Misuse of Drugs Act 1971 (Amendment) Order 2024

Lord Ponsonby of Shulbrede Excerpts

Tuesday 16th January 2024 Grand Committee

Those are the three points that I hope the Minister can cover in his response: monitoring the prevalence of the synthetic opioids in the instrument; how treatment services will be adapted to cope with people presenting as users of these new controlled substances; and the very specific point around prescribing and, in particular, paramedic prescribing of controlled substances.

[Lord Ponsonby of Shulbrede (Lab)]

My Lords, we too welcome the amendments in this instrument. I will start with two specific questions and then make some more general comments.

First, beyond adding the specific substances which the Minister referred to in his speech and in the document, what more are the Government doing to address the risks posed to our communities from drugs more generally? The second question is about a particular drug, xylazine, a non-opioid veterinary anaesthetic that is being used in combination with synthetic opioids to devastating effect. I understand that the Minister for Crime wrote to the ACMD in June to ask it to consider the harms of this drug and that he is still waiting for a response. How long should the Minister for Crime expect to wait before he gets either action or a response to his letter about this drug?

Those are my two particular questions. More generally, I want to use the same structure as the noble Lord, Lord Allan. The first question he asked was about monitoring the prevalence and usage of synthetic opioids. As I mentioned in other speeches, including in the King’s Speech debate, I travelled to North America in the summer and went to Portland, Oregon. I also went to Seattle in Washington state. I was shocked by the amount of drug use on the streets. I saw hundreds if not thousands of people sleeping rough on the streets of those two cities. I saw people shooting up in front of me in the middle of those cities—and I had young children with me. It was a truly shocking sight.

While I was there, I visited a court that dealt with drug issues. I also had breakfast with a district attorney who is an elected prosecutor. We spoke about the way their current drug policy is working. What was interesting and depressing to me was the uniform agreement across the political spectrum that it was a disaster, yet they did not agree on the solution to that disaster; there was an ongoing political debate on it. The district attorney also said to me—it is relevant to this debate—that there is a strong suspicion, or belief, that synthetic opioids are getting into prescribed drugs. He told me that he had gone on holiday to Mexico but had forgotten some of his normal prescription drugs, so he had to go and buy the drugs while in Mexico. He became aware that synthetic opioids are illegitimately getting into prescribed drugs. This is a very worrying development; it is all over the internet in that part of the world. It is something that we should be aware of as a possible problem over here as well. It really is a huge issue. I am sure that the Minister is aware of it, but it would be good to hear what is being done to monitor the scale of this problem, which is potentially coming our way.

The second point made by the noble Lord, Lord Allan, was about treatment services and more drugs being brought into scope. I am quite worried about the experiments being carried out in Glasgow. I suppose that would be a good question for the Minister to answer: what monitoring are the UK Government doing on the experiments being done around drug treatment centres in Glasgow? I will leave it there.

[Lord Sharpe of Epsom (Con)]

My Lords, I thank both noble Lords for their contributions to this short debate. I take on board the personal experience of the noble Lord, Lord Ponsonby, in the States; his observations are obviously extremely interesting. Perhaps it is worth pointing out that just under half of all drug poisoning deaths registered in this country in 2022 already involved an opiate of some sort. The noble Lord made some acute points; of course, the Government remain aware of the situation overseas and continue to monitor that as much as they monitor the situation here.

The noble Lord, Lord Ponsonby, asked me a specific question about xylazine. The ACMD is independent, so I cannot comment on its timeframes, but we are hoping for its response on this particular drug in early 2024. Obviously, we will come back to this as and when we have its response.

The noble Lord, Lord Allan, asked about monitoring and the noble Lord, Lord Ponsonby, backed that up. As I said, UK agencies are highly alert to the threat from synthetic drugs, including synthetic opioids such as fentanyl as well as synthetic cannabinoids and benzo- diazepines, which have been linked to drug-related deaths in this country. Along with law enforcement partners, the UK Government stand ready to respond to the threat from synthetic drugs. They have established a cross-government task force to monitor that threat and to lead and co-ordinate the government response to the risk from these synthetic opioids in the UK. The aim of the task force is to consider evidence-based policy; programmatic and legislative decisions in response to the level of risk; and the nature of synthetic opioids. Members of the task force include the Home Office, the Office for Health Improvement and Disparities, the Ministry of Justice, the National Crime Agency, HM Prison and Probation Service, Border Force and the police.

