Psychoactive Substances Bill [HL]

Lord Blencathra Excerpts

Tuesday 23rd June 2015 Lords Chamber

[Lord Patel of Bradford (Lab)]

My Lords, I have listened to arguments on both sides and I am struck by the point that we somehow think that the introduction of legal highs is a phenomenon we have never come across. We had cheap, smokeable heroin in the early 1980s. There were outbreaks in various cities across England where people were smoking heroin. There was anxiety. We had a knee-jerk reaction and we set up services for heroin users. Then we had amphetamines in the nightclub scene, and in the mid-1980s kids were sniffing solvents and glue. There was huge panic and uproar and we banned children from buying solvents in supermarkets. We thought that thousands of kids were going to die because they were sniffing solvents. Things moved on.

Then we had MDMA, GBH and crack cocaine, and then heroin came back again. These things keep coming. We do not want to have a knee-jerk reaction to yet another drug that young people will take. The evidence, from watching last night’s “Newsnight” report from Ireland, is the opposite of what the noble Lord said his police officers wanted here. Officers there were saying that they could not enforce this law. This is simply imposing a blanket ban on new drugs as they keep coming out—and they will keep coming out. We can ban one thing and I guarantee that in the next five years, there will be another substance that young people are using and we will be panicking again. We cannot continue to do this.

There is a desperate need to review the Misuse of Drugs Act 1971. We have had all these policies and other Acts dealing with prescription drugs, and we have never looked at the evidence—not just this Government but the Labour Government as well. We have never looked at the evidence because, as my noble friend Lord Howarth said, Ministers look at what the public want and they want hard, strong enforcement tactics on tackling the use of drugs. The evidence is fairly clear and we have a lot of it in this country, so we desperately need a review. Whether we need to tag that on to this Bill I do not know, but my anxiety is that we will be passing a Bill because of a knee-jerk response.

We have not looked at the connections with existing legislation. We are creating legislation that is not looking at harms but simply banning everything in sight under this umbrella body, and it seems to everyone to be unenforceable. We need to take a step back. There has to be an opportunity somewhere along the way to have a review and to look at drugs policy effectively.

[Lord Blencathra (Con)]

My Lords, I had not intended to speak on this amendment until I heard the speech of the noble Lord, Lord Howarth. With all due respect, I must say that he is profoundly wrong and also out of date. I say to the Minister that there is no need to do another independent review. A couple of years ago, EU Sub-Committee F, chaired by the noble Lord, Lord Hannay, conducted a thorough review of drugs legislation. We discovered in that committee that enforcement has worked exceptionally well for all the main hard drugs we have had in this country. Drug use of heroin, crack cocaine and other such drugs has dropped dramatically. Where we are in the lead, unfortunately, is with the use of the new psychoactive substances.

It would seem from the evidence that we took in committee that children today do not want to smoke the same old stuff their hippie fathers did. If it was good enough for dad, the kids today want something different. We see that in a whole range of things, such as children who go off Facebook because their parents have joined. The fads on drugs seem to have the same trends.

Enforcement has worked exceptionally well in driving down the use of heroin, crack cocaine and other serious drugs. Enforcement can work equally well on psychoactive substances, provided that we can get the legislation watertight. The Government have tried enforcement with psychoactive substances by naming certain drugs, and within hours the chemical composition is tweaked slightly and the law is no longer effective.

Enforcement works, provided we have effectively drafted legislation. I entirely support the views of the noble Lord, Lord Condon. We have an urgent problem at the moment with psychoactive drugs. We do not need to review the whole of the drugs Act in this Bill. Maybe a review in a couple of years might be sensible, after we have seen how the legislation proposed in this Bill works. Finally, it is not a matter of enforcement or harm reduction, which are not mutually exclusive. We have been doing both in this country. It is right to have criminalisation and tough enforcement action against drugs and, at the same time, a harm-reduction policy that tackles drug use among first-time users and young kids, who probably do not know any better. Yes, we need education. Yes, we need harm reduction. But for goodness sake, keep the criminal law, which works.

