When I think about our approach to drugs laws, I often recall the rather overused quote attributed to Albert Einstein:
“The definition of insanity is doing the same thing over and over again and expecting a different result.”
It sums up our drugs laws well. Prohibition has been in place for some time, yet people continue to use drugs and criminals continue to supply them. We put someone behind bars, someone else takes their place. Yet, we continue with this notion that drug laws are keeping us safe when they’re causing significant damage.
Last week, Dame Carol Black published her Home Office commissioned report, which concluded that Government interventions to restrict supply have had limited success, and even if all enforcement organisations were sufficiently resourced, it is not clear that they would be able to bring about a sustained reduction in drug supply.
To understand the immensity of the failure of drug policy, we only need to look at the statistics. The illegal drugs market in the UK is worth an estimated £9.4 billion a year, this is almost as big as the UK wine market. Last year, in England and Wales around three million people took drugs. Most used cannabis, with 2.5 million users. This was followed by cocaine with almost one million users.
These statistics do not paint a picture of a law that is working. Just as the Pietism Movement tried to impose its moral beliefs on the US population through alcohol prohibition and failed; the UK establishment has tried to impose its moral standpoint on an unwilling UK population, many of whom have chosen to ignore these laws and engage in recreational drug use.
When I highlight such statistics to the guardians of current drug policy, in response, I will inevitably hear “What about the children?”. Indeed, what about the children? The children who can buy drugs because drug dealers don’t have age restrictive sales policies? The children who are being exploited into county lines and a life of criminality?
Drug use among children (aged 11 to 15) has increased by over 40 per cent since 2014, this appears to be occurring across a wide range of substances and across most demographics.
The Children’s Commissioner estimates that around 27,000 young people in England and Wales identify as gang members, and 2,000 teenagers from London alone have been identified as having a link to county lines activity.
There are two options available to remedy the situation; legalisation and decriminalisation. Legalisation will provide a legal means in which people can purchase recreational drugs, through a licensed supplier, which have standards and pay tax. Decriminalisation will allow possession for personal use, not the legal sale of drugs. I personally think we should use both options. Legalise mainstream drugs, ones that make up the bulk of supply in the UK such as cannabis, and decriminalise the more harmful, but lesser-used, drugs such as heroin, treating addiction as a health issue rather than a criminal justice one.
The sheer number of people using cannabis is fuelling the illegal drugs market. Let’s put the criminals out of business, introduce quality control and bring in tax revenue – let’s legalise. Buying cannabis from the black market also acts as a gateway to more harmful drugs as dealers will use this as an opportunity to push more of their products; legalising it will sever this link.
Heroin and crack cocaine cost the UK over £16 billion a year, through reoffending, acquisitive crime, and health implications. In fact, offenders who regularly use heroin or crack cocaine are estimated to commit around 45 per cent of all acquisitive crime. Police action will not solve this alone and it’s common sense, and indeed financial sense, to invest in more treatments programmes for addicts. If we treat this as a health issue, by reducing addiction and increasing work opportunities, we can bring this bill down. We can’t do this if we just criminalise these users, who clearly need help.
This week, I raised these points at the Home Office Drugs Summit in Glasgow. While I’m not holding much hope that the Government will start listening, I do see light at the end of the tunnel. The public is becoming increasingly in favour of legalisation. In London, even the majority of Conservative voters are supportive of legalising cannabis.
The road has been long, but the end of prohibition is fast becoming a mainstream view.
Cllr Robert Ward represents Selsdon and Addington Village Ward on Croydon Council.
There’s a dreary monotony to the response after each tragic loss of another young life to knife crime. Politicians and talking heads express sympathy, brush quickly past solutions (a nod to “public health approach” and “Glasgow”), assert it is NOT about the police (“you can’t arrest your way to a solution”), then run out of time, to-ing and fro-ing on the number of things it is supposedly not about.
Dig beneath the public health approach and there’s little more than “treat violence like a disease”. Solutions offered are pleas for more of the services that impact young people, cue blaming ‘austerity’ if it’s an opposition politician. The truth is there’s no simple solution. Root causes are complex and of long standing.
The good news is the public health approach is well suited to such a situation. First applied in the United States, brought to Glasgow, and extended to the whole of Scotland in 2006, it is a four-step process: define and measure the problem; identify risk and protective factors; formulate and test interventions; scale up what works and stop doing what doesn’t.
“Reliable data on violence are important, not only for planning and monitoring purposes, but also for advocacy. Without information, there is little pressure on anyone to acknowledge or respond to the problem”.
Relevant data is typically maintained by different agencies, so hard to access coherently. The Youth Violence Commission warned the term ‘public health model’ is being used without a proper understanding of what is required to effect lasting change. Without good data you are fooling yourself.
This is a longstanding problem. Although success is claimed in Glasgow, the confidence that this was a result of the work of the Violence Reduction Unit (“VRU”) is, according to a recent UK government document, questionable. The initial flagship programme of the VRU, implemented in 2008, was Glasgow’s Community Initiative to Reduce Violence. Violent crime fell but it also fell in London. The programme was discontinued in 2011. According to Doctor William Graham, a police commander in Glasgow at the time, having a more structured evaluation and data collection plan from the start could not only have helped with implementation, but also strengthened the case for further funding.
After 2012-13, violent crime rose in London, but continued to fall in Strathclyde. However, from the same report:
“Although the decreasing trends in violent crime and hospital admissions due to assault throughout Scotland are compelling, it is not possible to link these reductions directly with any of the work of Scotland’s VRU”.
There is a pattern of failure to gather and analyse data to judge effectiveness.
This isn’t the only weakness. In Glasgow the VRU was set up by the police. In the early years, there was a focus on custodial sentences, DNA processes, and finger-printing all knife carriers. This moved on to a review of remand guidelines and changing sentencing recommendations on knife crime. Enforcement created the space to give preventative approaches a chance.
In contrast, in London, the Mayor has set up a VRU and in Croydon we now have a Violence Reduction Network. Both are led by former Labour councillors; indeed, the Croydon network is currently little more than that. Their adherence to the public health approach is weak. The Mayor’s VRU made a perfunctory effort at step one of the approach, but projects aiming to address the issues, whilst well meaning, show little attempt at quantitative evidence gathering to enable a judgement of their effectiveness.
Worse still, flexibility and objectivity are important because the threat changes constantly. What worked yesterday, may not work today. Drug distribution has evolved from crack houses to street delivery. Control of the streets, irrelevant beforehand, became important, leading to opposing gangs fighting over turf. Street distribution needs deliverers, sucking in younger and younger children. Recently, stabbing victims have become less likely to report an incident, or even attend hospital, because they know this will identify them.
If we are not informed by systematic use of current evidence – and choose projects without success measures, we will spend money ineffectively. We are left with traditional multi-agency working, delivering a scattergun of projects, selected on old information, the best sales pitch, and political favouritism.
That’s the public health approach in name only. It’s a more expensive way of doing what we already were doing. It is a betrayal of our young people and a waste of taxpayers’ money. It is another reason, if one were needed, to remove Mayor Khan in May. Some others might wish to sharpen up their act too.
