Drugs: Government Consultation Paper
Lord Bassam of Brighton (Government Whip (technically a Lord in Waiting, HM Household); Labour)
rose to move, That this House takes note of the Government consultation paper, Drugs: Our Community, Your Say.
Lord Bassam of Brighton (Government Whip (technically a Lord in Waiting, HM Household); Labour)
My Lords, the Motion on the Order Paper asks the House to take note of the Government's consultation paper, Drugs: Our Community, Your Say. In a sense, the Motion does not do justice to an important consultation document, which has been usefully received by people in the great out there. I thank all noble Lords who have stayed behind to join in the general discussion on the consultation paper and the associated consultation exercise that the Government have recently conducted. It says something about the interest in the subject that there are so many speakers at this late stage of the parliamentary year.
The public consultation period ended on
I shall provide some background to the consultation but perhaps I may first give a short overview of the history and content of the existing drugs strategy. The strategy, which was the Government's first comprehensive strategy to tackle drug misuse, was launched almost 10 years ago in 1998. Following a review and a number of recommendations made by the Home Affairs Committee, it was fully updated in 2002. The overarching aim is to reduce the harms caused by illegal drugs and, to achieve this outcome, it focuses on four key strands: first, preventing young people taking drugs; secondly, reducing the availability of illegal drugs; thirdly, reducing drug-related crime and its impact upon communities; fourthly, reducing drug use through the provision of treatment and support.
Over that period of nine years, extraordinary progress has been made in delivering this strategy, with challenging targets often exceeded or achieved early. Through the dedication and concerted action of a range of agencies and departments, we have seen a sustained reduction in drug use and the harms caused by illegal drugs. During the lifetime of the strategy, we have also seen the development of truly innovative programmes, such as the drug interventions programme and Positive Futures, which provides diversionary activities for the young people most vulnerable to developing drug misuse problems.
Tackling drug supply is a key part of our strategy. We have provided law enforcement agencies with the tools to tackle organised criminals and individuals who traffic or supply drugs by introducing the Proceeds of Crime Act 2002, which allows law enforcement agencies to seize the assets of convicted criminals, and further, under a new scheme which came into effect on
We have set up SOCA, the Serious Organised Crime Agency. It has been formed from the amalgamation of the National Crime Squad, the National Criminal Intelligence Service, that part of HM Revenue and Customs dealing with drug trafficking and associated criminal finance and a part of the UK Immigration Service that deals with organised immigration crime. SOCA became operational in 2006. Already, increasing quantities of drugs are being seized and organised crime groups and dealers disrupted. Figures published in SOCA's annual report for 2006-07 show that more than 74 tonnes of class A drugs were seized in that period, which, if sold on the UK market, would have raised in excess of £3 billion and generated considerable associated acquisitive crime. We will continue to support law enforcement agencies whenever the opportunity is identified.
We can point to further real successes that have been delivered by the strategy. The British Crime Survey data from 2006-07 show that fewer people reported the use of any drug within the past year than at any time since the survey began. Data from the same survey show that drug use among young people is falling; that more people than ever before are accessing high-quality drug treatment; that drug-related crime is falling, as more than 3,000 drug-misusing offenders are entering treatment through the drug intervention programme each month; and that intelligence-based enforcement approaches are targeting the organised criminal groups, where most impact can be made.
We can see where the drug strategy has been successful, but we can also see where more work is needed.
Lord Richard (Labour)
My Lords, I am sorry to interrupt my noble friend, but before he leaves that immediate point, the report says on page 20:
"The overall level of drug-related acquisitive crime for England and Wales has fallen by around 20 per cent".
Can he give us the basis for that figure? Where does it come from?
Lord Bassam of Brighton (Government Whip (technically a Lord in Waiting, HM Household); Labour)
My Lords, I will aim to pick up on that question later, but I think the figure is based on research that has been conducted.
As I have said, we can see where the drug strategy has been successful, but we can also see where more work is needed or where we need a change of approach. For example, while we can see that drug-related crime has been driven down, we also recognise that further support needs to be given to help those people stay clean and rebuild their lives so that they do not fall back into drug use and criminality. Drug users with the most severe problems account for around 99 per cent of the costs of drug misuse in England and Wales and do most harm to themselves, their families and communities.
There can be no doubt that the overall costs to society are enormous, but reducing the harms caused by drugs has been one of our top priorities and the benefits of successful engagement with drug treatment services are huge for individuals, their families and the wider community. Over the past 10 years one of the key aims of the national drug strategy has been to improve the availability and effectiveness of drug treatment interventions. We have met the "numbers in treatment" element of our target two years early. On reflection that is a remarkable achievement, but we are not complacent. We have been working closely with the Department of Health to ensure that drug users within the criminal justice system have access to drug treatment services.
The result of that cross-Government partnership work is the development of the drug intervention programme, also known as DIP. The programme provides a route out of crime and into treatment. On average, some 3,500 drug-misusing offenders are entering treatment each month. Engaging drug-misusing offenders in treatment has contributed to reductions in drug-related crime. We know that acquisitive crime, to which drug-related crime makes a substantial contribution, has fallen by 23 per cent since the introduction of DIP.
Prison drug treatment funding has increased year on year since 1996-97—up some 997 per cent to £79 million in the current financial year. Prisons now offer a comprehensive treatment framework, consistent with the National Treatment Agency's revised models of care, to address individual drug users' needs. Drug users can benefit from clinical services, CARATs and intensive drug rehabilitation programmes, with the treatment interventions supported by mandatory and voluntary drug-testing programmes. The numbers engaged in prison treatment have increased year on year since 1996-97.
To consolidate progress, the roll-out of the integrated drug treatment system—IDTS—continues. It is designed to boost the quality and increase the volume of drug treatment with a particular focus on drug users during their first 28 days in custody. By March of next year, full enhanced clinical services and psychosocial support through CARATs will be available in 29 prisons; additionally, enhanced clinical services will be available in a further 24 establishments.
The new drug strategy provides an opportunity for us to build on those successes and improve the treatment framework for those in prison. Prisons are already closely engaged with the drug intervention programme and offender managers to ensure continuity of treatment and wider integrated support requirements are considered on release from prison. We are also looking at how we might improve through-care arrangements and release-planning to ensure a seamless transition from prison to the community.
We are reaching more children and young people than ever before with sophisticated prevention messages. Our tracking of the impact of the FRANK drug awareness campaign has shown a significant shift in young people's attitudes to cannabis, with 57 per cent of them saying that cannabis would be very likely to damage the mind. That figure is up from 45 per cent one year ago.
Reductions in drug use among young people demonstrate that our cross-departmental young people and drugs programme is having a positive impact through improved targeting of early intervention for those young people most at risk of developing problems with drugs, through the work of youth offending teams, children's social care services and education support services, and through the provision of specialist substance misuse services for under 18 year-olds, which has been accessed by some 20,000 young people in 2006-07.
While we can see that we are reaching more children and young people than ever before with sophisticated prevention educational messages, it is also clear that more needs to be done to target the young people who are the most likely to develop problems with drug misuse. Drug misuse is not only a health, but also a social and community safety issue which has a disproportionate impact on vulnerable young people and deprived communities. The very nature of the mechanisms and levers of policy delivery will present new challenges and opportunities.
Across all government business is a move towards greater local accountability and priority-setting. This removes levers that exist in central government to ensure the delivery of specific policies, but it also presents an opportunity to begin to deliver drug policy in its wider context of social and personal well-being. We may hope that the consultation will provide valuable insights into how this new delivery landscape might most effectively be exploited to deliver the best outcomes for all.
While we can see where we need to commit our efforts now, it is quite simply impossible to anticipate every challenge that will arise over the coming years. However, a clearer picture of the scale and nature of those challenges may be formed by consulting the people who are most directly affected by drug misuse, or who have the greatest experience of it: those who work in the field and members of the public, whose lives and those of their families will be affected by policies such as these.
To consult as widely as possible and most effectively to establish dialogue on the key issues, officials in the Home Office produced and launched on
In seeking views on those subjects, we circulated around 5,000 copies of the document to delivery partners and stakeholders, and some 300,000 shorter leaflets were made available to members of the public in doctors' surgeries, libraries, police stations and other public places. Both documents were also available to download on the drugs.gov website.
This represents the widest and most comprehensive consultation conducted by the Government on drug misuse. We must be clear, though, on the nature and extent of this consultation and we should recognise the limits of policy of this kind. The objective was to invite views from the widest possible range of people whose lives are affected by drugs in any way, either directly or indirectly; or who simply had a contribution to make. The responses will help inform the direction and content of the new drugs strategy but within the existing legal framework and the international conventions which underpin it. The new drugs strategy will set out actions to reduce drug-related harm, not a legislative programme.
The key focus of the Government's drugs work is clear and unmoving—reducing harms to communities and the tough enforcement of our laws to punish those who deal in drugs and commit offences. That is a key strand of our total approach. The consultation sought the views of respondents on the classification of cannabis. Notwithstanding the decrease in use shown by the British Crime Survey, we need to look at the impact that reclassification has had and to address the public's concern about the potential mental health effects of cannabis use, and in particular the use and availability of increased strengths of the drug. Our final decision on the classification of cannabis will take fully into account the advice from the Advisory Council on the Misuse of Drugs, which will consider the responses to the consultation as part of its review, while retaining its emphasis on the evidence base. We should not use this debate to second guess the outcome of that review.
That concludes my opening comments. I look forward to responding to the many points that noble Lords will raise.
My noble friend Lord Richard asked a question about drug-related crime which it may be convenient for me to respond to now. The relevant figure comes from the recorded crime figures, which include a figure for recorded acquisitive crime. Drug-related crime makes a substantial contribution to acquisitive crime. These figures are published annually in the crime statistics for England and Wales, which incorporate the British Crime Survey and recorded crime data. I hope that helps my noble friend.
Moved, That this House takes note of the Government consultation paper, Drugs: Our Community, Your Say.—(Lord Bassam of Brighton.)
Lord Mancroft (Conservative)
My Lords, as the noble Lord, Lord Bassam, so kindly reminded us, this debate comes at the end of the Government's consultation on their new drugs strategy. Consultations are never perfect and are often easy to criticise, but as consultation papers go this one was noticeably thin and woolly. Frankly, its language is bland and while there is nothing much to disagree with, there is nothing much to excite the soul either.
More interestingly, bearing in mind that the object of the exercise is to build a new strategy, it contains no concrete strategic proposals of any sort, and merely invites readers to agree with the details of the plan. There is a bit of fine tuning here and there, but, to tell the honest truth, there is nothing of any substance. Indeed, the foreword by the Home Secretary could quite easily be interchanged with the forewords written by the previous three authors of drug strategies—David Blunkett, Jack Straw and Michael Howard. I looked them up and read them; they are almost the same.
One area I draw to the House's attention is the Government's use of figures in the paper, which the noble Lord, Lord Richard, mentioned. They are important because they are the basis on which the Government persuade us of their arguments. As the noble Lord, Lord Bassam, said, one example is the number of addicts accessing treatment, which increased from 85,000 in 1998 to 181,000 in 2005. That is a success, but it is somewhat mired by the detail. After all, the objective of treatment is not to see how many people you can cram in—although it is good to see the number increasing—but to make them better. During that period the number completing treatment "drug free" decreased from 5.8 per cent to 3.5 per cent. That is a truly appalling figure. One of the reasons for that is that the National Treatment Agency has chosen cheaper treatment rather than the most effective, which meant that last year more than 1,200 of the best rehabilitation beds were empty and some facilities even closed at a time when we are trying to increase capacity. That is not very clever in my view.
One of the key measures of drug use that we have always used is the number of drug related deaths. The Government say that they have declined by 2 per cent, but I noticed that the figure was a comparison between 1999 and 2005, whereas every other figure in the document compares 1998 with 2005. If you take those figures, the 2 per cent decline becomes a 10 per cent increase. I cannot believe that was done on purpose, but I would like the noble Lord when he winds up to explain exactly why that discrepancy in the figures occurs.
