| Previous Section | Index | Home Page |
Dr. Jack Cunningham: I should first acknowledge that my hon. Friend and I studied together for our PhDs many years ago. His commitment to science continued for many years after I had been hijacked by the Labour party and drawn to this place.
My hon. Friend mentions templates and DATs, and I visited the Lancashire DAT recently. Even more recently, we held a conference of the chairmen of all the DATs in the country and we shall soon follow that up with a similar meeting with all the full-time co-ordinators. We recognise that they need clear guidance and continuing dialogue with Keith Hellawell and Mike Trace, both of whom are doing an excellent job. We have many lessons to learn from the people working on the ground in the DATs and we are determined to learn them.
Dr. Iddon:
I am grateful for my right hon. Friend's comment.
DATs were originally set up with an overall co-ordinating role for the agencies working within their boundaries, but they now feel that they are expected to take part in the delivery of policy.
Schools are autonomous bodies and responsible for education policy delivery, with guidance from central and local Government. Similarly, health authorities are responsible for the delivery of health policy. I suggest that DATs must receive clear guidance if their role has changed recently--and they believe that it has. A perusal of the literature, including the excellent Home Office reports, demonstrates that we cannot afford to waste any more time because things are getting worse, day by day. There has been a dramatic rise in heroin usage and the age of users is decreasing. In countries with more radical policies, such as the Netherlands, the opposite is the case.
Mr. Howard Flight (Arundel and South Downs):
I may be anticipating the hon. Gentleman's next comments. However, in view of his medical background and direct experience in this area, I am extremely
Dr. Iddon:
I should point out that I am trained not in medicine, but in chemistry. I will refer to cannabis later in my speech.
The European Association for the Treatment of Addiction (United Kingdom) is a charity that seeks to improve access and quality in the treatment of people who depend upon alcohol and other drugs. Its members are 35 United Kingdom-based treatment centres, which are responsible for 4,000 treatment episodes a year. They reported recently that the level of state-funded treatment among providers has dropped in the past three years. Some centres, including NHS-funded centres, have closed and others, such as Drugs Northwest, feel at risk. That centre has only 24 beds and must serve the whole north-west region. Those facts are supported by the Standing Conference on Drug Abuse--SCODA.
I believe that the purchaser-provider split in the national health service has caused those problems for state-funded drug treatment centres because they are often regarded as the last places to which money should be directed. I hope that the extra Government money will quickly reverse that depressing trend. The new drug testing and treatment of offender orders being piloted depend on that. I agree with other hon. Members that there is a dire need for treatment of those in the under-18 age group.
My interest in this area of social policy has made me realise how much we depend on the voluntary sector, which is highly motivated and carries out some excellent work. There are some gaps, such as a need for more support groups for users. However, I have concluded that there are enormous numbers of such groups--small and large--and that better co-ordination between them would be useful. Why not have a national organisation like Age Concern that we could call Drug Concern? I recognise that some organisations, such as SCODA, are attempting to play a co-ordinating role, but they are not all-inclusive.
Mr. Michael Clapham (Barnsley, West and Penistone):
Does my hon. Friend believe that the new community safety agencies established under the Crime and Disorder Act 1998 could play an over-arching co-ordinating role between all bodies operating in a particular borough and focus their attempts to deal with the drug problem?
Dr. Iddon:
I would certainly welcome that possibility in the future.
I am chairman of the all-party drugs misuse group, and I take this opportunity to invite all hon. Members present for this debate to attend our meetings if they have not already done so. We are currently investigating the links between drug misuse and mental health. However, I must emphasise that my comments this morning are my own and do not represent the views of any member or members of that group.
People who misuse drugs can, and do, seriously damage their brains. There is clear evidence that Ecstasy damages the brain--we have still to establish whether that damage is reversible. This message appears to be getting
through to those who use Ecstasy, thanks to the assistance of the more responsible dance magazines, such as Mixmag. Other factors might be responsible for a drop in its usage, such as the fact that cheaper alternatives are now available--which, unfortunately, includes heroin. It is now being sold as Brown--a drug that is "safe to smoke". It is not, of course, and we must concentrate on getting the dangers of that evil drug across to our young people in particular.
As the dance scene changes, so do the drugs. So culture plays an important role in the misuse of drugs. We need "clean" role models that our young people can look up to--whether in the entertainment world or in the sports field. The misuse of drugs can, and does, often lead to mental illness. Cocaine and amphetamines will produce psychotic episodes in particularly vulnerable individuals. On the other hand, people who are mentally ill often misuse drugs as an escape mechanism.