Chris Bullivant is a freelance writer who has led two think tanks in Westminster and worked on K Street in Washington.
The withdrawal from the European Union ends a long and bitter split within the Conservative Party between eurosceptics and europhiles. There is no longer any need for MPs (or former Prime Ministers) to resuscitate a divide long healed by the results of 2016, 2017 and the two of 2019. In fact, in putting aside this divide, the Conservatives created a huge electoral success story.
Yet talk of a ten-year rule is over-egged. While the commitment to ‘get Brexit done’ unified many to vote Conservative, once achieved what will keep people voting Conservative, especially those from across traditional party lines?
The answer is to develop policy and narrative cross-pollinated by two influential, fully formed, but quite separate wings of the Party: that of social conservatives and economic liberals.
Having helped lead both a socially conservative think tank and a free market think tank, my observation is that personnel in SW1 from either camp rarely shared networks, pubs, or social media followers, with few opportunities for sharing each others’ language or ideas.
They are two sides of the same coin: occupying the same space but looking at the world with totally different perspectives.
Economic liberals are committed to the freedom of the individual to make their own choices: free from the state, free to do whatever they want, in particular to make profits free of regulation, because it is only profit that creates prosperity in a country.
Free market conservatives often overlap with social liberals who argue for freedom from the state for what we do in private. The freedom to view pornography, smoke weed, or consume sugary foods, is an inalienable right that should not be policed by the Government.
The other wing of the Party, social conservatives, is known to stand for marriage, family, and to have promoted ideas like ‘back to basics’ and ‘broken Britain’.
The two ends have different, and on the surface, competing visions of how to achieve a free society. Social conservatives believe traditional institutions outside of the government are best at assisting the individual to live the good life. Free market thinkers, and their social liberal colleagues, simply want maximum freedom of choice for the individual, usually with an onus on the individual to achieve success in the market.
Assuming there’s any truth to this observation that never the twain shall meet, it would make sense.
The social liberal sees government regulation of private, personal choices as the Church having been replaced by Government – who now heed the latest doctrines of the media-university-public sector complex.
To the free marketeer, social conservatives add to the problem, by promoting restrictive kill-joy policies like marriage, chasteness, and prohibition.
And yet this suspicion is to profoundly misunderstand social conservatives.
Social conservatism is about maximising people’s capacity to participate in the market – believing that for the market to be free, people need to be free to take advantage of it.
The work of the Centre for Social Justice (CSJ), for example, is an exciting reframing of poverty concerned with maximising the freedom of the individual – and being realistic about how it’s done.
They use a simple formula: a family, a job, a school, maintaining good health, and living within your means, are intrinsic to being able to do life well.
When I worked there I met a lot of people up and down the country who agreed with this basic outlook. They worked with poorly qualified young people, with the vulnerably housed, addicts, or sink estates, many in traditional Labour-voting areas.
Few of those I met voted Conservative, but they spoke the language of social conservatism – because it’s how life works. Family done well provides security and emotional development. Education done well nurtures and socialises the individual, gets you ready for entering the workplace and adult life. Work and saving is good, it affirms an individual’s dignity. Over time it should allow for increasing economic liberty. And freedom from addiction means your capacity to choose is not increasingly limited.
Yet to free market socially liberal conservatives, talk about family, education, and in particular policy related to substance addiction, smacks of state intervention in the private sphere. In the name of liberty, they mount opposition to the very means by which more people could participate in the market.
And this is where social conservatives make a vital contribution to policy formation. There are significant, not negligible, numbers of people who do not have all five of these socially conservative assets. In fact, too many don’t even have a positive experience of one of them, in turn reducing their capacity to enjoy the market.
To the man who went from foster-care and graduated the youth justice system with no parents, no job, no savings, and no schooling, marijuana legalisation is the final nail in the coffin of his life chances. It doesn’t matter that he won’t be arrested for possession; he will be incarcerated in a fog of diminished decision-making capacity, less socialisation, more chaos with one additional substance available for insulating him from the market.
On the other hand, most (but by no means all) SW1 think tankers have a positive experience of these socially conservative assets. For them, the additional liberty of, say, legalisation of the consumption of marijuana, is an added bonus.
Meanwhile back at the grassroots, the language of social and economic liberals is remote and irrelevant. It is part of a tidal wave of policy aimed at destroying the very things they know make a person function. Policy papers on relaxation of pro-social norms are the heady indulgence of the elite. They’d much rather hear the ‘common sense’ of social conservatives.
Friends, family, voluntary groups, charities, and churches, provide the assets by which individuals are able to maximise their liberty – and at the same time the very fruits of that liberty, the very point of a free market economy. They are the layers of existence between the individual and the state that give life meaning.
Social conservatives simply ask whether Government policy helps or hinders enjoyment of these assets. This is an argument that should appeal to economic liberals – because it is to ask, ‘How do you get the Government out of the way of people making a success of life?’
For example, we don’t need Government to create a legal marijuana market to regulate and tax, when it defies common sense in helping revitalise left-behind regions.
If putting aside Europhilia allowed the Conservatives to win big in 2019, how much more might putting aside the misunderstandings between these two tribes create massive electoral appeal, as well as a reason to govern for ten years?
These two sides of the Party need to talk to each other more.
Because social policy without free-market input can drift toward a lifeless focus on public sector reform, or a cul-de-sac of charity speak divorced from opportunity.
Free market groups disinterested in ‘how’ individuals participate in the free market can end up presenting a narrow vision of tax breaks or come across as uncaring – blaming individuals for their poverty.
Neither public sector reform nor freedom to eat a high salt pot noodle are a big enough vision to appeal to those left behind by London’s prosperity; nor to balkanised minorities who think only Labour can protect their rights; nor young people who think big-picture socialism is the key to ending inequality or helping the environment.
When these two tribes increasingly work and talk together, it will be a powerful force to inspire a decade of conservatism that is both principled and mission driven, that is both strong in theory and in practical action grounded in reality. Together, an unstoppable force.
The famous Omnishambles Budget was a result of one key flaw – not being open enough to float ideas with Parliamentary colleagues and test the water. The pasty tax. The caravan tax. The hairdresser tax – I could go on. The public will forgive you doing your best in an impossible situation, but they won’t forgive you cocking it up when it comes to public finances.
The replacement of the Sajid Javid with Rishi Sunak was undoubtedly the stand-out moment of last week’s reshuffle. I was in the meeting when Gavin Williamson and Rishi, then Chief Secretary to the Treasury, went through the Education budget in the last spending round, and it’s clear to me that Rishi will be a formidable intellect in Number 11 who, despite his age and relatively few years in Parliament, will have no trouble getting to grips with the top job at the Treasury.
There are doubtless major issues at stake about fiscal rules, the direction of the country and how we ‘level up’ spending across the country to help ensure that opportunity (and thereby productivity improvements) reach every corner of the UK.
But Chancellors also have many smaller levers at their disposal – which signal their personality, their understanding of the party in Parliament, and their intent. It’s vital that in these small measures the Chancellor ‘gets it right’ next month.
So I’ve got five small suggestions for the forthcoming Budget. None would cost the earth, but would knock some of those “barnacles off the boat”, and provide a small flurry of positive headlines:
Beer & Cider.
