In today’s Prime Minister’s Questions, SNP MP Tommy Shepphard raised the long-standing campaign from across the political spectrum to pilot overdose prevention sites in the UK. The most pressing need for such a trial exists in places like Glasgow City, where the drug death rate from 2014-2018 was 1227% higher than the 2017 European average. Scotland as a whole has the highest drug death rate in the EU. As the Adam Smith Institute has previously argued, these facilities—which exist in countries like Germany, France, Canada, and Australia—reduce drug-related deaths, alleviate health burdens, decrease syringe litter and engage marginalised populations with drug treatment, healthcare and other services.
The Prime Minister’s response was certainly more encouraging than the previous Government’s attitude. However, he raised the oft-repeated concern that these facilities could increase illicit drug use, echoing previous objections to their introduction. Common sense suggests that very few people would be swayed into cultivating a heroin addiction simply by having access to a place where they were less likely to die from it, but we needn’t rely on assumptions.
Perhaps the only benefit of the UK lagging behind the rest of the developed world in adopting harm reduction approaches to drug policy is that there’s international evidence to test that claim. A 2014 systematic review of 75 articles concluded that “no study found any increase in the total number of local PWID [people who inject drugs], irrespective of the SIS [supervised injection service] studied.”
This is hardly surprising for anyone who has studied the evidence on how wider drug policy affects how many people use drugs: there doesn’t appear to be a strong relationship between the degree of prohibition and levels of use. The Home Office admitted as much in 2014, citing a “lack of any clear correlation between the ‘toughness’ of an approach and levels of drug use”.
More recent studies looking specifically at cannabis have come to similar conclusions. Using data from 38 countries, one study found no statistically significant association between policy liberalization and higher odds of adolescent cannabis use. Another analysis concluded that “available European data suggest...moderate changes in statutory penalties have not been shown to be associated with changes in cannabis use prevalence.” A paper on cannabis decriminalisation in Massachusetts, Connecticut, Rhode Island, Vermont, and Maryland (USA) “did not find any increase in the prevalence of youth cannabis use during the observation period.”
Of course, even if these overdose prevention sites did increase illicit drug use, there would still be a strong case for introducing them. Drug use levels are not the only way to measure harm—and arguably not the most important. If one extra person started using drugs but two people who would have otherwise died from an overdose did not, we’d obviously consider this an overall reduction in harm and suffering. But if the Government’s rationale for holding back life-saving overdose prevention sites is that they may increase drug use, they have nothing to fear. The evidence shows that they don’t.