Overall, the statistics produced by the Government are odd. For example, the claim that drug use has stabilised does not bear comparison with the level of drug seizures or the fact that cocaine use is at its highest ever level in this country. Noble Lords are aware that statistics are like bikinis; what they reveal may be very interesting, but what they conceal is far more important. Over 20 years in the drugs field, I have learnt that the figures that we are given, genuine though they may be, need to be treated with a very large pinch of salt. It is unarguable, however, that by any measure—overall drug use, drug-related crime, drug-related deaths, level of drug seizures, cocaine use, or whatever—the UK has the worst drug problem in Europe by a long measure and the second worst in the world after the United States. If the Home Secretary, as she writes in her foreword,
"draws confidence from this progress",
she and I have very different ideas of what constitutes progress.
Realistically, there are only two things that you can do about drugs. You can try to reduce the demand for them, or you can seek to control their supply. To reduce demand, you provide treatment for the existing addict population and you try to prevent the rest of the population taking drugs in the first place. Somewhat obviously, you focus your efforts on young people. Rightly, the Government make strong play of their education programmes. While there is always room for improvement, here in the UK we now have pretty much the most comprehensive drug education in the world. In some parts of the country we have children in their second or third generation of drug education. It is worth remembering that in his foreword to the first ever drug strategy in the 1990s, Michael Howard wrote that many teachers would discover that their pupils knew more about drugs than they did. If it was true then, it is even truer now. If it is even half-true, why have we not seen a substantial drop in drug use? The problem is that the Government have not understood that education is only the solution inasmuch as ignorance is the problem; and ignorance is not the problem. There is no evidence from anywhere in the world that drug education by itself leads to any meaningful reduction in drug use, and to pretend otherwise is deception.
The Government still do not seem to understand that education and prevention are two very different things. If there is ever going to be a solution to the drug problem, it is in preventing drug use in the first place; but the word "prevention" occurs only twice in the Government's document. The second question in the consultation paper is, "What is the most effective way to keep children off and away from drugs?". The answer is that we do not know, and we are not going to find out if the Government do not spend more than 13 per cent of the budget on researching drug prevention. We need drug prevention; we need evidence-based, carefully researched drug prevention. This is a major gap in the strategy.
All those points are really just scratching away at the surface. They are important, but they are tactical details, and they will not work if the overall strategy is wrong. It is wrong, and we all know it. Despite the Government's increasing focus on reducing the demand for drugs, the reality is that it will all come to nothing if they cannot control the supply of drugs. They know that, which is why, despite the growing focus on demand reduction, 80 per cent of the budget is spent on attempts to restrict supply by using the criminal justice system.
The central plank of the Government's policy—not just for the past 10 years but for the past 30 years—has been the Misuse of Drugs Act, which purports to enforce a practical prohibition on those drugs that are perceived to be harmful. With the exception of cannabis, most drugs, such as heroin, cocaine, and amphetamines, are not actually illegal, but rather they are "controlled drugs", which means that their supply and use is strictly regulated. The trouble is that the regulations do not work and thus there is no control. Far from restricting the supply and use of those drugs, the current controls actually encourage their supply and use. It is not that prohibition is, per se, wrong, but rather that it does not work.
Chapter 5 of the consultation document looks at interdiction abroad, under the heading, "The UK market and supply routes". The two objectives in invading Afghanistan were the defeat of the Taliban and the eradication of opium poppies, which provide 80 per cent of the world's supply and 90 per cent of the heroin on UK streets. The past two years have seen a doubling of the poppy crop in Afghanistan. Does anyone think that farmers increase their production if they cannot sell their crops? Those poppies are coming here to be sold as heroin and, if the heroin coming into the United Kingdom increases, so does drug use.
Let us consider for a moment exactly what we are doing in Afghanistan. On the one hand, we are engaged in reconstruction—improving infrastructure, rebuilding industries and creating jobs. But the largest industry in Afghanistan is agriculture and the largest sector within agriculture is poppy cultivation, which we are trying to destroy. How exactly does that work? I do not think that it does work. Indeed, you do not have to be an expert to realise that it cannot work.
But it gets worse. Farmers in Afghanistan have to borrow money—and usually the Taliban is the only source of money—to buy the seeds for their crops. So if we burn the crop, we not only destroy their income for this year, but we make it impossible for them to repay their debts to the Taliban for last year. In other words, we drive them into the hands of the Taliban. Not only have we missed our economic goal, but we have made a political solution less likely and the situation on our own streets a great deal worse.
For too many years, the debate about drugs has been polarised, as the Home Secretary writes. But, as she says, this is coming to an end, although not, I suspect, in the way that she thinks. The failure to control drugs is no longer deniable or acceptable. For too long, the debate has been between those who claim to be tough on drugs and those who are attacked for being weak—between prohibitionists and legalisers. That is ridiculous. All sensible people on all sides of this debate agree that we want a reduction in drug use, in the harm that drugs do, in drug-related crime and in the number of addicts clogging up our courts and prisons. As taxpayers, we should no longer accept the annual bill of £19 billion for no discernible benefit.
I pray that my children will never, ever take drugs, but I know that a significant proportion of their generation, from all walks of life, do and will take drugs. I would like the Minister to explain, when he comes to answer this debate, why the Government think that it is better for my kids or anyone else's kids to buy drugs at an artificially inflated price—probably paid for by crime—of unknown strength and purity, which increases the risk of overdose, from criminals who are often armed and dangerous. The Minister could also tell us why the Government think that it is a good idea to follow a policy that benefits only criminals, international drug dealers and the Taliban.
For 30 years, we have passed more and more laws and given more and more powers to customs, police and the courts in an attempt to control the supply of drugs. The result is that we have the worst drug problem in Europe. Perhaps the most ironic question in the entire consultation document is No. 36, which asks:
"How can we further reduce the supply of drugs and improve detection?".
If ever there was evidence of a Government who have lost touch with reality, it lies in that question.
Yes, we can and should improve the quality and quantity of treatment and education. Yes, we must develop evidence-based prevention programmes. Yes, we can criticise the current system as too wasteful and too bureaucratic, with too many targets and too much central control. We can legitimately level those criticisms at all areas of government. But these issues are on the periphery. There is only one point to make. This drug strategy has not worked and cannot work. That is not because any Home Secretary is weaker or tougher than the last; it is because you cannot address health and social problems using the criminal justice system as your main weapon. We cannot devote the necessary resources to reducing the demand for drugs when we are pouring money into the criminal justice system at home and a mad foreign policy abroad, simply to deal with the unintended consequences of a policy designed 30 years ago to prevent drug use by restricting supply.
In other words, government policy has created a free-for-all in drugs, where only criminals benefit and the whole community—young people in particular—suffers as a consequence. Nothing in the current proposals leads one to conclude that this Government either understand this or have the courage to address it.
Lord Cobbold (Crossbench)
My Lords, I am pleased that the Government have found time for this important debate, albeit right at the end of this Session, and I welcome the opportunity to comment on the consultation paper before they make the final decisions on their drugs policy for the next 10 years.
The paper deals with all the issues on which there is general agreement: the importance of harm reduction, treatment and rehabilitation, education for the young on the dangers to health and the need to reduce reoffending. However, the problem is not in the areas where there is agreement but in those where there is disagreement, and the most important of these is the issue of prohibition. The consultation paper contains no rehearsal of the arguments for and against the present policy of prohibition; indeed, it seems to be a taboo subject.
Prohibition was expected to rid the world of drugs by now. It has manifestly failed, and the Government cannot possibly argue that it has been a success. Obviously, no Government like to acknowledge failure but we now have a drugs trade which is reckoned to be the second largest world trade after oil and is totally in the hands of criminals, costing this country up to £17 billion—or £19 billion, as the noble Lord, Lord Mancroft, has just said. To continue with present policies is to accept and effectively tolerate the existence of the criminal gangs that control the trade.
In Section 6.1 of his excellent submission to the consultation paper, Richard Brunstrom, chief constable of North Wales, lists six generally accepted key harms that arise from prohibition. They are: the creation of five types of crime; the creation of crisis in the criminal justice system; the economic costs; the undermining of public health; the destabilisation of producer countries; and the undermining of human rights. It is a formidable list, the details of which he sets out in his submission.
Question 37 in the consultation paper asks:
"What could we do more efficiently?",
"Where is value for money not being delivered?"
The answer is to seek a workable alternative to the policy of prohibition, and of course the obvious alternative is to get rid of criminal involvement by legalising and regulating all currently illegal drugs. But, sadly, this alternative is forcibly rejected by the Government. In a response to the Home Affairs Committee in 2002, the Government said:
"We do not accept that legalisation and regulation is now, or will be in the future, an acceptable response to the presence of drugs".
As I understand it, the Government have two principal arguments for rejecting legalisation and regulation. The first is, as expressed by the noble Lord, Lord Bassam of Brighton, in our debate on
"Legalisation of currently illegal drugs would run entirely counter to the Government's health and education messages. Our educational message, to young people in particular, is that all controlled drugs are harmful and that no one should take them. To legalise their supply for personal consumption would send a disastrously wrong message to the majority of young people, who do not take drugs, with the potential risk of increased drug use and abuse".—[Hansard, 2/3/06; col. 417.]
While that is clearly a risk, I think that in practice it would be substantially reduced by stressing that the move to legalisation was targeted exclusively at the criminal gangs that control the trade. Legalisation would reduce and, it is hoped, eliminate drug-related street crime and get rid of the street corner salesman, whose life is dependent on pushing his sales and encouraging his customers to move up the scale to stronger substances. All that should be welcomed by young and old. Other benefits would be quality control and income from taxation. It need in no way reduce the Government's message that all drugs are harmful; indeed, the anti-drugs campaign could be strengthened and be as effective as, for example, the campaign against tobacco.
The Government's second argument is the international dimension. The drug problem is global. Legalisation in one country could make that country a target for frustrated drug users from other countries and generate new criminal distribution activity. We are also signatories to the three United Nations drug conventions of 1961, 1971 and 1988. Unilateral action may therefore be somewhat limited.
What then should the Government do? I think that they should set up a commission to examine independently the arguments for and against legalisation and regulation. It might be established together with representatives from other countries and should in any case research the experience and aspirations of others. It should also examine the role of the United Nations and the relevance today of the three conventions.
It could be made a European issue. The Netherlands, Switzerland, Portugal, Spain, Italy, Belgium and Germany are all open minded. Only France and Sweden would be likely to be against any move towards decriminalisation. Beyond Europe, Canada and Australia are open minded, and only the United States is the ultimate protagonist of zero tolerance, which is hard to explain, given its experience of alcohol prohibition in the past century.
Sadly, our Government seem wedded to the zero-tolerance stance and, in putting forward these suggestions, we are probably just wasting our time. In his speech to the Labour Party conference a few weeks ago, Gordon Brown said that he would be sending out a clear message that drugs are never going to be decriminalised. Note the word "never". This statement is distinctly depressing and amounts to an open-ended licence to the criminal gangs that control the trade. We can only express the hope that Gordon Brown can be persuaded to change his mind and, as part of the 10-year policy review, at the very least support an open, independent, international inquiry into the pros and cons of legalisation and regulation versus prohibition.
Finally, on the question of cannabis reclassification, it will come as no surprise that I would not support the reclassification of cannabis from class C to class B. Indeed, I would support recommendation No. 46 of the House of Commons Science and Technology Committee's report, "Drug classification: making a hash of it?" of July 2006, to,
"decouple the ranking of drugs on the basis of harm from the penalties for possession and trafficking".
The Government rejected that recommendation.
In conclusion, I repeat my basic concern about how our sophisticated democratic Government can live with a situation where the second largest traded commodity after oil is totally in the hands of criminals.
Lord Richard (Labour)
My Lords, I shall be brief. I have three points to make and then I shall sit down. Before I start, may I say that I am disappointed with the Government's consultation paper. It asked a large number of questions, all on the periphery of the argument, and failed to ask the really important ones. The only reference in the document to the consideration of a real change in Government strategy appears on page 27, a part of which the noble Lord, Lord Cobbold, drew attention.
What does it say? Under the heading, "Questions for Consultation", it asks:
"What are the most effective ways of preventing and reducing the harms caused to young people and families by drugs ... How can we improve the effectiveness of specialist drug treatment services"?
Those are two admirable questions. It continues:
"What more could be done to reduce the impact of drugs and associated crime on local communities?"—
another good question—
"How can we further reduce the supply of drugs ad improve detection and the prevention of importation"?
That is a pretty strong question. Finally, the question that the document should have addressed at the outset:
"What could we do more efficiently? Where is value for money not being delivered"?