In 1894, Conservative Clubs were established, providing beer less expensively than public houses and in direct competition with clubs affiliated to the Labour Party.
The ability to get an inexpensive pint in convivial surroundings is seen internationally as one of the hallmarks of Britain. With the craft beer renaissance in recent years, a couple of small but significant moves in this area would be well received, especially by the huge memberships of CAMRA in the country and by the APPG on Beer in Parliament.
Britain faces some of the highest beer taxes in the world outside Scandinavia. A freeze would be welcome, but at a cost of about £85 million, a penny off a pint of beer and cider would go down a treat.
Furthermore, small beer producers currently pay half the duty rate if they produce under 60,000 hectolitres a year (about a million pints), but if they produce anything over that they pay full duty on the whole amount.
A staggered scheme that removed this cliff edge wouldn’t be impossible, and would be welcomed by craft breweries across the land. The current half-price duty scheme costs the Treasury around £60 million a year. It wouldn’t take much to provide a non-cliff edge that would also allow the expansion of small breweries and enhanced competition in the broader market.
For about £100 million, the new Chancellor would be the toast of the town.
Nothing grinds people’s gears more than charity chief executives preaching while pocketing massive pay cheques themselves.
All Government appointments that earn more than the Prime Minister must be approved by Number 10. Extending this principle to charities would be a helpful way of highlighting those with excessive executive pay, especially in the international aid sector. This small change would cost nothing, but throw in some much-needed transparency, and ensure that people aren’t taking the mickey out of donors.
For a change in the procurement rules, the Chancellor could be the champion of transparency.
Ok, this is particularly personal for me. North West Durham is one of the biggest motorhome producers in the UK and we also have some beautiful countryside where people drive them to park up for a week or two.
In September last year, Vehicle Excise Duty and road tax on new motorhomes went up a lot (as EU Regulation 2018/1832 was gold plated, treating them like cars in the British tax system) meaning that now, during the first five years of buying a new motorhome, you pay over £5,000 in tax rather than about £1,200. New motorhome (which start from around £42,000) sales are down 10 per cent as a result.
This is damaging domestic tourism, and the environment by pushing people on planes. Reversing this counterproductive measure would save jobs and, in the end, would probably be net positive for the Exchequer, although the initial cost would be around £25 million.
So for an initial hit, the Chancellor could avoid being the man who doubled down on the second ‘caravan tax’ – show he’s in touch with the aspirations of “Blue Wall” voters, and save jobs in both UK manufacturing and domestic tourism.
This was developed by left-wing social workers in Hackney – not the opening of a sentence you’d expect from me. However, this programme saves lives, helps end abuse, and it also saves taxpayers lots of cash.
It came about when social workers noticed women (often with a combination of the ‘toxic trio’ of domestic abuse, substance abuse and mental health problems) having child after child that was then being taken into care.
What Pause provides is an intervention after a woman has had her second child taken into care – helping her take control of her own fertility and helping her seek other services and a job, and building her back up from what I can only imagine is the most soul-destroying of situations.
Crucially, the programme is voluntary and part of it is offering women, usually for the first time, long-term contraception so they can break the cycle of pregnancy and then having a child removed.
For people in this group who are not on Pause, conception rates are high, roughly a third (with a large number of the conceptions being terminated). When on Pause, it drops by 90 per cent plus. Thus allowing women, often in the most difficult of circumstances, the ability to start to regain control of their lives, get a job and start to become independent.
To roll this programme out nationally would cost £20 million. Initial studies of the programme have shown that payback in terms of saved court time, costs of putting children in care, etc is about 18 months – a rate of return usually only “delivered” by Ponzi schemes. And the Government would know it’s working within a year were it rolled out nationally.
For the Chancellor to show he’ll take good ideas from anywhere and empower the most vulnerable women, often for the first time in their lives, this is a tiny cost with a massive payback in every way.
This one’s simple and can get easy headlines. Local authorities are slashing public toilets across the country. One of the biggest reasons is that local councils pay business rates on them. That’s right. They’re not currently exempt. It is madness.
I declare an interest as the Co-Chair of the Local Democracy APPG (the voice for town and parish councils). For our high streets, tourism areas and our ageing population, the ability to have a loo nearby is important and we don’t want to see more lost.
Relieving councils of business rates on loos would require primary legislation. The move was proposed before but got lost in the wash up last year. At a cost of £8 million a year, which goes directly to local government in most cases, this is a small cost/big win for the Chancellor.
So for under £150 million, the Chancellor could please:
Every beer & cider drinker; social worker; charity donor; town and parish councillor; motorhome manufacturer, retailer and owner; caravan site owner, and public toilet user in Britain. In my humble opinion, if there is a bit of slack to play with, the new Chancellor could do worse pick up some of these ideas.
Dr. Karla Lacayo remembers a 21-year-old who was brought in to the emergency room by an alert friend who said she was sleepy. As the triage nurses wheeled her in, she turned blue. With the hallmark symptoms of an opioid overdose—slowing respiratory rate, arousal difficulty, constricted pupils—they immediately gave her naloxone, a drug that reverses overdoses. But, resuscitated, she sat up, pulled out her IV—and walked right out the door, despite being counseled that she had just nearly died of an opioid overdose. “My heart was thinking, this girl will be back … and I hope not dead. Her addiction had taken over her. She didn’t want help. She wanted to use again,” recalls Lacayo, an emergency medicine physician with Novant UVA’s Prince William and Haymarket Emergency Departments and the medical director for the Haymarket Emergency Department.
The incident is alarming, but stories of opioid addiction coming to a head in emergency rooms across the nation—and right here in Northern Virginia—have become increasingly common as dependence on the drugs enters crisis territory.
Lacayo says she and her colleagues have seen “significant increases” in opiate overdoses in recent years, with opioids now the majority of drug overdoses being treated in the ER.
Her anecdotal observations mirror the national and local statistics. In 2017, the most recent year available for statistics from the Centers for Disease Control, more than 47,000 Americans died from an overdose of opioids, which include both legal and illegal forms of them: prescription painkillers, heroin and synthetic fentanyl (which is a powerful opioid similar to morphine but is 50 to 100 times more potent than heroin). That staggering number of deaths is on par with the number of Americans killed in the Vietnam War or from AIDS during its peak in 1995. In Virginia, 1,507 opioid deaths in 2017 put the drug as the leading cause of unnatural death in the state, ahead of firearms-related deaths (which saw 1,041 deaths that year).
Opioid addiction in Virginia, like the rest of the nation, is now considered a major public health emergency. But what is being done about it? Quite a bit in Northern Virginia. Interviews with local doctors, hospital administrators, health officials, nonprofit professionals, first responders and counselors reveal one common goal: to save lives. From new emergency room protocols to police officers trained to recognize overdoses to proactive hospital initiatives, this is a snapshot of the extensive work being done locally to combat the opioid epidemic.
“I’m going to help as many people as I can.”