[Lord Patel of Bradford]

My Lords, before the noble Lord sits down, yes, there may have been a reduction in the use of illegal drugs over the last five years. I know that Ministers have responded by saying, “We do not need to look at this any more, because drug use has plateaued and acquisitive crime has decreased, although drug-related deaths have increased”. Why has that happened? Not because of better enforcement but because, for the last 10 years, the Labour Government piled £800 million per year into drug treatment—and drug treatment that worked. That was a pooled, ring-fenced pot of money. We quadrupled the number of people treated, and it worked. For every £1 invested, within a year you had a £2 return and on a longer-term basis you had an £8 return. Drug treatment works. We do not have the same evidence for education prevention and we do not have the evidence for enforcement, but we do have the evidence that treatment works.

The problem is now that the £800 million a year has gone into Public Health England’s £2.6 billion budget, which goes to the 152 local authorities around the country to spend as they wish. That money is not ring fenced. There is no local authority in the country that has the expertise or the inclination to spend hundreds of thousands of pounds on drug treatment. Instead, funds are rapidly being withdrawn and we see the outcome: we see drug services shutting down and we see drug-related deaths going up. I guarantee that within five years we will see acquisitive crime going up and drug use increasing again. This is not to do with enforcement policies; it is clearly to do with how we invested that money properly last time.

[Lord Blencathra]

Again, I must disagree with the noble Lord, Lord Patel. Of course, harm reduction is good and of course treatment is essential, but unless we have Customs and Excise and the National Crime Agency and all the others interdicting tonnes and tonnes of drugs, we would need a lot more treatment because we would have a lot more drug addicts in this country. Enforcement has worked. Enforcement is driving down the use of those drugs which were rapidly increasing in the 1980s and the 1990s. There is no suggestion that that trend is wearing off, and there is no suggestion that enforcement is now failing with those drugs. Enforcement is failing in the new psychoactive substances for two reasons. First, the kids find it trendy and sexy to use them because they are not using the same old drugs that dad smoked. Secondly, we do not have legislation tight enough to enable the police and the enforcement authorities to use enforcement properly against those psychoactive substances.

[Baroness Meacher (CB)]

My Lords, I support this amendment and the comments of the noble Lords, Lord Paddick, Lord Howarth and Lord Patel, but I have to say that I cannot support the noble Lord who has just spoken. This country has some of the strongest and toughest rules and legislation relating to drugs, yet we have one of the highest levels of use of the dangerous drugs that we try to ban. The reality is that we are not succeeding. Countries with relatively liberal, harm-reduction, health-focused policies do a great deal better than we do.

I want to use this opportunity to try to get across to the Minister and to your Lordships why I feel so strongly that we need a review of the Misuse of Drugs Act. I worked in secondary mental health for about a quarter of a century on and off, working with severely psychotic patients. I would say that the majority of those patients take cannabis. Why do they take it? They have told me many times, “Because it makes me feel human”. Thankfully, I have never had a psychotic illness, but if you do and you are given antipsychotic medication, the mix of the illness itself and the medication leaves you feeling, if I may put it this way, subhuman. You do not feel that you have any feelings; you feel dead. If you take cannabis, it makes you feel human. That is the word these patients use—“human”. In my view, that is not unreasonable.

If herbal cannabis is illegal, which it is, these patients along with all sorts of young people all over the country—I am slightly less sympathetic about them, but I am very sympathetic about patients—are driven to take skunk, very high THC cannabis, which is bad for their hallucinations and voices and makes them worse. But they still take the cannabis because it is so important to them to feel human. As I say, that is not unreasonable.

While they were within our services, these people were treated as patients because they had severe health problems. However, it always struck me as peculiar that when they left our hospital, day centre or whatever it was, these very sick people could be picked up by the police and charged with a criminal offence. Why? Because of their health problem. When our Convenor, as she was then, said when I came to this House, “Molly, you must put your name down on the ballot for a debate”, I said, “Oh no”, but I did and I won the ballot. I was told to produce a subject within the hour, and it came to my head that it would have to be about drugs. I feel strongly that our laws are illogical, unjust and cruel, and they are doing an enormous amount of damage to very large numbers of children and young people. That is why I cannot say that I am against the amendment tabled by the noble Lord, Lord Paddick.

