Baroness Meacher
To ask Her Majesty’s Government what action they are taking to respond to the United Nations Secretary-General’s statement of 26 June 2013 on drug policy urging Member States to “conduct a wide-ranging and open debate that considers all options”.
Baroness Meacher (CB)
My Lords, I seek a response from the Minister to my Question, but I must first congratulate the Government, and in particular the former Home Office Minister Norman Baker, on the production of the report Drugs: International Comparators. The report benefits greatly from fact-finding visits and discussions with 11 countries. It is a great pity that the executive summary omits the key findings of the report, most particularly that there is no clear correlation between the “toughness” of an approach and the levels of drug use. This is probably the most significant finding, with very clear implications for drugs policy, and yet the executive summary makes no mention of it. The report also omits all the recommendations that I understand had been prepared by officials.
The report makes clear that the UK has experienced a recent fall in the use of traditional drugs. There are at least two explanations for this. One is a rapid rise in the use of so-called new psychoactive substances, many of which are of course extremely dangerous, and are in fact more dangerous than the original, traditional drugs. More particularly, the second reason is that, although the possession of illicit drugs remains a criminal offence, the police now focus fewer of their resources on arresting drug users. Therefore, fewer young people are criminalised and, as a result, many will quickly recover from their drug problem and return to school or to work. It is interesting that our police have to compensate for the failure of our politicians, is it not?
Nevertheless, the UK remains the overall highest user in Europe of the four most used drugs. This is an incredibly important point. We are the hub for the distribution of new psychoactive substances across Europe. We have no reason to be satisfied with our performance. What are the Government therefore doing to promote an open debate on effective policies, which we clearly do not have here? Which options are being actively considered?
Will the Minister also inform the House what the Government’s response is to the recent change in US drugs policy? The US policy shift was defined in the recent statement by William Brownfield, the US Assistant Secretary of State for the Bureau of International Narcotics and Law Enforcement Affairs. The US of course drove the “war on drugs” for 50 years. Now the US is driving policy in the other direction, and is at last in line with the fundamental objectives of the UN conventions: the health and welfare of individuals. We have never had that before. Brownfield envisages changes in policy through shifting enforcement priorities, such as decisions not to arrest drug users and greater flexibility in interpreting the conventions.
The Brownfield doctrine, as it has come to be called, is based upon four simple points: defending the integrity of the core of the conventions; allowing flexible interpretation of the treaties; allowing different national and regional strategies; and tackling organised crime, which is fair enough. This is all incredibly new. Do the UK Government agree with these four points?
In support of the doctrine of flexibility, we can point to one of the key architects of the 1961 convention on narcotic drugs, Herbert May. We should not forget him. He argued in 1955—he was a man of foresight—that a central goal of the convention was to provide “greater flexibility” to the international system due to the likelihood of changes in circumstances—surprise, surprise—as well as medical and scientific innovations and research. Yes, Herbert May, this is precisely the argument behind the new Brownfield doctrine. The modern world cannot turn its back on the evidence of effective drug policies, nor can we turn our backs on the need for further experiments and evaluation of them.
What does this mean in practice? For the UK, much of the evidence is summed up in the Government’s excellent report, Drugs: International Comparators. On the basis of the evidence, the UK should be rolling out heroin-assisted treatment clinics and decriminalising the possession and use of all drugs. Heroin-assisted treatment clinics have been trialled and evaluated extensively in Switzerland, and introduced in the Netherlands, Spain, Canada, Germany, Belgium and Denmark, with pilots in the UK. The European Monitoring Centre for Drugs and Drug Addiction reviewed recent studies of this approach and concluded that there is strong evidence for the efficacy of HAT, when compared with methadone treatment, for long-term heroin-dependent individuals who do not respond to other forms of treatment. HAT achieves, in its words, marked reductions in the continued use of illicit street heroin and, to a lesser extent, in the use of other drugs such as cocaine and alcohol. It also achieves improvements in physical and mental health, as well as reductions in criminal activity, compared with levels prior to entering treatment. Would it not be wonderful if we could achieve that here? Will the Minister explain to the Committee why the Government have only three pilots rather than rolling out this well tried and evaluated policy across the country?
The Portuguese model of decriminalisation of drug possession, which involves dissuasion commissions and an increase in spending on treatment rather than on prisons, has been extensively evaluated and found to be beneficial. The essence of the policy is that, instead of arresting and charging a person caught in possession of a small quantity of any illegal drug, that person will have their drug confiscated and will then be referred to the local commission for the dissuasion of drug addiction, composed of a lawyer, a doctor and a social worker. The main aim of the commission is to explore the need for treatment and to promote healthy recovery.