Nick Yacoub was 10 when his neighbor asked if he wanted to smoke marijuana. He heard, “Wanna be friends?” and said yes. By the time he reached high school, he was taking pills from other kids: Percocet, Vicodin, OxyContin. First arrested at 17, then arrested again by Fairfax PD at 19, his drug use had spiraled into heroin, cocaine, crystal meth. He was also dealing. “[I was] doing whatever it took to stay high … on drugs 24/7.” Drug-detoxed in jail, released and into rehab. He began drinking a fifth to a half-gallon of liquor a day post rehab stint. One night, drunk and swerving on the road, Loudoun County PD arrested him for a DUI. He went into alcohol withdrawal in jail, vomiting blood. “There was no medically assisted treatment, there was a trash can.” He went back into recovery, eventually got sober and, before long, he was leading the support groups. “It was the first selfless thing I’d done. That’s the most important part of my story,” says Yacoub. “Service to others helped me maintain my recovery. I’d taken a suggestion: When you’re feeling angry, sad, depressed, feeling like using, help out someone who’s worse than you.”
Yacoub, now 34, celebrates Nov. 22, 2007, as his recovery date. The Fairfax-Falls Church Community Service Board, support groups, treatment centers, a 104-day recovery program, followed by a sober living residence, all helped him dig out his “skeletons” he says. (He notes the youngest in recovery was 14; oldest, 77.)
Yacoub graduated from George Mason University in 2013 with a psychology degree, and is now working as a certified peer recovery specialist for Fairfax-Falls Church CSB, assigned to the year-old Striving to Achieve Recovery program at the Fairfax Adult Detention Center, where he helps inmates who want to recover from substance use disorder. “These men get a healthy sense of pride. They build support. We help them with release planning, employment and housing.”
“I care about the people in the unit,” says Yacoub, who hopes to expand the program. “We don’t want it to be 1% of the jail. Since 80% of people in jail have a problem with substances, we want to offer it to more people … We help people develop a better lifestyle.”
“The conversation has changed.”
Back when Yacoub was at the height of his addiction, there weren’t many opioid protocols in emergency rooms. But now, as the epidemic has intensified, emergency rooms are often the first line of defense, which is why many local hospitals have instituted programs to recognize symptoms, proactively help patients get treatment and to prevent addiction to a painkiller.
In Novant UVA’s emergency rooms, Lacayo says, to treat pain, the doctors try non-opioid medications, such as non-steroidal anti-inflammatories, acetaminophen (Tylenol) or muscle relaxants. Before stepping up to potentially addictive opioids, they have a number of protocols in place that include checking Virginia’s Prescription Monitoring Program (a statewide database that tracks patient prescriptions of controlled substances), analyzing patients’ past use, searching for emerging patterns (essentially looking at addiction risk) and whether or not the patient has been “medication shopping” at multiple hospitals.
“If they’ve had multiple visits to multiple providers prescribing narcotics, that’s a red flag and we don’t prescribe,” says Lacayo. Even if a patient doesn’t present an addiction risk, doctors will only write a narcotics script for three days.
The protocols are similar at Sentara Northern Virginia Medical Center (SNVMC) in Woodbridge. Dr. Debra Lee, director of the emergency department, says she’s conservative with prescription painkillers (and the hospital also instituted a three-day limit). If she prescribes a narcotic, she talks about the addictive properties, how “infrequent exposure can lead down a slippery slope. Even within a few days of opiate utilization there’s an increased risk.”
Getting addicted, she says, “is not a weakness. These are strong, serious medications.”
She admits, even with precautions in place, the risks are troubling to her. “You go into this profession because you want to help,” yet she worries people with excruciating pain, from a kidney stone or dislocated shoulder for example, may start down a path of addiction if prescribed a painkiller. Though she intervenes in addictions, treats overdoses and serves on a committee to prevent ER narcotics, “No doubt I’ve contributed to someone’s opiate addiction,” she says. “I can’t sleep at night because I want to get them help.”
Lacayo says, “I think there’s much more awareness among providers. We’re much more vigilant about how these meds are prescribed. The awareness of the public, that’s a great thing. I’ve tried to prescribe narcotics when someone’s absolutely needed it, and they’ll say they prefer not to take them. We didn’t see that five years ago. With awareness and resources, we’ll turn this around.”
Lee agrees conversations with patients are easier now. She says, “The conversation nationally has changed and progressed, when [we] give options to patients, they often say they want to avoid it.” She urges people to ask their doctors why certain meds are necessary; check underlying problems first.
“Nothing in the natural world can beat that.”
With so many headlines about the opioid crisis, one may ask: How does someone get addicted? Is taking an opioid for pain management really that dangerous? And is addiction really that quick? The answer, say doctors, is yes, it’s dangerous and dependency can be quick. And, like most addictive substances, it comes down to brain chemistry.
“Any individual given an opioid for an extended period of time will be dependent, and manifest withdrawal,” says Dr. Ash B. Diwan of Piedmont Family Practice in Warrenton. He’s board-certified in family practice, as well as addiction medicine, with 14 years experience treating opioid addictions. But not everyone dependent will get addicted, which is a behavior disorder, he says. Most people are OK for, say, a root canal, with a low-dose for two to three days. (And first line for pain is always anti-inflammatory, such as Advil, or an analgesic, like Tylenol, he says.)
Opioid addiction is physiological, Diwan explains. The brain’s outer core is decision making, morality, choices; the inner part, the limbic system, is survival, feeling good. When the dopamine rises 20 times, you feel good; it reinforces behaviors. Drugs bind to the same reward center, and opioids increase dopamine by 1,000. The inner system supersedes the conscious human outer core. Rewired, the brain is hijacked, changing circuitry. “Nothing in the natural world can beat that, but now you need higher doses to feel normal,” he says. “It takes years to go back to normal.”
Similar to what is happening in emergency rooms, Diwan advocates for a multi-pronged approach: awareness and screening, abolishing stigma, understanding treatment and increasing access to care.
But he also says those in the throes of addiction may also need the drug buprenorphine, which is essentially a low-dose opioid, to control the craving and “to wean the patient down and off” of the drug. Counseling, he says, is also a must.
“The goal is creating a connection.”
In addition to preventive measures, doctors are working to get those already addicted into treatment much sooner.
“Traditionally, at most hospitals, patients who came to the emergency department in need of addiction treatment were discharged with a list of local treatment centers they could try calling for an appointment,” says Dr. Darren Morris, director of clinical operations for emergency medicine, at Virginia Hospital Center in Arlington. “Now, if a patient comes to our emergency room in opioid withdrawal and is interested in treatment, we’ll start them on evidence-based medical treatment with buprenorphine immediately, right on the spot in the ER, and we partner with the VHC outpatient addiction treatment program, Arlington County and other local organizations to directly schedule a next-day appointment. Studies have shown starting this treatment in the emergency department doubles the likelihood of the patient starting and continuing treatment compared to just a referral.”
That’s Inova’s thinking too: Get the patient treatment, stat. The medical center’s Comprehensive Addiction Treatment Services offers inpatient detox and outpatient, a partial hospitalization program, dual-diagnosis programs, sober living and relapse prevention, along with medication-assisted therapies, such as buprenorphine and naltrexone (a similar drug for dependency weaning) injections.
Novant’s Prince William also has a detox unit and an intensive outpatient program for substance abuse and recovery. Virginia Hospital Center has inpatient and outpatient addiction treatment programs and Sentara works with local and statewide centers.