Of course I understand that this Bill is about psychoactive substances, and we will come to discuss them, but the fact is that we have only one market, and it is the market for illegal drugs. It is not a market for psychoactive substances over here and a market for controlled substances under the Misuse of Drugs Act over there. They are one market, and therefore it makes no sense to look at this market without looking at that market. That is why I believe firmly that the Government would find it very helpful to look seriously at how the market is working and to draw conclusions from other countries.

We will come to the experience of Ireland and psychoactive substances, where a ban has been in place for four years. What does the deputy chief of the drugs and organised crime branch say about the ban? It has not worked. Therefore, Ireland is thinking of going back to its misuse of drugs Acts. I think that we will be in the same position, so it is really important that we get the Misuse of Drugs Act right as well as the Psychoactive Substances Bill. If we do not, we will just go round and round in very unfortunate circles from one bad policy to another.

I have something else that I want to say. The Labour Party is worried about a delay in this Bill. It does not need to worry, because bans do not work. They have not worked in Ireland. A little bit of delay will not make any difference. We now know from scientists that, of the deaths which have been caused by psychoactive substances, maybe every single one of them—certainly 90% of them—has been as the result of young people taking banned substances, not legal highs. I want to make that point very strongly. A ban does not stop people taking a substance, and some of them will die from doing so. If low-level psychoactive substances were regulated and labelled, with the consequences of taking them clearly specified, the risks and side-effects explained and the maximum dose made clear—in the case of ecstasy, you must take water, but you must not take more than 1 litre, or whatever it is—they would be much safer. My only concern is the safety and well-being of our young people.

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[Lord Rea (Lab)]

My Lords, like the noble Lord, Lord Walton, who spoke last week during the supplementaries on the Question for Oral Answer tabled by the noble Baroness, Lady Meacher, on this topic, I served on the Select Committee which looked into the medicinal use of cannabis. One of the central recommendations was exactly what the noble Lord, Lord Ribeiro, has suggested. We need controlled trials. The noble Baroness has just backed up that suggestion as well. But it is very difficult to get these trials going. As she has said, because cannabis is an illegal substance, it is difficult to get people to agree to do the work. One or two trials have been carried out which resulted in the production of Sativex, but only one firm is producing it. As the noble Baroness said, it is terribly expensive and can be prescribed only on a named basis; it is very difficult for doctors to prescribe it to patients who have been shown to benefit from cannabis by getting it illegally.

One of the problems with getting cannabis illegally is that you do not know the ratio of the different cannabinoids in the illegal drug. It has been shown—this was told to us in our committee—that there is a huge range of effects from different cannabinoids. The one that gives the psychoactive effect, tetrahydrocannabinol— THC—is something that people who take cannabis for medicinal purposes do not like. But it is very difficult to find an illegal version of cannabis that contains a good ratio with more cannabidiol—CBD—which is the calming one that reduces spasms. Sometimes people have thought that it does not stimulate psychotic results but prevents them; it is an antipsychotic drug.

So there are real reasons why it should be made legal for researchers to concentrate on doing proper, controlled clinical trials to work out what cannabis can do, and what components or mixtures of cannabis components are most effective. This is crying out to be done, but as things are, it is very difficult to get scientists to agree to do it because of the illegality of the substance.

[Lord Blencathra]

My Lords, I have no idea whether cannabis is relevant and effective in dealing with nausea or spasms caused by motor neurone disease or other diseases, but I have a wee bit of experience of multiple sclerosis, and I say to the House that I do not want to be used as an excuse to legalise cannabis, because it is not necessary for treating the spasms that come from multiple sclerosis; there is already a fairly large range of drugs on the market that deal with that.

The spasms are difficult to describe and usually happen at night. The main muscles of the body—the torso, the legs and the chest—just spasm, and it is difficult to get a bit of sleep when that happens. In my case, when it started getting bad, my consultant said, “In that case, we must give you a drug that will deal with the spasms”. At the top of the list is baclofen, which is dirt cheap and highly effective. The maximum prescribed dose is 50 milligrams. I take 10 milligrams in the morning and 20 milligrams at night and have had no more body spasms because of it.