In the UK, a person found in possession of even a small quantity of an illicit drug is still far too often, despite attempts by the police to go in the right direction, arrested and will have a criminal record, with all the disadvantages throughout life that such a record brings. Can the Minister explain to the Committee what the Government see as the advantages of the UK system over the Portuguese model? The evidence suggests that there is no advantage whatever.
There are two other policies which merit an open debate, as proposed by the UN Secretary-General. The first is a transfer of the primary responsibility for drug policy from the Home Office to the Department of Health. Most of our European neighbours did this some years ago, and it would make an awful lot of sense if we followed suit. Of course, close liaison with the Home Office would be necessary to deal with certain aspects.
Secondly, also very important is the rescheduling of cannabis from Schedule 1 to Schedule 2 to recognise the fact—not an illusion—that cannabis has medicinal properties. That is all that this would mean. It makes no sense to have Sativex, a cannabis-based medication, available on the NHS while having cannabis in Schedule 1, implying that it has no medicinal properties. We know that patients with multiple sclerosis and those suffering the side-effects of chemotherapy—very sick people—go to enormous lengths, travelling to Europe to pick up less than three month’s worth of cannabis. They say that it is the only thing that helps their symptoms. If they could obtain the drug just through a simple prescription on the basis of their diagnosis, would that not be a reasonable policy? Again, will the Minister agree to consider this proposal and ask the Home Office to undertake a serious study of the feasibility of such a change?
Finally, I want to put on record that the APPG for Drug Policy Reform, which I chair, is working with Latin American and European Governments to provide guidance across the world—it sounds a bit ambitious—on interpreting the UN drug conventions for the 21st century. The focus will be on the need to promote the central purpose of the UN conventions for the health and well-being of individuals and communities, and it will take account of the Brownfield doctrine. Can the Minister give the Committee an assurance that the Government will support an open debate on that guidance when it is fully prepared? The US, Latin America and Europe are all moving forward. Will the UK continue to be left behind?
Lord Rea (Lab)
My Lords, as the first speaker after the noble Baroness, I can do no better than say that I agree with practically everything that she said. I thank her not only for bringing this subject to your Lordships’ attention today but for the tireless work that she has done in looking at the international aspects of drug policy and in bringing together players who are not happy with the present policies. As she said, the 1971 Act, based on the 1961 UN convention, aims to reduce or eradicate drug use through legislation which treats drug users as offenders rather than as patients needing treatment and care. Many people, now joined by the Secretary-General of the United Nations, question the effectiveness of the war on drugs as currently waged, with most funds going into enforcement rather than the treatment of users. It has remarkably little effect.
At the risk of repeating several speeches I have made over the years in your Lordships’ House, I first became involved in the drug scene as a GP in a north London practice in an area where drug use was pretty rife. I practised in association with the UCH drug clinic, which had a methadone substitution programme. We found that drug abusers were very problematic patients and, despite the methadone substitution, we had several deaths from heroin overdoses due to the drugs having an unexpectedly high heroin content. Users were not satisfied with the methadone dose they were prescribed.
It is worth noting that, although heroin use has fallen among younger people in this country recently, death from heroin overdose continues at a high level. This occurs because the supply is totally unregulated, of completely unknown strength and in the hands of a criminal system. It became clear to me when I was in practice that most of the harm caused by drugs occurred because of the unknown purity and strength of the drugs. The need to regulate drug supply seems very clear since the current punitive approach is not reducing the levels of demand or of drug abuse. Regulating the supply of drugs needs to be in responsible hands, but this is not easy when the substances are prohibited.
I will leave that for the time being and go on to mention what we can perhaps do in the mean time to ameliorate or reduce the number of deaths. One thing is the use of needle exchange clinics, which greatly reduce the transmission of HIV. Luckily we have needle exchange clinics in this country. Not all countries do. I am glad to say that they continue to exist, as I am afraid they are still necessary. Another thing that can be done to reduce heroin deaths is to increase the use of naloxone, the opiate antagonist. Several drug clinics are now working with schemes to supply naloxone, with accompanying educational programmes. The noble Lord, Lord Ramsbotham, will perhaps amplify this when he speaks.
As the noble Baroness described, there is now some light on the horizon. The recent Home Office report on international comparators, which she described, has shown that less punitive policies can be more effective in controlling the effects of drug abuse. Like the noble Baroness, I hope that the Government can learn from the study of this document and start to move with the times.