On any view of the matter, the Government's drugs policy has transparently failed. I do not particularly blame the Government for this. The same is true of almost every other country on Earth, whether that country has capital punishment for drug dealers and carriers or whether, as in this country, we have strong prison sentences.
It is worth while looking for a moment at what the drugs strategy was meant to achieve. As I understand it, when it was amended in 2002 it had four major elements: first, preventing today's young people from becoming tomorrow's drug users; secondly, reducing the supply of illegal drugs; thirdly, reducing drug-related crime and its impact on communities; and fourthly, reducing drug use and drug-related offending through treatment and support, and reducing drug-related death. Taken as a whole, none of these has been entirely successful, and most have been spectacular failures. We have not succeeded in controlling the supply of drugs. We have not succeeded in curbing the number of young people who are becoming users. We have not succeeded in radically reducing drug-related crime, and we have not done very much to give drug addicts proper treatment and support.
Like the noble Lord, Lord Cobbold, I recommend that noble Lords look at the document issued by the North Wales Police Authority in response to the consultation paper we are considering today. Its view is clear, and interesting not only for what it says but whence it comes: that that police authority should urge the repeal of the Misuse of Drugs Act 1971 and its replacement with a "misuse of substances" Act based on a new "hierarchy of harm" that would also include alcohol and nicotine. It also advocates that the police authority should seek affiliation with the Transform Drug Policy Foundation, which is campaigning for the repeal of prohibition and its replacement with a legal system of regulation and control. These are bold recommendations, coming from a police authority.
I have not come to any conclusions easily or quickly. If the drug strategy were working, then it would clearly be much better that it should be allowed to work successfully. But it is not working successfully, and we must now accept the reality of its failure and start asking ourselves what alternative policies we could substitute which might be more successful. I am not in a firm position to suggest many such policies. My inclination now is much the same as that expressed recently by the noble and learned Lord, Lord McCluskey, in somewhat bold phrases:
"If people are addicted to heroin, give them heroin. I'm not suggesting you sell it at newsagents, but if you were to offer it to addicts in a medically controlled setting, there would be no criminal market".
That argument seems to me to be unanswerable.
The politics of this issue are decidedly complicated. It is one of those topics that a Member of Parliament who has to stand for re-election would find very difficult indeed to discuss. There are no votes in the reform of drug policies, but there may be votes in drug toughness; certainly, there would be greater peace from the tabloids if an MP or Government were to do that. It is, however, precisely the sort of issue that your Lordships' House is very well fitted to examine. Like the delicate issues of human fertilisation and embryology, a detailed examination of the existing drugs position, the present drugs policy and the alternatives should be undertaken either by a committee of your Lordships' House or, alternatively, by a Royal Commission.
The problem will not go away. Governments have for many years tried to make it go away and they have not succeeded. It is time that we had, at some level, a major, dispassionate and objective look at the policy and the possible alternatives. This House is in a position to play a major role in areas where the other place cannot. The problem is not at present being solved and it needs to be. I frankly know of no other way of sensibly proceeding with the matter.
Baroness Finlay of Llandaff (Crossbench)
My Lords, I intend to address the evidence base for the strategy on drugs and the changing face of drug use and addictions. They are not synonymous but, of course, associated. I also intend to question how our domestic drugs policy is linked to international policy, because demand and supply are integrally linked. Last week, we debated a major drug: alcohol. Alcohol is a legal drug associated with the problems of other substances that are not legal, but seems to have slipped through this drugs policy net.
First, let me congratulate the Government on taking a harm reduction approach, following on from the 1998 strategy. I declare my interest as a member of the UK Drugs Policy Commission and the Advisory Committee on the Misuse of Drugs.
Much has been achieved. The national treatment agency seems a good idea. The National Institute for Health and Clinical Excellence guidance is clear and draws on evidence, as far as we have evidence. But that is the problem. The knowledge base to underpin the strategy is woefully underdeveloped through lack of investment in UK research in the field. Changing classifications, legalising or not, is tinkering with the drugs while crime is rife. But why is addiction occurring? We understand neither the problem nor the efficacy of some potential interventions. Why is the young brain physiologically so susceptible to addiction? What are the causal pathways into and out of problematic drug use? Why do UK youths have higher levels of addiction than our European partners? Among school children aged 11 to 15, the use of any drug was 21 per cent in 2003 and fell to 17 per cent in 2006, with a commendable reduction in frequent use among children who have truanted or been excluded. But perhaps we could do better—much better.
Interventions such as the drug interventions programme and enforcement activity form the centrepiece of the strategy. Which are the most effective and for which sub-population? We just do not know. Do new substances emerging pose an even greater threat? Or how might some new substance-antagonists that could be produced decrease addiction risk in the long term? Some of those who turn up in accident and emergency with hepatitis C or HIV, or are victims of sexual assault and so on, are sad, pathetic, vulnerable people—victims at the end of a chain of social disaster and exploitation. And then there is another group, if one can generalise, who are locked into crime and criminal activity. Third-party, innocent people in our society are the victims of that.
I ask the Minister why Home Office funding to evaluate and monitor our drug strategy is only about 0.5 per cent of this year's budget for drugs and how that will be rectified. Contrast that with 20 per cent of the US federal drug treatment and prevention budget allocated to research. Will the revised strategy have a dedicated pillar to improve the research and knowledge base, and a programme to deliver this? Without evidence, these policy proposals will be open to unfettered attack from polarised and ill-informed opinion.
Since 1998, the number of people in contact with structured drug treatment services has doubled to 195,000 recorded in 2006-07 in England. Harm reduction programmes have expanded, but one in four of those entering treatment dropped out within 12 weeks of triage assessment and only 14 per cent successfully completed treatment. There are about 320,000 problem opiate and crack users in England, with an unknown number of problematic cocaine and cannabis users and unknown numbers of new problem drug users each year. As a member of the Advisory Committee on the Misuse of Drugs, I have read much about cannabis and we will look again and afresh at it. I simply want to point out that since cannabis was reclassified in class C, there is no evidence of increased usage overall. Classification is a guide to the police and to sentencing, but there is no evidence that classification of a particular drug deters use. Meanwhile, its illegal use must not be confused with therapeutic use in multiple sclerosis. Here the problem is that the well-being of some patients is difficult to quantify objectively. I declare my interest as president of MS Cymru.
The trends in drug use are changing. Syringe exchange schemes reveal a very high use of anabolic steroids as well as opioids, with over 50 per cent of needle exchanges in some areas being anabolic steroid users, often obtained in body-building gyms. Thus needle exchange schemes have become an important source of information to agencies over what is happening in the illicit drug market world. By contrast, UK Sport is very active and indeed effective in its work to rid competitive sport and all sports of all drugs and it is to be commended for its work.
Industrial substances such as benzylpiperazine, gamma-butyrolactone—known as GBL, a precursor of gamma hydroxybutyric acid, or GHB—and also 1, 4-butanediol are being imported through the internet and increasingly abused. Substances such as GBL and 1, 4-butanediol have very wide industrial uses, such as cleaning motorcycle chains, among other things. They are imported by the barrel-load for our industry, so they are particularly difficult to monitor, and as soon as one website is closed down, another pops up, so it is an ever-chasing game.
There is recent evidence of contamination of ecstasy tablets. Ecstasy appears to be ubiquitously available in clubs on Saturday nights, and I remind noble Lords that Methaqualone, also known as Mandrax or Mandy, was prevalent in the 1970s and then LSD had its peak, so we have a constantly changing picture.
The greatest return on investment in managing drugs is likely to be found by further widening the availability, choice and quality of treatment and self-help programmes. The National Treatment Outcomes Research Study estimates the benefit-to-cost ratio as somewhere between 18:1 and 9.5:1, which suggests that for every £1 spent on treatment for opioid users, almost £10 will be saved, but no programme can be effective without motivation to change behaviour, which is why NICE guidance stresses the importance of short interventions to begin motivational change and why programmes such as Narcotics Anonymous and Cocaine Anonymous are effective.
Prison services need improving. I remind noble Lords that deaths from opioids are particularly prevalent in drug addicts who have been away from drugs for some time and have lost tolerance. They go back on the street and have a dose at the same level as previously, but having lost tolerance, they get respiratory depression, often vomit, inhale their own vomit and die. Those particularly at risk are prisoners coming out from prison into the community and those coming from a detox regime who relapse. HM Inspectorate of Prisons recently published The Mental Health of Prisoners: A thematic review of the care and support of prisoners with mental health needs which highlighted the fact that 40 per cent of new arrivals in prisons report drug use. It is sad that that report concludes that there continues to be a lack of co-ordination between substance misuse and mental health services.
Lastly, I shall address the contentious area of the international dimension, which has already been referred to by the noble Lord, Lord Mancroft. The Government state in their report that:
"At an international level, effective counter-drugs policies cannot be separated from broader foreign policy",
"About 90 per cent of the heroin that reaches the UK originates in Afghanistan and passes through Turkey and the Netherlands".
The current policy is failing. The cost of street heroin has fallen to £54 per gram, despite record drug seizures. The consultation document goes on to point out that:
"Afghanistan is a particular priority for the UK".
In a response to Frank Field MP regarding the UK counter-narcotics strategy in Afghanistan, the Prime Minister wrote:
"Eradication is the responsibility of the Afghan Government and is set out in the National Drug Control Strategy. The Strategy takes an integrated approach and focuses on four key priorities - targeting the traffickers; strengthening alternative livelihoods; developing institutions and reducing demand. It is not an eradication-led strategy, but recognises that there is an important role for eradication".
The experiences of Pakistan and Thailand have demonstrated that ridding a country of illegal opium production is a "long and difficult process"—those words are from the Government's own report—so why not encourage contracts with farmers who grow poppies? Buy up the raw opium through contracts, rather like a common agricultural policy, and require the production of another crop as well. A breach in the contract by selling to organised crime could have some sanction associated with it, and policing would be the responsibility of the Afghan Government, not ours, which is compatible with their declared policy. If I were a farmer with mouths to feed, I would grow what I know best, and I would hate with every ounce of my body someone who destroyed my livelihood and my ability to feed my family. That is human nature. With a steady contract and a decent price, the farmers might even have a higher standard of living than at present.
The noble Lord, Lord Malloch-Brown, informed this House last week that the market for legal poppy for medicinal use is already crowded and there is no additional demand. I do not believe that it is beyond the wit of government to use financial incentives in other parts of the world to encourage diversification. Others growing poppies could easily divert and start producing other substances. I am thankful that the UK does not endorse the US approach of herbicidal spraying, but however a crop is destroyed, there are costs. There are indirect costs to our international security. It must be better to grow poppies than to grow terrorists.
Nearly 20 per cent of the world's top medicines were discovered in Britain. This pharmaceutical expertise is a national strength. With drug development costs around £550 million for each drug, a free government-purchased supply of raw opium would not even dent the costs, but it could make obtaining substrate easier.
The raw opium could be supplied for research and drug development, to develop new analgesics with lower addiction potential and fewer side effects and to develop longer-acting antagonists to help addicts stay off drugs. Our pharmaceutical industry should also be urged to manufacture cost-controlled analgesics to supply those countries where millions suffer and die daily without any analgesics because they are too expensive, even if their country allows them to be prescribed. Make no mistake; in some countries you cannot even get analgesics.
I urge the Government to think again; it is not too late to rethink the international dimension to the drugs policy.
Lord Ramsbotham (Crossbench)
My Lords, I am conscious that there are many experts in this House who know a great deal about this subject. I hope that the Government will listen carefully to what they say.
We are frequently told that what we are involved in is a war on drugs. So, as a former soldier, I thought that, rather than just look at the consultation document, I would carry out an appreciation of the problem as one might if one were taking part in a war—by looking at all the factors to be considered and at whether there are gaps or anything else that needs to be weighed in the balance. I shall run through this appreciation very shortly, because I should like to expand later on a number of its aspects.
An appreciation begins with the ground—but I do not think that there is any argument about the ground over which this war is being fought. It is the economic, social and political well-being of every country in the world and the well-being of every man, woman and child in those countries. It is nothing more, nothing less.
Where is the enemy whom we are considering? Again, I think there is little argument about that. The enemy are those who grow and supply the harmful substances that put the ground at risk, in particular the dealers, whom I regard as about the most despicable beings on Earth. Terrorists, murderers and paedophiles all may have some reason for turning to those particular activities; dealers are interested only in themselves. Their greed and demand for personal gain pay no attention to the misery that they are causing to the people to whom they deal these substances.
