Dangerous Drugs

Dan Poulter Excerpts

Tuesday 12th September 2023 Commons Chamber

[Chris Philp]

My hon. Friend is right to point to Dr Nicholl’s work, and I thank him again for his campaigning on this issue, without which we possibly would not be here today taking this legislation through Parliament. The evidence we have seen about the neurological damage caused in particular by large-scale consumption of nitrous oxide is very worrying. Neurological units around the country have seen cases of people who have been paralysed and suffered really quite serious consequences. The numbers are not enormous, but they are extremely worrying, and the severe cases, including paralysis, are deeply concerning. I agree completely with what my hon. Friend just said.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I draw the House’s attention to my declaration in the Register of Members’ Financial Interests: until recently, I was an acting consultant addiction psychiatrist. On the point about other uses of nitrous oxide—legitimate medicinal and industrial uses—moving it away from the psychoactive substances regulations to the Misuse of Drugs Act puts a number of limitations on its use in its current settings. What consultation has my right hon. Friend or his Department done with the medical sector as a whole, and also with other commercial providers or users of nitrous oxide, in advance of laying these regulations before the House?

[Chris Philp]

We have conducted further engagement and consultation with the ACMD and others in industry to understand the implications of this move. I am jumping ahead a little, but we intend to table a further statutory instrument that will take effect alongside this one, which will make it clear that the sale and use of nitrous oxide for legitimate purposes will not be criminalised in any way—it will continue to be permitted. The definition of legitimate use will be very broadly drawn in that SI, because nitrous oxide is used for a wide range of medical research and commercial purposes, and we are not going to try to comprehensively list those purposes. A wide-based exemption for legitimate use will be put in place to make sure that we do not unintentionally stymie either medical research or commercial use of this drug.

It is worth saying that the use of nitrous oxide is quite widespread. Among those aged 16 to 24—

--- Later in debate ---

[Chris Philp]

The hon. Gentleman will be aware that the consumption of beer does not, generally speaking, lead to severe neurological damage and paralysis in the way that the consumption of large amounts of nitrous oxide does.

[Dr Poulter]

I do not wish to be disobliging to the Minister, but the ACMD was very clear that it did not believe that the medical harms of nitrous oxide pose anything like the significance of those caused by many other street drugs, or indeed alcohol. Alcohol-related brain damage causes much more neurological harm than many street drugs do, so I think it would be helpful for the Minister to correct the record on that point.

[Chris Philp]

I have referred to the ACMD advice before, and the ACMD did note the anecdotal reports of severe paralysis caused by excessive nitrous oxide consumption to which I have referred already. On this occasion—rarely, but not uniquely, disagreeing with ACMD advice—the Government, as we are entitled to do, took a broader view. We thought about the association with antisocial behaviour and about the fact that among 16 to 24-year-olds nitrous oxide is the third most used harmful substance, and that is why we took the step we did. Of course, I acknowledge that, as my hon. Friend said, alcohol can have an adverse effect as well, but we feel that in this particular case the misuse of nitrous oxide merits action. Many Members have raised concerns about the effect it has had in their communities, and we are responding at least in part to the concerns that Members have raised.

Nitrous oxide is currently regulated under the Psychoactive Substances Act 2016. It is not, of course, currently an offence to possess nitrous oxide; it is only an offence under the PSA to knowingly or recklessly sell it for personal consumption. So by controlling nitrous oxide as a class C drug under the Misuse of Drugs Act, it will not just be an offence to recklessly or intentionally sell this substance for personal consumption, but be an offence to possess it except for the legitimate use exemptions I mentioned earlier. As I said in response to my hon. Friend’s earlier intervention, we will be bringing through a further SI to set out the definition of those legitimate uses. As I said a moment or two ago, those will be extremely wide-ranging to make sure we do not inadvertently stymie legitimate commercial, medical or research use.

In summary, it is clear that drug misuse ruins lives. In the case of nitrous oxide, it also contributes significantly to antisocial behaviour. The Government have listened to the public and to parliamentarians who have been speaking for their constituents, and that is why we are taking this action.

--- Later in debate ---

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

It is a pleasure to follow the SNP spokesperson, the hon. Member for Glasgow Central (Alison Thewliss). I do not disagree with much of what she said. I believe the Government will achieve very little through these measures, except perhaps to cause considerable disruption to industry and the medicinal use of nitrous oxide. I am far from convinced by the changing reassurances given by the Minister at the Dispatch Box in that respect.

I once again draw the attention of the House to my entry in the Register of Members’ Financial Interests. I am a practising NHS psychiatrist. Until recently, I was working as an acting addictions consultant psychiatrist and I have dealt with the misuse of drugs extensively throughout my medical career.