Baroness Stern (CB)
My Lords, I, too, thank the noble Baroness, Lady Meacher, for tabling this debate and for her unflagging work to bring about a less damaging global drug control regime. In many parts of the world, she is seen as a leading engine of the movement to bring about change, and her energy, commitment and strategic wisdom bring great credit to the United Kingdom and your Lordships’ House. This is a small debate, but it is a contribution to the very big debates that the United Nations Secretary-General has called for.
The noble Baroness, Lady Meacher, has given us some very good news about the changed approach of the United States Government, at last. I shall begin with more good news. It was reported last week that Iran is debating ending the use of the death penalty for drug offences. I declare an interest as chair of the All-Party Parliamentary Group for the Abolition of the Death Penalty. Apparently 80% of Iran’s executions are for offences connected with drug trafficking, and the numbers are estimated to be large. We have the figure of 331 executions for drug offences in Iran in 2013. I was in Iran some years ago discussing criminal justice reform. I attended a meeting with a group of reform-minded young people. One man said, “We execute many drug traffickers in this country. We have a very draconian approach, yet every year the number of drug addicts increases and the volume of drugs entering the country grows. There must be a better way”. Indeed, there must be a better way than a system that leads to the execution of drug traffickers. I want to acknowledge the excellent work done by the Foreign Office to try to ensure that the UK does not support drug interdiction efforts that could lead to the imposition of the death penalty.
Of course, the execution of drug traffickers is just one—a most egregious one—of a range of harms that result from the current drug regime, which prioritises interdiction and punishment over treatment and other social measures. The effect on the prisons of the world has been disastrous. Prisons are full of an increasing number of small-time drug users and low-level dealers, all crammed into overcrowded, violent prisons. The health consequences are serious. For example, Hepatitis C, which is spread by injecting drugs, is rife in prisons. Research suggests that in some parts of the world the infection rate in prisons is at least 10 times higher than in the community generally. This is a harm that affects a segment of a country’s population.
The harm caused by the criminality and violence of the drug trade is incalculable. In Mexico alone, 50,000 people have been killed in the past five years due to drug and organised crime-related violence. Sick people suffer because the drug control system puts barriers in the way of providing opiates for pain control and palliative care. The damage caused by the current arrangements is also made clear in the report from the West African Commission on Drugs, chaired by Kofi Annan and the former Nigerian President Obasanjo. It notes the progress that west Africa has made. It states:
“Civil wars have receded, democracy has gained ground and our economies are growing. But a destructive new threat is jeopardizing this progress: with local collusion, international drug cartels are undermining our countries and communities, and devastating lives”.
Do the Government intend to participate fully in the upcoming debate about global drug policy? The Minister will know that DfID is regarded around the world as the premier development body. It is widely admired and seen as a model. The Foreign and Commonwealth Office is similarly highly regarded for its excellent human rights policy.
Drug policy reform is essential both for ensuring further development in low and middle-income countries and for protecting human rights. Will the United Kingdom be in the forefront of the international process that is now under way? Will it support what DfID and the Foreign Office have done so successfully for many years? Will it be advocating an approach that aims to reduce harm and protect vulnerable people from violence and destabilisation?
Baroness Walmsley (LD)
My Lords, I, too, pay tribute to the amazing and valuable work of my noble friend Lady Meacher on making drugs policy more effective and relevant in today’s national and global situation. She has been indefatigable, and I admire her persistence.
I had been interested in drugs policy for many years before I met the noble Baroness, but I find myself very much in tune with her views. In 2001, I was asked to chair a Liberal Democrat policy working party on drugs policy. It was then that I first met my noble friend Lord Paddick, who at that time was a senior Metropolitan Police officer and was taking the lead in doing exactly what the noble Baroness has recommended—having his officers focus on the dealers rather than the users—and getting a lot of stick for it.
The thrust of our report was that the use of illegal drugs should be treated as a health matter rather than as a criminal matter. Even at that time we had evidence that the UK’s punitive regime was not working. Our objectives then, as now, were to reduce harm, address the crimes of those who destroy people’s lives by peddling drugs to them, and get the big drug money out of organised crime. We were aware then, as we are now, that whole families are destroyed by drug use and that addiction can be a major tragedy for families, especially when there are children in the household. So to say that the Liberal Democrats are soft on drugs is, and always has been, untrue: we have simply identified that the war on drugs has failed many of our citizens and we need to find a more effective strategy.
