Drug Consumption Rooms

Ronnie Cowan Excerpts

Wednesday 17th January 2018 Westminster Hall

[Ronnie Cowan (Inverclyde) (SNP)]

I beg to move,

That this House has considered drug consumption rooms.

It is nice to see you again, Ms Ryan.

Let me start with a few undisputed facts. Drug deaths due to overdose are increasing year on year in the United Kingdom. People have been taking drugs of various types for thousands of years. In the last 100 years or so, we have run a campaign to criminalise and persecute people who take certain categories of drugs. We decide which drug belongs in which category. Some criminals have become staggeringly rich through their involvement in the production and supply of drugs. Users are stigmatised as junkies, crackheads and stoners. Society adopts this language to dehumanise and ostracise sections of a community. That facilitates their abuse and allows them to be used as scapegoats.

Where are we now? The drive to arrest and incarcerate the producers, distributors, dealers and users—often referred to as the war on drugs—has seen a massive increase in violent crime and corruption, along with hundreds of thousands of deaths and the criminalisation of some people for the most minor offences. The perceived problem that the war on drugs set out to solve has been compounded by the war. As a result, time, money and lives have been wasted. [Interruption.]

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On resuming—

[Ronnie Cowan]

As I was saying before we were so rudely interrupted, we created this situation and we can fix it, but doing so will take a change in attitude at governmental level. Rather than pay lip service to people with an addiction, we need to start listening to what they are asking for. We need to treat addiction as a health issue rather than a criminal justice issue, not just in part but in its entirety.

Drug consumption rooms are part of the solution. Supervised drug consumption facilities, where illicit drugs can be used under the supervision of trained staff, have operated in Europe for the past three decades. Those facilities aim primarily to reduce the acute risk of disease transmission through unhygienic injecting, prevent drug-related overdose deaths and connect high-risk drug users with addiction treatment and other health and social services.

[Caroline Lucas (Brighton, Pavilion) (Green)]

Does the hon. Gentleman agree that one of the big strengths of DCRs is their ability to reach people with drug addiction problems who are not otherwise known to the services? If we build relationships and trust with such people over time, we are much more likely to get them into services that can begin to address the reason for their addiction.

[Ronnie Cowan]

I completely agree. The first step of the healing process is building a working relationship with someone and earning their trust, so that they come back and do not have the suspicions that we have built among drug users.

Drug consumption rooms also seek to contribute to reductions in drug use in public places, in discarded needles and in public order problems linked with open drug scenes. Typically, they provide drug users with: sterile injecting equipment; counselling services before, during and after drug consumption; emergency care in the event of overdose; and primary medical care and referral to appropriate social healthcare and addiction treatment services.

Currently, people are sharing needles, using a product that may kill them instantly, and living chaotic lifestyles that harm them, their friends and their families. DCRs provide needles, which instantly reduces the spread of HIV and hepatitis C, instantly improves the health of the user and instantly engages users back into society, where they can be signposted to relevant services. Needle exchanges also go some way towards doing that, but the paraphernalia leave the premises and are often discarded in public places or shared with other users. Users may choose to inject themselves in streets, doorways or gardens near to the exchange, which is unsuitable for users and local residents.

The great thing is that we have evidence from 10 other countries that DCRs work. The first supervised room was opened in Berne, Switzerland, in June 1986. Further such facilities were established in subsequent years in Germany, the Netherlands, Spain, Norway, Luxembourg, Denmark, Greece and France. Outside Europe, there are facilities in Australia and Canada. A total of 78 drug consumption facilities currently operate in seven European monitoring centre for drugs and drug addiction-reporting countries.

[Grahame Morris (Easington) (Lab)]

I congratulate the hon. Gentleman on securing this debate on a potentially controversial subject, but perhaps one where we need to look at the evidence. Does he agree that there are not only health benefits but other benefits in terms of crime prevention and reduction? The Home Office’s figures say that 45% of crimes are caused by drug users stealing in order to feed their habits. Tackling that through the introduction of consumption rooms would bring considerable benefits.

[Ronnie Cowan]

Absolutely. To my knowledge, the closest thing we have had to that in UK was opened by John Marks in the Wirral back in the 1980s. At that time, local crime dropped by more than 90%. We have the information at our fingertips.

Most interestingly, no country that has adopted DCRs has ever regretted it and subsequently closed them. Switzerland and Spain have closed DCRs, but only because the need for them reduced significantly—they were so successful that they put themselves out of business.

Before the festive recess, I asked the Prime Minister at Prime Minister’s questions to change the law to facilitate DCRs in the UK—or, if not, to devolve the relevant powers to the Scottish Parliament so the Scottish Government could do so. The law needs to change to protect the people who supervise the rooms and to enable the relevant police forces to take a consistent stance that does not set them apart from the rest of the judicial system.

