Drug Consumption Rooms
(6 years, 9 months ago)
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Ronnie Cowan (Inverclyde) (SNP)
I beg to move,
That this House has considered drug consumption rooms.
It is nice to see you again, Ms Ryan.
Let me start with a few undisputed facts. Drug deaths due to overdose are increasing year on year in the United Kingdom. People have been taking drugs of various types for thousands of years. In the last 100 years or so, we have run a campaign to criminalise and persecute people who take certain categories of drugs. We decide which drug belongs in which category. Some criminals have become staggeringly rich through their involvement in the production and supply of drugs. Users are stigmatised as junkies, crackheads and stoners. Society adopts this language to dehumanise and ostracise sections of a community. That facilitates their abuse and allows them to be used as scapegoats.
Where are we now? The drive to arrest and incarcerate the producers, distributors, dealers and users—often referred to as the war on drugs—has seen a massive increase in violent crime and corruption, along with hundreds of thousands of deaths and the criminalisation of some people for the most minor offences. The perceived problem that the war on drugs set out to solve has been compounded by the war. As a result, time, money and lives have been wasted. [Interruption.]
Ronnie Cowan
As I was saying before we were so rudely interrupted, we created this situation and we can fix it, but doing so will take a change in attitude at governmental level. Rather than pay lip service to people with an addiction, we need to start listening to what they are asking for. We need to treat addiction as a health issue rather than a criminal justice issue, not just in part but in its entirety.
Drug consumption rooms are part of the solution. Supervised drug consumption facilities, where illicit drugs can be used under the supervision of trained staff, have operated in Europe for the past three decades. Those facilities aim primarily to reduce the acute risk of disease transmission through unhygienic injecting, prevent drug-related overdose deaths and connect high-risk drug users with addiction treatment and other health and social services.
Caroline Lucas (Brighton, Pavilion) (Green)
Does the hon. Gentleman agree that one of the big strengths of DCRs is their ability to reach people with drug addiction problems who are not otherwise known to the services? If we build relationships and trust with such people over time, we are much more likely to get them into services that can begin to address the reason for their addiction.
Ronnie Cowan
I completely agree. The first step of the healing process is building a working relationship with someone and earning their trust, so that they come back and do not have the suspicions that we have built among drug users.
Drug consumption rooms also seek to contribute to reductions in drug use in public places, in discarded needles and in public order problems linked with open drug scenes. Typically, they provide drug users with: sterile injecting equipment; counselling services before, during and after drug consumption; emergency care in the event of overdose; and primary medical care and referral to appropriate social healthcare and addiction treatment services.
Currently, people are sharing needles, using a product that may kill them instantly, and living chaotic lifestyles that harm them, their friends and their families. DCRs provide needles, which instantly reduces the spread of HIV and hepatitis C, instantly improves the health of the user and instantly engages users back into society, where they can be signposted to relevant services. Needle exchanges also go some way towards doing that, but the paraphernalia leave the premises and are often discarded in public places or shared with other users. Users may choose to inject themselves in streets, doorways or gardens near to the exchange, which is unsuitable for users and local residents.
The great thing is that we have evidence from 10 other countries that DCRs work. The first supervised room was opened in Berne, Switzerland, in June 1986. Further such facilities were established in subsequent years in Germany, the Netherlands, Spain, Norway, Luxembourg, Denmark, Greece and France. Outside Europe, there are facilities in Australia and Canada. A total of 78 drug consumption facilities currently operate in seven European monitoring centre for drugs and drug addiction-reporting countries.
Grahame Morris (Easington) (Lab)
I congratulate the hon. Gentleman on securing this debate on a potentially controversial subject, but perhaps one where we need to look at the evidence. Does he agree that there are not only health benefits but other benefits in terms of crime prevention and reduction? The Home Office’s figures say that 45% of crimes are caused by drug users stealing in order to feed their habits. Tackling that through the introduction of consumption rooms would bring considerable benefits.
Ronnie Cowan
Absolutely. To my knowledge, the closest thing we have had to that in UK was opened by John Marks in the Wirral back in the 1980s. At that time, local crime dropped by more than 90%. We have the information at our fingertips.
Most interestingly, no country that has adopted DCRs has ever regretted it and subsequently closed them. Switzerland and Spain have closed DCRs, but only because the need for them reduced significantly—they were so successful that they put themselves out of business.
Before the festive recess, I asked the Prime Minister at Prime Minister’s questions to change the law to facilitate DCRs in the UK—or, if not, to devolve the relevant powers to the Scottish Parliament so the Scottish Government could do so. The law needs to change to protect the people who supervise the rooms and to enable the relevant police forces to take a consistent stance that does not set them apart from the rest of the judicial system.
Ian C. Lucas (Wrexham) (Lab)
Like my hon. Friend the Member for Easington (Grahame Morris), I think the evidence is important. I am confused about the position in Scotland, where criminal justice is devolved. The hon. Gentleman referred to devolution, so will he clarify why the UK Parliament needs to take that step? I am genuinely interested.
Ronnie Cowan
Certain aspects of the law are not devolved to Scotland and the laws we require to allow people to work in these facilities with impunity rest here at Westminster. I want those laws to be devolved to Scotland, because we have the appetite to do the job.
The Prime Minister’s response was that she knows some people are more liberal about drugs than she is. She is not minded to do anything, which completely misses the point. It is not about having a liberal attitude but about compassion and treatment for vulnerable people.