Our own troops are difficult to identify in this largely intangible war. International cooperation has already been mentioned. The Government mention national policy and strategy in their documents. Information and statistics have been quoted. There is also public opinion. Finally, there are treatment agencies, which also have been mentioned. Those are five things and perhaps there are more.
What is the aim of this war? The Minister expressed it very clearly in the introduction to the consultation document. It is,
"to address the complex and wide-ranging problem"
of damage caused to individuals, families and communities by illegal drugs.
That is the aim of the war and the ground. The enemy has been identified, and our own troops have been identified. One has now to look and see how effective our own troops are at tackling the enemy. Looking at the evidence, I believe that this war is not being won. All the evidence, however produced, does not seem to satisfy any suggestion that it is being won.
Complacency has been mentioned, and the Minister said that the Government are not complacent. However, any document that can show such figures on the appalling number of people still involved in taking these drugs while using the phrase "huge success" is complacent.
I was interested that one response to the consultation document, by an organisation called Transform, said that the Government know,
"that its support for drugs prohibition creates significant harms ... The submission demonstrates how the Government: manipulated the entire consultation to close down genuine debate on drug policy; set the framework in such a way as to have determined the outcome before the consultation had even finished; ignored ten years of constant criticism of its drug policy; hid internal reports critical of prohibition; treats criticism of drug policy with disdain and contempt; refuses to evaluate prohibition; is a hostage to US inspired geopolitical forces; and uses drug policy for electioneering ... This is despite the fact that the Government admits that prohibition itself is a significant cause of harm".
Transform is not just a back-street organisation; it is extremely serious, involving a number of people coming together to discuss the problem, which they have done for many years. The response continues:
"The consultation should have been a thoroughgoing review of the policy making process and the impact that policy has in the everyday world. In the event, it turned out to be a sham. The consultation document is another dodgy dossier. It contained no proposals, breaking one of the fundamental rules for consultations".
I am sorry that the Government did not produce a more substantial consultation document after the first strategy from 1998 to 2002 and the second period from 2002 until now. I now come to the next element in all this, which is the information and statistics that are presented. They have already been referred to by the noble Lords, Lord Mancroft, Lord Cobbold and Lord Richard. I have always been especially concerned about prisons, which have been mentioned. When I first went into prisons, I was told that policy was being built around something called a mandatory drug test, in which 10 per cent of prisoners were tested every month. The aim was to reduce the number who tested positive. The figure of 10 per cent has gone down to 5 per cent. In one prison, I found a man with nine certificates on his wall. I asked what they were. They told me that he did not use drugs and that they showed that he had tested negative and if I came next week, there would be a 10th. That meant that they could always keep their figures up.
In Wymott Prison, a large prison half for training and half full of sex offenders, they said that there were no drugs. I did not believe a word of it walking around the training wing and I then discovered that the only people that they tested were the sex offenders who did not use drugs. When I went to Rochester Prison, I was told that there were no drug users either among the young offenders or the people in the ordinary part of the prison. I did not believe it. I discovered that they were inspecting the asylum seekers and immigration detainees, who did not have access to drugs, and claiming that they had zero drug use. Rubbish. I was appalled to see in the consultation document that this nonsense is still being perpetuated, because it states that positive tests are down by 58 per cent from 1996-97, from 24.4 per cent to 10.8 per cent for 2005-06. I do not believe that the level of drug use in our prisons is 10.8 per cent. If you believe that and base policy on fudged figures, you will have fudged results.
I mention that because I am extremely concerned that if you are fighting a war, you must do it on hard information and evidence. You cannot do it on fudge. If you do, you will end up with a fudged result. That is why I am extremely concerned about two things. One I shall deal with very shortly, because I hope that the Government will take note of it.
Another reply to the consultation comes from 18 drug organisations which have put together a paper on residential treatment. Residential treatment is known to be the most successful way of treating people who are addicted, but it takes time. The trouble with too many of our treatment programmes is that they are short and that people do not get full value from them. Yet the figures show that our residential homes are not as full as they could be, and some have had to close. I commend the fact that the report includes these 18 organisations. Not all of them are involved in residential treatment; a number of people are involved in either harm reduction or addiction programmes, and they support the case for these. They have the sense that too many areas will not place people in treatment programmes that run for more than three to six months. This is simply not sensible when tackling deeply entrenched behaviour. My concern is that I find no evidence in the consultation document that that sort of view from people on the ground is being sufficiently noted.
Finally, my conclusion that prohibition has been excluded is derived from the fact that it is not mentioned in this consultation document at all; nor is legalisation or prescription. It assumes that this policy, which has been pursued and has failed, is to go on. I therefore do not believe that this consultation document is a worthy one on which a future strategy should be based. Too much of the evidence is suspect. Most particularly, I do not believe that all the things that have been proven to work, even though they cost money, have been included. I agree very strongly with my noble friend Lord Cobbold that a commission, rather than a consultation document that does not include proposals, is needed to go into not only the aspects which the Government choose to include but all the aspects that are known to people, including the problems of the prohibition, legalisation and prescription of drugs. The latter must have a role because, as sure as anything, what is happening now is failing, and we as a country cannot afford to go on allowing that to happen.
Lord Brooke of Alverthorpe (Labour)
My Lords, I am associated with several charities in the drug and alcohol field, but today I speak particularly as a trustee of Action on Addiction, which is well qualified to offer a meaningful contribution to the new strategy. It operates long-established treatment services in both the residential and non-residential sectors, such as Clouds House, which are acknowledged as some of the best in the country. It has facilitated cutting-edge research, and has shown leadership in the development of services for families affected by addiction, including children, through its Families Plus service. It has also established world-class courses for training addiction counsellors at its centre for addiction treatment studies.
My contribution will probably be a little different from that of most who have spoken so far, as it focuses on the treatment, family support, workforce development and research sections of any new strategy. On the issues that others have addressed tonight, my view is that, regardless of whether we decriminalise drugs or have more effective enforcement, people will continue to suffer from addiction, and they need help to recover from it. After all, alcohol is legal and has been deregulated. Do we have addicts? Of course we do. We have an increasing number of addicts; there are four times as many addicts of alcohol as there have ever been addicts of drugs. We must bear some of those issues in mind when we consider how to deal with the nuts and bolts of addiction and with addicts, which is the purpose of my contribution.
A significant amount of money has been invested over 10 years of drug treatment. As a result, we must acknowledge that more people have had access to some kind of treatment and, somewhat late in the day, we are starting to see a growing recognition of the need to provide proper support to families and carers, including children. In some areas, there have been clear improvements in commissioning and service provision. However, while some improvements have been made over the life of the current strategy, they are not wholesale across the board or deeply rooted, and much more needs to be done to ensure that we continue to make further progress both in treatment delivery and in the systems within which treatment services must operate. To do so, we must learn the lessons of the past 10 years and act accordingly, and I bring that home to the domestic scene rather than the international one.
First, given the extent of the problem and its national impact, it is a scandal that so few people who need treatment for alcohol dependence are able to access it: currently, only one in five, according to Alcohol Concern. That is an over balancing of the direction of resources in the drug treatment field. I am not arguing that the amount of money spent on drug dependency should be reduced, but there should be a better relationship between expenditure on alcohol and drug addiction than we presently have instead of having separate silos. The national treatment agency is the National Treatment Agency for Substance Misuse, not only drug misuse, and if it is to continue it should be allowed to act according to that encompassing remit.
We must avoid repeating the mistake of over investment on treatment obtained via the criminal justice system; most of the debate so far today has been about that. If things continue in the same way it will be at the expense of voluntary access to treatment. There must be a balance, otherwise we will continue to see the perverse situation of addicts committing crimes to get treatment and those who could otherwise have avoided the criminal justice system by entering treatment, being caught up in it. It is important that we avoid that.
Treatment should be obtainable in a timely way that takes advantage of any appearance or increase in the addict's motivation to change, something that the noble Baroness, Lady Finlay, has raised previously. We should continue to ensure that a harm reduction platform is secured in order to stabilise those with chaotic lifestyles that have such a widespread damaging impact. But we must ensure that the process does not stop there, as it has tended to do over the past 10 years, with thousands piling up in a methadone cul-de-sac. Everyone should be offered and encouraged to take the opportunity to make meaningful progress to a life completely free of drug dependency. High on my wish list would be a drug strategy that fostered independence and abstinence if possible, not a dependency on other drugs.
Next, we must undo the equation that treatment inevitably and exclusively means medical prescription, and recognise that psychosocial interventions are, in the end, likely to play a key role in preventing relapse to illegal drug use. If we know that various forms of social support are key to sustaining recovery, we should ensure that we target adequate resources to that purpose. We must continue to ensure that pathways of care are commissioned, rather than unrelated treatment, rehabilitation and care episodes—where everything is dealt with separately and never brought back together through pathways of care. We must cease the obsession with outputs—numbers in treatment—and focus on outcomes and the quality of treatment inputs needed to achieve them.
At the moment, "in treatment" can mean anything and very little, and result in the experience of being caught in a rapidly revolving door or endlessly treading water in a sea of prescriptions. It is all very well for the NTA to trumpet 180,000-plus people "in treatment", but that says nothing about the quality and effectiveness of that treatment. As the NTA itself has said, quantity without quality is a waste of resources. It also wastes lives and exacerbates and demoralises people. Commissioning and purchasing should be driven by the need to secure targets related to volume and price.
The quality of commissioning, purchasing and care management needs significant improvement in many areas too. Training is essential to achieve this. For a start, there should be consistency across the country, and more controversially, I suggest that we should divest from poor quality, wasteful NHS services in this arena. I know that that will upset many of my noble friends within Government, but money is going in and in many instances it is not producing the results that it should. If that money was directed to the voluntary sector, we would see far better outcomes and value for money than we are at the moment. We should move funds to the voluntary sector, particularly into the residential services that were mentioned previously, and we should examine them to ensure that people are providing value for money and getting good results. In turn, they should be given the cash to ensure that beds are filled. Many of them were left empty last year and the same has happened this year. When people are crying out for treatment, it is a scandal that beds are left empty. They could be used to assist people to get back to sobriety.
I move to a separate subject. We must rationalise the current wide variety of regulations and standards and produce a coherent, workable system that can be applied across all the models of care. I suggest that we should make a start in the area of residential treatment and see whether we can introduce some standardisation and commonality of approach. Gradually, we could then roll that out over a wider area. Further, if we want to make the most of the voluntary sector's considerable expertise, we must be prepared to keep to the commitment that voluntary organisations are able to recover the full costs of providing services in line with voluntary sector compacts. We must rigorously examine the ratio of spending on bureaucracy to that of spending on actual service delivery and training. Why should good services that directly benefit people's lives struggle for resources while new government agencies grow and grow, consuming funds? As an aside, we seem to have far more conferences and receptions. I suggest that a good start would be to halve the conferences and receptions planned for the coming year. We would then release a significant amount of money that could be put on the front line to assist addicts and their families.
Turning to families, there are many more people affected by substance misuse than there are substance misusers. The evidence of the impact on their lives suggests that this constitutes a major public health issue and should be addressed as such. The health and cost benefits of providing proper support to families affected by substance misuse are likely to be very significant indeed. I would argue that that the key recommendations published in HiddenHarm should be implemented without delay. That would ensure that the 1.3 million children of substance misusers receive the help they desperately need. Action on Addiction has developed an effective brief intervention called M-PACT that supports these children, and which we are now aiming to make more widely available across the country. I would be happy to show the details of that intervention to my colleagues on the Front Bench if they would like to examine them in the context of the strategic review.
A competent workforce is also essential to quality and effectiveness, but it is no good highlighting how important workforce development is, noting the continuing deficiencies in knowledge and skills, while at the same time failing to provide any tangible support to those like Action on Addiction's Centre for Action Treatment Studies. We need to resist investment in short-term, superficial training, which has little lasting impact, in favour of courses that produce competent professionals with portable skills. We also need to see the further roll-out of treatment programme accreditation and schemes such as that organised by the European Association for the Treatment of Addiction. It is all about quality rather than numbers, because it will be quality that produces the desired results in the end.
I believe that we have made some progress over the past 10 years—I am not as critical as some of the previous speakers in the debate—but there is much work to be done. If we begin to address some of the nuts and bolts issues in detail in the way I have endeavoured to address them, as well as looking at the wider national and international issues, we have a prospect of making more progress in the ensuing strategic period of the next 10 years.