Of course, someone struggling with addiction must want help. That’s why two of Inova’s ERs, Alexandria and Mount Vernon, are running a HERO (Helping to Engage in Recovery Opportunity) pilot, launched last year, where peer recovery specialists talk with patients. “The goal is to create a connection,” says Maria Hadjiyane, senior director of behavioral health adult ambulatory services. “There’s somebody there to say, ‘This is my story, this is how I got help. This is how I got sober. I’d like to help you.’ We’ve had some success with that.”
Novant UVA Culpeper Medical Center also has an initiative where local community organizations provide peer recovery specialists or social workers to work with a patient facing addiction, leading them to treatment, therapy, groups and support.
A Bipartisan Effort
In Rep. Jennifer Wexton’s (D) 10th district, from NoVA to the Winchester area, she’s met with police, providers, advocates, a recovery center and hosted a roundtable on the epidemic. A member of the bipartisan Freshmen Working Group on Addiction, she’s introduced and passed the EFFORT Act in the House to expand research. If passed in the Senate, it would expand opioid research at the federal level. “This is an issue I’ve been working since my time in the state senate. I’ve continued to work across the aisle to find solutions here in Congress,” she said via her communications director. “The opioid crisis has impacted too many families in my district and across Virginia, leaving devastation and heartbreak in its wake.”
In September, President Trump announced $20 million for Virginia for the epidemic. Almost $2 billion in federal grant money is going to states and localities nationwide.
“I was surprised at how quickly it worked.”
The front lines of the opioid crisis aren’t just in hospitals.
Police and other first responders have also found themselves faced with confronting the opioid crisis in a health care capacity. Case in point, they now carry naloxone—the fast-acting opioid overdose reversal drug—and train community members on how to use it.
When a call came over Alexandria PD radio about someone doing CPR on an unresponsive person near Mill Road, narcotics commander Lt. Michael Kochis was nearby. Finding no pulse or breathing, he thought it was too late. The person’s friends said they’d been at a party, so Kochis sprayed naloxone in the victim’s nostrils. The person gasped and coughed as medics arrived.
“I was surprised how quickly it worked,” Kochis says, touting the lack of liability and side effects of the drug if it’s not an opioid overdose. “Any officer would’ve done the same. Medics do this every day.” Virginia EMS workers reported 7,775 uses of naloxone in 2018.
Like Fairfax and Arlington counties, which also have opioid task forces run through the county government, the city of Alexandria’s opioid task force has undertaken a multitude of efforts. The police department created a “recovery bag” initiative in early 2019. When detectives interview a person at the hospital, they give them a bag with a burner phone, preprogrammed to the narcotics unit, treatment and resources. “If we can get these people help right after they almost died, they’re more willing to hear the message,” says Kochis.
Other state and local agencies are also referring people to treatment, forming community partnerships, meeting with treatment clinics and recovery programs, and substance abuse coalitions, to combat the problem.
“Our approach is to get people the help they need,” says Joshua Price, supervisory special agent with the Virginia State Police and coordinator of the Northwest Virginia Regional Drug and Task Force (Winchester and Front Royal area). “No one plans to be addicted.” When they interview those suffering from addiction, some people say they developed addiction from a prescription, some not. The police say they see a lot of heroin overdoses—which is cheaper than legal opioids and easier to get on the street.
The task force’s deadliest year, 2017, saw 40 opiate deaths and 190 injuries. In 2018, there was a reduction, which Price attributes to the increased use of naloxone. But in 42 toxicology results, 40 are fentanyl-related. They’ve had to purchase laser equipment to detect fentanyl (and other controlled substances) to prevent first responder deaths from exposure to fentanyl-laced narcotics.
“I knew something was terribly wrong.”
For the Atwood family, the awareness of naloxone came too late.
“If you knew him for 15 minutes, you’d never forget him,” says Mark Atwood, of his son, Chris, who died of a heroin overdose in 2013, after battling addiction for six years.
The son of an attorney and a personal trainer, Chris was bright, outgoing, popular (he was Reston’s South Lakes High School’s homecoming prince as a write-in in ninth grade). An empathetic listener, he even helped talk two friends out of suicide.
Things spiraled at 15. He’d admitted experimenting with drugs and smoking marijuana since 12. (With anxiety and ADD, he called his head “a never-ending hamster wheel.”) His family took him to rehab. He escaped. They tried a Pennsylvania treatment center and a Utah wilderness program that he liked, and AA and Narcotics Anonymous, but “most of the time we couldn’t tell if he was actively using,” says his dad. Recovering on buprenorphine, he didn’t want to rely on it. He tried to wean himself. In January of 2013, he overdosed and was revived. After another month in rehab, he planned for a sober house.
That’s when his sister, Ginny, drinking coffee at her desk at work, felt something wash over her. “A God moment,” she calls it. “I knew something was terribly wrong, so I went home … and found him.” Chris had a fatal overdose. She wishes she had the reversal drug naloxone, but their family didn’t know of it. “All those rehabs—no one had ever told us about it. A treatment center could’ve written the prescription.”
“Three days later, we knew we had a mission,” says Mark Atwood. “We started the foundation right away.” As executive director of The Chris Atwood Foundation, Ginny Atwood Lovitt says the organization has gotten three state laws—in as many years—passed to increase access. It has dispensed over 15,000 doses of naloxone, trained groups how to administer naloxone, given short-term housing grants—and saved 400 lives.
In 2015, it’s important to note, the Virginia Health commissioner issued a standing order that allows anyone to obtain a prescription for naloxone from a pharmacy without a prescription.
“There’s a tremendous thirst for knowledge.”
For the Atwood family, that crucial element of knowing about the overdose drug was missing. A recent $16 million gift from the Russell Hitt Family for a new awareness program, Act on Addiction, at Inova hospitals is aiming to change that.
He notes the nature of the crisis is complicated and changing.
“While opioid prescribing itself has peaked and started to come down a bit, because of efforts on education and limiting prescribing, we’ve seen a rise in illicit heroin use and synthetic opioids like fentanyl,” Clark says.
As fatality headlines warn, heroin’s more highly potent cousin, fentanyl, can be lethal. On the street it might be laced into cocaine, marijuana or meth. Clark also warns about other mixtures, like benzodiazepines or alcohol mixed with narcotics pain relievers. (One SAMSHA report of treatment admissions showed it had increased 570%.)
The limits for prescribing will have “minimal impacts in terms of the total risk pool of patients” consuming substances, he says.
Echoes Diwan, the pain and addiction specialist in Warrenton, “Just because doctors aren’t giving [opioids] as much, it hasn’t slowed down the epidemic … Numbers are increasing with overdose, even though the numbers of prescriptions are coming down.” As police are seeing on the front lines, many are turning to illegal forms of it on the street.
“We can put a large dent and crush this epidemic, but we have to implement effective treatments. Medication is very useful and counseling is equally useful, and if it prevents overdose and death, we’ll keep them on [medication-assisted treatment] as long as required.”
Clark urges a greater need for identifying people, helping them into treatment, and better screening and referring to treatment for those with depression, anxiety and other psychiatric problems, which carry increased risks for substance use disorder. “If you can get [those] under remission, it makes it easier to treat substance use disorder.”