Douglas Ross (Moray) (Con)
Before we move too far away from law enforcement in Scotland, will the hon. Gentleman explain what the police’s response would be if he were to get the powers devolved? Would they be asked to ignore people in possession on their way to such venues, regardless of how far away they were?
Ronnie Cowan
The police would have the authority to stay within the law. We would not ask them to turn their eye from people who were breaking the law. The law would allow people to carry in their own drugs.
Ronnie Cowan
The limit from which a drug may be carried in has not been defined. The point is that the Scottish Government and the Lord Advocate have asked for this facility to happen.
Ronnie Cowan
The alternative would be having people shooting up in alleys and contracting HIV and hepatitis C. That might be what the hon. Gentleman wants to see in Scotland; it is not what I want to see anywhere in the United Kingdom.
Nobody is saying that drugs are for everybody or that drugs are great. What I and many others are saying is that if we want to stop damaging society and help the many individuals who have a drug addiction problem, we need to change our approach. DCRs are not a magic wand or a silver bullet and they will not resolve every issue, but they are humane, productive and cost-effective. The total operating costs of the Glasgow safer drug consumption facility and heroin-assisted treatment facility are estimated at £2.3 million per annum. A 2009 Scottish Government research paper suggested that in 2006, the cost attributed to illegal drug use in Scotland was around £3.5 billion.
The Vancouver Insite DCR costs the Canadian taxpayers 3 million Canadian dollars per year. The facility claims that for every dollar spent, four are saved, as they are preventing expensive medical treatments for addicts further down the line. That figure is recognised in many other countries. A 2011 ruling by the Supreme Court of Canada concluded that Vancouver’s Insite safe injecting room saves lives with no negative impact on public safety in the neighbourhood, and that between eight and 51 overdose deaths were averted in a four-year period. A study in Sydney showed fewer emergency call-outs related to overdoses at the time safe injecting rooms were operating. A study of Danish drug consumption found that Danish DCR clients were empowered to feel
“like citizens rather than scummy junkies”
—their words, not mine.
These findings corroborate other investigations that DCRs are an essential step towards preventing marginalisation and stigmatisation. NHS Greater Glasgow and Clyde estimates that the annual cost to the taxpayer of each problem drug user is £31,438. It further estimates that the introduction of a new heroin-assisted treatment service could save over £940,000 of public money by providing care for just 30 people who successfully engage with the treatment. Even if we did not give a damn about people with addictions, it would make good financial sense to provide those facilities. It is more cost-effective to provide DCRs than it is to pick up the bill after the damage has been done.
DCRs are more than just a practical solution; they are humane, compassionate and financially effective. I can think of only two reasons why the UK Government are so resistant to the proposal: either they are stuck in an ideological mindset that people with addictions are not ill but are the product of poor lifestyle choices, or they simply do not care. The UK Government have stated:
“It is for local areas in the UK to consider, with those responsible for law enforcement, how best to deliver services to meet their local population needs.
We are committed to taking action to prevent the harms caused by drug use and our approach remains clear: we must prevent drug use in our communities, help dependent individuals recover, while ensuring our drugs laws are enforced.”
That cowardly stance simply underlines the UK Government’s disengagement from the reality of the situation. It pushes responsibility on to the shoulders of local administrations and the police force, while refusing to furnish them with the legal powers to act responsibly within the law. The Home Office-led study “Drugs: International Comparators” from 2014 concluded that there was
“some evidence for the effectiveness of drug consumption rooms in addressing the problems of public nuisance associated with open drug scenes, and in reducing health risks for drug users.”
It also said that the ECMDDA report
“considers that on the basis of available evidence, DCRs can be an effective local harm reduction measure in places where there is demonstrable need”.
Despite the evidence that DCRs are financially viable, the United Kingdom Government have chosen to ignore it. Can the Minister please tell me why?
In conclusion, I once again ask: will the UK Government look at the growing body of evidence and change the law to allow DCRs to be opened in the UK without fear of prosecution? Will the UK Government devolve the relevant powers to Scotland to allow the SNP Government to pursue ambitious and innovative new measures to tackle the public health issues of unsafe drug consumption?
Douglas Ross (Moray) (Con)
It is a pleasure to serve under your chairmanship, Mrs Ryan. Thank you for understanding that I am unable to stay until the end of the debate and still calling me to speak.
I congratulate the hon. Member for Inverclyde (Ronnie Cowan) on securing the debate, but I must say from the outset that I am against the introduction of these facilities. The problem with support for drug consumption rooms is that it is based on a faulty assumption that the issue with class A drugs is the circumstances in which they are consumed. It is true that many users of class A drugs are killed, injured or exposed to infection by particularly unsafe means of consumption, such as dirty needles. However, the answer is not to create state-sanctioned drug consumption rooms, but to address the real issue: the consumption itself. Our efforts must be focused on getting people off these drugs. Diversions such as drug control rooms only serve to distract from that purpose, or even make matters worse.
Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)
I congratulate the hon. Member for Inverclyde (Ronnie Cowan) on introducing the debate. My hon. Friend makes a point about helping people to get off drugs. Surely the first step is engaging those people with medical services? The purpose of drug consumption rooms is to do exactly that, and to help people to engage in a safe way. That can be the first step to getting them off the drugs.
Douglas Ross
I agree that engagement is important; I disagree that the only place in which that engagement can take place is in these drug rooms. I stick by what I said earlier. We really have to ensure that we do not go down this route, because there is ultimately no safe way to take class A drugs—that is why they are classified as such.
Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)
Will the hon. Gentleman give way?
Douglas Ross
I will give way in a moment. Someone may use a drug consumption room once—they may even use it regularly—but there is no guarantee that they will use it all the time. As long as someone is addicted to these drugs, they cannot be kept safe. They certainly cannot be set on a course towards recovery, and the drug-free life that every human being deserves.
Douglas Ross
I think we are short of time, so I want to keep going.
Drug consumption rooms could even make things worse. Some drugs, such as heroin, work in such a way that many people build up a tolerance to them, so in order to get the same high and to satisfy their addiction, they end up having to take more and more of the drug. We therefore could be faced with the prospect of the state building a facility to passively watch over someone sinking deeper and deeper into an addition that becomes more and more likely to kill them with each hit. Instead of building drug consumption rooms and trying in vain to make addiction to these drugs safer, we should be redoubling our efforts to help people overcome their addictions altogether.
When it comes down to it, the only safe approach, and the only thing that we should be encouraging, is detox and abstinence. That approach also has the added benefit of being less regionally biased. I for one cannot foresee many drug addicts in Moray, which I represent, making use of a drug consumption room in Glasgow, but drug addiction is not limited to the large cities or the communities close to them. This issue affects all parts of the country, including small and relatively remote rural communities such as my own. There may be fewer addicts in Moray than in other parts of Scotland, but they deserve the same level of support. The issue should not be reduced to a postcode lottery.
Grahame Morris
Members of this House and members of the public have strong feelings on this issue, so it is important that we consider the evidence and the arguments. The hon. Gentleman says that he is against drug consumption rooms. I am not familiar with the situation in Moray, but I understand that shooting galleries exist. In my constituency, they are located in private dwellings, with drug addicts using dirty needles and tainted drugs of unknown quality and strength. Why does he believe that dangerous, private shooting galleries are preferable to drug consumption rooms?
Douglas Ross
The hon. Gentleman started his remarks by saying that we must base our decisions on evidence. The evidence from Professor Neil McKeganey, founder of the Centre for Drug Misuse Research said:
“we surveyed over 1,000 drug addicts in Scotland and we asked them what they wanted to get from treatment. Less than 5% said they wanted help to inject more safely and the overwhelming majority said they wanted help to become drugs free.”
That is the evidence that I am looking at.
I want to further explain how this issue has an impact on more rural areas. The opioid epidemic in the United States has shown us how drug addiction crises can become a dispersed and largely rural phenomenon, rather than something confined to parts of cities within reasonable distance of a drug consumption room.
There are, of course, other issues, such as policing—an issue that is close to my heart, given that my wife is a police officer. We obviously could not have police officers standing outside a drug consumption room ready to arrest anyone who walks in for possession, but where do we draw the line? Do we have an exclusion zone, within which the police do not arrest people for possession? As I was trying to ask the hon. Member for Inverclyde, what if someone is further away, but still claims to be en route to the consumption room? Do we prosecute them? Could it even be used as a valid legal defence? After all, it would be the Government actively setting up these places where drug possession and consumption are condoned. That would set us on the road to a sort of selective decriminalisation.
The hon. Member for Glasgow Central (Alison Thewliss) and the Scottish National party want powers over drugs, including the Misuse of Drugs Act 1971, to be devolved to the Scottish Parliament, but I believe the UK Government are correct to expect the police to enforce the law. I do not support SNP Members on that matter. We all want to help drug addicts, bring addiction levels down, reduce the number of deaths and injuries, and cut the crime rate, but drug consumption rooms are not the best way to do that. The best and right thing to do is to enforce the law and focus on getting people off drugs altogether.
Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)
One of the clearest failings in public policy has been the war on drugs. Treating addicts as criminals has clearly failed; it does not work. It led to 3,744 deaths last year alone. If hon. Members think more enforcement will work, I am afraid they are sadly deceived. The evidence from around the world shows time and time again that DCRs are a way to help people stop taking drugs. They are places where people can engage safely.
Let us take Sydney as an example. In 1999, the Kings Cross area of Sydney was known particularly for its large number of overdoses and deaths. In the British national picture, I see similar patterns in parts of Brighton and Hove. I remember visiting Sydney at that time, and it was a problem. Drug consumption rooms were trialled, and after 10 years KPMG commissioned an independent report, which found that in those 10 years there was not one single fatality among any of the users who had attended the rooms. Let me repeat that, because some hon. Members do not seem to get the difference. In Sydney, where there were 4,400 drug users, not one single person died, whereas 3,744 died in Britain last year. I know which system I would prefer: the one that led to no deaths on my hands. People who advocate for a cracking down are advocating for the deaths of sons, daughters, friends and family members. That is the cruel reality of the current policy.
Bill Grant (Ayr, Carrick and Cumnock) (Con)
For clarity, is the hon. Gentleman saying that, after the introduction of DCRs in Sydney, there were no drug deaths whatever as a result of the introduction, or were there no drug deaths among the users of the rooms?
Lloyd Russell-Moyle
The KPMG study found that there were no drug deaths among the people who had used and engaged with the rooms, of whom there were 4,400 over that time. During that period, there was an 80% reduction in the number of ambulance call-outs relating to drug issues in Sydney, and a reduction in the average number of overdoses in public locations by more than three quarters. The rooms provided 9,500 referrals to welfare services in the wider communities. Most importantly, they won the support of residents and neighbours.