Lord Adebowale (Crossbench)
My Lords, I apologise for missing the Minister's opening of the debate and the contributions of the noble Lords, Lord Mancroft and Lord Cobbold. I was told the debate was starting at 6.30 pm and I had to go and earn a living. I apologise to the House for my late arrival but, even having arrived late, I have listened to some excellent contributions. I hope that I can add some value to the debate from my position.
There is a sense of déjà vu or groundhog day whenever there is a drugs debate; the issue becomes one of legalisation versus prohibition. I do not want to go there, save to say that the remarks of the noble Lord, Lord Brooke of Alverthorpe, are common sense: we need to start from where we are as opposed to where we wish to be with our drugs policy. The question here is about treatment and, in that regard, I should declare an interest as a member of the ACMD, that much maligned but interesting group of people, and as the chief executive of the social care organisation, Turning Point, which I am told is the largest provider of substance misuse services in the voluntary and/or third sector in the country. We have a body of knowledge from which to speak and that is why I thought it would be useful to contribute to the debate.
Turning Point provides services across the range, from tier one to tier four, and this includes both community and criminal justice services as well as residential services. For the majority of our service users, substance misuse is only one of a range of complex needs which contribute to their social exclusion. We need to take this on board in discussing the drug strategy if we are not simply to do what we have always done. If we do, as Einstein pointed out, we will get what we have always got, which is a sense that we have not moved much further from where we are.
Let me give your Lordships some facts. Half of the people we see at our drug and alcohol services suffer from mental health problems. Around half of those accessing drug and alcohol services have mental health problems according to the Department of Health's own figures on dual diagnosis, and 84 per cent of homeless people have drug or alcohol problems. Regardless of which side of the House you happen to sit, we need to acknowledge that the Government have made major strides in drug policy over the past 10 years. You may argue that getting people into treatment is not enough, but we would all agree that it is better than not having people in treatment. The Government have got more people into treatment with a significant programme of investment, and it is essential that they continue to invest in and improve the success of existing treatment approaches, and increase the numbers of people entering and completing treatment.
I further agree with the comments of the noble Lord, Lord Brooke of Alverthorpe—the noble Lord, Lord Ramsbotham, also made these points—in relation to the criminal justice system and the balancing of investment to ensure that we do not get perverse incentives. I have received letters from fine, upstanding middle-class members of our community who have had sons and daughters commit crime in order to access treatment. It is not the intention, but there is a perception that there is a fast route to treatment through the criminal justice system which I would like to see rebalanced.
So what do we do? Where are the solutions to be found? Let us take a forward looking, positive approach to what can be done. We need to deal with and manage better wrap-around care. It is time to build on the success of the past 10 years and not denigrate it for its failings. We need a new drug strategy which is ambitious for substance misusers and ambitious about their potential to re-enter and contribute positively to our communities. It is not always a dead-end for many of Turning Point's and other services' clients. The Government must build on the existing framework so that treatment encompasses the full complexity of substance misusers' needs and provides wrap-around support to enable them to take a full role in society.
The areas of people's lives that need specific support are employment, housing support, healthcare and issues such as support on leaving the criminal justice system. My own organisation and others—I am not simply going to advertise Turning Point—have specific measurable outcome-focused programmes that have been shown to work, and require further investment and attention for those programmes to be rolled out so they are working everywhere, not just in the places that are lucky enough to have them. Those services are the stepping stone allowing current and former drug users to become citizens again—positive citizens—and that must be the aim of the Government's drug strategy, along with moving them away from the social exclusion that substance misuse can create.
Helping drug users into employment and providing stability links in with the Government's agenda on increasing the number of people in paid employment, reducing benefit dependency and targets for social exclusion. It is imperative that people do not fall off the end of the conveyor belt of the treatment journey with no ongoing support. The drug strategy must make wrap-around care an essential part of a drug user's treatment journey, not an add-on or an optional extra. There must be clear targets for commissioners and providers to prioritise these essential services to deliver more integrated and effective solutions in drug policy.
If you simply set targets, they will be reached. We have all come across the concept of "gaming". What we know and what we need to learn is that organisations like mine need to add value. The point is not just to get someone into treatment but to get them into positive, active citizenship. We—and I personally—are not against the idea that noble Lords have mentioned of managing harmful drug addiction through treatment with alternatives like methadone. It is not a moral question, simply one about what works for the individual and their relationship with the treatment that is appropriate for them.
Turning Point and others recommend an integrated approach to the treatment of substance misuse through extended interpretation of treatment to encompass these wrap-around services and aftercare support. I would also include financial advice and housing support as part of the integrated treatment process. We recommend that the new drugs strategy includes a target focused on the requirement to provide integrated aftercare support for substance misusers, built into their treatment plan. That must also include support for the more problematic users and specific aftercare support for offenders.
Since the publication of the previous drugs strategy, patterns of drug use have changed. The new strategy needs to reflect that and develop new services to build on current provision. The increasingly complex needs of drug users, as the noble Baroness, Lady Finlay, mentioned, and the lack of tailored and flexible accessible services to respond to those changes are a significant challenge for the Government over the next 10 years. The Government must address the wholesale absence of treatment systems specifically for crack and stimulant users and for those with dual diagnosis of substance misuse and mental health problems. With half of substance misusers already having a mental health problem, as I have mentioned, the Government cannot afford to ignore the needs of that client group who may access services only when a crisis point has been reached, often becoming NHS "frequent flyers", clogging up A&E departments and becoming the very people who cost us the most.
Users of other substances often turn up at our services simply because they have nowhere else to go. That includes those with problems with the stimulant khat, those using prescription drugs and steroid users. Alcohol misuse is a significant problem affecting individuals. It feels like déjà vu to say it, but we plead with the Government to take due care about what is said about alcohol. It is a significant challenge to the social infrastructure of this country and the Government need to pay attention to that. Alcohol services are less common than drug services and less likely to be part of a co-ordinated response with other agencies; for example, with children's services. Turning Point's own report identified that tonight one in 11 children will have gone home, if it can be called "home", to a place where their parents or carers are misusing alcohol. I emphasise that: tonight. We are calling for a national inquiry to investigate fully the scale of the problem and identify recommendations for service delivery to support those families.
In order truly to come of age, the next drug strategy should be an integrated substance misuse strategy that covers all problematic substance use. It is essential that the new drug strategy addresses dual diagnosis—co-existing substance use and mental health problems—and acknowledges the Dual Diagnosis Good Practice Guide.
In addition, the new drug strategy needs to turn its attention to blood-borne viruses. We at Turning Point are concerned that, despite the welcome and necessary increased investment in drug treatment, there has been an alarming increase in blood-borne viruses. We contacted nearly 900 injecting drug users across England and asked them about their injecting practices and blood-borne virus status as part of our report on blood-borne viruses, At the Sharp End. Our findings are truly alarming. There is a new generation of injecting drug users, using heroin and crack together, who are at greater risk of infection and may not have been tested or received treatment for their illness. We recommend that the new drug strategy sets out a clear commitment to reduce the transmission of HIV, hepatitis B and hepatitis C and improve access to treatment with clear targets to ensure delivery. This is a public health matter; it is not an issue just for the drug-using community; it will affect us all and the generation to come. We must act.
In too many drug action teams there is an inadequate understanding of commissioning. Commissioning should be the means by which one understands the needs of the client, and/or the community in which they live, to build a platform for procuring appropriate services. That often does not happen. One gets cheap purchasing of the cheapest service, which is why residential services are not often focused on and there is often an odd mismatch between what NHS provides, because of its relationship with the commissioners, and what the voluntary and third sector provide. Commissioning must be clearly defined, and commissioners must be held accountable for the process of commissioning drug services. They must be able to audit and provide evidence of the methods that they have used to understand the needs of their community.
I have a positive attitude toward the Government's drug strategy. Much has been done that must be acknowledged, but there is much yet to do—to coin a phrase. I shall end with a story, because it is important that we bring the individual into the debate. I shall talk about someone who represents the aim of the Government's drug strategy, which is to produce positive citizenship in our approach to treatment.
Cathy is 27. She was referred to Turning Point's employment and education support project, which supports current and former drug users who wish to access learning or work opportunities. She was on a methadone script, but continued to use heroin as well, partly through boredom and partly through the lack of proper continuing support. That happens a lot; whether one likes it or not, that is the reality. She wanted to go to the gym and return to study—substance misusers often say such things. We at Turning Point sat down with her and helped her work through the funding requirements for a passport to leisure and arranged an appointment for her to use Adult Directions software to help her to decide what course she wanted. We helped her engage with her fitness desires and to understand the realities of becoming involved in fitness programmes in colleges. We also made sure that at every point of potential failure she was supported to take the next step forward.
To cut a long story short, Cathy is still on her course; she is doing a national diploma in animal management; she is enjoying it; she has stabilised her drug use and is no longer topping up her methadone with heroin, which is a big step towards total abstention from drug use that we must understand. She is due to start a work placement in conjunction with her course in January, and we will continue to support her in finding a suitable work place. Cathy has recently become engaged to her partner and is excited about the possibilities that her future now holds. We work with tens of thousands of potential Cathys. I urge the Government in their drug strategy to ensure that what we can do through wrap-around care helps all the other Cathys and people like her in this country.
Lord Jay of Ewelme (Crossbench)
My Lords, it is surely a tribute to the noble Lord, Lord Williamson, attending his last debate as Convenor of the Cross Bench Peers, that more than half of your Lordships present this evening are sitting on the Cross Benches.
I shall focus on the supply side of the drugs issue—where the drugs come from and how we should try to reduce and control the supply into this country, and thus the harm they do and the harmful criminal activity they spawn. I have deliberately chosen to speak in this debate rather than in last week's debate on Afghanistan and the Middle East in order to emphasise the point—as did the noble Baroness, Lady Finlay—that the supply and demand of drugs are two sides of the same coin and cannot be considered separately. In that context I was disappointed that less than one page of the consultation document is devoted to questions of supply.
The facts are straightforward—around 90 per cent of the heroin sold in Britain comes from opium poppies grown in Afghanistan, most of it reaching us via Turkey, the Balkans and the Netherlands. The great majority of the cocaine sold in Britain comes from the coca plant grown in Colombia and in neighbouring South American countries, reaching us direct from South America or via the Caribbean, especially Jamaica. The Government's basic approach, working with the Governments of the source and transit countries and through multilateral organisations including the European Union and the UN, is to seek to eliminate production, disrupt transit routes and thus reduce the flow of illegal drugs into this country. I have great admiration for those carrying out this policy. I have seen at first hand, for example, the work that the British authorities are doing in Jamaica, in close co-operation with the Jamaican authorities, to interrupt the supply of cocaine through Jamaica to the United Kingdom. I greatly welcome the unprecedented co-operation that we are now seeing among the different UK Government agencies involved—the Home Office, the FCO, SOCA, the intelligence agencies, the Armed Forces and HM Revenue and Customs. That co-operation is admirable and necessary and, as the noble Lord said in introducing the debate, there have been striking successes.
I have huge admiration, too, for the work of our troops in Afghanistan, particularly in Helmand province in the south, to combat the Taliban and Afghan warlords and, working with DfID and other colleagues, to try to persuade Afghan farmers to switch from the opium poppy to other crops. But the question that we have to ask is whether this approach is working or is likely to work, or whether there are other approaches that may—I emphasise "may"—be viable alternatives.
Let us consider Afghanistan, as others have done. There is some good news. The noble Lord, Lord Malloch-Brown, told your Lordships last week that the number of poppy-free provinces in Afghanistan,
"has increased from six ... to 13".—[Hansard, 23/10/07; col. 1013.]
over the past year. That is good but the noble Lord also told us that the total area under cultivation in Afghanistan rose this year by 17 per cent, and that cultivation in Helmand Province has risen this year by 48 per cent, following a rise of 162 per cent last year. According to the Senlis Council, which has done a great deal of work on this over the past few years, the cultivation of illegal opium now directly involves 13 per cent of Afghanistan's population and the indirect figure must surely be a good deal higher.
