The Royal College of Physicians back decriminalisation. It's time for the Home Office to listen to reason.



Welcome news today with the announcement that the 500 year old Royal College of Physicians - representing 34,000 doctors, has endorsed the 2016 report from the Royal Society for Public Health; ‘Taking a new line on drugs’ - which makes a clear and unambiguous call for ‘Decriminalising personal use and possession of all illegal drugs’ among its recommendations. Transform were pleased to have both worked on the production of the RSPH report, and engaged in dialogue with the RCP encouraging them to endorse it.


Key recommendations of the RSPH report:

  • Decriminalising personal use and possession of all illegal drugs, and diverting those whose use is problematic into appropriate support and treatment services instead, recognising that criminalising users most often only opens up the risk of further harm to health and wellbeing. Dealers, suppliers and importers of illegal substances would still be actively pursued and prosecuted, while evidence relating to any potential benefits or harm from legal, regulated supply should be kept under review.

  • Transferring lead responsibility for UK illegal drugs strategy to the Department of Health, and more closely aligning this with alcohol and tobacco strategies.

  • Preventing drug harm through universal Personal, Social, Health and Economic (PSHE) education in UK schools, with evidence-based drugs education as a mandatory, key component.

  • Creating evidence-based drug harm profiles to supplant the existing classification system in informing drug strategy, enforcement priorities, and public health messaging.

  • Tapping into the potential of the wider public health workforce to support individuals to reduce and recover from drug harm.



The Royal College joins a growing list of medical and public health voices who have endorsed a similar position. This now includes the Royal Society for Public Health, The Advisory Council on the Misuse of Drugs (ACMD), The Faculty of Public Health, The British Medical Association, The World Health Organisation,  UNAIDS, EMCDDA, The Red Cross, Médecins du Monde, the BMJ and The Lancet. The reasons why these groups now support decriminalisation are well trodden, but bear repeating; there is no evidence criminalisation is an effective deterrent but plenty of evidence that it is expensive, harmful, and discriminatory - increasing risk behaviours and creating political and practical obstacles to effective public health responses.


“There is a growing consensus, backed by a strong international evidence base, among the health community and among the public that criminal justice approaches to drug harm have failed, and that we must start treating drugs first and foremost as a health issue. It is critical that the health community speaks with a united voice on this issue in order to drive meaningful policy change, and so we hope other medical colleges will soon follow the lead of the RCP.”

Shirley Cramer CBE, Chief Executive of RSPH


Many of these agencies have historically been deeply conservative on the drugs issue - and that they are now willing to step out shows just how far the reform debate has moved into the mainstream. This can no longer be seen, in any way, as a radical position. They need not fear the dreaded Daily Mail backlash either. When the RSPH, somewhat apprehensively, published their report, the media coverage was at worst neutral, and for the most part overwhelmingly positive. Indeed the only criticism they seemed to get was in a Times editorial that chastised them for not calling for legalisation of supply as well.  



We also hope that the Government and Home Office are paying attention. It has long been clear that their refusal to budge on the decriminalisation question had nothing to do with evidence, but was purely and cynically motivated by political calculation. But their standard response to reject *any* kind of drug policy reforms that challenge the ‘tough on drugs’ narrative rings increasingly hollow. Endlessly recycling the line that  ‘drugs are dangerous, they destroy lives and communities’ in lieu of intelligent engagement with evidence of innovative new policies that actually work simply won’t wash anymore. This is particularly the case when the Home Office’s tired, dogmatic and evasive responses collide with the overwhelming body of expert opinion (including from their own Home Office appointed experts in the ACMD).


It is part of a pattern with the ongoing, and frankly disgraceful, Home Office objections to innovative harm reduction interventions including drug safety testing and drug consumption rooms. These developments - that all include decriminalisation in some form - are contrary to their tough on drugs, zero tolerance narrative - that they seem unable to retreat from. It’s almost as if they are addicted to ‘war on drugs’ rhetoric. Maybe the Royal Society of Physicians can help with their rehabilitation?    


The medical and public health agencies also have growing support amongst police and enforcement professionals on the decriminalisation issue. Several police authorities are already piloting or fully implementing ‘diversion’ schemes where people who are caught in possession are diverted away from the criminal justice system into treatment or education programs. In these examples the law hasn’t actually changed - only its application. So whether this can technically be called ‘decriminalisation’ is moot (It's an ill-defined legal term; there is more than one way to do decriminalisation - the devil is in the detail as this IDPC resource demonstrates). But whether we call it decriminalisation, de facto decriminalisation, diversion or something else - it is the outcomes that we should be concerned with. And crucially the effect is basically the same from the user perspective, in that the threat and stigma of arrest, prosecution and a criminal record for personal possession and use is removed.


So, now that decrim has the support of the public health and medical establishment, the UN, Police, public opinion supports at least an experiment with the approach - and even the Daily Mail don’t seem too bothered - what exactly is the objection? The Government have surely run out of excuses - reform of this antiquated, cruel and failed criminalisation model is long overdue.   


Author: Steve Rolles, Senior Policy Analyst at Transform Drug Policy Foundation

Twitter: @SteveTransform