We were aware even then that a major barrier to a more imaginative approach was the usual narrow interpretation of the UN convention. Our report committed us to work with other countries to arrive at a consensus about how to move forward within the convention. So the UN Secretary-General’s statement of 26 June last year was particularly welcome to me, and it should be regarded as an open invitation to all countries to consider all options. That is why I am so pleased that the noble Baroness, Lady Meacher, has worked with the leaders of many other countries who have courageously spoken out and said that we need new approaches. We should not be frightened that the international community will condemn us if we do things differently.
The recent publication by my right honourable friend Norman Baker MP of a research paper called Drugs: International Comparators was particularly welcome. As he has said, we must look at the evidence without prejudice and consider carefully whether some of these new ideas might work for us in this country. Of course, different cultures and circumstances apply in different countries, and you can rarely transplant ideas lock, stock and barrel. However, there is often a germ of an idea that can be useful. It was clear from the report that there is no correlation at all between reduction in drug use and a punitive criminal justice approach. Indeed, pragmatism and a health-based approach are showing great results all over the world, and that is how we should approach it here.
I was surprised to read that there is little evidence that the special drug courts are reducing reoffending. I had the opportunity to question Norman Baker about that at a meeting yesterday. It seems that here is a good idea which has not produced the results for which it had the potential, merely because of the lack of treatment and diversion services that are needed to sit alongside a drug court system. It is a great shame that the resources were not made available, since many of the judiciary were very enthusiastic about this approach. I believe it could have worked, given the availability of the appropriate services. It has the potential, in particular, for helping addicted women to address their drug habit and keep their children.
I was also interested in the pragmatic idea of providing clean needles in prisons, which is done in some other countries. Apparently the law prevents this here. However, the law is currently failing abysmally to keep drugs out of prison. Indeed, the saddest thing is that some offenders go into prison clean and come out as drug users. Of all the things that would encourage them to go back to offending, that is it. I believe that we should find a way to provide clean needles under the auspices of providing medical services.
My main objective is to discourage young people from taking up the use of drugs at all through information and education. So-called legal highs, which are no such thing, have become very widespread, and this is worrying. I support a blanket ban, but at the same time I believe that a health and diversionary approach to users—not dealers—is the right approach, for these as well as the more traditional illegal drugs. I also support the pilot schemes for last-resort use of opiates for hard-core heroin users for whom other methods have failed. I hope that the Government will seriously consider a rollout of the pilots that have been successful.
Under this Government we have continued to try many innovative ways to discourage drug use and address its harms. However, the mood music is still punitive and the responsibility is still within the Home Office. I, like the noble Baroness, Lady Meacher, would like to see a change in the tone of government rhetoric on drugs and a wholesale shift of responsibility for users to the Department of Health, so that the criminal justice system can be freed up to deal with the real villains, the dealers. I also hope that this and future Governments will become more open-minded about talking to other countries about new approaches within the convention and new interpretations of our international obligation, so that we can really start to fight drugs more effectively in the international community. This is what the Secretary-General wanted to see resulting from his statement.
Lord Ramsbotham (CB)
My Lords, I declare an interest as chairman of the cross-party group on criminal justice, drugs and alcohol. I agree with every word that my noble friend Lady Meacher said. I thank her for obtaining this debate, and I salute her for her determined attention to all aspects of national and international drugs policy. I want to comment on two things in particular and then give one example of where I think the policy really needs to pull indecision together. I hope that the debate called for, when it happens, will have as its objective the production of a clear, consistent and continuous national policy which can be followed by all those who have any responsibility for dealing with users and abusers of drugs.
It first became clear to me that there was no national policy when I was in the Army and we had to guard two prisons because of strikes by prison officers. One of my military police sergeant-majors complained to me that he had seen two prisoners exchanging cannabis, had taken them in front of the governor and had been told to dismiss it because cannabis was common in prison. He said to me, “This is ridiculous—we kick out any soldier who is using drugs, yet this is going on in our prisons”.
I then found, of course, that there was absolutely no policy when I started inspecting prisons. Drug responsibility was in the hands of the director of nursing, which may have been a predicator of what America has adopted, but it was absolutely pointless because no governor took any notice of what the director of nursing said. No prison had any common policy on who was assessed when they came in. There was no common policy on treatment, no common treatment for withdrawal and no interest in people who might pick up stronger drugs on release and subsequently die. In fact, there was nothing, and there is still nobody in prisons who is responsible for making certain that there is a common policy in every type of prison.
Going further, I ask whoever conducts the debate called for to add two words to the words “wide-ranging and open”, and those words are “cross-party”. I feel that one of the problems that we have suffered from is the ping-pong between parties, which has led to nothing more than inertia. The real tragedy of the inertia is that it leads to ruined and lost lives because delay in doing anything will inevitably lead to that. Rather than risk one party saying this and one that, could we please have a cross-party consensus so that everyone will be able to follow the common national policy that comes out of it?
