burgled, as well as making any necessary repairs. Although this might increase the authority’s costs in the short term, it will also reduce the likelihood of any repeat burglary, and thus create savings in the repairs budget in the medium to long terms. The benefits to the tenant would of course be both financial, through avoiding losses in subsequent burglaries, and personal and emotional through avoidance of the often severe trauma of repeat victimisation.

Drug-Related Crime

In broad terms the connections between dependent drug use and acquisitive crime are obvious. Dependent users of heroin, crack/cocaine, amphetamines and other drugs (including alcohol) need to finance their addiction, and few have the means to do so easily or entirely legally. Although many addicts become adept at avoiding non-drug expenditure on items such as food, clothing, housing or heating, and some generate income through involvement in the sex industry, occasional or regular involvement in acquisitive crime such as shoplifting, burglary, fraud or drug dealing is frequently unavoidable.

The issue of whether dependent drug use is a root cause of crime can of course be complex. It is probable that drug use and non-drug offending share common socio-economic root causes at least to some extent. However, there is no shortage of evidence that drugs cause crime at the more obvious and immediate level.

Little research has been undertaken in the UK to assess true levels of drug-related crime, and accurate data on crime levels themselves are scarce. Hard data on the numbers of drug users and ‘problem’ drug users in the community are also scarce. However, the Institute for the Study of Drug Dependence (ISDD) recently undertook a brief project on behalf of the Home Office’s Central Drug Coordination Unit (CDCU) to quantify what proportion of recorded crime (by financial cost) was committed by dependent heroin users in England and Wales to finance their drug use. The researchers took great care to identify where weaknesses lay within the available data sets, and were consistently cautious in making their estimates.

They concluded:

Less than half of the income of dependent heroin/ polydrug users is raised through acquisitive crime (excluding drug dealing and prostitution).

Between one per cent and 21 per cent by cost £58 million and £864 million respectively) of all reported acquisitive crime in England and Wales is committed by dependent heroin users to finance their drug use.

The researchers also suggested that despite the generally poor quality of available data, it would be better to regard 11 per cent of all reported acquisitive crime as a single point estimate than to take either the top or bottom points of the range quoted above.

It should be borne in mind that heroin is by no means the most widely used illicit drug in England and Wales. In some inner city areas dependent use of crack/cocaine appears to be becoming more widespread than dependent use of heroin, and use of amphetamines is considerably more widespread than either (although use of amphetamines is more likely to be recreational than is use of either heroin or crack/cocaine).

The researchers also strongly recommended that "improvement in the quality of information and research [into crime and drug use] be regarded as an urgent priority" Drug use is of course not equally prevalent across the whole of England and Wales, it is concentrated within the larger cities, and particularly in London. Some divisions of the Metropolitan Police are reported to have estimated that drug use may lie behind 70 per cent or more of the acquisitive crime within their areas.

Developing a Community Safety Oriented Response to Drugs

The links between drug use and acquisitive crime have now been recognised by the Government. As a result, community safety figures prominently in the Government’s drug strategy, Tackling Drugs Together. The strategy also requires the establishment of an entirely new set of local structures to take over the strategic planning of drugs interventions and services, through which local authorities, police and the probation service will become equal partners with health service providers and commissioners.

The new planning groups, Drugs Action Teams (DAT) and Drugs Reference Groups (DRG), will have a major task ahead of them. Since the introduction of the 1920 Dangerous Drugs Act it has only been possible for heroin and cocaine users legally to obtain supplies of their drug of addiction through a medical prescription. Since the 1967 Dangerous Drugs Act, only specially licensed doctors operating from specialist clinics have been able to prescribe either heroin or cocaine (or more recently dipipanone) to addicts in treatment for their addiction. For the most part these clinics only offer methadone to heroin addicts usually on a reducing basis although methadone maintenance is also available in some areas. It has become effectively impossible for heroin and cocaine users to obtain maintenance treatment with their drug of choice. This enforcement of the criminal laws prohibiting drug possession (without a prescription), and increasing efforts to prevent the further spread of drug use.

