My Lords, I want to put on record the significant change in the position of the United Nations on drug policy at the UN General Assembly special session in April this year. This is a transformation in the UN position after no fewer than 55 years of a destructive, prohibitionist interpretation of the UN conventions.
The stated objective of the UN conventions on drugs is to advance the health and welfare of mankind. That remains a good starting point today. The problem has been that the UN conventions of 1961, 1971 and 1988 were drafted without any evidence base. In 1961, there was virtually no understanding about how best to reduce addiction and the harms caused by drugs and the drug regime itself.
For a long time it was believed that prohibition and prison sentences would create a drug-free world. President Nixon famously predicted such an outcome. How wrong he was. For more than half a century, far from reducing drug use and addiction, the prohibitionist approach has been accompanied by an explosion in drug use across the globe. The regime has generated a trade worth more than $300 billion for criminal gangs and terrorists. What an outcome.
For the past six years, our All-Party Parliamentary Group for Drug Policy Reform has been promoting the arguments for a new interpretation of the drug conventions through our international meetings of Ministers and senior officials from Latin America and Europe, our European initiative, my meeting with the ECOSOC president, and our briefing of President Santos of Colombia—a key player—before the UNGASS this year. Our guidance on interpreting the UN conventions provided the text for our international work. Human rights and public health were central to our argument, along with the emphasis upon flexibility and evaluation of new policies to produce an evidence base for future drug policy. We produced the guidance with the support of the White House senior staff in Washington and senior officials on drug policy in Mexico. George Soros, who backs our ideas, provided an invaluable link between ourselves and the deputy Secretary-General of the UN. He, too, supports our arguments. It may seem fanciful but I am confident that our small input to the key players of the UN and US was helpful but, of course, the presence of President Obama in the White House must have been a key factor in these developments.
At the UNGASS in April, the deputy executive director of the United Nations Office on Drugs and Crime was one of a number of UN top officials who signalled this dramatic change of direction. He finally made absolutely clear that:
“The Evidence based public health approach is here to stay”.
Surely the new UN position requires a major rethink of drug policy worldwide.
What does this mean for the UK? The Government need to adopt policies supported by evidence that they will reduce addiction, particularly among young people, and will reduce the harm caused by drugs and the drug control system. Three policies could be adopted immediately by the Government on the basis of evidence. The first is the decriminalisation of drug possession and use, as pioneered in Portugal all those years ago, and extensively evaluated and shown to be a success. It is interesting that all political parties in Portugal support the decriminalisation policy. The second is heroin treatment clinic programmes pioneered by the Swiss and, again, proven to be cost effective in rigorous evaluations. The third is the legalisation and regulation of cannabis for medical use. I will concentrate on the third. Cannabis currently sits in Schedule 1—the schedule for dangerous drugs with no medicinal value, believe it or not. This has become unsustainable, and I would say laughable if it were not so serious. We have abundant evidence to support a change of that schedule. The reason for urgency is that the current policy is contrary to the human rights of hundreds of thousands of patients with severe chronic illnesses who we know could benefit from this change. About 10% of these people go to drug dealers but the rest just cannot face it. Should a very sick person risk arrest and being placed in a cell simply to get their medicine? The current position is also a terrible waste of NHS resources and inhibits research into the medicinal potential of this rather remarkable plant. I should make it clear that I have no personal interest in this issue. I have never smoked a cigarette and certainly not a spliff either. My only addiction is to chocolate and I am lucky; it is legal.
We now have a comprehensive and professional analysis of the research evidence proving that cannabis is not only a great deal safer than many prescribed medicines which it can replace, but works more effectively for some patients—not all—than prescribed medicines. If the Minister were not so ridiculously overworked, I would hope she would read the report of Professor Mike Barnes, honorary professor of neurological rehabilitation at Newcastle University, and Dr Jennifer Barnes, a clinical psychologist. The Barnes report looks at research evidence across the world and sets out those conditions for which there is now good evidence, through random control trials and other research, which makes very clear the efficacy of cannabis in treatment. These include chronic pain, including neuropathic pain, spasticity, nausea and vomiting, particularly in the context of chemotherapy, and the management of anxiety. Barnes also found moderate evidence of success in a range of other disorders and some evidence for including a further list of conditions, including drug-resistant childhood epilepsies. Barnes emphasised the need for more research. He certainly did not exaggerate the benefits of cannabis—very far from it; he rather underestimated the benefits. In order for that research to take place and for those improvements to be seen, we need a change in the schedule of cannabis.
Is the Minister aware that in early October the Medicines and Healthcare Products Regulatory Agency published its opinion that products containing CBD—one of the two primary ingredients of cannabis—should be regulated as medicinal products? The absolutely correct position of the medicines regulator does not sit easily with the Government’s outdated cannabis schedule.
At present, many parents of children with treatment-resistant childhood epilepsies are buying CBD from private companies or on the web and, despite the risks, they find that it can have dramatic and positive results for their children. I have a video of a child who was suffering hundreds of seizures a day and was unable to do anything. He was expected to die within a week when his father went to his consultant, who agreed that the child should be given cannabis. That little boy remains alive. He has very few seizures—perhaps one or two a day—and is able to run about and play. I have had helpful discussions with the chairman and chief executive officer of the MHRA, who are keen to ensure that these severely ill children continue to gain access to their cannabis medicine. How can the Government continue to deny the medical value of cannabis?
The evidence for cannabis as a treatment for chronic pain, including neuropathic pain, is examined in detail in the Barnes report. One of the great benefits of cannabis compared with other drugs seems to be that the side effects are often very much milder or even negligible, in marked contrast to the many side effects of prescribed pain-relieving medicines. Cannabis can also help patients whose pain does not respond to prescribed medications at all. The Barnes report considers the pain-relieving qualities of smoked herbal cannabis, as well as the synthetic versions. Of course, smoked herbal cannabis is a much safer option than the synthetic variants. In studies where patients smoked cannabis with 8% to 9.4% of THC, it reduced pain significantly in 46% of them, with mild side-effects. Any doctor will know that that is a pretty good result.
I hope that others will talk about the growing number of countries and US states which already provide legal access to cannabis for medical purposes under regulations. If cannabis has no medical value, maybe the Minister can explain why Germany is passing a government-backed law legalising cannabis for medical use for 60 conditions. Professor Barnes pointed to only four conditions where he said there was good evidence. I would say that he was being very modest. How can the UK Government sustain that discredited position?
Our APPG inquiry into medicinal cannabis includes a recommendation that the UK adopt a system of regulation based upon the German model. This would involve rescheduling cannabis to Schedule 4, thus recognising its medicinal value, and introducing a system of licensing for producers and suppliers, with availability of cannabis through doctors’ prescriptions. I ask the Minister to take this proposal forward in the light of the new UN support for an evidence-based drug policy and the new Barnes report, which shows that we have that evidence.