I raise the issue of the use of naloxone, which the noble Lord, Lord Rea, mentioned, because we were given a good briefing the other day in our cross-party group. The Advisory Council on the Misuse of Drugs gave advice to the Government on whether naloxone should be made more widely available in order to prevent future drug-related deaths and to help engage and educate those most vulnerable to suffering an opioid overdose in May 2012. Its advice was that, first, naloxone is a safe, effective, evidence-based, World Health Organization-recommended drug with no dependency-forming potential. Its only action is to save lives by reversing the effects of opioid overdoses, and it is already used by emergency services personnel.
The prevention of drug-related deaths, of which there were 1,957 in 2013, is one of the eight key outcomes for delivery in a recovery-orientated drug treatment system, which is what we claim to have. Currently, naloxone is available on prescription to people at risk of opioid overdose, but it will have its maximum effect on deaths if it is made available to people with the greatest opportunity to use it and those who can best engage with heroin users, such as their families and carers. They will, of course, have to be educated in its use, but that is not impossible. Following the 2012 report, Scotland and Wales conducted successful pilots and have since introduced national strategies for its use. England, which ran a programme, has had no similar rollout and none is planned until October 2015, three years after the report.
However, it is not going to be a national strategy but will be left to local authorities. One of the organisations in our cross-party group made a freedom of information request to find out how much knowledge there was of naloxone in the local authorities. It found that, of the ones that replied, 60 local authorities had no plans and had given no priority or money to naloxone; 10 were thinking about it; and 60 have local strategies, some of which are good and some of which are poor. I merely rest on that because the lesson of naloxone should be borne in mind when we are looking for a common national strategy.
Baroness Warnock (CB)
My Lords, I join others in expressing my extreme admiration for my noble friend Lady Meacher for bringing this debate. As has been said already, it is a tiny taster of the enormous debate we will have later. She has worked at an international level and has interested herself in the problem we are facing today in the United Kingdom and in a coherent government strategy which will lead to a revolutionary change of view.
I wish to say a little about the entrenched view that drugs are a matter of criminality. People of my age and of up to 15 years younger than me need to go back and think about the 1960s, which was when drugs hit the general consciousness. It was a time of student revolt and the introduction of the pill. At the time, I was the headmistress of a girls’ school, and we were completely ignorant of the drugs scene and absolutely terrified. We had the most terrible problems in Oxford with undergraduates occupying the Examination Schools and smoking cannabis just for fun. We knew where the cannabis came from. There was a kind of route that started in Birmingham and came down to Oxford and then London, and round and round it went. What I remember most about that time was the fear—the absolute terror that we felt and all parents felt.
If I had any success as a headmistress it was entirely because I had teenage children myself and therefore nothing shocked me. I had one son who still does me a great deal of good, but he did me great good then by being expelled from his public school for cannabis use. The school did not admit that but I knew it. This meant that parents realised that I was not going to be surprised or overreact or anything.
At that time, I must say, I was thankful that the use and possession of drugs was a criminal offence. The reason I was thankful was that I could threaten my pupils that if they were caught with possessing drugs or sharing drugs, if any drugs were found on school premises, I would hand them over to the police because they would have committed a criminal offence. This did restrain them. I felt at the time that the only way of preventing what started as recreational use but could so easily have become addiction—we did not know—was threatening criminal action. So I started off from that point in the 1960s, and I was very slow to change my mind. I did not think about it very much; it just seemed self-evident that it was the using of the drugs which had to be picked on and not the trafficking of them. We hardly thought about trafficking and where the drugs came from and the criminality that goes with drug trafficking. It vaguely passed our minds but it was not what we concentrated on; it was the use. I think that what we now need, and what my noble friend has done so much to get us to think about, is a complete change of attitude towards the use of drugs compared with the trafficking of drugs. This, of course, has the wide international consequences with which she has been and is so greatly involved.
The first thing that made me change my mind was that I had a very good former pupil who later became a victim of MS; she wrote to me, saying that she spent hours of her life trying to negotiate with all her friends to get hold of cannabis because cannabis-related drugs were the only thing that gave her any relief. That seemed to me such an appalling, inhumane attitude towards cannabis that from that moment on I started to think that drugs with a medicinal use, at least, must be treated in a different way.
The other thing is that I have family connections with Portugal, so I know quite a lot about what happens in Portugal, and how it works. I am simply defeated in trying to answer the question of why the Government do not give more attention to following what is in fact a strikingly successful model.