There is now little option but to accept that this approach has failed. In many areas the prices of both heroin and cocaine have remained remarkably stable in simple cost terms since the late 1970s, and have fallen if inflation is taken into account. At the same there has been a substantial increase in the numbers of people getting involved with these drugs. These two factors together suggest that the supply of heroin and cocaine has consistently tended to outstrip demand.

What can be done to undermine the illicit drug market? Clearly enforcement of the criminal law has not succeeded, despite the fact that the amounts of drugs seized and numbers of prosecutions have climbed steadily over recent years. There is no longer any realistic basis to the notion that enforcement alone can solve the problem. The criminal justice system simply does not have the capacity to deal with the problem. London is now thought to have 40,000ð 80,000 problem drug users, far exceeding the capacity of the criminal justice system to cope. So, the scale of the problem continues to grow. It is surely time to develop a credible and realistic analysis of the nature and scale of the problem (including the consequences both for users and for the wider community), evaluate its short, medium and long-term consequences, and seek solutions that address the reality of the problem.

Several key factors need to taken into consideration in the process:

The notion of the evil, non-addicted drug pusher making huge amounts of money by dragging drug-free innocents down into the mire of addiction is, by and large, a myth. The heroin and cocaine markets at retail level are served mainly by addicts who engage in small scale supplying to support their own habit, probably because this is a lot safer and easier than other crime or prostitution.

While any drug use can be dangerous, use of contaminated street drugs is generally more dangerous than use of pharmaceutically pure drugs.

It is seldom possible to force an addict to stop using drugs unless her/his supply can be stopped.

At present the capacity of treatment services in most areas is far outstripped by the numbers of drug users who might benefit from treatment.

At a simplistic level it is tempting to regard prescribing as a panacea for reducing drug-related harm. With regard to heroin, it is possible that simply providing a user with her/his drug of choice may substantially reduce offending by that addict. Also, daily use of pure pharmaceutical heroin does little harm to the user, whereas street heroin is usually adulterated prior to sale. So prescribing heroin to addicts may deliver both community safety and health gains. Methadone maintenance programmes also provide community safety benefits. However, many heroin addicts who receive methadone continue to use street heroin as well, and may therefore continue to raise money for heroin through crime. There is also increasing concern that methadone may be more physically harmful to the user than is heroin, so the health and community safety gains offered by methadone treatment may be less than those offered by heroin.

The arguments surrounding prescribing become very much less clear cut when other drugs are considered however. Patterns of crack use amongst dependent users seem to be less consistent than patterns of heroin use, although binge use seems common. It would be very much more difficult to justify supplying cocaine to a user in the long term, partly because this could simply lead to binges of longer duration, and partly because cocaine and its derivatives are physically more harmful than is heroin. In terms of community safety also the benefits of such prescribing would be very much more questionable, because of the risk that the prescription would do little or nothing to reduce ongoing illicit use, and therefore have equally little value in terms of crime reduction.

A second contentious issue that the community safety approach raises relates to the ‘leakage’ of prescribed drugs onto the illicit market. There are grounds for concern about the extent to which prescribed methadone may be being sold on to raise money for heroin. Methadone’s proponents sometimes argue that if more heroin were prescribed this also would be sold on, possibly even to a greater extent than is methadone at present (because of heroin’s higher street value). But consider a group of heroin users who are being prescribed methadone, who find this does not fully meet their needs. If they can sell the methadone they can use the money to buy heroin. If this group has its prescribed treatment changed from methadone to heroin, why would they sell the heroin? While some might be sold on for reasons of pecuniary gain, heroin users tend to prioritise getting heroin above all their other needs so most would tend to retain their prescribed heroin and look for other ways to raise funds.

Acquisitive crime is not the only community safety issue connected with drug use. Two further issues are the extent of violence associated with drug use and drug supplying, and the vulnerability of users to victimisation and exploitation.