Through the UK’s drugs strategy, which was published in December 2021, we are implementing an end-to-end plan to disrupt the supply of all drugs at every stage of the supply chain from a source to the street. As part of that strategy, we have provided additional resources to the international networks of the NCA and the Home Office in key source and transit countries; this is for them to work with other Governments in identifying and disrupting cartels that seek to exploit the UK, as well as to seize drugs before and during their journey to the UK and the EU.

Also outlined in the strategy, we have increased the availability of naloxone, including naloxone nasal spray, to prevent drug-related deaths, and have committed to supporting local provision of a broader range of medicines, including newer medicines such as long-acting buprenorphine injection. We believe firmly in the importance of engaging with experts and delivery partners to respond swiftly to the evidence of emerging drug threats, including learning from international partners through international fora such as the US-led Global Coalition to Address Synthetic Drug Threats.

On the health situation that was brought up by both noble Lords, FRANK, the Government’s free drugs advice service, contains information on synthetic opioids, synthetic cannabinoids and benzodiazepines, which will be updated to reflect the changes when this legislation comes into force. The Department for Education has also worked with the Office for Health Improvement and Disparities to make sure that good-quality teaching resources are available for teachers providing drug, alcohol and tobacco education, and lesson plans on drugs, alcohol and tobacco are available on the PSHE Association website.

We are of course concerned that banning these substances will discourage people from access to treatment services, but the Government’s drugs strategy, From Harm to Hope, published in December 2021, is clear about the Government’s ambition to achieve stigma-free treatment, providing the full, positive impact of treatment services for those seeking help. But, noting the potential harms associated with misuse of these substances, we believe it is necessary to take action to restrict access to these drugs and reduce their misuse. Through the drugs strategy, we are investing more than £2.8 billion over three years to support people through treatment and recovery, which includes support for those who have used a range of drugs and suffered various health harms.

Of course, key to all this is reducing the demand for drugs. We are committed to reversing the rising trend of drug use in society, to protect vulnerable people from harm and exploitation. It enables us to keep our communities safe and we must therefore reduce the demand for drugs, which fuel violence and exploitative criminal markets. Around 3 million people in England and Wales report using drugs each year, putting themselves at risk and driving a violent and exploitative supply chain, including through so-called recreational drug use. Through programmes announced as part of the drugs strategy, such as drug testing on arrest, and our plans to roll out pilots to change behaviour and attitudes towards drug use, we will provide the powers and access to appropriate interventions and support. We also know that we need to step up action in addressing the visible forms of drug use within our communities, so we will work with our enforcement partners to see what more we can do to tackle this, while ensuring that those who need treatment and support are diverted into the appropriate services.

The noble Lord, Lord Allan, asked a very specific question about remimazolam. There are no known established legitimate uses for any of these substances except remimazolam. The Government recognise the importance of ensuring that that in particular remains available for legitimate and lawful purposes, so in line with the recommendations from the ACMD, remimazolam will be placed in part 1 of Schedule 4 to the 2001 regulations, as I said in my opening remarks. That will enable lawful access in healthcare settings, subject to the requirements of the 2001 regulations. The remaining 19 substances will be placed in Schedule 1, as I mentioned, and access will therefore be permitted only under a Home Office-controlled drug licence. That will ensure that organisations can still lawfully undertake research with these substances, should they choose to do so.

On the specific question about paramedics, that is a Department for Health situation: it would have to request that paramedics be able to prescribe or use this drug in the appropriate way. I hope that answers the questions that I have been asked and, again, I thank both noble Lords for their participation in this debate. These are dangerous substances with the potential to cause significant harm, and they should therefore be subject to the strict controls under the 1971 Act. With that, I commend this order to the Committee.

[Lord Ponsonby of Shulbrede (Lab)]

I specifically asked about the Glasgow drug consumption rooms and whether there is a UK oversight of the way they are operating, rather than just a Scottish Government oversight.

[Lord Sharpe of Epsom (Con)]

With apologies, I forgot that question and, as it happens, I also do not know the answer—so I will have to find out and write to the noble Lord.