One of the things we hear time and again—I am sure this will be brought up—is that people do not want these things in their backyard. As colleagues have said, the reality is that they are in people’s backyards—quite literally. I remember canvassing up flights of stairs in tower blocks, and people were shooting up right in front of me. They had nowhere to go and no support was offered. The only thing we can do is ring the police, but we know that in a day or so the revolving door will start again. How does that help with the pressure on our police? How does that help with the pressures on our communities? The reality is that it does not.
Globally, countries have gone down two tracks: the prohibition track or the treatment track. At the same time, in all those jurisdictions, usage has slightly decreased. However, in jurisdictions that go down the prohibition route, the harm caused by those harder drugs has rocketed and the number of people getting stuck in long-term habits has increased. Under the treatment route, as we have seen in Portugal and so on, we have seen long-term usage go down and the harm slashed. Surely that is what our policies must be about: the harm to communities and individuals.
I will not speak for much longer, because I know that lots of other colleagues want to speak, but I will touch on some of the issues that have been raised about policing. I feel the policing issue is something of a straw man argument. If there is a centre that people are asked to go to for treatment and to abstain from drugs and stop their addictions entirely, should those people be stopped from going to the centre on the off chance that they might have drugs on them because they are addicts? Should they be followed home? Should we try to entrap them? We do not do that at the moment, so suggesting that the police would need to do that with DCRs is a straw man argument.
No law is perfect, and there are grey zones, but surely it is better to work within those legal grey zones, deal with issues through dialogue with the police and save lives, than to have a system in which we have a hard and fast rule and thousands and thousands of people die. Some 56 people died from 2014 to 2016 in my city of Brighton and Hove—it is also the city of the hon. Member for Brighton, Pavilion (Caroline Lucas), who I am sure will testify—which is actually lower than in previous years.
Douglas Ross
To clarify, I was not suggesting that the police are going out and searching everyone on the way in to DCRs. I was suggesting that there is a reasonable concern that, if someone in the vicinity of a drug room is stopped and searched and found to be in possession of something like heroin, they could say they are on their way to the drug room and may therefore not be charged. That is why the Lord Advocate in Scotland was not able to give his permission for the example in Glasgow.
Lloyd Russell-Moyle
It is interesting that that does not seem to be a problem elsewhere. That is all I can say. Let us base this on evidence from elsewhere. I have spoken for long enough, so I shall sit down.
Crispin Blunt (Reigate) (Con)
I am delighted to follow the hon. Member for Inverclyde (Ronnie Cowan) and I congratulate him on securing the debate. I recognise that we have a shared interest in the work that we jointly do as officers of the all-party parliamentary group on drug policy reform.
The hon. Gentleman will be unsurprised that I largely agree with his analysis. My hon. Friend the Member for Moray (Douglas Ross) might be a little more surprised about that, but I congratulate him on his speech and on taking part in the debate and representing a view that appears to represent the majority in Parliament. That is an example of the challenge one faces in getting consideration of this issue into the era of evidence and in getting it addressed around the issue of public health.
The Under-Secretary of State for the Home Department, my hon. Friend the Member for Louth and Horncastle (Victoria Atkins), who will reply to the debate for the Government, is entirely typical in that in nearly all the nations of the world drugs policy sits in an interior or Home Department where drugs policy sits. That is frankly wrong. It ought to be sitting in Health. We are dealing with a very serious health issue.
It would be very nice if the world’s objective to deliver detox and abstinence, as elucidated by my hon. Friend the Member for Moray, was realistic. The world has been trying to do that collectively for nearly 60 years, and the position continues to get worse and worse. The criminal justice consequences of this policy are utterly appalling, and I speak from experience, having served as the Minister responsible for prisons, probation and criminal justice for two and a half years. That is just in the United Kingdom. Half of acquisitive crime is driven by addiction, and if we cannot do anything about addiction, we should be not remotely surprised that the cost to our country of the criminal justice impact is in the order of £13.5 billion, which I think was the figure given in the Government’s latest drug strategy.
From a criminal justice perspective, I would have traded the massive savings we make in criminal justice to get this issue out of criminal justice and into public health. As I have got into this issue and understood it better, I see that these two things go hand in hand. We would get a significant public health advantage by being more transparent and open about our treatment of addiction. Even if a country was not prepared to go outside the global convention and global policy on the war on drugs—to go as far as Portugal has gone—and simply decriminalised low-level use, it would see a massive improvement in its public health outcomes.
Dr Poulter
My hon. Friend is making a characteristically constructive and well-informed speech about a matter he knows well. One of the problems with the current approach is that by punishing people who, through addiction, are medically unwell—that is the way I see it, as a doctor—we are worsening the ability to engage with them effectively in healthcare terms and worsening the spiral of addiction through debt and the criminal justice consequences. Does he agree that that needs to change?
Crispin Blunt
I wholly agree. My hon. Friend, with his medical background, speaks with authority on this matter. Drug consumption rooms plainly, on the basis of evidence around the world, ought to be part of our attempt to treat people who find themselves in the wretched position of being addicted to the most difficult and dangerous drugs. It is simply about the evidence. No one has died globally in a properly overseen drug consumption room, and yet in our country, 1,707 people died as a result of illicit heroin use in 2016. The extraordinarily stark contrast between the figures in Portugal and Scotland alone ought to make all of us think very carefully about the implications of our current policy.
Douglas Ross
I hope my hon. Friend will agree that while no one has died in a drug consumption room, that does not mean that no one who has used a drug consumption room has died as a result of drug taking. As I said in my speech, we cannot get everyone to go every time. Some go once, and some go every now and then. We cannot force them to go every time.