Faced with that evidence it seems to me that we have to ask ourselves whether the present approach to controlling poppy production in Afghanistan is right or whether there may be a better alternative. The Senlis Council, which as I say has studied these issues in great detail, has proposed that there should be in the first instance a pilot project to examine the feasibility of controlled production for medicinal purposes, using the local community structures in Afghanistan and working with the Afghan Government and international agencies. It seems to me that that approach of controlled production for medicinal purposes has real merit and needs to be closely examined. I accept that there are arguments against that approach, as the noble Lord, Lord Malloch-Brown, explained last week. I welcome his proposal for a more structured approach to the cultivation of alternative crops in Afghanistan to make them more attractive to growers by comparison with the opium poppy.
That approach is not incompatible with controlled cultivation of the poppy as well. I did not find wholly persuasive the arguments made by the noble Lord, Lord Malloch-Brown, against controlled cultivation; I refer in particular to the argument that there is not at present sufficient medical demand for morphine to justify controlled production of the poppy in Afghanistan. Even if there were insufficient demand, there might still be advantage in controlled production; benefiting growers, local communities and the Government and squeezing criminal activity. The bigger point is that the argument about insufficient demand today is a static argument. At present, 80 per cent of morphine is consumed in five developed countries, including the US, the UK and France. The developing countries, with 80 per cent of the world's population, use 5 per cent of the world's supply. The objective need for morphine for patients in the developing world is no less than in the developed world, not least for palliative care. As countries develop and as health delivery systems improve, that demand will grow.
That, surely, is the context in which we should be considering opium poppy production in Afghanistan and elsewhere. Can the international community put in place an internationally controlled regime of poppy production that will help to meet the growing demand over the years ahead in the developing world and the developed world? How can we work with Governments in consumer countries to ensure effective and controlled user regimes?
The arguments in respect of cocaine and coca are more complex. There are medical uses for the coca plant, as local anaesthetic and for the creation of bloodless fields in surgery. That is much less significant than the importance of opium and morphine, and there are effective alternatives. Furthermore, our influence over the control of coca production and trade in South America, where US influence clearly predominates, is less than over poppy production in Afghanistan, where Britain has the lead in co-ordinating the international anti-narcotics effort. Nevertheless, given the scale of the harm that cocaine and crack do to our society, the perverse influence of international crime that flows from the policy of prohibition and the misery that the resulting conflict causes in Colombia and other producing countries, it seems to me that we should be looking with a genuinely open mind at alternative approaches thereto.
None of this is easy but, to say the least, it is not obvious that the present policy of prohibition is working or will work in the future. Surely the Government now need to look, perhaps via a commission, as some other noble Lords this evening have proposed, with international partners and with a genuinely open mind at alternative approaches to supply, in particular in relation to the opium production in Afghanistan. I hope that in closing the Minister will be able to give us an assurance to that effect.
The Earl of Erroll (Crossbench)
I will talk later about what I see as some of the causes, but I want to start with the old saying that laws seldom prevent what they seek to forbid. The real problem is the politicians' public posturing to try to get headlines that they are being tough on things, without thinking of the effect. That means that changes can be very tricky, because I can imagine the newspaper headlines screaming out the moment someone wants to take one of the more sensible approaches that have been recommended by several noble Lords, including the noble Lords, Lord Cobbold and Lord Mancroft.
I see drug abuse as primarily a medical problem rather than a criminal problem; the criminals flow from it. The challenge is that most of us use a drug of some sort. Most of us stick with legal drugs, such as alcohol or nicotine. Some of us use coffee to speed us up. Others use the expression, "I could murder a cup of tea"; there is a drug in tea, which is why people so long for it. We need pick-me-ups; we need things to help us to interact socially, because we are shy, or to cope with the stresses of life. Some people can handle drugs in sensible quantities and in a controlled way. Unfortunately, some people cannot; some people are less stable and not everyone is normal—in fact, who is? We all have differing degrees of stability or instability.
It is no good when people who are very stable say to those at the edges, "You must not do this and I'm going to stop you doing this". The desire to isolate or insulate yourself from life is very powerful. Throughout my life, I have known people who have taken drugs in various ways. Invariably, they have had a need to insulate themselves from the realities of life when things got stressful. That was particularly true of those who took hard drugs. People, including some high-powered businesspeople, could not handle the stress when things went wrong. That is the real problem.
If we then make drugs illegal and crack down on them, as we have done, that forces the price up. At that point, you get the crime problem, as people need to commit crime to fund their habit. There is a point at which people become addicted. There are people on the edges who would not have become addicted to drugs if they had not been introduced to them. I shall return to that point at the end of my little talk.
I am very much in favour of decriminalisation. The British Crime Survey figures, which I read in the newspapers on Friday, show that since the confiscate-and-warn policy came in on cannabis, cannabis use has gone down from 24 per cent to 21 per cent. So it looks like the policy is working. Why reverse it now? Is that not completely perverse?
Let me answer a point made by the noble Lord, Lord Richard. I remember that when, in the good old days, heroin was supplied by doctors under prescription to addicts—that is exactly what used to happen before all this posturing—we had about 7,500 addicts and it was reckoned that there were about as many again who were not registered. In other words, we did not have a serious problem. Then one of the parties—I think that it was the party now in opposition—decided to get tough on these things, since when the situation has become out of control. Clearly, we have gone the wrong way and we should take a lesson from that.
For some history on all this and some facts on addiction and whether you can get over it, there is a very good book, Heroin Century, written by Tom Carnwath, with whom I think I was at school. He did not take drugs but he ended up in the Midlands running a place with a lot of addicts along with a person who had taken drugs; together, they collaborated on the book. It contains a lot of common sense and I highly recommend it for a rational, well argued approach from someone who has been on the front line and sees the truth and the falsehoods of the public statements that people make.
I agree with my noble friend Lord Jay about some of the solutions on the supply side. I have heard it said before that we could use quite a large proportion of the Afghan crop for proper medical and pharmaceutical use. Why not get the pharmaceutical companies to do that? They are used to running well regulated operations with controlled drugs—those drugs that must not get out and be released generally. I am quite sure that they would cope with that properly, particularly with someone breathing down their necks to make sure that they did not put a foot out of line.
On the demand side, why are so many young people turning to drugs? I think that in many cases it is because they are bored out of their skulls. The Health and Safety Executive has closed down things that were fun and exciting to the extent that even the Royal Society for the Prevention of Accidents says that our play places are so safe that people are now playing on railway lines to get their kicks and that we need to make play a little more dangerous. People are terrified of being sued, despite the fact that Part 1 of the Compensation Act says that the courts, which have in the past levied huge fines against schoolteachers and scout masters, ought not to permit a compensation claim if there is a good reason for that or if it would close down a publicly desirable activity. But, unfortunately, the insurance companies do not seem to have noticed that.
We are also selling our playing fields, and that is highly significant. Peer-group pressure plays a large part in drug-taking. You are sitting there with no excitement, no challenge and no risk-taking. You get in with a group of people who are doing something exciting and illegal and suddenly there is peer-group pressure to start taking drugs. There is then pressure, manipulated by the people selling the drugs, for you to take the drugs that they find more interesting to sell because they produce a higher profit margin. People get dragged along by their peer group, and we need to establish activities so that the peer group moves in a different direction—one in which there is a desire to be fit and healthy, to perform well and so on. That is the point of team sports and the activities surrounding them—for example, for the supporters, who are not necessarily as good at taking part, and for the coaches and the mentoring that comes from the coaches. We have destroyed a lot of that through the willy-nilly sale of playing fields.
We must get a bit more excitement and challenge into life. We need to accept that a few more people may get injured or killed taking part in dangerous and risky activities, but that is nothing compared with a generation being wiped out by drugs, which is far worse. We have shifted the problem from an area which was good for society to one which is evil.
Baroness Miller of Chilthorne Domer (Spokesperson in the Lords, Home Affairs; Liberal Democrat)
My Lords, it has been a privilege to listen to the contributions to this debate, and it is particularly interesting that many of them came from the Cross Benches. I fully take on board the inappropriateness of a political response to this problem, with accusations of people being hard or soft, and I hope that my response from these Benches will not be inappropriate. I acknowledge the expertise of the noble Lords who have spoken. I am fairly new to the Home Office brief, so I am very much in listening mode.
One theme running through the contributions was disappointment with the Government's consultation exercise. However, I pay credit to the Government for having brought it forward, because it is time to reassess the situation: drug use is changing; the threat is changing; and the policy options are certainly changing. But the question is whether a consultation such as this was needed. The answer this evening seems to have been very clear: the noble Lord, Lord Mancroft, said that it was a woolly consultation and "thin", and the noble Lord, Lord Richard, said that he was disappointed with the paper.
My disappointment with the consultation paper lay in the fact that it was very wide-ranging. It encompassed drugs in their totality, whether legal or illegal, including everything legal but harmful—for example, volatile substances and alcohol, whether used by a majority or a minority. However, extremely harmful substances such as crack cocaine were barely mentioned in the consultation. It would have been useful if the Government had issued one consultation paper focusing on health issues, both physical and mental, with the aim of stopping people starting on drugs and helping users to quit. That, on its own, would have been a very valid consultation. A second consultation could then have focused on criminal issues, covering legalisation and other issues on which we need to focus, such as on how to deal with criminals and the supply of drugs. In effect, the subject should have been covered by two separate consultations. The Minister said that 1,100 responses came in. I admire those who replied, because it must have been extremely difficult for them to respond to such a breadth of questions, or perhaps they focused on only one or two of them.
The Government are also to be congratulated on some of the steps that they have taken over the past 10 years—for example, in introducing the Proceeds of Crime Act. Other speakers referred to the general downward trend in drug usage, including, as we learnt last week, in cannabis use. I fully acknowledge the justified worry about the new strength of cannabis—the sort of cannabis known as skunk—and about the psychosis produced in some cannabis users. Again, those are specific issues that should be dealt with as health issues. I should have preferred this to be two separate papers: health issues and criminal issues.
Another theme that came through this evening was the issue of supply. I bow to the knowledge of the noble Lord, Lord Jay of Ewelme, and agree with his analysis of the doom and gloom response of the noble Lord, Lord Malloch-Brown, when we debated Afghanistan and poppy cultivation. He had something slightly more cheerful to say when he was talking about a CAP-style support of other products. If we consider the history of Afghanistan and what it used to be able to grow—fruit, nuts, wheat and so on—and think of the world debate around biofuels and the demand for land to grow other things, we see that that is a powerful combination. It is not treating the matter with sufficient urgency to say, as the noble Lord, Lord Malloch-Brown, did, that DfID will look at it in the long term.
As for South America and cocaine cultivation, in the past 10 years the Government have done nothing but withdraw from South America. They have closed embassies there and, although we have a few remaining embassies elsewhere, now regard Brazil and Mexico as the two hubs. However, when we talk to ambassadors in central America we hear that we are fire-fighting instead of being influential players. I part company with the noble Lord, Lord Jay: I do not think it is sufficient to rely on the influence of the United States. The United States' aerial spraying of Colombian fields has not produced the results that it hoped for. It has not proven very effective. A rethink of our attitude to and policies on central America are very much needed.
I turn to some of the other issues which arose in the debate. I was particularly struck by the comments of the noble Baroness, Lady Finlay of Llandaff, about young brains and addiction. The issue was addressed also by the noble Lord, Lord Adebowale, who said that young people have complex needs, and by the noble Earl, Lord Erroll, who talked about the young needing danger. It may be difficult for us to cast our minds back to when we were between 14 and 26, but I think that we did react differently to things then. We needed a kick out of life and some danger. Young people are not stupid; they know that driving fast is dangerous, but they still do it. There are all sorts of issues around why young brains tend towards addiction that merit further exploration.
I completely relate to the issue of complex needs. During my time as a local government councillor, numbers of homeless people presented themselves because they were on drugs. The noble Lord, Lord Adebowale, quoted a figure of 84 per cent of homeless people using drugs, a figure which is no different from eight years ago. There are complex needs in that sector of the population and criminalising them has never helped them. What would help is a recognition that spending money on residential treatment is cheaper and far more effective than prison.
The next issue is whether it is a good idea to have a consultation such as this one when the Prime Minister will only close down the debate by saying that drugs will never be decriminalised, a point already made today. This occurs against a background in which a member of a law enforcement body, Richard Brunstrom, Chief Constable of North Wales Police, has been quoted as saying that he will campaign hard for the legalisation of drugs such as heroin. The evidence of falling cannabis use also suggests that reclassification may have had a beneficial effect.