Okay, I cannot speak for all multiple sclerosis sufferers. When I was a constituency Member of Parliament, I had constituents come to me who said that they wanted cannabis legalised so that they could deal with their MS. I said that there were clinical trials under way that resulted in the drug Sativex, but they were not so keen to take a pill; they wanted to smoke a joint because it made them feel better in many other ways. Well, it could, but I do not want people who wish to smoke cannabis to get high to use the excuse that it is essential for multiple sclerosis sufferers in order to remove their pain and spasms.

If baclofen does not work—it seems to work for about 95% of people—doctors usually try tizanidine: I will give the Minister the spellings later. Following that, going down the list, is gabapentin. It is not usually prescribed because the other two drugs are usually much more effective. At the bottom of the list is Sativex, which is the cannabis derivative. The problem here, as has been stated already, is that NICE reviewed it and concluded that it was not cost effective. Unfortunately, that is absolutely right, because it costs 10 times as much as baclofen, which I have in my pocket at this precise moment.

I therefore think that the solution is: patients should be prescribed baclofen. If that does not work, they can go on to tizanidine, and if that does not work they can try the next legal drug, gabapentin. If those three do not work, then people can be prescribed Sativex. I suggest that my noble friend the Minister should say to the Department of Health and NICE that in those priority corridors it should be permissible to use it throughout the whole of the United Kingdom. Wales overruled NICE and has allowed Sativex to be prescribed. It is not prescribed, except by private prescription, in England, Scotland and Northern Ireland. I think that that is wrong. It should be allowed to be used by doctors but not as the first port of call.

There is merit in rejecting the amendment as far as multiple sclerosis is concerned. It may be beneficial for other illnesses when people suffer spasms but it is not necessary to deal with the problems that occur with multiple sclerosis. I wish to put my liberal credentials—or near liberal credentials—on the table. A part of me takes the view that if people want to smoke a cannabis joint and get high, okay, let them but do not expect the taxpayer to pick up the bill for the cancers and other illnesses they may get later. Similarly, a part of me thinks that if people want to eat themselves through gluttony into obesity and sit on their backsides, taking no exercise, let them, provided the NHS does not have to pay for that.

As the taxpayer has to pay for these things and for the dangers which smoking cannabis can cause, the taxpayer and the Government must be in a position to say, “No, I’m sorry. You’re not allowed to smoke that because there are alternatives that can deal with the alleged problem”.

[Lord Howarth of Newport]

May I say how welcome it is to see the noble Baroness, Lady Chisholm of Owlpen, on the Front Bench alongside her colleague from the Home Office? I hope that she will report this debate to her colleagues in the Department of Health. It is excellent that the two departments are represented on the Front Bench for this important debate.

The noble Lords, Lord Rea and Lord Ribeiro, spoke with all the authority of their medical expertise, and the noble Lord, Lord Blencathra, spoke with the authority that comes from his own unfortunate experience. I follow the noble Baronesses, Lady Hamwee and Lady Meacher, in commending to the Committee, and very much to the two departments represented on the Front Bench, the report just recently published under the auspices of the All Party Parliamentary Group for Drug Policy Reform by Professor Val Curran and Mr Frank Warburton, entitled Regulating Cannabis for Medical Use in the UK. Had they heard the presentation of this report by Professor Curran from University College London, they would have been persuaded that the arguments put forward are eminently reasonable.

She talked about the severe constraints applied to the progress of medical research by the Government of the United Kingdom’s persistence in listing cannabis in Schedule 1. She told us that it costs a minimum of some £5,000 to achieve the licence and to pay for the secure conditions to enable the pursuit of research into the medical properties and potential benefits of cannabis. That is a severe discouragement, particularly in the stringent climate of funding for academic research. She estimated that research on cannabis costs some 10 times as much as research on other drugs. It is a serious constraint, yet a significant body of evidence strongly suggests that cannabis-based medications can be beneficial for a whole series of conditions, many of which have been itemised by previous speakers.

The noble Lord, Lord Ribeiro, drew attention to the tentative evidence that may be emerging of benefits in relation to post-traumatic stress disorder. That is certainly a pressing and important issue for us in this country, as well as in America. Professor Curran also told us that there are suggestions that cannabis could be beneficial in the treatment of schizophrenia. It would seem perverse in the extreme to continue to deny ourselves the opportunity effectively to pursue research on the medical benefits of cannabis when patients suffering from such a range of diseases could be assisted.