The final thing is, of course, you only have to look at the prison population to see that the so-called war on drugs just does not work and, therefore, it is inevitable that we must change our minds. So I beseech the Government to take a strong and revolutionary look at where we are and make some policy which is coherent, consistent and well understood.
Lord Mancroft (Con)
My Lords, I hope you can spare me two minutes in the gap. I, too, risk—as the noble Lord, Lord Rea did—boring noble Lords by repeating what I have said in your Lordships’ House many times before. Drugs are primarily a health problem, with significant social consequences, as we all know. It was for the historic reasons that the noble Baroness, Lady Warnock, just told us about so very graphically that the establishment of the day, and the political establishment, decided to address what we now know is a health problem by using the criminal justice system to restrict drugs, a pillar of this policy being the Misuse of Drugs Act 1971. Indeed, the international comparators report says:
“Our legislative response to drugs is based in the 1971 Misuse of Drugs Act, which continues to provide a flexible yet consistent legislative framework to control emerging harmful drugs and target illegal suppliers”.
The problem is it does not actually work and that is why we are having this debate today.
We have been given evidence that drug use in the United Kingdom has levelled out and is, perhaps, even falling. Most of the evidence comes from the national crime survey. I have to tell the Government that no reasonable, intelligent, well informed person outside either the House of Commons or the Home Office actually believes this to be true. Public opinion—well informed opinion—has moved on significantly. We know that drug use is not falling. Virtually every other piece of evidence tells us this. I ask your Lordships to push your minds back a bit; one of the reasons we were given for sending soldiers into Afghanistan was to eradicate the poppy crop, but the United Nations tells us that in the 10 years since we have been there the poppy crop has increased fourfold, and 80% of the Afghan poppy crop is aimed at the United Kingdom. Are we really pretending that a fourfold increase in production is aimed at a falling market? That simply is not realistic. At the other end of the equation, the numbers accessing treatment continue to rise, and there is some evidence that the waiting lists are continuing to rise too.
None of this would matter if the second plank of the Government’s drug strategy was working. In the introduction to the 2010 drugs strategy the Home Secretary said:
“This strategy sets out a fundamentally different approach to tackling drugs and an entirely new ambition to reduce drug use and dependence. It will consider dependence on all drugs, including prescription and over-the-counter medicines”.
I noticed that only last night when I was writing this as I was watching the television programme about the appalling rise in prescription drug use in this country. That clearly has not worked either.
Why is this so important? It is very simple. Millions of people in the United Kingdom take drugs. We can debate whether the number is going up or down or, probably, staying vaguely the same, but the number is in the millions. The vast majority of the people who take drugs in this country have minimal, if any, health or social consequences. They do not get arrested, they do not commit repeated acquisitive crimes and they do not visit A&E. The 350,000 chronic and chaotic drug users are the ones who cost us money and it is those people we should be spending our £15.5 billion on, not the remaining people in the population who do not cause us any problems.
Baroness Smith of Basildon (Lab)
My Lords, I add my thanks to the noble Baroness, Lady Meacher, for the opportunity to have this debate today. She is a doughty campaigner for drugs reform. She and I have had a number of discussions on different issues in your Lordships’ House and although we may not always agree on policy, I think that we have a very similar goal as regards the drugs issue. I, too, welcome debate and believe that evidence-based policy is extremely important. A wide-ranging and open debate that considers all the options can only be the way forward. If we do not consider all the options we will be doing a disservice to those who are affected by drugs and to their families.
I was also struck by the noble Baroness’s comments on the new psychoactive drugs. We have recently had two areas of debate, in two different Bills, regarding drugs. One of the Bills was on drug driving, and the other was the anti-social behaviour Bill, which deals with the so-called and completely misnamed “legal highs”. One of the things that struck me was the communications that I received from families who had lost somebody. These family members had either died or been seriously ill from using these psychoactive drugs. The situation is horrendous. If you talk to young people now and ask them whether they know where to get these drugs, most will say that they know where to find them.
Unusually for me, I made a few notes before I came into the debate. I wanted first to listen to the debate—which has been very thoughtful—and then make a few observations. I have heard the noble Baroness, Lady Meacher, speak before about Portugal, and when she first mentioned it I did not know about the Portuguese examples. I have since read quite a bit about it. There is certainly a great deal of merit in such an approach, and it seems to have successes. This should be fed into any debate that the Government undertake about the kind of approach that could be taken to get people away from drugs, and reduce the associated criminality.