Crispin Blunt
No, of course my hon. Friend is right, but I am not entirely sure what the merits of his point are.
Crispin Blunt
The truth is that we will never solve the problem. Humanity has been using drugs in one form or another for thousands of years. My hon. Friend almost certainly uses a drug, unless he is a teetotaller.
Crispin Blunt
Then frankly my hon. Friend is in quite a rare position. The vast majority of people—certainly Members of this House—use a drug perfectly legally, and that drug is called alcohol. It happens to be the drug that the Advisory Council on the Misuse of Drugs said is probably the most dangerous drug in use in the United Kingdom in terms of its impact. He is a football referee, and having seen football crowds he will know the difficulty of policing crowds under the influence of alcohol. Alcohol is a significant and difficult drug.
Caroline Lucas
The hon. Gentleman mentioned the Advisory Council on the Misuse of Drugs, and that body has recommended that DCRs are a policy that we should pursue. Would he agree that it is the case that not only have DCRs not been a venue where people have died, but they have been one of the most effective interventions at getting people away from addictions? DCRs are not being complacent about addiction; they are being realistic—[Interruption.]
Joan Ryan (in the Chair)
Order. We have two more speakers, and they will be able to get in. We will resume immediately once everyone is back from the Division; we will not take the 15 minutes. If there are two Divisions, the same applies. As soon as the second one is done— I think there will be two—I ask everyone to get back quickly, apart from Members who have informed me that they cannot do so.
Crispin Blunt
I shall conclude by saying that one should recognise the challenge facing the Minister, given the circumstances she faces. It is difficult enough when our policy and, I believe, global policy are stuck in absolutely the wrong place; we have had 60 years of the policy not working. She then has to deal with the legislative framework that she has to operate within. She then has to try and find a way actually to get drug consumption rooms working, when the overwhelming evidence on the ground is of the benefits they can bring to the communities in which they are placed. They get needles and addicts off the streets, stop people shooting up on the streets, and put addicts on the route to recovery. That is able to happen in an entirely safe place. The public health outcomes need to be a priority for us.
Recognising those difficulties, all I ask of the Minister is that she learns, as I am learning about this issue as I engage with it, and that she and the Government remain open to all the evidence that is coming in from all around the world, through all the different examples. On drug consumption rooms, I very gently suggest that the evidence from around the world is utterly overwhelming about their merits.
Joan Ryan (in the Chair)
May I just say that if Back Benchers who wish to speak stick to three minutes each, everybody will get a turn to speak?
Mr Paul Sweeney (Glasgow North East) (Lab/Co-op)
Thank you, Ms Ryan, for your agile and dynamic chairing of this debate, and congratulations to the hon. Member for Inverclyde (Ronnie Cowan) on securing it. It is on a vital issue that we need to address in this House.
The Glasgow safer drug consumption facility and heroin-assisted treatment pilot project were initially advocated by the Labour administration on Glasgow City Council. It was led by Councillor Matt Kerr, who was convenor of social work at the time, acting on a recommendation from the Glasgow City Alcohol and Drug Partnership that it was a worthwhile and heavily evidenced method to improve the safety and hygiene of intravenous drug use in the city. Indeed, it received cross-party support and benefited from wide support, including that of the hon. Member for Glasgow Central (Alison Thewliss), who at the time was serving on Glasgow City Council.
As many Members may be aware, the issue of drug use and drug-related mortality in Glasgow is particularly acute, and it is a problem that necessitates radical and disruptive new approaches. Almost a third—267—of all Scotland’s drug deaths in 2016 occurred within the Greater Glasgow and Clyde NHS health board area. Per 1 million people, there are 283 drug-related deaths in Glasgow, but the average across the EU is just 20. That means that Glasgow’s drug death rate is an appalling 1,315% higher than the EU average and 329% higher than in England and Wales.
Last year, 1,707 people died in the UK from a heroin overdose, yet no one has died from an overdose in a supervised drug consumption room anywhere in the world at any time. That is due to both the hygienic environment and medical supervision, as well as the readily available supply of life-saving overdose drugs, such as naloxone.
According to the most recent estimates, around 13,600 people aged between 15 and 64 in the Glasgow City Council area are problematic drug users. That represents 3% of the population, which is the highest prevalence rate of all local authorities in Scotland and significantly higher than the Scottish average of 1.75%.
In my constituency of Glasgow North East, there are particularly high levels of drug use in Possilpark and Springburn, which are two of the most economically deprived areas of the constituency following eight long years of brutal austerity. That serves only to drive up levels of despair and alienation in these communities, which is one of the main reasons why people fall into the pernicious trap of hard drug addiction. These areas have also been plagued by the brutal organised crime war between rival factions seeking to control the supply of drugs in the city.
Drug consumption rooms offer hope in this otherwise bleak landscape of despair. They are used as an effective public health measure in the Netherlands, Germany, Denmark, Spain, Norway, France, Luxembourg, Switzerland, Canada and Australia, with 90 facilities currently operating in 61 cities.
It is clear that drug consumption rooms are a worthwhile and practical measure to introduce to Glasgow. They benefit society, for example by reducing drug-related litter and needle-stick injuries, reducing the spread of disease and making our streets safer, as well as having significant health benefits for those who use drugs. Drug consumption rooms significantly reduce fatal overdoses and the needle-sharing that can lead to infections, including HIV and hepatitis, by providing people with sterile equipment. They have also been shown to increase the number of people entering treatment programmes.