[Ian C. Lucas (Wrexham) (Lab)]

Like my hon. Friend the Member for Easington (Grahame Morris), I think the evidence is important. I am confused about the position in Scotland, where criminal justice is devolved. The hon. Gentleman referred to devolution, so will he clarify why the UK Parliament needs to take that step? I am genuinely interested.

[Ronnie Cowan]

Certain aspects of the law are not devolved to Scotland and the laws we require to allow people to work in these facilities with impunity rest here at Westminster. I want those laws to be devolved to Scotland, because we have the appetite to do the job.

The Prime Minister’s response was that she knows some people are more liberal about drugs than she is. She is not minded to do anything, which completely misses the point. It is not about having a liberal attitude but about compassion and treatment for vulnerable people.

[Douglas Ross (Moray) (Con)]

Before we move too far away from law enforcement in Scotland, will the hon. Gentleman explain what the police’s response would be if he were to get the powers devolved? Would they be asked to ignore people in possession on their way to such venues, regardless of how far away they were?

[Ronnie Cowan]

The police would have the authority to stay within the law. We would not ask them to turn their eye from people who were breaking the law. The law would allow people to carry in their own drugs.

[Douglas Ross]

From how far?

[Ronnie Cowan]

The limit from which a drug may be carried in has not been defined. The point is that the Scottish Government and the Lord Advocate have asked for this facility to happen.

[Douglas Ross]

The Lord Advocate?

[Ronnie Cowan]

The alternative would be having people shooting up in alleys and contracting HIV and hepatitis C. That might be what the hon. Gentleman wants to see in Scotland; it is not what I want to see anywhere in the United Kingdom.

Nobody is saying that drugs are for everybody or that drugs are great. What I and many others are saying is that if we want to stop damaging society and help the many individuals who have a drug addiction problem, we need to change our approach. DCRs are not a magic wand or a silver bullet and they will not resolve every issue, but they are humane, productive and cost-effective. The total operating costs of the Glasgow safer drug consumption facility and heroin-assisted treatment facility are estimated at £2.3 million per annum. A 2009 Scottish Government research paper suggested that in 2006, the cost attributed to illegal drug use in Scotland was around £3.5 billion.

The Vancouver Insite DCR costs the Canadian taxpayers 3 million Canadian dollars per year. The facility claims that for every dollar spent, four are saved, as they are preventing expensive medical treatments for addicts further down the line. That figure is recognised in many other countries. A 2011 ruling by the Supreme Court of Canada concluded that Vancouver’s Insite safe injecting room saves lives with no negative impact on public safety in the neighbourhood, and that between eight and 51 overdose deaths were averted in a four-year period. A study in Sydney showed fewer emergency call-outs related to overdoses at the time safe injecting rooms were operating. A study of Danish drug consumption found that Danish DCR clients were empowered to feel

“like citizens rather than scummy junkies”

—their words, not mine.

These findings corroborate other investigations that DCRs are an essential step towards preventing marginalisation and stigmatisation. NHS Greater Glasgow and Clyde estimates that the annual cost to the taxpayer of each problem drug user is £31,438. It further estimates that the introduction of a new heroin-assisted treatment service could save over £940,000 of public money by providing care for just 30 people who successfully engage with the treatment. Even if we did not give a damn about people with addictions, it would make good financial sense to provide those facilities. It is more cost-effective to provide DCRs than it is to pick up the bill after the damage has been done.

DCRs are more than just a practical solution; they are humane, compassionate and financially effective. I can think of only two reasons why the UK Government are so resistant to the proposal: either they are stuck in an ideological mindset that people with addictions are not ill but are the product of poor lifestyle choices, or they simply do not care. The UK Government have stated:

“It is for local areas in the UK to consider, with those responsible for law enforcement, how best to deliver services to meet their local population needs.

We are committed to taking action to prevent the harms caused by drug use and our approach remains clear: we must prevent drug use in our communities, help dependent individuals recover, while ensuring our drugs laws are enforced.”

That cowardly stance simply underlines the UK Government’s disengagement from the reality of the situation. It pushes responsibility on to the shoulders of local administrations and the police force, while refusing to furnish them with the legal powers to act responsibly within the law. The Home Office-led study “Drugs: International Comparators” from 2014 concluded that there was

“some evidence for the effectiveness of drug consumption rooms in addressing the problems of public nuisance associated with open drug scenes, and in reducing health risks for drug users.”

It also said that the ECMDDA report

“considers that on the basis of available evidence, DCRs can be an effective local harm reduction measure in places where there is demonstrable need”.

Despite the evidence that DCRs are financially viable, the United Kingdom Government have chosen to ignore it. Can the Minister please tell me why?

In conclusion, I once again ask: will the UK Government look at the growing body of evidence and change the law to allow DCRs to be opened in the UK without fear of prosecution? Will the UK Government devolve the relevant powers to Scotland to allow the SNP Government to pursue ambitious and innovative new measures to tackle the public health issues of unsafe drug consumption?