Although the debate is concentrated on the end-user and the value of treatment rather than a punitive approach, we also have to recognise the serious criminality that goes alongside drug dealing. Huge benefits and profits are made by unscrupulous dealers and criminal gangs, who use this money to fund their other activities. It is a trade in absolute misery for others. It has to be a criminal offence; we can never deny that it is such and it should be treated as such. The availability of drugs has to be taken into account, and the point has also been made about prisons. Obviously, there have been some massive police successes and some amazing seizures. In my own county, where we have ports and airports and various ways of entering, there have been a number of seizures of drugs, and yet this does not seem to have a serious impact on the drugs that are available on the ground. This is partly because of the new compounds, the new psychoactive substances that can be manufactured.
Perhaps I was naive as a teenager, but I would not have known where to get drugs. I saw a noble Baroness smile; I do not think I was particularly naive. Talking to youngsters in schools now, I am surprised by the number of them who know far more than I do about this. They have far more knowledge of what is available. They even tell me the prices, which seem to me to be extraordinarily low. This can only be a matter of supply and demand.
The noble Lord, Lord Ramsbotham, referred to the ping-pong of politics. That is a great shame in a number of ways. Being a party-political hack, I consider that, although sometimes it is impossible to reach agreements between parties, there are areas where there could be far more of that kind of cross-party discussion, which would be very helpful.
I am conscious of time, but I wanted to raise one further point. I felt very sympathetic to the comments that were made in much of the debate, but I would have to put an alternative point of view about removing drugs policy from the Home Office and into the area of health. On face value, I would have considerable sympathy with that, partly because we recognise that treatment works. If you look at the figures, we have a much better record on treatment in this country than in many European countries. The number of opiate users receiving treatment in the UK is 60%, compared to only 12% in the Netherlands and 25% in Sweden. I recognise the enormous value of having health-based policies.
I do not know whether other noble Lords saw a recent article in the Guardian on 25 November. It was written by Paul Hayes, who is a former chief executive of the National Treatment Agency for Substance Misuse, which works between the Home Office and the Department of Health. His view is that the only reason why Governments put money into treatment programmes is the criminality which goes alongside so much drug use. In the article, he writes that:
“The government estimates that drug misuse causes £15bn worth of harm to society—£13bn of this being the cost of drug-related crime—dwarfing the £5bn of health harm from smoking”.
His point is that that is one of the drivers which puts money into treatment. There is that driver of the Home Office recognising that this involves aspects of community safety, for example. In contrast, the Department of Health sees ongoing treatments, which are essential for many drug addicts, as being perhaps not the best use of their money. He writes:
“Put simply, the Home Office sees drug treatment as value for money, while the DH sees it as a wasted opportunity”.
He concludes:
“So what may appear at first sight as ‘common sense’, or a more liberal-minded approach to drugs misuse—by treating it as a health issue rather than a criminal activity—would most likely result in drug policy becoming the responsibility of a department”—
he means the Department of Health—
“that isn’t very interested, has a wealth of competing priorities, and a track record of seeking to disinvest from the very intervention that the proposal is designed to promote”.
I am not offering that as my particular view, but I think that it has to be included in the mix if we are looking at evidence-based policy.
Baroness Williams of Trafford (Con)
My Lords, along with other noble Lords, I thank the noble Baroness, Lady Meacher, for tabling this Question. She has championed the importance of having a balanced and evidence-based approach to drugs policy, which I strongly support, and I am grateful to have the opportunity today to set out the Government’s action on this policy. We have debated drug policy privately and publicly, and, as many noble Lords have said, we seek the same outcome—the restriction of the supply of and demand for drugs to keep our nation healthy.
Our 2010 drug strategy aims to tackle the harm caused by drugs by balancing activity across three strands: reducing the demand, restricting the supply, and building the recovery of those who have taken to drug use or are dependent on drugs. We are reducing the demand for drugs by preventing their use in the first place through various strategies and methods. We are restricting the supply by tackling drug dealing on our streets, strengthening our response at the border and combating the international flow of drugs to the UK by disrupting drug trafficking upstream. There has been great progress in this area.
Many noble Lords, in different ways, referred to a proportionate approach to people caught in possession of an illegal drug. Our law enforcement officers take a proportionate approach and the vast majority of people caught in possession of an illegal drug are not imprisoned, with only 3% of offenders found guilty of drug possession last year being sentenced to immediate custody.
It is vital that the police and the criminal justice system have a range of measures available to them, including community-based interventions and referral to appropriate treatment, as well as tools to deal robustly with serious and repeat offenders, who cause the most harm in our communities.