Use of a safe space provides the opportunity to start engaging people and to build up trusting relationships with appropriate professionals, which supports them to take those first steps towards dealing with their addictions. The benefits of DCRs have already been demonstrated elsewhere, yet attempts to set up the UK’s first DCR have been blocked. That is despite the idea being supported by the British Medical Association.
That decision is typical of a Government who take little heed of scientific evidence of what works and what saves lives. This is primarily a question of public health, as has been said before, and not one of criminal justice. I therefore urge the Government to adopt an open-minded approach, heed the consensus of all relevant parties and expert bodies in Glasgow, and reconsider amending the obsolete Misuse of Drugs Act 1971 to permit the piloting of the safe drug consumption facility in Glasgow. That will allow them to assess the opportunity that that facility may bring to mitigate and solve the extensive harms caused by the unregulated and unsafe drug consumption environment in my city.
Thangam Debbonaire (Bristol West) (Lab)
Thank you for your patience with the many Divisions throughout the debate, Ms Ryan. I will not repeat what other hon. Members have said, but make some specific, Bristol-related remarks.
I understand why people have an instinctive reaction that drug consumption rooms must be harmful, because they appear to facilitate the use of drugs. To hon. Friends who have doubts, however, I say that we already have a drug consumption room in Bristol: it is called Bristol. It is called the square outside my office, the doorstep into my office and the blocks of council flats at the side of my office. It is called virtually every part of the city centre.
The harms caused by that existing drug consumption room from the drug consumption that goes on there, the resulting drug litter, and the visible harm to drug addicts and to bystanders—people who have no interest in taking drugs but want their children to be able to play in the local playground—are many and varied. They hurt the most vulnerable and the very people we on this side of the House are here to represent, so I encourage all hon. Members to consider the use of drug consumption rooms.
In Bristol, we have very high rates of injecting and of poly-drug use, particularly crack cocaine mixed with heroin that is then injected. Public Health England recognises that we have high levels of complexity in the people who use such drugs and in the high levels of admission to hospital for drug-related harms.
Another harm is more widely shared among us all: the cost of the existing drug consumption room regime to the health economy. The total length of stay in the Bristol Royal Infirmary in 2015-16 for drug-related admissions was 2,758 days, with an estimated cost of £1,103,200. I thank Jody Clark for providing those figures from Bristol City Council’s “Bristol Substance Misuse Needs Assessment”. Hospital admissions specifically for injuries caused by injections accounted for 1,005 bed days—36% of all drug-related stays. That is from just 71 individuals who had an average stay in hospital of 14 days each—more than twice the average 6.6-day stay for all drug-related admissions—and an estimated cost of in excess of £400,000.
I urge all hon. Members to consider that if we want to give our health service more money, if we want to make our streets safer, and if we want to save the lives of people who have drug addictions, as I do, we need to invest in drug consumption rooms. However unpleasant it is to have to step over a very aggressive and slightly frightening—sometimes very frightening—drug addict on my office steps, I do not want them to die. I want their lives to be saved and I want the people who live in the blocks of flats near my office to be able to send their children out to play.
For all those reasons, and because nobody has ever died in a drug consumption room that was officially sanctioned and clinically run, I urge all hon. Members to consider the drug consumption rooms we have at the moment and support this alternative.
Alison Thewliss (Glasgow Central) (SNP)
I congratulate my hon. Friend the Member for Inverclyde (Ronnie Cowan) on securing this important debate. In Glasgow city centre, there are around 500 people who inject drugs on a regular basis. Someone who comes to Glasgow will probably not see it, but for many of my constituents it is a huge issue.
Before I was elected in 2007, the issue of discarded needles was raised by a resident, who pointed me to a bin in a children’s play park. I have an enduring horror that sooner or later a child will get pricked by a contaminated needle, which is a daily hazard for our council cleansing staff. No one should have to live with that risk.
The issue has never gone away, but has simply moved around. Earlier tonight, a constituent, Andy Rae, told me that he had come home to find two contaminated needles on his doorstep. As the hon. Member for Bristol West (Thangam Debbonaire) said, the problem is already there. It is on my office doorstep too.
A constituent wrote to me over the weekend to say:
“In the 18 months that I have lived here there have been countless times that I’ve seen people injecting drugs in the bin area, doorways, and carpark…They leave behind their needles, bloody wipes, spoons, and bottles all over the area, strewn all over the ground/grass/hedges, as well as urine, vomit and blood on the ground…This is a nice, quiet, residential area, home to people both young and old, families with children, students, people taking their dogs out, and is also in very close proximity to the children’s play park directly across the road.”
Another constituent, who I spoke to on Monday, told me about witnessing prostitution in bin shelters and groups of people taking drugs under the stairs.
I regularly walk around that part of my constituency, reporting needles as I find them. After my surgery on Friday, I saw among the usual places a young woman injecting herself behind a derelict building. There is no dignity for that woman—only desperation. That is the reality of life for intravenous drug users in Glasgow, and of the impact of their behaviour on residents. It is deeply damaging for everyone involved. Each of those people injecting drugs is someone’s child, is loved by somebody, and we owe it to them to find a better way.