The state of Virginia, along with a number of Northern Virginia counties, are suing Purdue Pharma, owned by the billionaire Sackler family, the makers of prescription drugs like OxyContin. Similar to other states suing, the suit alleges Purdue convinced Virginia doctors to prescribe millions of opioid pills, downplaying addiction risks. The state is also suing Teva Pharmaceuticals and Cephalon, alleging similar claims about products that include fentanyl. While Purdue has reached a settlement with more than 20 states for billions of dollars, as of press time, the case with Virginia was still ongoing.
“We’re on the right track, but there’s a lot more we need to do.”
The stats on young people and opioids are particularly troubling. NICUs often treat babies born to addiction (In Virginia, eight babies per 1,000 births are born with neonatal abstinence syndrome.), while people ages 20 to 24 were seen in emergency departments for fentanyl/heroin overdoses more than any other age group. In 2016, 3.6% of adolescents ages 12 to 17 reported misusing opioids in a nationwide survey. In Fairfax County’s 2018 youth survey of eighth, 10th and 12th graders, 2.9% said they’d misused a prescription pain reliever in the last month, a decline from 4.4% in 2017.
“The bad news, 2.9% represents 900 students,” says Dr. Benjamin Schwartz, director of epidemiology and population health for the Fairfax County Health Department. “We asked in the survey why they’d used painkillers. More said to relieve pain than to get high.” With prescriptions in medicine cabinets, “This is a problem we can solve. It’s not like breaking up a drug cartel. We need people to not store in the location where it could be misused.”
Schwartz stresses all ages are at risk in all parts of Virginia; it’s not just in urban or rural areas. “Fairfax County, despite the wealth, is not spared the risk,” he says. He wants people to realize opioids take a greater toll than other causes of unnatural death here. “In the last five years, the number of deaths have taken off.”
With the highest total number of deaths in the state (thanks to a large population), Fairfax created an opioid task force in January 2018. The coordinator, Sarah Bolton White, shares five priorities: education; prevention and collaboration; early intervention and treatment; data and monitoring; and harm reduction.
“I’m humbled by the amount of damage this does to people’s lives. At focus groups at treatment facilities, I’ve heard stories of lives getting ruined, how incredibly difficult this is to beat. I have a ton of respect for people trying to beat this,” Bolton White says.
For people who have already lost someone, the concerted push by hospitals, county governments, organizations came too late, but it’s undeniable how much work is being done to save more lives, to prevent more tragedy, to find hope in the crisis. Chris Atwood’s sister says she’ll continue to work toward that goal. “Their lives have value,” says Lovitt of the people her brother’s foundation aims to help. The work, she says, helps to “keep Christopher alive. He knew intellectually heroin had ruined his life, and he hated it. But his brain was saying no. His brain had learned that opioids are necessary for survival.”
Does this Virginia Tech researcher hold the key to a vaccine?
The vaccine is aimed at preventing the drug from getting to the brain. Working with a team of collaborators and grad students, the experiment involves injecting mice with the vaccine to see if they produce antibodies toward particular opioid molecules.
“We’d been studying the vaccine with nicotine. Nicotine molecules are small, like opioid molecules. Small molecules don’t illicit immune response in human bodies. But the more antibodies a vaccine can generate, the more small molecules can be prevented from entering the brain,” says Zhang.
At a recent NIH meeting, Zhang heard the testimony of a mother who lost her son. “As a researcher, you feel her pain. As a parent of two boys, I feel her pain as a loving pain. I cannot imagine the parent losing the child, nothing is more painful than that,” he says. When he received the grant, starting work in July 2019, “We were very thankful, happy we could potentially do something to help people with their loved ones, help the nation address the opioid crisis. If we can save a life, it’ll be rewarding.”
"I'm definitely open to different models around decriminalisation."@UKLabour leadership candidate @jessphillips says she's "open" to the conversation around drugs being decriminalised, adding that current policy isn't working.
It feels like I’ve woken up from a dream. Not a White Christmas, but a sea of blue-collar, spanning the length and breadth of the country, on the electoral map. For many years as MP, I’ve been campaigning for us to be the “Workers’ Party” – the representatives of blue-collar men and women up and down the country. In Essex, we use the term, “white-van conservatism”.
It is extraordinary to think that this dream has been realised by the election of MPs from all over the country, from Bishop Auckland, to my own constituency of Harlow.
Of course, the narrative from the Corbynites is that their catastrophic performance is because of Brexit. But, if you look at long-term trends, Labour have been losing the vote of working people for a number of years. The Labour movement is seen as an enemy of aspiration. In my own constituency, the Labour vote has not veered from 30 to 38 percent since 2010. Having said that, the results this time around were remarkable.
We have a real chance to fundamentally change our Party for the better. As the Prime Minister said, many people have lent us their vote, and they won’t be so generous next time if we get it wrong.
The Conservative Party must take this opportunity to become the true Workers’ Party.
That means, first, being incredibly careful with our narrative and language, and ensuring that we’re seen as the party of the ladder of opportunity and the safety net.
We should be modest, humble and kind in all our dealings with the public. Real thought and care about our language must be taken at all times, but particularly when we face the media, to ensure that Tories don’t come over as heartless or lacking emotional intelligence. Too often, we’ve allowed ourselves to be seen as out of touch and not on the side of people who are struggling. Each of us has a role to play, individually, to change this perception.
Second, let us show that we Conservatives have a real passion for our public services and are just as proud of increased funding for the NHS – as we are of the necessary tax breaks for small businesses – which we know increases investment and employment opportunities.
Third, we have to be relentless about cutting the cost of living. Lowering taxes is a moral good. We must convey that it is not all about helping rich people in the city or tycoons. This means, as the Manifesto pledged, focusing on cutting taxes for the lower paid by continuing to reduce income tax and making increases to the National Living wage a priority.
But we shouldn’t just cut taxes for lower earners, we need to ensure they know about it. On wage slips, for example, the Treasury should set out exactly how much the Government is saving taxpayers. The wage slip should read: “Your tax bill would normally be £X, but the Conservative Government has discounted it to £Y, saving you £Z.”
A simple, practical mechanism to ensure that workers on lower incomes know that it is Conservatives that are cutting their tax bill.
So, too, should the fuel duty freeze continue – again, as mentioned by the Prime Minister in the campaign. More action needs to be taken to improve Universal Credit so that its purpose of eliminating the poverty trap finally becomes a reality.
Fourth, many working people in communities that have now voted Conservative are passionate about apprenticeship opportunities for their children. Our vocational and technical education reforms should be at the forefront of policy for our Education Secretary. Every single young person should have the offer of a high-quality apprenticeship – right through from Level 2, up to degree-level. Conservatives should aim for 50 per cent of students to take up degree apprenticeships.
Conservatives must come good on school funding and continue to provide as much parental choice of schools as possible and do everything to improve standards of reading and numeracy. Skills, Standards, Social Justice and Support for the profession should be the four s’s mantra of our education policy.