Drug-related violence can be divided into two main categories. Firstly there is the violence that is associated with intoxification. This is most evident with regard to alcohol rather than the illicit drugs and it seems probable that it can only be reduced through an overall reduction in levels of intoxification. The second category of violence is associated with drug dealing, and results directly from the fact that drugs are a high value commodity, irrespective of their legal status. The potential profits from drug supplying are substantial, so it should be no surprise that violence is generated between competing suppliers. One need look no further than the development of major organised crime (and the associated violence) as a consequence of the prohibition of alcohol in the US earlier this century to understand how a large illicit drug market can generate violent crime problems which, once established, may persist for a very long time.

The victimisation and exploitation of drug users seems to be a direct result of the illicit nature of the drug market. For example, an addict might be forced into prostitution as a means of financing her/his drug use. Prostitutes are particularly vulnerable to a range of crime and exploitation, sexual violence through to protection rackets and simple robbery. The core problem for illicit drug users is that the nature of their lifestyles greatly reduces their access to redress through the law if they are victimised. This in turn makes them ideal victims and they may well be targeted by offenders as a direct result.

Problems and Pitfalls

An approach to the drugs problem which takes account of community safety, if successful, might result in positive changes for both users and the wider community. Acquisitive and violent crime should fall, the health and welfare of existing drug users should improve, and the size of the illicit drugs. market should contract as both users and small scale suppliers enter treatment. However, this approach also poses some new problems.

Firstly, drawing attention to offending by users may tend further to stigmatise them and provide a justification for a much tougher approach to them. Secondly, even if a user’s drug needs are fully met by prescription s/he may continue to offend.

Drug policy in the UK is already harsh towards users and small-scale suppliers. After a few years caught in the desperate cycle of raising money by any means and trying to buy drugs without being robbed, users have little stake left in society. So would they stop committing crime just because of a prescribed supply of the drugs they are addicted to? If not, what could be done to re-integrate users within the wider community? Would provision of high quality educational, training and other services help? Finally, what sort of messages would we be sending to non-drug users if we start to provide users with much better services?

There is no easy answer to these concerns. However, drug-related offending is now a recognised phenomenon. If drugs agencies choose to down play it as an issue they should not be surprised if social policy makers take a different tack and the demonisation of the ‘junkie’ carries on regardless. Crime is an issue of massive public concern, and the political benefits of reducing it are, potentially, equally massive. Surely then drugs agencies should be actively working to address the community safety agenda. It is not impossible to see ways in which the community safety approach can benefit users, but this will not happen unless those who develop the agenda have at heart the interests of users as well as those of the wider community.

Above all, we need to educate our communities about all aspects of the drug problem. Preventive and harm reduction messages are valuable to users and potential users in the short term, but they do little to defuse the ticking bomb that is drug related crime.

Social policy makers and the community in general need to be much better informed about the drugs scene. In particular they need help in differentiating the problems that derive from drug use itself from those that derive from our existing policies in relation to drug use. From a community safety standpoint drugs services are at least as suitable cases for treatment as are the drug users themselves.

Jacob Veale is the community safety coordinator at the London Borough of Lewisham, and has a specialist interest in drugs issues and drug-related crime.

References

Mott, J (1991 ) Crime and Heroin Use in Whynes, in DK and Bean, PT (Eds) Policing and Prescribingðthe British System of Drug Control.

ISDD (1994) Paying for Heroin Estimating the Financial Cost of Acquisitive Crime Committed by Dependent Heroin Users in England and Wales.

Veale, J (1994) Harm Reduction and the Comunity in The International Journal of Drug Policy, Volume 5, No. 2, Mersey Drug Training and Information Centre.

Morley, A Drugs and the Community What Local Authorities Can Do, London Drug Policy Forum.

Lofts (1991 ) Policing the Merseyside Drug Treatment Programme in Bammer, G and Gerrard, G (Eds) Heroin Treatment New Alternatives (National Centre for Epidemiology and Population Health; Australian Institute of Criminology; National Drug and Alcohol Research Centre) [of Australia]

Dale, A, Jones, S (1992) The Methadone Experience: The Consumer View, The Centre for Research on Drugs and Health Behaviour.

Newcombe, R (1995) Methadone Mortality Are British Drug Treatment Services Neglecting The Main Harmful Effects of Prescribing Methadone?, 3D Research Bureau.