There has been no means of dealing with the situation. It is imperative that we do something different. The Glasgow health and social care partnership has concluded that the only way to deal with public injecting is to provide a safe, managed space for people to inject. By doing so, we can also respond to the concerns of residents and businesses and meet the needs of a very vulnerable and marginalised population who do not engage in services. The partnership has a clear and well thought through proposal for a drug consumption room. I commend its report, “Taking away the chaos”; if the Minister has not already read it, I urge her to look at the evidence that it has gathered.
I pay particular tribute to Saket Priyadarshi for his work, to Susanne Miller of Glasgow City Council for her commitment, and to people like Kirsten Horsburgh of the Scottish Drugs Forum for their advocacy of this important project. The health and social care partnership has done significant work on establishing needs and protocols on how it would work, on listening to a range of health professionals as well as to those who use drugs, and on finding a means of funding the project. It would be more than just a room; it would be a service—a bespoke service staffed by health professionals, with a wrap-around service to help people to reduce their drug use and stabilise their lives. There would be opportunities for people not currently accessing health services to do so, and for people to get assistance to rebuild their lives. The proposed Glasgow model is all about engaging with drug users to promote treatment, rehabilitation and social integration, as well as providing harm reduction services.
The Minister must recognise that not taking action, but rather just doing what we have already done, comes at a cost that has manifested itself in the treatment for the latest HIV and hepatitis C outbreak in Glasgow. Inaction also comes at the cost of emergency admissions to hospital. As the report notes:
“Over the last five years, the Scottish Ambulance Service has recorded an annual average of 232 ambulance attendances at suspected overdoses”
just in Glasgow. The hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) mentioned the Australian example, which shows how such costs could be saved.
There is a risk to council staff and housing association staff from clearing up needles—sometimes in their hundreds—on sites. As soon as those needles are cleared, they come back again and again. There is also a human cost—the cost of lives written off and wasted. The hon. Member for Glasgow North East (Mr Sweeney) cited some of the figures, including the 867 drug deaths in Scotland in 2016 alone. We cannot put a price on that. For every person lost to addiction a family is bereft.
Anyone’s Child: Families for Safer Drug Control supports drug consumption rooms. I have listened carefully to people who have lost family members, and they made it clear that drug consumption rooms would be a positive intervention. At the very least, their loved one would not risk dying alone in a filthy lane. Instead, they would be in a place of safety, supervised by medical professionals. As hon. Members have mentioned, there has been not one single death in any drug consumption room anywhere.
Our difficulty in Glasgow is that the project cannot go ahead without the permission of the UK Government, unlike in Ireland, where the Ana Liffey project and the then Minister—now Senator—Aodhán Ó Ríordáin changed the law to allow it. The Lord Advocate cannot pursue the matter. An exemption from the Home Office has been refused. I have a cross-party letter signed by the majority of MPs in Scotland, requesting leave for the pilot to go ahead. If it does not work, fine, but at least let us try. The status quo is not acceptable.
I invite the Minister to come to my constituency in Glasgow and see how people are living. She could then see whether she would like to put up with what my constituents put up with every day, or whether she would find it acceptable for somebody she cared about to drop their trousers and inject heroin into their groin in a manky back court surrounded by excrement and contaminated needles.
I will end with words quoted in the health report from someone in recovery:
“You need to think about it differently. That’s where I think safe injecting routes and injecting heroin…you take away the chaos. Then you have a chance to work on the attitude.”
Carolyn Harris (Swansea East) (Lab)
I congratulate the hon. Member for Inverclyde (Ronnie Cowan) on securing this important debate. I thank all hon. Members not just for their contribution, but for sticking with us through this very disturbed debate. I congratulate you, Ms Ryan, on steering the ship safely to the end.
The Opposition have made no secret of our disappointment in last year’s drug strategy. We waited nearly two years for it; frankly, we expected something more radical, more substantial and certainly with more funding. No amount of gloss can hide the significant problems with the approach to drugs policy that the Government have taken since taking power in 2010: it has been ideological and plagued with irresponsible cuts.
All the Members in the debate have expressed the truly shocking scale of the problem. The UK has the highest recorded level of mortality from drug use since records began. There are record numbers of deaths from morphine, heroin and cocaine use. There are more deaths from overdoses than from traffic accidents, and there is an ever-increasing incidence of HIV and hepatitis transmitted via unhygienic injecting.
Drug consumption rooms have operated in Europe for three decades, most notably in countries that have had greater success in reducing drug deaths than we have. Even if the Government are misguided and will not look at evidence from other countries, I would have thought that they would have taken the advice of their Advisory Council on the Misuse of Drugs. In 2016, in response to the unprecedented drug deaths, it recommended that the Government consider the introduction of drug consumption rooms. I believe the response was:
“It is for local areas in the UK to consider, with those responsible for law enforcement, how best to deliver services to meet their local population needs.”
I agree that the local authorities are best placed to deliver such services. However, when responsibility for alcohol and drug treatments was transferred from the NHS to local authorities in 2013, it signalled the most significant and problematic change to funding. Although I am not criticising our overstretched local authorities, the transfer of responsibility brought an end to the ring-fenced budget for drug treatment, resulting in a reduction of services.
In an ideal world, no-one would take those harmful substances, but we do not live in an ideal world. Therefore, we cannot base life or death decisions on ideology. We have to go with what works. If the evidence is clear that drug consumption rooms prevent overdose deaths and the spread of disease, we at least need to trial them. Glasgow was set to do that until it was blocked by the Government. The Member for Inverclyde secured the debate for the main purpose of calling for the devolution of drug legislation to Scotland, but the drugs problem is UK-wide and we need a UK-wide solution.