Fifth, it is high time we deal with the lack of housing in this country. We have to be bold and build hundreds of thousands more houses, recognising that 90 percent of land is not yet built on. It cannot just be about schemes like Right to Buy and Help to Buy, great though they are, but also about real affordable housing that people can rent.
Sixth and finally, whatever happens, as well as being the Workers’ Party, Tories must be a movement for social justice, too. Millions of our countrymen and women struggle everyday, whether it is a parent waiting for 39 weeks for their child to be diagnosed with a mental health issue, or people living in ghetto-type social housing, or individuals being sucked into a spiral of dependency on addictive drugs. We should do more to combat abusive relationships and domestic violence, too.
Conservatives must be the Party for these people as much as those who are already climbing the ladder of opportunity. Our job is to bring people to the ladder, to help them climb up and be ready with a safety net should they fall. The Party that enables and strengthens social capital, as much as economic capital.
I’m talking, of course, about bird poop (they have lots of birds in Columbia).
If so, you might get arrested — for possession of cocaine.
According to a Vice report, cops across America have been using the same type of $2 test to determine whether any given suspicious substance is the ol’ 80’s standby or other illegal doorways to euphoria.
And that test has come up positive when supplied with bird droppings.
Additionally, it’s interpreted doughnut crumbs as meth and vitamins as oxycodone.
Man — that’s making want a dozen glazed meth.
In every case known to Vice, drug trafficking charges were eventually dropped, thanks to further testing by a state lab.
But the initial tests — known as “presumptive field tests” — have, as stated by Vice, “a history of being almost laughably wrong — if they weren’t putting people behind bars, even temporarily. And the follow-up lab tests that eventually clear people’s names can take weeks, if not months.”
During that interim, the article asserts, some who are innocent may be scared into accepting a plea deal rather than risking worse at trial.
Furthermore, those who can’t afford bail are stuck in jail as they decide which to do.
The article spotlights Cody Gregg, a homeless Oklahoma City man. He pleaded guilty, purportedly to get out of the city’s terrible lockup. He was charged with possession after a janky test identified powdered milk as Satan’s Snow.
The guy was sentenced to 15 years in prison.
It took nearly two months of jail time before he was cleared.
Claflin University Biology Professor Omar Bagasra insists, “You cannot indict somebody — put somebody in jail — over something you know has a very high rate of false positives.”
He knows a thing or two about it — he once partook in a Marijuana Policy Project study that determined a common field test wrongly identified spearmint, eucalyptus, and patchouli as the Devil’s Lettuce.
His research team pinpointed “the serious possibility of tens of thousands of wrongful drug convictions.”
To stress their point, the group repeatedly produced false positives before the National Press Club — from common substances such as chocolate bars.
As per a 2016 ProPublica investigation, the cheapo tests lead to thousands of arrests each year.
Fortunately, they’re frequently inadmissible in court, hence the follow-up in a proper lab.
But here’s how the little critters work: An officer drops a sample of something into a small pouch, then he breaks a capsule containing compounds which ignite a chemical reaction. A few moments later, your Kool-Aid Pixie Stick may have just snagged you a deuce in the joint.
The problems with the tests aren’t unknown to the powers that be, but they don’t always trickle down:
In 2000, the Justice Department issued guidelines requesting the tests’ manufacturers include warning labels telling cops that the tests could produce false positives and therefore require appropriate training. But ProPublica’s investigation found those guidelines were largely ignored. Newer, more accurate tests are available, but police departments don’t typically buy them because they can cost tens of thousands of dollars.
“If officers are not trained to get the message that a positive drug test is more equivocal than the label would make you think, you’ll have police officers thinking, ‘Positive means it’s definitely drugs,’” said Carl Takei, a senior staff attorney at the ACLU’s Trone Center for Justice and Equality. Instead, a positive result means that the presence of drugs can’t be ruled out but should be weighed with plenty of other evidence before officers proceed.
The pouches’ flaws were considered — to a degree — amid the arrest of aforementioned homeless Cody Gregg:
Oklahoma City Police told VICE News that the officers did weigh other evidence in Gregg’s August arrest for possessing the powdered milk that tested positive for cocaine.
For example, Gregg had a prior history of drug convictions and ran from police when they attempted to stop him for a missing taillight on his bicycle. Once they retrieved the backpack he was carrying, they found the clear bag of a “white powdery substance” and a scale, too. All of those things factored into his arrest — not just the presumptive drug test.
Tulsa County public defender Natalie Leone claims she handles a drug case with false positives about once a month.
One such was that of Calamitous Carl:
This past May, Tulsa police found one of her clients, Carl Fisher, with a glass container of liquid that tested positive for meth in the field. Fisher, who’s homeless, was asleep in a car in a residential parking lot when officers approached him with guns drawn because they considered the car stolen. They tased him multiple times and dragged him out of the car, body-camera footage shows.
Fisher was arrested on drug charges, resisting arrest, and assault on a police officer. He was behind bars for nearly two months on what was initially a $160,000 bail before state lab results cleared him. He then remained in jail until October, when he agreed to plead no contest to the charge of resisting arrest.
So we’ve learned a few things: Firstly, don’t sleep in strange cars.
And as for your wacky substances, you’re out of luck initially, if a cheap test points the wrong way.
You may need to bolster your case to the popo. So maybe keep those vitamin bottles. And candy bar wrappers. And that doughnut box.
County Lines is one of the biggest and fastest-growing issues facing the police across the country. It involves gangs in cities such as London using young people to deal drugs over a network of dedicated phones placed in smaller towns, suburbs and rural areas across the country. Horrifyingly, the children involved can be as young as 11 and deal mostly class A drugs such as heroin and crack cocaine.
I am so glad that this is something our wonderful Prime Minister, Boris Johnson, has committed to tackling. The Prime Minister made it clear in his speech to Conference that we Conservatives will not stand for this any longer, saying how he was committed to “rolling up the evil county lines drugs gangs that predate on young kids and send them to die in the streets… and we will succeed.”
It is paramount that we stamp out County Lines as it is not simply a drug enforcement issue – it is child exploitation. Something needs to be done and we are better placed to deal with the problem than ever before. Through improved reporting and enforcement, as well as having a Prime Minister who is desperate to tackle this issue, we can confront the problem head-on.
The Prime Minister has committed to getting 20,000 more Police Officers on our streets. He has started recruitment within six weeks, whilst the Mayor of London, Sadiq Khan, has disgracefully taken over six months to start the recruitment drive he promised, meanwhile choosing PR over policing.
At City Hall, the London Assembly Conservatives developed a fully-costed plan to put 1,378 more police officers on our streets by cutting the £83 million that the Mayor has wasted on PR, bureaucrats, and other pointless expenditure. Whilst Johnson prioritises keeping us safe, Khan shamefully prioritises his own image.
It is thanks to a Conservative government that the £3.6m National County Lines Coordination Centre became fully operational a year ago. This is starting to greatly aid officers in tackling the problem. Thanks to improved awareness and investment from the government, the picture around county lines is the clearest it’s ever been.
More Police Officers on the frontline is a great start to tackling this issue but we all agree that a wider, strategic approach is what will help bring down the organised gangs who co-ordinate the County Lines. Reporting cases of County Lines is key for this to work and the good news is, reporting is vastly improving.