I believe in an evidence-based approach to policymaking. This issue has been examined by the ACMD at the request of the Government. The ACMD suggested very clearly that this was not the appropriate legislative vehicle to deal with nitrous oxide. It made that recommendation for two reasons. First, we already have the Psychoactive Substances Act 2016, so if we want to deal with the illegitimate sale and supply of nitrous oxide there is already legislation in place to do that. Secondly, we have other laws that can be used, for example to deal with the unacceptable littering that sometimes occurs with the canisters used in the recreational use of nitrous oxide.

[Mark Garnier]

Is my hon. Friend aware that the ACMD was asked many years ago to opine on exactly this point and it was chased up by two Home Secretaries to try to get a response? It was not until this statutory instrument was first talked about earlier this year that the ACMD got around to answering the Government’s request to make a judgment.

[Dr Poulter]

I am aware that it takes some time to compile ACMD reports. The reason is that the ACMD likes to look at the evidence in the round. There are a number of issues to look at here, such as harms of use. There is relatively limited evidence and data to suggest that nitrous oxide is substantially more harmful than many of the substances we use daily, such as caffeine. Using caffeine to great excess has very profound and immediate health consequences, as does alcohol. The point was made by the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle) about the Notting Hill carnival and the number of beer cans and other forms of rubbish left there. If we look at the social and health harms of alcohol, which is a legal drug and one that is misused legally, they are considerably more profound than what we are talking about or indeed many other street drugs.

[Sir Greg Knight (East Yorkshire) (Con)]

Can my hon. Friend clarify to the House what his conclusion is on this matter? Is he saying that he opposes the measure, or is he saying that if the measure goes ahead he wants the Government to keep the matter under review?

[Dr Poulter]

If the House divides this evening I will be voting against the measure for the further reasons I am about to outline.

I think it would be helpful to remind the Minister what the ACMD actually said with regard to legislation:

“Based on this harms assessment, the Psychoactive Substances Act 2016 remains the appropriate drug legislation to tackle supply of nitrous oxide for non-legitimate use. There is, however, a need for enforcement of the Psychoactive Substances Act 2016 to be supported by additional interventions designed to reduce health and social harms. Based on this harms assessment, nitrous oxide should not be subjected to control under the Misuse of Drugs Act 1971 for the following reasons”.

Those reasons have been drawn out to some extent during the debate, but they are neatly summarised by the ACMD in its recommendations to the Government in its report.

First,

“Level of health and social harms”,

which is relatively limited, and

“current evidence suggests that the health and social harms are not commensurate with control under the Misuse of Drugs Act 1971.”

Secondly,

“Proportionality of sanctions: the offences under the Misuse of Drugs Act 1971 would be disproportionate for the level of harm associated with nitrous oxide and could have significant unintended consequences.”

Thirdly,

“Impact on legitimate uses: control under the Misuse of Drugs Act 1971 could produce significant burdens for legitimate medical, industrial, commercial, and academic uses. The current scale and number of legitimate uses that stand to be affected is unknown but is estimated to be large.”

I think it is fairly clear that the Government did not carry out a proper impact assessment before bringing this measure to the House.

[Bob Stewart (Beckenham) (Con)]

I thank my good friend for allowing me to intervene. Does that mean that he thinks we should do nothing at all?

[Dr Poulter]

No, I do not think it means we should do nothing. I think that if we believe, as I think many of us do, that we should control the illegitimate supply of nitrous oxide, we should look at existing legislation, such as the Psychoactive Substances Act 2016, which was designed and taken through its stages by my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning). This point was discussed at some length during its passage. The focus was not on criminalising use and the potential users, but on controlling the supply: a clear distinction was drawn. The Minister may correct this view, but the ACMD made it clear in its report that better enforcement of that existing legislation to control illegitimate supply would be a much better and more proportionate way of dealing with the issue at hand, and the same was suggested more broadly in the evidence supplied to the ACMD while it was compiling its report.

So there is already a legitimate means of dealing with this, but unfortunately there is the potential for unintended consequences, and I was not reassured when the Minister said earlier that the Government would introduce another measure—which no one in the House has seen as yet—to ensure that there would be no such unintended consequences. If a Government are introducing two good pieces of legislation, they should introduce both of them together so that the House can consider them in the round. My concern is that primary legislation such as the Misuse of Drugs Act is tightly drawn, and unless it is amended, it is difficult to introduce another measure to sit beneath it and mitigate its provisions. I am therefore not reassured by the Minister’s comments, but in any event it is not good or effective government not to present the two measures at the same time so that we could consider the issues in the round.

Because I believe that there is already legislation in place which needs to be better enforced to deal with illegitimate supply, and because I do not believe that the Government have given adequate weight or consideration to the potential unintended consequences for legitimate users of nitrous oxide—which the Minister effectively admitted in his opening comments—I believe that the Government are in the wrong place at present, and that it would have been better to produce a proper impact assessment of the legitimate uses to sit alongside this measure before bringing it to the attention of the House. For all those reasons, I will vote against the order if it is put to a vote.