Like many, I am uncomfortable with the uncertainty we often find ourselves in when it comes to drugs and the law: legal highs, more widespread drug use, changes in legislation in other countries, decreased prosecutions for lesser drug offences and even festivals such as Glastonbury offering drug testing facilities. We have been sending mixed messages for far too long. We must address that before we are to move forward in a meaningful way.
The Opposition are clear: the ever-increasing spread of disease and record number of deaths from drug use are unacceptable. This must be dealt with as an urgent public health issue. The Government must take responsibility and they must review the legislation as a priority.
The Parliamentary Under-Secretary of State for the Home Department (Victoria Atkins)
It is a pleasure to serve under your chairmanship, Ms Ryan. I join others in congratulating you on your skilful navigation of the timetabling and the Divisions this evening. I am grateful to the hon. Member for Swansea East (Carolyn Harris) for giving me a little extra time to respond in what is a very complex debate. I thank the hon. Member for Inverclyde (Ronnie Cowan) for bringing the debate and for his obvious passion and commitment to this topic.
I will start from a position of agreement: nobody in this House wants people to become addicted to heroin, crack cocaine or any drugs. We are all grappling with the ways in which we can fight that drug battle, help addicts and ensure that gangs do not lead young people on to the wrong paths and into taking drugs. We want to rid our country of these awful substances if we possibly can. It has already been said that that is incredibly difficult, as it is in every country in the world, and nobody has the answer yet.
To be very clear from the start, the Government do not agree with the hon. Gentleman’s suggestion. We have no intention of introducing drug consumption rooms, nor do we have any intention of devolving the United Kingdom policy on drug classification and the way in which we deal with prohibited drugs to Scotland. Drug barons do not respect geographical barriers or boundaries and I dread to think what would happen if we devolved our UK-wide policy in the way that the hon. Gentleman suggests—it would then create an internal drug market within the UK, adding further to the pressures on law enforcement.
The hon. Member for Inverclyde is looking a bit askance at me. He knows my background. I used to prosecute criminals for a living. I prosecuted drug gangs; I prosecuted international drug gangs, so I know whereof I speak. There has been a certain naivety in some of these arguments about what these international gun-toting criminals will do if we, the UK, regulate prohibited drugs. They are not going to run away and study university degrees and lead law-abiding lives. They are going to find ways of undercutting the regulated market, which presumably the hon. Gentleman is calling for, with prices. They will find ways of getting to their addicts. They will still continue their awful trade; it is just that under the hon. Gentleman’s model, as I understand it, it will be the taxpayer who is helping to pay for some of the drugs that we are against.
Ronnie Cowan
Imagine the people whom we would drive out of business! This will do the same thing as it did in the 10 other countries where it has been introduced. I am talking about drug consumption rooms to help people with addiction problems through that phase of their life. Some 90% of people who use drugs in a recreational fashion do not have an addiction problem. We are talking about people with an addiction problem and helping them through that in a compassionate and humane way. That is what DCRs are about.
Victoria Atkins
I will come to what DCRs are about, because their purpose is not recovery. Their purpose is to provide a place where illicit drugs that have been bought in the local area are then consumed in a place funded either by the taxpayer or charities. Recovery is an optional part of that usage; it is not the sole purpose of it. That is very different from our drug strategy. I will come on to that in a moment.
Let me first of all deal with the international comparisons, because much has been made of the evidence from abroad. I accept that there is no clear answer here, but I am obliged to put into context some of the evidence that has been put to this Chamber by the hon. Member for Inverclyde and the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle). Ten countries have DCRs. Seven of them are in the European monitoring centre for drugs and drug addiction, and in those seven countries, 78 facilities exist. When we are talking about changing our national drugs policy, we have to be very clear about the limits of the evidence on which the hon. Gentlemen are relying.
The hon. Member for Inverclyde mentioned some countries. Canada has kept its provider, Insite, not because of the evidence that the services provided by Insite work, but because the users of Insite brought two court actions, and the Canadian Supreme Court ordered the Minister who wanted to close them to grant an exception to Insite in order to respect the constitutional rights of facility users and staff. I read that, with my legal hat on, not as an endorsement of the effect of DCRs but as a constitutional issue.
France has not agreed to use these rooms permanently. It is running a pilot project for six years. In terms of Spain, the evidence I am given by those who sit behind me is that there is one room open in Catalonia for one hour a day from Monday to Friday. When we hear that there have been no deaths in DCRs, which I accept, we have to understand the context in which these rooms are operating. I suggest that one hour a day from Monday to Friday does not support a great deal of people; we are not talking about the majority of heroin users in that town in Catalonia.
The hon. Member for Brighton, Kemptown talked about there being no deaths in Sydney. I was grateful to my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant) for clarifying that the hon. Gentleman was in fact saying that there were no deaths in DCRs, not that the introduction of DCRs has stopped deaths from heroin in Sydney as a whole.
We do not know, because nobody has done the research yet, what happens to addicts when they leave DCRs. DCRs are not residential. Addicts are there for a number of hours. We do not know what happens when they leave those clinics and walk down the street. We do not know the impact. As we have heard, they are not there every single day. This is not a regular form of treatment, and that is precisely why I will now turn to the drug strategy. Recovery is at the heart of the Government’s drug strategy. We have brought together Health, Education and all of the relevant Departments to tackle drug addiction and the illicit trade in drugs and to look at the answers within the community, including with the police, but recovery is at the heart of it. I am sorry to hear of the experience in Scotland.