According to the most recent intelligence assessment, 2,000 individual phone numbers have been identified as being used for established County Lines networks – almost three times the previously established figure of 720. Although this may appear concerning with the number of cases growing, with reports of County Lines improving, the police are in a good position to combat the problem. For example, in 2015, an intelligence gathering exercise found only seven police forces were reporting County Lines. This has swiftly grown to 38 forces by 2017 and then up to 44 forces in 2018, including the British Transport Police (BTP), highlighting the vast improvement in the police’s capabilities and response to the issue.
As well as improved reporting, enforcement is improving by using modern slavery legislation. This legislation is helping to deter gang leaders from using young people for County Lines. Gang members are less worried about going to prison for dealing drugs than they are for child exploitation or trafficking as there is a stigma attached and harsher repercussions than just drug crime.
The growth of County Lines is hard to track as drugs gangs go to where the markets are. It is supply and demand. However, reports demonstrate the scale of the problem, with the Children’s Society estimating 4,000 teenagers in London alone are exploited through County Lines, whilst according to the Children’s Commissioner, at least 46,000 children in England were caught up in gangs.
Whilst it is clear Johnson understands the scale of the problem and the need to take action, sadly the current Mayor of London does not. Sadiq Khan uses the excuse that crime is rising faster outside of London than it is inside of London to defend his poor record and avoid dealing with the problems on his doorstep. The shocking reality is that the Metropolitan Police force area is the largest exporting hub of County Lines in the UK, with 65 per cent going into other forces. Disgracefully, Sadiq Khan is exporting crime to other areas of the country to avoid taking action.
I am thrilled that we have a Prime Minister who is doing all he can stop the evils of County Lines, setting an example to the Mayor of London of how to get his priorities right. The London Assembly Conservatives will continue to hold this failing Mayor to account and do all we can to stop the appalling exploitation of children through County Lines.
You might say socialism and liberalism are ideologies, while Conservatism is more like a character trait. But that’s not quite right. Socialism and liberalism are ideologies about maximising one thing, be it equality or freedom. In contrast, Conservatives believe in a wider variety of ideals.
So what kind of conservative are you?
Since the classic Liberal party gave way to Labour, we’ve been the party of the free market and sound money, even more so since the Thatcher/Reagan era. The free market is a such huge part of what we are about, it tends to dominate, but there’s much more to conservatism.
Perhaps you are a law and order Conservative: patron saint Thomas Hobbes, who, inspired by his experience of the civil war, observed that without strong authority and law and order, life tends to be “nasty, brutish and short.”
But in a nice example of how conservative ideas fit together, a strong law and order policy is also a One Nation policy: because who suffers when there is crime and disorder? Those who live in the most deprived fifth of neighbourhoods are 50 per cent more likely to be victims of crime than those in the richest fifth.
Perhaps you’re a conservative because you believe in Liberty. Habeas Corpus. Limits on Government. Legal protection of personal and family life. Liberty always raises contentious issues like hunting or drugs. Or think of recent cases like the gay marriage cake. I thought the courts got it right: a business can’t refuse to serve gay people, but people can’t be made to promote political views they don’t hold, even if I disagree with those views.
What do we think about the growing deployment of live facial recognition technology in public places? Liberty lovers might want to ban it. Law and order fans might want to allow it.
Liberty-loving conservatism can also clash with another ideal – social conservatism. Are you worried about family breakdown? What do you think about transgender issues? What do you think about full facial veils? That question pits liberty against traditional pattern of our society. France banned them, we allow them.
Do you think what you get out of the welfare system should be linked to what you put in? And how should we make choices about immigration: do we just think about migrants’ skills and earnings, or how easily they will integrate into our culture? I incline to the latter view.
One big idea that I think fits under social conservatism is the idea of the nation state. National self-determination and the lack of a shared European demos powers the idea of Brexit, but it also explains why we are prepared to make compromises to try and keep the United Kingdom together.
Zooming down from the nation to the individual, conservatism is about individual self-reliance. That’s why we strongly support individual home ownership. Mrs Thatcher expressed this well. She said that people: “are casting their problems at society. And, you know, there’s no such thing as society. There are individual men and women and there are families. And no government can do anything except through people, and people must look after themselves first. It is our duty to look after ourselves and then, also, to look after our neighbours.”
Things like the doubling of the Income Tax Personal Allowance and the National Living Wage – and also welfare reforms – are about self reliance. George Osborne was onto something when he talked about a “higher wage, lower tax, lower welfare spending” society. Personally, I believe tax should be based on the ability to pay, and so we should bring back the higher tax allowances for children Labour abolished in the 1970s.
But conservatives don’t just believe in individualism. We are the society party. Civic conservatives know that many problems can’t be solved by either the free market or the state. David Cameron said: “There is such a thing as society, it’s just not the same as the state.” When we think about problems like loneliness in an ageing society, we can only solve them by catalysing and helping voluntary groups and family life. The Big Society may have been a good idea, badly timed. But the ideal of voluntary action remains very attractive, I find particularly to younger conservatives.
Conservatism is also about gradualism. Burke attacked the French revolution as a huge, risky, leap-in-the-dark.
Gradualism is behind all our biggest policy successes. Welfare reforms started under Peter Lilley, continued under New Labour, and then under another Conservative government – and now have the record employment. The academy schools programme also spanned governments: from Kenneth Baker to Gavin Williamson.
In contrast, Socialists believe in utopian leaps. In the USSR and under China’s Great Leap Forward millions died, yet John McDonell still says, “I am a Marxist”. In contrast we should be proud gradualists. What do we want? More use of evidence. When do we want it? After randomised control trials.
As well as gradualism, Conservatism is about pluralism and decentralisation. Environmentalists have shown us why it is dangerous to have a monoculture of anything, because if things then go wrong, they do so on a huge scale. Think about the Irish potato famine.
Take a more recent policy example: during the heyday of disastrous progressive teaching methods, they swept all before them. But independent schools and grammar schools were a bastion for traditional methods (like phonics), which could then make a comeback after trendy methods failed.
Devolution allows experimentation. In the US they say the states are “laboratories of democracy”. Ideas like welfare reform or zero tolerance policing were tried locally and taken up nationally when they worked. Conservatives also believe in pluralism in a deeper way. People have different ideas of the good life.
That’s one reason I think we should keep the honours system – to recognise those who are motivated by something other than money, whether they want to serve their country on the battlefield, or help their community by running a youth club. That should inform our thoughts on things like childcare. Do we just focus on maximising employment or education? Or let people choose if they want to be stay at home parents?
I’m sure readers will point out things I’ve missed. But those are some of the main elements of Conservatism.
Law and order. The Constitution. Liberty. Social Conservatism. Civic Conservatism. Individual-self reliance.
Gradualism. Pluralism. Ideas that are sometimes in tension, but which fit together.
Conservatism is a bit like the roof of parliament’s Westminster Hall: which is held up by a lot of huge, ancient beams all resting on each other. Likewise, the elements of conservatism fit together, and have also made something really strong and enduring.
This article is based on a contribution by the author to a Centre for Policy Studies event, “Free Exchange: The case for conservatism”, at last week’s Conservative Party Conference.