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[The Parliamentary Under-Secretary of State for the Home Department (Victoria Atkins)]

It is a pleasure to serve under your chairmanship, Ms Ryan. I join others in congratulating you on your skilful navigation of the timetabling and the Divisions this evening. I am grateful to the hon. Member for Swansea East (Carolyn Harris) for giving me a little extra time to respond in what is a very complex debate. I thank the hon. Member for Inverclyde (Ronnie Cowan) for bringing the debate and for his obvious passion and commitment to this topic.

I will start from a position of agreement: nobody in this House wants people to become addicted to heroin, crack cocaine or any drugs. We are all grappling with the ways in which we can fight that drug battle, help addicts and ensure that gangs do not lead young people on to the wrong paths and into taking drugs. We want to rid our country of these awful substances if we possibly can. It has already been said that that is incredibly difficult, as it is in every country in the world, and nobody has the answer yet.

To be very clear from the start, the Government do not agree with the hon. Gentleman’s suggestion. We have no intention of introducing drug consumption rooms, nor do we have any intention of devolving the United Kingdom policy on drug classification and the way in which we deal with prohibited drugs to Scotland. Drug barons do not respect geographical barriers or boundaries and I dread to think what would happen if we devolved our UK-wide policy in the way that the hon. Gentleman suggests—it would then create an internal drug market within the UK, adding further to the pressures on law enforcement.

The hon. Member for Inverclyde is looking a bit askance at me. He knows my background. I used to prosecute criminals for a living. I prosecuted drug gangs; I prosecuted international drug gangs, so I know whereof I speak. There has been a certain naivety in some of these arguments about what these international gun-toting criminals will do if we, the UK, regulate prohibited drugs. They are not going to run away and study university degrees and lead law-abiding lives. They are going to find ways of undercutting the regulated market, which presumably the hon. Gentleman is calling for, with prices. They will find ways of getting to their addicts. They will still continue their awful trade; it is just that under the hon. Gentleman’s model, as I understand it, it will be the taxpayer who is helping to pay for some of the drugs that we are against.

[Ronnie Cowan]

Imagine the people whom we would drive out of business! This will do the same thing as it did in the 10 other countries where it has been introduced. I am talking about drug consumption rooms to help people with addiction problems through that phase of their life. Some 90% of people who use drugs in a recreational fashion do not have an addiction problem. We are talking about people with an addiction problem and helping them through that in a compassionate and humane way. That is what DCRs are about.

[Victoria Atkins]

I will come to what DCRs are about, because their purpose is not recovery. Their purpose is to provide a place where illicit drugs that have been bought in the local area are then consumed in a place funded either by the taxpayer or charities. Recovery is an optional part of that usage; it is not the sole purpose of it. That is very different from our drug strategy. I will come on to that in a moment.

Let me first of all deal with the international comparisons, because much has been made of the evidence from abroad. I accept that there is no clear answer here, but I am obliged to put into context some of the evidence that has been put to this Chamber by the hon. Member for Inverclyde and the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle). Ten countries have DCRs. Seven of them are in the European monitoring centre for drugs and drug addiction, and in those seven countries, 78 facilities exist. When we are talking about changing our national drugs policy, we have to be very clear about the limits of the evidence on which the hon. Gentlemen are relying.

The hon. Member for Inverclyde mentioned some countries. Canada has kept its provider, Insite, not because of the evidence that the services provided by Insite work, but because the users of Insite brought two court actions, and the Canadian Supreme Court ordered the Minister who wanted to close them to grant an exception to Insite in order to respect the constitutional rights of facility users and staff. I read that, with my legal hat on, not as an endorsement of the effect of DCRs but as a constitutional issue.

France has not agreed to use these rooms permanently. It is running a pilot project for six years. In terms of Spain, the evidence I am given by those who sit behind me is that there is one room open in Catalonia for one hour a day from Monday to Friday. When we hear that there have been no deaths in DCRs, which I accept, we have to understand the context in which these rooms are operating. I suggest that one hour a day from Monday to Friday does not support a great deal of people; we are not talking about the majority of heroin users in that town in Catalonia.

The hon. Member for Brighton, Kemptown talked about there being no deaths in Sydney. I was grateful to my hon. Friend the Member for Ayr, Carrick and Cumnock (Bill Grant) for clarifying that the hon. Gentleman was in fact saying that there were no deaths in DCRs, not that the introduction of DCRs has stopped deaths from heroin in Sydney as a whole.

We do not know, because nobody has done the research yet, what happens to addicts when they leave DCRs. DCRs are not residential. Addicts are there for a number of hours. We do not know what happens when they leave those clinics and walk down the street. We do not know the impact. As we have heard, they are not there every single day. This is not a regular form of treatment, and that is precisely why I will now turn to the drug strategy. Recovery is at the heart of the Government’s drug strategy. We have brought together Health, Education and all of the relevant Departments to tackle drug addiction and the illicit trade in drugs and to look at the answers within the community, including with the police, but recovery is at the heart of it. I am sorry to hear of the experience in Scotland.