I pay tribute to the Government's hard-hitting "Talk to Frank" campaign; the telly adverts were extremely effective and no doubt played their part. But surely a consultation such as this, to be effective, must be predicated on no options being closed down. Against that background and the themes running through this debate, we must take this issue out of politics. Several speakers suggested that we should have a commission on this. The Government are setting up a climate change body which will be independent of politics, because hard choices will have to be made there. Perhaps the same should happen with this issue. As the results of the consultation come in, an independent commission could be established. It could move away from the "hard on drugs/soft on drugs" arguments and produce the sort of result that all noble Lords speaking this evening would wish for—a result where the various types of substance harm no longer affect our younger generation and we can move forward into a much brighter future.
Baroness Hanham (Shadow Minister, Home Affairs; Conservative)
My Lords, I join the noble Baroness, Lady Miller, in saying that it has been a great privilege to be part of this debate tonight, and to have listened to acknowledged experts on all parts of the drugs scene. Like the noble Baroness, this is my first Home Office debate, and I look forward to many more of this standard. I also thank the Minister for bringing this debate to this House and his comprehensive introduction of the consultation paper. I agree with several noble Lords that his overview was somewhat complacent, particularly in light of what we have heard today.
The consultation, as has been said, has just ended. I have noted that it is intended that a response to it will be issued within three months, but that that response will appear on the Home Office website. To save all of us plodding through the website—and it is quite a plod—trying to find the responses and what the Government are proposing, perhaps the Minister can ensure that those of us involved in this debate might have that response sent to us. I also hope that, at the end, the Minister will be brave enough to bring those responses—and the Government's response to them—back to this House so that we can have a further debate on what has emerged from the consultation.
No one underestimates the calamitous effect that the misuse of drugs has on young people, families, communities and crime, nor the difficulties in bringing it under control and limiting the damage that as been done to the lives of those involved. This debate has demonstrated that drug abuse is a real and dangerous threat to our society, despite the fact that the Government have devised significant policies to grip the problem. As has been underscored by number of speakers tonight, comparatively little progress in diminishing the situation has been made in effect. However we look at statistics and however much we quote different year starts and different statistics, the facts are alarming.
To throw out a few of my own statistics, which I am sure will be taken up and argued about by others, the United Kingdom currently has the highest level of problem drug use. As my noble friend Lord Mancroft pointed out in his excellent speech, it has the second highest level of drug-related deaths in Europe.
The economic cost from drug and alcohol abuse is estimated at about £39 billion a year. The British Crime Survey has reported a 14 per cent rise in drug offences over the last three months of 2007, which is a staggering increase of 66 per cent over 2003. The Home Office's statistical bulletin on drug misuse shows that class A drug use has increased by 26 per cent since the Labour Government came into power and the number of young people who claim to have used cocaine over the past year has increased from 3.2 per cent in 1998 to 6.1 per cent in the latest statistics. That is a desperate picture.
Families of young drug users are becoming increasingly anxious at the lack of progress on bringing those rises to an end. I am sure that the Minister will be aware of the briefing that is to take place tomorrow afternoon in Portcullis House, mounted by families of young people who have used or are using cannabis. The organisation is called Talking About Cannabis. The Government's decision to lower the classification of cannabis to class C—one which, effectively, carries no penalty—has left a lacuna in the hierarchy of drug offences. It was a decision that disregarded the dangers posed by new, high-strength strains of cannabis such as skunk, which causes, as we have heard, severe psychosis, personality changes and other mental illnesses.
It is debatable—I throw it out as my contribution to that debate—that if being in possession of or smoking cannabis carried a higher penalty, it would surely deter the shocking 35 per cent of under-15 year-olds who are believed to use it and who will be much more susceptible to other drug use later in life. I am therefore glad that the Minister has been able to reassure us that reconsideration is being given to the reclassification of cannabis as a class B drug. We can only hope that this matter will be taken very seriously and that the views of the parents who are meeting tomorrow will be taken into account. I appreciate that there are other views on reclassification and noted what was said by the noble Baroness, Lady Finlay.
This becomes of even greater relevance when one notes the recent Joseph Rowntree report on cannabis. It shows that there is a widespread variation in the awareness among young people of the dangers of this drug, the downgrading of which has, I am afraid, led to mixed messages and muddle as to its effect. Spiralling drug abuse exists in a symbiotic relationship to spiralling crime. Sadly, that has become all too clear in the last few months as violent crime and gun crime have bought death and injury to young, innocent people on our streets. The Government, despite a whole host of measures—many of which are in this consultation document, from education programmes for the young to rehabilitative programmes for offenders—have failed to tackle this serious drug abuse, which means that a major cause of crime does not just persist but thrives.
I know that the Minister will agree that it is the human cost of drug abuse which is the most alarming. The pain and misery drugs cause to the lives of addicts and their family and friends is immeasurable. The amount of crime perpetrated by those desperate to support their habit accounts for almost half of all those committed to prison for offences from the most minor to the most grievous, and the number of children who have to be taken into care because of one or other parent being involved in drug-taking is a significant amount of a family court's workload.
The Government's consultation paper suggests that drug-related deaths have fallen from 1,538 in 1999 to 1,506 in 2005 and that there has been a 20 per cent reduction in the number of young people taking drugs. That seems to be slightly at odds with the figures I have quoted and others have mentioned tonight. But I put it to the Minister that after six years of a supposedly successful policy, saving only 32 lives, even if they are special, may not be entirely the progress which we would have wished for.
The noble Lords, Lord Brooke and Lord Adebowale, have great experience in the care of those needing treatment. I have known about Turning Point for many years and all that time I have had great admiration for the work the noble Lord, Lord Adebowale, does in making sure that those on drugs and misusing substances get the care and support they need.
There are treatment programmes associated with criminal and social drug taking but a strong focus on abstinence seems to have been lost in the hierarchy of goals for treatment. Maintenance and management is often the option—whether for financial reasons, rather than for lack of facilities, is far from clear—rather than the tougher challenge of longer-term programmes which work to break the cycle of addiction. The result is that methadone has become the mainstay of the reply to drug dependency. It is administered as a measure intended to create stabilisation and ensure "retention to treatment". However, most alarmingly, the number of methadone prescriptions in England has almost doubled from just under 1 million in 1995 to just under 2 million in 2004—they are the latest figures we have, but I dare say that 2006 will show that the figure has gone up again. That is an increase of 86.5 per cent.
As noble Lords will know, it is very difficult to get addicts off methadone; it is simply swapping an illegal drug for a legal one, but the crucial problem the dependency—remains. One European study calculated that methadone was involved in 35 per cent of drug deaths. In the face of such facts, are the Government looking at other, better alternatives? We have been talking about places in residential care not being taken up. That is simply not acceptable. Residential care is the route for people becoming cured through the ability to maintain a long-term programme, and we must see whether money or programmes cannot bring that about in a better way. It is an important aspect of the treatment of people who are suffering from substance misuse.
We believe that drug addiction should not be tackled in isolation—that has already been mentioned by the noble Lord, Lord Adebowale—but as part of addiction as a whole. Alcoholism is often the portal to other substance abuse, especially for children and adolescents, and needs to be figured into any strategy intended to tackle drug dependency.
The Government have correctly identified that educating the young about the dangers of drug abuse is a key weapon in the fight against addiction, and they must be commended for their establishment of information and advice helplines and websites such as www.talktofrank.com and the Department of Health's teenage health demonstration sites as well as the Positive Futures programme and other programmes that get children out and, as the noble Earl, Lord Erroll, suggested, doing something active and using their physical strength.
Education needs to be reinforced by a campaign of deterrence. Have the Government considered using shock tactics on children to show the grave medical implications of addiction and spell out in very large, loud letters the implications of involvement in drugs? As my noble friend Lord Mancroft said, this consultation does not once mention preventing young people starting on the downward spiral.
The consultation paper points out that effective action requires a co-ordinated and flexible approach from all enforcement agencies and government departments. Estimates suggest that approximately 20 tonnes of heroin and 18 tonnes of cocaine are illegally smuggled through customs each year. The massive haul stopped by the Royal Navy last week demonstrates the necessity for constant vigilance.
We have had extremely thoughtful speeches today from the noble Lords, Lord Ramsbotham, Lord Cobbold and Lord Jay, about the possibility of a commission looking at the entire problem. That is up to the Government to decide on, but it seems sensible at some stage for somebody to take on all the aspects of drug addiction from the minor to the major—and the major includes all the problems of poppy growing in Afghanistan, and the possibility, which I think is a revelation, of the poppy being used for regular and proper pharmaceutical purposes.
I look forward to the Minister's reply to what has been an extremely important debate. It has raised a huge number of questions, which went well beyond the limit of the consultation paper—perhaps everything about drug misuse always will go wider than that. But we have had some immensely useful contributions today, and I am sure that the noble Lord will agree with that.
Lord Bassam of Brighton (Government Whip (technically a Lord in Waiting, HM Household); Labour)
My Lords, I start by thanking all who have taken part in a stimulating debate that has been, as the noble Baroness, Lady Hanham, said, broad-ranging. I tried to make some notes on points raised by noble Lords during the course of it. I suppose that there was, certainly at the outset, a big theme that the consultation was simply wrongly based because it focused only on a strategy which believed in prohibition and did not examine issues relating to the potential for the legalisation of drugs.
The noble Lord, Lord Adebowale, said: "We are where we are". The Government's view is that legalisation is not a strategy that we wish to take on board. It is not an approach that we welcome for reasons which noble Lords have valuably summarised in their contributions.
My noble friend Lord Richard was disappointed with the paper. He said that he thought it was part of a failed policy. I take a different view. Views on the Government's policy and strategy were certainly wide. There were those who thought we had made progress; those who thought we had made less progress; those who completely disagreed with the basis of it; and those who said we were looking at some of the wrong issues.
I was very interested in some of the contributions, particularly that made by the noble Lord, Lord Jay, on supply-side issues, which was echoed in part by the noble Baroness, Lady Finlay of Llandaff. And I always listen with great interest and care to what the noble Lord, Lord Ramsbotham, says, not least because of his experience in the Prison Service—and lessons clearly need to be learnt from that.
The noble Lord, Lord Adebowale, makes a very telling contribution when he talks about treatment regimes and some of those issues that we need to examine further. My noble friend Lord Brooke drew attention to the need to look at addiction in the round and not just separate out drug and alcohol addiction.
I welcome the noble Baroness, Lady Miller, to the generality of Home Office debates, particularly the ones on drugs. I have taken part in perhaps too many debates, in some senses because I have had to deal with the matter for some eight years. Nevertheless, I recognise that the challenges change. The noble Baroness made the point that the threats change all the time, and that fashions and styles and interest in different drugs change over time. I was reflecting on my many years of taking an interest in the subject.
One thing is absolutely crystal clear to me; there is a tremendous amount of expertise in your Lordships' House on the issue. It is expertise that should not be ignored because it clearly enables Government to think more broadly. As noble Lords made plain during the debate, we know that drugs have a profound effect on people's health, their life chances, their family and their entire community. As such, it is a subject of tremendous complexity and one that is unique in the intensity of the debate to which it gives rise.
I take it from that that we should not seek to shy away from that debate. That is why the Government have sought out a range of views and opinions that can inform the development of the strategy. Noble Lords may be critical of that, and that is right, but we have tried to confront the issues and we think it right that we do so because it is in our interest to have a broad debate. In particular, I was interested in the notion that there should be an independent commission. I am not sure that that is a role for government, but the idea of drawing on broader views outside government, given the breadth of this debate, has merit in itself.
It is clear that the Government should continue to strive to get more people into treatment. No Member of your Lordships' House would demur from that. I do not think that anyone demurs from the need to protect communities from drug-related crime and nuisance and to provide young people with the information that they need to be able to resist drug use. I was pleased that there was support and encouragement for the Frank campaign, which has had an impact. The noble Baroness, Lady Hanham, made that point. I know that my children are very aware of it. The elder of the three of them has been through both school and college. They are very aware of the impact of drugs and have found some of the information useful as they have grown older.
It is also clear what else should be done. People need additional services to support them to remain free of drugs. The particular needs of black and minority ethnic groups and other communities must be addressed. There needs to be a stronger focus on addressing the needs of young people. The purpose of the consultation exercise and this debate is to contribute to work that will develop a set of policies and actions that will individually and as part of a coherent strategy reduce the harms caused by drug misuse.
