My Lords, I congratulate my noble friend Lady Meacher on keeping drugs and the law on the agenda—not only in this House but on the world stage. She has done much to encourage other countries and the World Health Organization to revisit the UN conventions on narcotics, as she has told us. Until the last few years these were regarded as virtually set in concrete in a prohibitionist mode. I speak of her as my noble friend because on this issue, her position is closer to mine than is that of my party.
My credentials for joining this short debate are, first, that for 30 years I practised as a GP in inner London, which has higher than average drug abuse levels, and, secondly, that 18 years ago I was a member of your Lordships’ Science and Technology Committee, which was chaired by Lord Perry—Walter Perry—and looked into the medicinal use of cannabis. Now, that has been superseded by the Barnes report, mentioned by the noble Baroness. Things have certainly moved on internationally since our committee reported, but there has been little fundamental change in the UK, though several other countries have made cannabis—and other drugs—legally more available.
The Select Committee took careful account of the composition of cannabis and its effects, both beneficial and harmful. One important finding was that,
“no-one has ever died as a direct and immediate consequence of recreational or medical use”.
In other words, it is a very safe drug. It can, however, have ill effects, one being that, rarely, it can precipitate psychosis. Our report considered that,
“there is little evidence that cannabis use can precipitate schizophrenia or other mental illness in those not already predisposed to it”.
It is sometimes difficult to say which came first: cannabis use or psychosis. Heavy use, of course, may slow cognitive processes and impair concentration, and therefore driving, and heavy users may suffer academically. But short-term use appears to have no lasting ill effects. Some adverse effects, occasionally lung cancer, are due to the products of combustion in inhaled smoke, which frequently include tobacco.
Since ancient times, preparations containing cannabis have been used therapeutically for a number of symptoms. In particular, we noted how effective it sometimes is in relieving the painful spasms associated with multiple sclerosis, but it is not a cure for MS or any other illness.
To avoid the ill effects of inhaled cannabis a pure extract has been incorporated by GW Pharmaceuticals into an oral aerosol spray, Sativex, which now has a product licence. However, it is so expensive that NICE has disallowed it for prescription. Vaporisers for cannabis are available in the USA. The price is too high, but it is coming down.
The fact that there are some undesirable effects of this drug, and all other drugs, strengthens the case for these products to be decriminalised and made available on prescription or through regulated, licensed outlets. Their effects could then be monitored more closely and the strength and purity of the product be subject to scrutiny before a licence is granted. However, as things stand, and as the noble Baroness said, cannabis will continue to be used illegally for therapeutic as well as recreational use in this country. It is illogical that patients should have to break the law in the UK to gain relief, when in several other countries they do not.