Correspondence

ACMD 3-year work programme 2025 to 2028: commissioning letter

Published 2 June 2025

Professor Owen Bowden-Jones,  
Chair, Advisory Council on the Misuse of Drugs (ACMD) 
C/o 1st Floor,  
Peel Building   
2 Marsham Street   
London   
SW1P 4DF

By email only ACMD@homeoffice.gov.uk

2 June 2025

Dear Owen,  

Re: Three-year commissioning letter to the ACMD – 2025-2028

The ACMD continues to provide invaluable evidence-based advice on a number of important drug-related matters. I would specifically like to thank the ACMD for the recommendations and pre-emptive approach it has taken towards the emerging threat of synthetic opioids. I am impressed at the pace with which your reports have been delivered, and the rigorous monitoring undertaken by the ACMD to inform the future proofing of our legislation, helping the Government to ensure it is effective at responding to the threats we face.

I also thank the ACMD for the recent Work Programme letter to the Home Secretary, dated 12 March, which sets out the ACMD’s self-commissioned work for the remainder of the year. I am pleased to endorse that set of issues for consideration.

I look forward to receiving the reports on drivers of powder cocaine use as this remains a high priority for this Government. In 2023, 1,118 deaths in England and Wales involved cocaine, which is 30.5% more than 2022 and represents the 12th consecutive annual rise. The government’s wastewater analysis indicates cocaine consumption rose by 7% between 2023 and 2024. It therefore remains critical that we receive the ACMD’s advice and actionable insights on the matter as soon as possible. As we continue to see an increasing trend in drug supply via the internet and social media, I am also looking forward to reviewing your advice on internet-facilitated drug markets. I am equally keen to consider views from the ACMD on whole system responses to the prevention drug use in children and young people which I am sure will provide invaluable insights. More recently, in January, I commissioned the ACMD to provide an updated harms assessment on ketamine following a concerning trend of increased use. In light of recent tragic deaths which underline the urgency of taking any appropriate action, I look forward to the receiving the ACMD’s findings at the earliest opportunity.

All of these remain important areas for consideration, and I appreciate the ACMD prioritising their completion.

I have prepared the below commission setting out my priorities for the ACMD’s next three-year work programme. I appreciate that some of these strands of work will continue after your current term ends and therefore I would be grateful if the ACMD could liaise with my officials to ensure that the work is appropriately prioritised.

I would therefore like to set out the Government’s three-year commission to the ACMD as follows:

Drug use and the Government’s Safer Streets mission

In its recent report on ‘Synthetic Cathinones’, the ACMD wrote about the Government’s Safer Streets mission, the emphasis which that places on tackling anti-social behaviour (ASB) in town centres, and the connection between drug use and criminality in many of the areas which are the focus of that work. Recommendation 5 of that report covered some of the public health responses for the police and courts to consider when dealing with crimes committed by drug users.

Building on that analysis, we would like the ACMD to look into the following issues:

• What is the best available evidence from the UK or other countries on the extent to which dependent drug users who commit acts of acquisitive crime can be deterred from reoffending, and what (if anything) does that evidence tell us about the most effective means by which we can use the criminal justice system, or other consequences, as a deterrent?

• What are the best examples from overseas countries, regions, municipalities and pilot studies that we can learn from in the UK? In particular where has effective action been taken to reduce the involvement of drug users in acquisitive crime, antisocial behaviour and other repeat offending, including in public spaces and/or in groups, and what common lessons can be drawn from these examples?

• As part of the above, what is the best available international evidence on the imposition of treatment requirements on repeat offenders as a condition of their sentencing or probation, and on the most effective, cost-efficient and reliable means of monitoring compliance with those orders, including any use of electronic monitoring or tagging?

Drug use in women and girls

We would like the ACMD to take a thematic look at drug use by women and girls in the context of the Government’s Safer Streets Mission and particularly the goal of halving violence against women and girls. While this should reflect on previous ACMD vulnerabilities reports such as the 2006 ‘Pathways to Problems’ report and the 2011 ‘Hidden Harms’ report on children of drug users, we would welcome the ACMD taking a fresh look at this topic. This should consider the links between drugs, alcohol and domestic abuse and look at women and girls as both victims and/or perpetrators of violence. We would also welcome reflections on innovative approaches to what works to prevent use in this cohort, the specific barriers to women and girls accessing support and/or treatment, potential gaps in, or opportunities provided by, current provision and the particular needs of specific groups of women (e.g. those from black and minority ethnic groups, the LGBT+ community or those with a disability).  

We would like the ACMD’s views on the following questions:

• What role do drugs play in domestic abuse and wider violence against, and exploitation of, women and girls as well as violence committed by women and girls?

• What are the barriers to women and girls accessing treatment and support services?

• What opportunities are there to improve outcomes for women and girls and ensure services are aligned to their specific needs?

• What evidence-based solutions are there to prevent drug use by women, and what role can diversion and early intervention play in this context?

The Government’s Health Mission remains an important priority and recognising the harm caused by drugs and the need to reduce drug use form an important contribution to that mission. As such I would also like the ACMD to consider the following review of medicinal cannabis.

Cannabis-Based Products for Medicinal Use (CBPM) review

The changes to the Misuse of Drugs Regulations 2001, to include Cannabis-Based Products for Medicinal Use (CBPMs) came into force in November 2018. At the time there was a firm commitment to review this legislation to ensure it had the appropriate impact. In November 2020, the ACMD concluded that there was insufficient evidence available at the time to fully assess any and all the consequences of the legislative change. A note was made that much of the evidence would fully emerge in several years. As five years have now passed since the last consideration and it has almost been seven years since the initial implementation, we believe that the ACMD should review the current evidence and provide the necessary recommendations regarding CBPMs.

We would like the ACMD to consider the following questions:

• Can the ACMD provide a review of Cannabis-Based Products for Medicinal Use following the implementation in November 2018, with an assessment as to whether the legislation has had the desired impact?

• Can the ACMD identify any unintended consequences which were not anticipated at the time of implementation and offer recommendations on how to mitigate these, including any inhibiting effect that the availability of CBPMs through private prescriptions has had on the incentive to conduct clinical trials to develop safe, effective and cost-effective products for use via the NHS?

And, based on this analysis, it would be helpful for the ACMD to revisit the findings and recommendations from its previous work on barriers to research with Schedule 1 drugs to see what direct evidence and lessons there are from the experience with CBPMs that would be useful for the Government to consider when assessing representations for the potential use of psilocybin and other controlled drugs to treat depression, and for the facilitation of further research towards that end.

As you are aware, there may be subsequent commissions, not included in the above, to account for new and emerging threats which may need to be expedited by the ACMD. We may also need continued advice on prevention and we will be able to set this out once we have considered carefully your report on prevention.

Additionally, we must remain reactive to the need to update the legislation, namely the Misuse of Drugs Act 1971 (and the associated Regulations) to account for new emerging substances, the need to comply with our international obligations and the need to reflect the changes in healthcare settings. I would appreciate the ACMD being able to advise on such matters alongside the delivery of the existing ACMD’s work programme.

I am keen to explore some future themes for ACMD commissions, and we would be particularly interested in the ACMD views in due course on some of the findings from the 2011 ACMD’s hidden harms report especially whether there is any opportunity to reduce parental substance misuse and support children and families as well as the most effective interventions to support this cohort and prevent longer-terms harms.

I would be happy to discuss the above work and how these can be prioritised with the recently published ACMD work programme.

Yours sincerely,

(signed) Diana Johnson

Rt Hon Dame Diana Johnson DBE MP

Minister of State for Policing, Fire and Crime Prevention