Building recovery is important and we are doing it by supporting individuals to recover from dependence through timely and effective treatment, as well as through local services which encompass housing, employment and appropriate support to maintain a stable family life and a life free from crime. For example, we have maximised public health benefits for users through the legal provision of foil, which came into force in September 2014, and we have agreed the wider provision of Naloxone, to which a number of noble Lords referred, from October 2015. As the noble Lord, Lord Ramsbotham, pointed out, Naloxone can reverse the effects of opiate overdose. We will work with local authorities, prisons and others to ensure that it is available to those who need it and those who can administer it.
There are positive signs that the balanced approach is working. Despite the cynicism of the noble Lord, Lord Mancroft, on this point, there has been a long-term downward trend in drug use over the last decade. More people are recovering from their dependencies now than in 2009-10 and the number of heroin and crack cocaine users in England has fallen to 294,000.
A number of noble Lords referred to the international comparator study. The Government need to continue to consider further options by looking to others to see where our learning and understanding can be enhanced. The challenges that drugs present in the UK and other countries are always changing and we need to stay abreast of developments around the world. That is why we recently published the findings of the international comparator study, which looked at responses to the misuse of drugs in other countries and makes clear that this is a complex problem. Each country’s social, cultural and legal context has shaped its responses, and what works in one country can be inappropriate in another.
The noble Baroness, Lady Meacher, has referred to Portugal in the past and she referred to it again today. The report on the decriminalisation work in Portugal is clear that the decrease cannot be attributed to decriminalisation alone. Drug use has gone down and outcomes have gone up, but there has of course been a significant investment in treatment in Portugal.
The study has made an important contribution to the ongoing development of and debate on drugs policy, and it provides us with a strong body of evidence on which to consider further responses to the evolving challenges of drug misuse. It has also reinforced our commitment to a balanced approach based on evidence, and we will continue to advocate for this approach to be pursued internationally.
The noble Baroness, Lady Smith, has spoken about the inaptly named legal highs. She responded to the amendment to the Misuse of Drugs Act that I proposed the other day. We have added a number of new legal highs, so they will now become illegal highs once the measure is implemented. We have led the international response to this challenge, putting in place a forensic early warning system, using innovative legislation to ban more than 350 substances and galvanising international action with partners at the UN and G7.
In December last year, we established an expert panel to look at this matter. The panel considered all available options for how the UK’s response to new psychoactive substances can be enhanced beyond the existing measures. I understand that the noble Baroness also contributed to this review, for which we are grateful. The panel made a large number of recommendations, which we are already taking forward, including developing proposals for a general ban, which we also talked about, similar to that introduced in other countries, such as Ireland.
We do not have much time left to deal with individual points that noble Lords made. The noble Baroness, Lady Meacher, said that the ICS showed that there is no link between tough penalties and drug use. However, it does not say that there is no link or impact. It makes clear that approaches to drugs legislation and drugs possession are only one element in a complex set of factors that affect drug use, including prevention, treatment and wider social and cultural factors. It would be inappropriate to compare the success of drugs policies in different countries based solely on trends which are subject to differences in data collection.
The noble Baroness also talked about medicinal cannabis which is not used to treat multiple sclerosis. Other noble Lords made this point. Some years ago, I worked as a nutritionist with sufferers of multiple sclerosis, and I remember the campaigning that went on then to try to make Sativex available. I am very pleased that it is now available. We have no plans to legalise cannabis or to change our approach to its use as a medicine. I was not sure what medicinal cannabis the noble Baroness was referring to in treatment for things other than multiple sclerosis.
The noble Baroness, Lady Stern, made a very important point about the death penalty. I personally and the Government are absolutely against the death penalty for all sorts of reasons. I think the noble Baroness will understand that.
The noble Lord, Lord Ramsbotham, asked what the Government are doing to get prisoners off drugs. The Ministry of Justice is taking various approaches, including piloting drug recovery wings, increasing the number of drug-free environments and developing and testing liaison and diversion services in police custody suites and courts.
I am rapidly running out of time. It is important to mention the United Nations General Assembly Special Session on Drugs in 2016. In addition to leading the global response on new psychoactive substances, we continue to advocate for a balanced, evidence-based approach to drugs internationally. We agree with the UN Secretary-General that the UN General Assembly Special Session on Drugs will be a key forum for engaging in open dialogue on these issues. This event represents a unique opportunity to engage with all UN member states, international organisations and civil society on how we can improve the global approach to drugs.
On that note, I thank all noble Lords. I will reply in writing if there are any points I have not addressed. It would be great if we could have a cross-party approach on this.