Legalisation or decriminalisation of any drug is not within the purview of the purpose of the consultation. That is not to say that it is a debate that should not be had, but the Government have made our position firmly known—several noble Lords referred directly to the comments of the Prime Minister, who made his position very clear. As I said, I am aware that there are those who are very critical of the Government's review of our drug strategy and are similarly critical of our stance on the legalisation of currently controlled drugs. They see the prohibition of the production, supply and possession of drugs such as heroin and crack cocaine as contributing to the misery of so many whose lives have been blighted by their use of such drugs.
I think that most legalisers would acknowledge—they appeared in the confines of this debate—the harmfulness of many currently controlled drugs. Some called for an evidence-based approach to the law relating to the prohibition of such drugs in the hope of a move towards a regulated supply of those drugs. Although we understand that point of view, we as a Government have to make a judgment on what is best for public health. Central to our thinking is our responsibility for protecting the health and welfare of the British public. We have taken the position that prohibition is the best means to do that and we have been unequivocal in our stance of having no intention of either decriminalising or legalising currently controlled drugs for recreational purposes.
In response to the Home Affairs Select Committee report, The Government's Drug Policy: Is It Working? in 2000—
Lord Mancroft (Conservative)
My Lords, far be it from me to interrupt the Minister when he is in full flow, but he has made his position very clear to the whole House. He acknowledges that many of us here do not agree with that position. The difference is that we have explained why have reached the conclusion that some of us—most of us, including me—arrived at. The noble Lord has said, "This is the Government's position and the Government are not going to budge from it". Fine, I understand that, but can he answer a very simple question: why?
Lord Bassam of Brighton (Government Whip (technically a Lord in Waiting, HM Household); Labour)
My Lords, because we believe that our policy is not only right but evidence-based and that we are making progress. I know that the noble Lord dissents from that view and that other noble Lords take a similar view to a greater or lesser degree. It is for that reason that have begun to set out the strategy that we have and why we have decided further to consult on the way in which that strategy should be perfected.
To make our position plain—it is worth putting this on the record—we do not accept that legalisation and regulation are now, or will be, an acceptable response to the presence of drugs. As I said earlier, my right honourable friend the Prime Minister reinforced that view at the recent Labour Party conference when he said that,
"drugs are never going to be decriminalised".
Legalisation is not open to us in view of our international obligations. I know that some noble Lords dissent from that, but that is our view. The current policy of prohibition on drugs is international and is governed by UN conventions that make unlawful the production and supply of many harmful drugs and limit possession exclusively to medical and scientific purposes. It would be wrong for us to lose sight of that perspective. There is no effective cost-benefit analysis of such a policy, if one could be made. Any such policy would need to address the international dimension.
The impact of legalisation on levels of consumption globally is key to any meaningful cost-benefit analysis. Without accurate figures for this, it is impossible to ascribe meaningful figures to the likely public and individual health cost or properly to assess the impact on productivity and industry or on the level of industrial or traffic accidents. Such fundamental difficulties call into question whether the task is an appropriate use of research funding. The impact of drugs on health is the only legitimate reason for control, and there is overwhelming evidence that the widespread use of these drugs worldwide results in enormous social harm and economic costs associated with that use. That includes the many thousands of drug-related deaths, the spread of HIV/AIDS and hepatitis B and C through injecting drugs, and the mental health disorders associated with the use of drugs.
The Government, like the international community generally, believe that the prohibition of narcotic and psychoactive drugs is a crucial element in keeping the level of drug use under control. Such drugs would become easier to access if they were to become legally available, and we would expect levels of use and the resultant harm and costs to individuals and society to expand significantly in the way in which alcohol and tobacco use has done. We do not intend to give a green light to such drug use. We do not take this robust stance lightly. We acknowledge that there are apparent benefits to an alternative system to prohibition, such as taxation, quality control and a reduction on the pressures on the criminal justice system, but in our view these are outweighed by the costs to the physical and mental health of individuals and society that result from dependence on, and addiction to, what are mind-altering drugs. Legalisation would not safeguard these very real public health interests or allay the concerns; nor would it necessarily significantly undermine international organised crime. For this reason, the Government will not pursue legalisation either domestically or internationally. It is all too easy to lay the problems of the use and misuse of drugs here and abroad simply at the door of prohibition.
Baroness Miller of Chilthorne Domer (Spokesperson in the Lords, Home Affairs; Liberal Democrat)
My Lords, I apologise for interrupting the Minister, but I sense that he is about to leave that issue. Will he comment on the policing of the drugs business and on why some sections of the police are calling for legalisation?
Lord Bassam of Brighton (Government Whip (technically a Lord in Waiting, HM Household); Labour)
My Lords, as we have heard in your Lordships' House, there is clearly a debate in policing agencies. The views of the chief constable, which were quoted in the debate, are well known but are not generally held in ACPO. They are certainly not held by the majority in ACPO, which is fairly self-evident.
Many of the problems related to drugs are underpinned by poverty, unemployment and the erosion of family and community life. They are not created simply by prohibition. The Government are seeking to reduce the number of people who use drugs. The real impact on reducing drug use and drug harm has to be through the identification and setting of actions that will have the most impact. The Government's view is that the national drug strategy itself, not law reform, has the real impact on reducing harm through education, prevention, early intervention, treatment and enforcement. Many of those issues were referred to in this evening's debate. That is why the ongoing development of our drug strategy, following wide consultation, is such a priority. The national drug strategy is central to the Government's approach to drugs, drug use and drug harm reduction.
That is a cursory summary of responses to views expressed during the debate. I am conscious of the time and of the many questions that were asked during the course of the discussion. I shall try to answer some of them if the House will indulge me for a few more moments.
I want to make a point in reply to the query of the noble Baroness, Lady Hanham, regarding the consultation being on the Home Office website, because it was a fair point. Of course, we will publish and widely communicate the new drug strategy and I am sure that there will be more debates of this sort. We will also be making available through various means a summary of the consultation responses in line with the Cabinet Office codes of practice. It is important that we seek to do that.
The drug strategy itself comes to an end in March 2008, and we contend that there have been successes in terms of prevention, education, early intervention, treatment and enforcement. There is evidence to support that contention. I know that we have had a lot of statistics pushed into the debate this evening, but the British Crime Survey data for 2006-07 show that class A drug use among young people remains stable while the use of any illegal drug in the past year has fallen compared with 1998—down from 31.8 to 24.1 per cent. We argue that there is success. Schools survey data also show that for 11 to 15 year-olds, the use of any drug within the past year has fallen by some 17 per cent.
In terms of our strategy for treatment, record numbers of drug users are entering and staying in treatment—more than 195,000 in the past financial year. That is a 130 per cent increase on the 1998-99 baseline. A national treatment target of 170,000 people receiving treatment has been exceeded two years earlier than anticipated and we are on track to meet our target to direct 1,000 offenders a week into treatment through the criminal justice system.
Those are bold figures and I know that some noble Lords were critical of the treatment methods and techniques and argued for particular strategies to be adopted. I was interested in particular by the reference by the noble Lords, Lord Ramsbotham and Lord Brooke of Alverthorpe, and others to the need to do far more in terms of residential treatment. I certainly do not disagree with that. It is certainly part of the Government's strategy to increase access to residential treatment. We plan over the next period to fulfil our commitment to increase the availability of inpatient treatment and residential rehabilitation for substance misusers. In February, we announced a £54 million funding package to improve inpatient and residential treatment for drug and alcohol abusers and to ensure that there was better access for that. That is certainly something that we see as an important priority.
The noble Lord, Lord Adebowale, made a plea for what he described as "wrap-around" services. The Government are committed to ensuring that drug treatment is effective and that means that we make every effort to ensure that services are in place to support the gains made through treatment. It is certainly important to ensure, particularly with drug misusing offenders, that they receive support when they are released into the community and we need comprehensively to address that issue. That is part of our National Reducing Re-offending Delivery Plan and certainly part of our drug interventions programme, which aims to do exactly that.
Employment and benefit surgeries operate throughout the prison estate in England, Wales and Scotland. Jobcentre Plus advisers see prisoners on a one-to-one basis at both the induction and pre-release stages of their custodial sentence and provide help and support as do the other agencies. The Prospects programme is a three-year pilot programme which aims to reduce reoffending among drug misusing offenders who have been sentenced to 18 months imprisonment or less. That programme plays an important part in ensuring that we provide wrap-around treatment, because we recognise the importance of ensuring that there is proper after-care service for those who are released back into the community.
I was interested in particular in the comments of the noble Lord, Lord Jay, on our strategy in Afghanistan. It is something on which we expect there to be continued debate over time, and the noble Lord was right to draw attention to the important comments made last week by my noble friend Lord Malloch-Brown when responding on the issue of Afghani opium production. I repeat what has been said before: it is an issue for the Government of Afghanistan. We have to recognise that the poor security situation in the country means that there can be no guarantee that opium will not be smuggled out for the illicit narcotics trade. We agree with and support the Government of Afghanistan's position and we are a designated partner nation to counter narcotics. We do not believe that licensing opium cultivation is a realistic solution to the problem of the opium economy in Afghanistan. It risks a high level of diversion of licit opium into illegal channels and would send a mixed message to farmers, undermining the effectiveness of the Afghanistan Government's counter-narcotics campaign. We think that illicit cultivation could increase as a result.
There is also a question of whether it would be economically viable. As I said earlier, there has not been any systematic market testing across the world to calculate the demand for additional morphine-based medicines and as yet there is no evidence to show that Afghani opium would be price-competitive in a global marketplace. The UK supports the Government of Afghanistan in tackling the drugs problem—
Lord Jay of Ewelme (Crossbench)
My Lords, I thank the noble Lord for giving way. Does he agree that those are exactly the sort of issues which ought now to be examined so that we can make a better, evidence-based assessment of whether there is a case, in the longer term, for controlled poppy cultivation in Afghanistan?
Lord Bassam of Brighton (Government Whip (technically a Lord in Waiting, HM Household); Labour)
My Lords, it is a fair point to argue, and it may well be that there is a case for more research work, but it is important for us to support the Government on the ground. With all the problems the Afghanistan Government have to face, we owe them that. Our role is a valuable one. Indeed, in his speech the noble Lord referred to some of the valiant work being undertaken in support of that programme. Indeed, there have been some successes in terms of disrupting the drugs trade by targeting traffickers and trying to strengthen and diversify legal rural livelihoods. I see that as a strong point. I recognise that this is an issue, but it is a not strategy that we see ourselves agreeing with. However, we should perhaps review it from time to time.
Quite a lot of comment was made about insisting on an abstinence-based drug treatment approach. I understand the strength of feeling behind that. The noble Baroness and my noble friend Lord Brooke both referred to it. In fairness, one should observe that treatment is based on the assessed needs of individuals, and treatment plans are designed to meet those needs. We have to ensure that treatment programmes set out a plan to include the right sort of goal. That might be abstinence or, in the case of entrenched users, the prescription of substitute medication. I understand that that is a controversial view for some, but in certain cases there needs to be a managed change of behaviour. The use of substitute medication can play a part in that.
Lord Brooke of Alverthorpe (Labour)
My Lords, I should like to intervene briefly on that. I believe that a whole variety of solutions have to be employed in assisting individual addicts, but the increasing concern of many people is that the view on abstinence within the industry, so to speak, is that in many respects it is opposed to it. Many people on methadone have told me that they are never given the opportunity to try to get clean.
Lord Bassam of Brighton (Government Whip (technically a Lord in Waiting, HM Household); Labour)
My Lords, the noble Lord makes a valid point which, in a sense, is a reflection of the debate. There are no easy answers for individuals and we must ensure that there is a range of treatment programmes available to facilitate people getting off drugs over time, away from the dangers that drugs bring to their lives and repairing the damage that they can do.
I am conscious that I have a sheaf of notes left which contains references to points and questions raised. However, because of the lateness of the hour and having been told that I have already run over time, I shall put together the other questions that have been asked about our strategy and our approach in a compendium letter, which I shall happily share with all Members of your Lordships' House.
This has been a good debate. Although many views are at variance with the Government's stated policy, it is important that we should continue to have debates such as this, not least because we may find some more answers to a problem which, for sure, is not going to go away. It is a part of a very complex set of issues relating to the use and abuse of drugs in our society. I am grateful to all who have taken part in the debate.