EU Drugs Strategy: EUC Report

Baroness Massey of Darwen Excerpts

Thursday 19th July 2012 Lords Chamber

[Baroness Massey of Darwen]

My Lords, I am very grateful to the noble Lord, Lord Hannay, for drawing our attention to the report of the European Union Committee on the EU drugs strategy and for introducing this debate with such vigour. I declare an interest as the chair of the National Treatment Agency for Substance Misuse—the NTA. It was set up as a special health authority in 2000 to improve the availability, capacity and the effectiveness of drug treatment in England and has had notable successes. Chief among them has been the doubling of the number of people in treatment since its inception and the dramatic reduction of waiting times. From April 2013, the National Treatment Agency’s key functions will be taken over by a new body with a wider remit, Public Health England. However, the NTA, with its limited remit of treatment issues, has provided support in developing a drugs strategy in England. Today I shall draw on some of our experiences.

The report before us recognises—indeed, emphasises —that drug policies and their remit should remain within the competencies of member states, which is surely right. As the noble Lord, Lord Hannay, said, and the noble Lord, Lord Mancroft, emphasised, we cannot simply transfer policies from one country to another. Countries are quite different in many respects. I hope that the report will not just be a nice piece of literature but will inspire debate. The EU strategy touches on aspects that are of importance to drugs strategies across the world. Many of these aspects are covered by drugs strategies for England, although some of the concerns are beyond the remit of my agency, the National Treatment Agency. As a government agency, the NTA is bound by government policy and, as such, has no separate view on some of the substantive issues raised by the EU Committee’s report such as decriminalisation and drug trafficking. I shall therefore limit my remarks today.

One important issue that was touched on by the noble Lord, Lord Avebury, is money. As the report points out, tackling drug use effectively saves large sums of money. We in England have done extensive research on the economic aspects of drug treatment and it is estimated that for every pound spent on drug treatment alone, approximately £9 is saved. Savings to the NHS and savings from tackling drug-induced crimes are enormous.

The scale and quality of drug treatment and recovery services in England, provided by not only the NHS but the voluntary sector, is admired by experts across the rest of the world. I shall draw on that expertise in sharing some observations today. I welcome the committee’s report and agree with much of it. However, I shall put two particular issues raised by the committee under the spotlight of further scrutiny: first, the adequacy of statistics and, secondly, the role of harm reduction in public health.

I start with statistics because the report calls for an improvement in the quality and comparability of national statistics. It suggests the UK may need to change the way in which it collects data so that EU-wide statistics are more consistent. It is difficult to disagree with this wider European aim but we should not infer from it that there is anything wrong with the accuracy or scope of our own national statistics. I declare another interest here: the NTA is responsible for running the National Drug Treatment Monitoring System, one of the most comprehensive data sets in the NHS. Its findings are independently evaluated and validated by the National Drug Evidence Centre at the University of Manchester and published as national statistics. A close study of the EU Committee report shows that it is not criticising our statistics on drug treatment at all. Where the committee finds fault is in the provision of figures on the prevalence of drug use, which is a completely different matter. I welcome the opportunity to make this distinction and clear up any confusion that there may be.

In this country, the British Crime Survey estimates drug use among the general population. It is notoriously difficult to measure drug use, not least because it is a covert, criminal activity. The British Crime Survey suggests that the trend in class A drug use is static, with about 3% of people admitting to using class A drugs in the past year, mainly powder cocaine.

To understand what is happening in more detail, the Home Office and the NTA have commissioned independent experts from the University of Glasgow to estimate the number of the most problematic drug users—heroin and crack addicts—who would benefit from specialist treatment. The ongoing research suggests there has been a significant fall in the number of people in England who are addicted to these problematic drugs, from a peak of 332,000 in the middle of the previous decade to 306,000 at the last count. This trend is echoed in the demand for treatment services, as measured by the National Drug Treatment Monitoring System. The number in treatment is falling, from a peak of 211,000 in 2008-09 to an anticipated 198,000 in 2011-12. In particular, we are seeing a steady reduction in the number of heroin users entering treatment for the first time. This has fallen from 48,000 in 2005-06 to a predicted—I emphasise that—estimate of 9,000 this year. At the same time, waiting times remain low. On average someone can access a treatment programme within five days of being referred. The proportion of clients waiting more than three weeks to start treatment is 2%: the lowest ever.

What all this means is that the drug treatment system in England continues to respond quickly to demand, but that the nature of this demand is changing. With fewer new clients coming into treatment, the challenge for the future is overcoming addiction among an increasing proportion of older, entrenched ex-users already in the system, who by definition are more complex to treat. Any drugs strategy in any country must take account of the realities of drug use at a particular time. While it may be difficult to compare statistics about drug use across Europe, we can be extremely confident that we know what is happening about drug treatment in England and we have a positive story to tell.

This brings me to the committee’s point about harm reduction and decriminalisation. The report says that members were impressed by the evidence from Portugal on the effectiveness of its public-health-oriented national strategy. They noted that harm reduction and public health policies were increasingly being adopted internationally, and suggested that EU member states should learn more from each other. As I said, the National Treatment Agency has no view on whether a policy of decriminalisation would be beneficial in this country. However, what is often forgotten in the debate on decriminalisation is that in England we already tackle drug dependency as a public health issue.

What has happened in Portugal as a consequence of changing the law on the possession and use of drugs is comparable with what already happens in England, within a different criminal jurisdiction that makes illegal the use of and trade in dangerous drugs. In both countries treatment has been expanded. Portugal changed the law in 2001 in order to expand treatment. In England, treatment was expanded in the same period within an existing legal framework. Unfortunately the benefits of our public health approach too often get lost in controversy over whether we have lost the so-called war on drugs, or whether we should legalise particular substances. The fact is that in England there has been a steady increase each year in the number of people overcoming addiction and embarking on the road to recovery. In 2010-11 the official statistics showed that 28,000 individuals successfully completed treatment, an 18% increase on the previous year. Information given to the NTA board indicates the equivalent figure for 2011-12 is anticipated to be almost 30,000, among them an increasing group of opiate users, who are the hardest to support.

I agree with the view of the committee that the EU drugs strategy should improve the collection of information so that member states can learn from each others’ experiences. I also agree that the new strategy should use the EU’s public health obligations to further the inclusion of harm-reduction measures in national policies. In England, we are already successfully demonstrating the benefits of a public health approach through our existing data. I welcome the opportunity to call attention to a track record in treatment and recovery that many other countries would envy, and I hope that the Minister agrees.