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[Lord Blencathra]

My Lords, I am sympathetic to the noble Baroness’s amendment. Of course, we need some monitoring information and we need information around effectiveness, but I am just not sure that the Home Office or a government department is the right body to produce such independent information. It may be, but I have my doubts.

My main concern about the noble Baroness’s amendment is the timescale. Having listened to the noble Lord, Lord Howarth, I am now very concerned about the timescale if the Government, or anyone else, attempted to report on the wide range of things he has suggested. I am not being facetious, but it struck me that compiling a report of the length that the noble Lord wants would probably end up taking longer than the new sexual abuse review by the distinguished New Zealand judge. I do not mean that as a facetious comment or to diminish the work she is doing.

The noble Lord, Lord Howarth, and many others in this Chamber have some experience in government. I think we know that if a government department were to produce a report within 12 months, it would have to be approved by the Cabinet at month 11. This is a territorial Bill and would need to go round all the territorial Governments in months 9 to 11 to be checked by them. It would need to go round the UK government departments in Whitehall, probably in month 8 or 9, to be amended by them, which means that the Minister in the Home Office, or wherever, would need the first draft in about month 6, which would mean that civil servants would start writing it in month 3.

I say to the Minister: if the Government have to produce a report, preparing one within 12 months of the Act would not be sensible. It would be impossible—no, it would not be impossible, but it would include only a fraction of the information that one would want. There may be merit in the Government producing a report, but not of the length that the noble Lord, Lord Howarth, has suggested and certainly not within the 12-month timescale.

[Lord Rosser]

We have an amendment in this group and it is not about post-legislative scrutiny. It calls for the Secretary of State to publish an annual report on new psychoactive substances and sets out some of the information that must be included in the report.

There is currently a real lack of data collected and published on new psychoactive substances and their impact. For example, the first indication of a new drug tends to come from a hospital admission. If this happens in the United Kingdom, the National Poisons Information Service is informed and it then advises the European Monitoring Centre for Drugs and Drugs Addiction. The EMCDDA tells the National Poisons Information Service of drugs detected elsewhere in Europe. However, the Home Office keeps its own lists, the main one being the forensic early warning system, and, to date, successive Ministers have been unable to explain the relationship between the EMCDDA list and the Home Office list, which suggests that data are not being collected and published in a consistent or helpful way. Similar problems arise with monitoring drug-related deaths and overdoses. No proper data are collected on drug deaths as the data we have rely on examining countless records, which is why they are often incomplete and take years to publish.

There is a significant problem, too, with hospital admissions. The National Poisons Information Service collects new drugs but does not collect data on all drug- related overdoes. We do not know how many hospital admissions result from taking these new substances. Nor do we know in how many cases new psychoactive substances were a factor for those needing to access mental health services. Anecdotal evidence suggests that legal highs are a major factor, especially for adolescent mental health services.

In their response to the expert panel, the Government accepted the importance of information on new psychoactive substances and that it should be shared systematically at both a local and national level in a timely manner. However, the Government did not appear to accept the current inadequacies in the information, including those to which I have referred.

The expert panel said that, with the rise in the availability of NPSs, coupled with possibilities for NPS market development via the internet, the UK drug scene had become increasingly complex and fractured, and that a number of information issues arose from this. These included,

“the difficulty for any one agency to keep to keep abreast of all the new developments … the acknowledgement that the Misuse of Drugs Act 1971 needs to be supplemented by other legislation has meant that more professional networks require information including trading standards … the current time lags involved between data collection and publication of data obtained by current networks mean these systems cannot be employed in the service of providing more timely early-warning-type information; and … the need to collect, analyse and distribute information in a more systematic and timely fashion to help inform policy and practice at both a national and local level”.

Frankly, the Government’s response did not address all these issues since there seems to be a view that the forensic early warning system’s annual report can fit the bill. In its recommendations, the expert panel says:

“There is a need to establish prevalence, evidence and harms associated with NPS”.

