Drug Policy

Lord Ramsbotham Excerpts

Thursday 11th December 2014 Grand Committee

[Lord Ramsbotham (CB)]

My Lords, I declare an interest as chairman of the cross-party group on criminal justice, drugs and alcohol. I agree with every word that my noble friend Lady Meacher said. I thank her for obtaining this debate, and I salute her for her determined attention to all aspects of national and international drugs policy. I want to comment on two things in particular and then give one example of where I think the policy really needs to pull indecision together. I hope that the debate called for, when it happens, will have as its objective the production of a clear, consistent and continuous national policy which can be followed by all those who have any responsibility for dealing with users and abusers of drugs.

It first became clear to me that there was no national policy when I was in the Army and we had to guard two prisons because of strikes by prison officers. One of my military police sergeant-majors complained to me that he had seen two prisoners exchanging cannabis, had taken them in front of the governor and had been told to dismiss it because cannabis was common in prison. He said to me, “This is ridiculous—we kick out any soldier who is using drugs, yet this is going on in our prisons”.

I then found, of course, that there was absolutely no policy when I started inspecting prisons. Drug responsibility was in the hands of the director of nursing, which may have been a predicator of what America has adopted, but it was absolutely pointless because no governor took any notice of what the director of nursing said. No prison had any common policy on who was assessed when they came in. There was no common policy on treatment, no common treatment for withdrawal and no interest in people who might pick up stronger drugs on release and subsequently die. In fact, there was nothing, and there is still nobody in prisons who is responsible for making certain that there is a common policy in every type of prison.

Going further, I ask whoever conducts the debate called for to add two words to the words “wide-ranging and open”, and those words are “cross-party”. I feel that one of the problems that we have suffered from is the ping-pong between parties, which has led to nothing more than inertia. The real tragedy of the inertia is that it leads to ruined and lost lives because delay in doing anything will inevitably lead to that. Rather than risk one party saying this and one that, could we please have a cross-party consensus so that everyone will be able to follow the common national policy that comes out of it?

I raise the issue of the use of naloxone, which the noble Lord, Lord Rea, mentioned, because we were given a good briefing the other day in our cross-party group. The Advisory Council on the Misuse of Drugs gave advice to the Government on whether naloxone should be made more widely available in order to prevent future drug-related deaths and to help engage and educate those most vulnerable to suffering an opioid overdose in May 2012. Its advice was that, first, naloxone is a safe, effective, evidence-based, World Health Organization-recommended drug with no dependency-forming potential. Its only action is to save lives by reversing the effects of opioid overdoses, and it is already used by emergency services personnel.

The prevention of drug-related deaths, of which there were 1,957 in 2013, is one of the eight key outcomes for delivery in a recovery-orientated drug treatment system, which is what we claim to have. Currently, naloxone is available on prescription to people at risk of opioid overdose, but it will have its maximum effect on deaths if it is made available to people with the greatest opportunity to use it and those who can best engage with heroin users, such as their families and carers. They will, of course, have to be educated in its use, but that is not impossible. Following the 2012 report, Scotland and Wales conducted successful pilots and have since introduced national strategies for its use. England, which ran a programme, has had no similar rollout and none is planned until October 2015, three years after the report.

However, it is not going to be a national strategy but will be left to local authorities. One of the organisations in our cross-party group made a freedom of information request to find out how much knowledge there was of naloxone in the local authorities. It found that, of the ones that replied, 60 local authorities had no plans and had given no priority or money to naloxone; 10 were thinking about it; and 60 have local strategies, some of which are good and some of which are poor. I merely rest on that because the lesson of naloxone should be borne in mind when we are looking for a common national strategy.