UK government on the wrong track? – Efforts to improve drug policies cause discord in professional circles
The first article is written by the founder of the Global Drug Survey, Adam R Winstock, the executive director of Release, a UK agency that provides legal advice and arranges legal representation for people charged with the possession of drugs, Niamh Eastwood as well as a professor of criminal justice at University of Kent, Alex Stevens and relates to a new drug strategy for the UK, which was published by the UK government in July 2017. The strategy aims to prevent misuse of drugs and drug dependence and comprises the conclusion, that the measures “will reduce crime, improve life chances, promote better health and protect the most vulnerable”. The strategy is introduced at the right time since drug related deaths represent a more common cause for death than traffic fatalities and were even increasing under the former drug strategy from the year 2010. Nevertheless, the 2017 drug strategy had to expose itself to utmost criticism by the three authors of the article.
In their opinion, the strategy proves the refusal of honest and open conversations between the government and affected groups. The strategy “lacks honesty, coherence, and realistic financial support. It is based on false claims and is full of empty promises. As a result, more people will die from drug-related deaths that could have been prevented.” This is their scathing judgement on the government’s strategy. For example, the strategy states to support opioid substitution, although funding for the substitution was cut. Furthermore, the reduction of health damages is not mentioned in the context of illegal drugs, but the aim is to ban them completely. The three experts conclude that it is significant for a good drug strategy to accomplish improvements in population’s health and wellbeing, whereas a “society free of drugs” is an unrealistic goal, and cannot be the aim of such a strategy.
But where could the funding for drug prevention come from when the English National Health Service (NHS) is already struggling with its budget for drug prescriptions? The second article by Azeem Majeed, professor of primary care at Imperial College London, relates to a plan of the NHS to strengthen efforts with the so-called clinical commission groups (CCGs) to reduce wasteful and ineffective drug prescriptions. The CCGs are already focusing on the restriction of funding for drugs with limited clinical value and OTC products. Majeed sees several pitfalls in the implementation of a national evaluation.
Regional regulations by the CCGs could lead to regional quality differences in healthcare. A national approach could help to standardize prescriptions. But the efforts of the CCGs to implement regional regulations have not been stopped by the NHS England so far. Furthermore, changes in law to set the right legal basis for the restriction of prescriptions have not been made yet.
Majeed identifies OTC drugs and diet food items as the most controversial products. Certain patients might not be not able to pay for these drugs, which aggravates social differences in health. Hence, he concludes that the government needs to be sensitive to the problem, that the financial changes required in the NHS are accompanied by a greater financial burden for patients.
Eyes are directed to the British government and the NHS to see how they will deal with the limited financial resources and how drug regulations and policies need to be aligned to ensure qualitative care and health promotion. Currently, the solutions don’t seem to be satisfying.
Read more background information in the following articles:
http://www.bmj.com/content/358/bmj.j3643
http://www.bmj.com/content/358/bmj.j3679
Link to the drug strategy:
https://www.gov.uk/government/publications/drug-strategy-2017