It suggests that we should:

“Develop detection and data collection tools across criminal justice and health services, and other relevant settings, for example, schools and universities”.

A recommendation refers to developing,

“internet tools to monitor internet activity around NPS”,

and to the need to:

“Record health and social harms related to NPS by utilising professional networks and other early warning systems … understand local markets, including through headshops, retail outlets, prisons and local police assessment”.

On enhancing the share of information on NPSs, the panel said:

“Sharing information at both local and national levels is essential in helping to achieve a reduction in the demand and supply of drugs and in promoting comprehensive and effective interventions”.

It is fairly clear from the report of the expert panel that it does not think enough is currently being done in the area of the provision of information. The purpose of this amendment, as I said at the beginning, is to provide for the Secretary of State to publish an annual report on new psychoactive substances. The amendment sets out, in not quite so extensive a list as that of my noble friend Lord Howarth of Newport, some of the information that should be included in that report.

I hope the Minister will reflect further on this issue—the importance of information on NPSs—and the adequacy of the current information and the systems and methods by which it is provided. Our amendment gives the Minister the opportunity to do just that and I hope it is an opportunity she will take.

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[Lord Howarth of Newport]

My Lords, the definition of a psychoactive substance in the Bill does indeed seem to me rather vague. We should be grateful to both noble Baronesses who have so far spoken in this debate for pressing the Government to tighten the definition and to give us some clarification. It would be helpful if the Minister would explain to the House the basis upon which he was able to give us an assurance—I thought he gave it rather tentatively and with less than full confidence—at Second Reading, that if he were to send a bouquet of flowers for the gratification of Lady Bates, he would not be in breach of the law. I see that it is suggested that incense might be caught under the law. How can he be sure that all kinds of substances and activities that, on a common-sense view, people would regard as innocent may not in fact be caught?

I would also like clarification—if this is not leaping ahead too far—as to what is, in Schedule 1, a traditional herbal remedy. The term is terribly loose. I fancy that it is going to be quite difficult for police officers or courts to be very clear what the term “traditional” in a legally binding context means. How in practice does he foresee psychoactive substances are going to be identified? Will there have to be tests in court? That would seem to be expensive and disproportionate. Will there have to be a large number of placebo-based comparative scientific trials? Again, that would seem expensive, disproportionate and impractical. I think he owes it to us to clarify a little further than the drafting of the Bill does what he means by psychoactive substance.

[Lord Blencathra]

My Lords, I would be interested in hearing the Minister’s response to the noble Baroness, Lady Meacher. She seems to have a fairly good point—to me as an amateur anyway.

I wish to make my remarks mainly about Amendment 9. This may be heretical to noble and learned Lords and parliamentary draftsmen, but why can we not have the Government’s definition and the definition in Amendment 9? Definitions are going to be the big problem with this Bill—everybody recognises that—and I see no merit in brevity of definition if it makes for confusion. On the other hand, we do not want it to be tautological and we do not want too big a definition which is contradictory. I am sure that noble and learned Lords and parliamentary draftsmen will ensure that that does not happen. I ask the Minister to keep an open mind on this and be relaxed about extending the definition or picking up bits of Amendment 9 if it helps to bring more clarity, irrespective of the length of the definition.

[Lord Tunnicliffe]

My Lords, I shall comment briefly on this group. I hear the debate on Amendments 7 and 8 and will be interested in the Minister’s response. On Amendment 10, similarly, we will be interested in the Minister’s response.

On Amendment 9, I see this Bill—and I will be grateful if the Minister can flesh out whether he sees it in the same way—as a very narrow Bill. Broadly speaking, everything is illegal except the things that are defined as legal. Bringing in the word “significant” seems to me to be getting into significant bad and not significant good, and therefore we are into the area of legal challenges et cetera. The idea of the Bill, I think, is to be free from legal challenge and that is why it is formed in that way. The Minister will no doubt enlighten me.

The point of the noble Lord, Lord Howarth, on the process—of how the judgment will be made that a substance is psychoactive—is a good one. I would be grateful if either now, or perhaps in writing, the Minister could spell out how the Government envisage determining whether a substance is indeed a psychoactive substance.