Many people are both mentally ill and on drugs. Dual diagnosis--which has been referred to already--is not yet common in this country. We continue to treat people on psychiatric wards without also treating the possible cause of their problems, which is a complete waste of valuable national health service resources. In the United States of America, 50 per cent. of those with a mental illness are believed also to misuse drugs. This is a difficult area in which to collect data, because the illegality leads to a fear of admission. In the United Kingdom, the figures are estimated to lie between 30 per cent. and 50 per cent.
Drug misusers often have multiple problems: unemployment, homelessness, involvement with the enforcement agencies, relationship breakdowns, mental illness and poor health in general. Consequently, their lives can be chaotic and they are the army of the socially excluded. They are often unknown--and not even counted by the census. We really do not know how many people are in this army, but at least the Government are attempting to address their problems through their policies and trying to prevent any more people joining up.
Even if such people are on benefit, they will present problems--when they enter the new deal gateways, for example. Unless their drug misusage is addressed, it is doubtful whether they will be able to concentrate on employment opportunities. I hasten to add that some addicts can, and do, hold down responsible jobs by being clinically maintained. They do not have to rely on the street market for dangerous supplies of their drug of choice, which is often heroin.
The witnesses that the all-party drugs misuse group have heard from have given us some interesting evidence that we will include in a report to be published in the autumn. One woman told us that she felt safer in prison than on a psychiatric ward because she knew how long she would be in prison, whereas the psychiatric ward wanted her back in the community as quickly as possible. She added that it was easier to get back into prison than on to the psychiatric ward. Another witness made the perfectly valid point that society, including schools, does not teach children how to deal with their emotions as they grow up and, in adulthood, these can become unmanageable in some cases.
Mike Ward from Surrey social services has re-examined a number of high-profile homicide cases in which the coroner concluded that the perpetrators were mentally ill and that this was the cause of the murders.
By talking to the friends and relatives of those convicted of the crimes, it became obvious to Mike Ward--who has written a book on the subject--that, in the majority of those high-profile homicide cases, the misuse of drugs, rather than mental illness, had caused the murders. Such cases have stigmatised mental illness, and we need to put that right.
Those working in the drug treatment field desperately need to know more about mental illness and those working with the mentally ill need to know a lot more about drug misuse. Funding mechanisms for those two areas of activity need to be brought closer together, and I hope that the Government will address those problems.
The Mental Health Act 1983 is out of date--I understand that the Government are currently reviewing it. I believe that any new mental health Act should include a reference to the misuse of alcohol and drugs. Rehabilitation for drug misusers following in-patient treatment is another problem that must be addressed. Returning a detoxified patient to his or her community and allowing renewed contact with his or her peer group results in the "revolving door" syndrome. In any case, some rehabilitation units will not accept clients who have been dually diagnosed. Although they are recovering from a mental illness, they are unwelcome in those units because they are known to be clinically maintained on illegal drugs.
Although I recognise that there is a place for methadone in drug treatment programmes, the House should not forget that methadone has resulted in more deaths than heroin and we need to review the way in which it is prescribed. I know that the Home Office and the Department of Health have the matter in hand. People who are maintained on methadone while working cannot be expected to visit a pharmacy daily. However, we cannot continue to allow methadone to leak on to the streets in ever-increasing amounts and become a street drug in its own right.
There are safer alternatives to methadone, and I have been urging the Government to investigate their use. Buprenorphine, for example, is now licensed for use in the United Kingdom, but it is not yet in common use because of a technical problem that has been drawn to the attention of the Secretary of State for Health. Buprenorphine is the drug of choice in countries such as France, where methadone is hardly used. It would also be helpful if the Secretary of State would allow laevo-methadone and laevo-alpha-acetylmethadol to be used by practitioners, at least on an experimental basis.
Drug trafficking is the best pyramid selling racket in the world. It is exploitation, mainly of the poor by the rich. Merely removing personnel from any level of those globalised financial pyramids, whether they are people at the base or Mr. Big at the top, does not and will not stop that trade. Those pyramids have an almost magical ability to reform. Profit is their driving force. Raw materials are plentiful and cheap, profits are high and the operators pay no taxes--at least not to Governments. That is the alternative economy, or the black market.
Ironically, tougher enforcement--the Tory approach--is good for business because it drives up street values and increases profits. Prohibition is not, and never has been the right tool to deal with such rackets. The black market in drugs is the third largest industry in Britain. It is larger in volume than steel or oil, and it is a rapidly growing,
supply-led market. Over the three years from 31 March 1993, the number of heroin users aged under 19 increased by 35 per cent. Between 1995 and 1996, smack seizures increased by 52 per cent., according to a recent Home Office report.
That report is one of the best that has emerged from the Government, but it makes depressing reading. It rightly addresses one substance. Too often, in a debate such as this, we try to deal with all substances of abuse together, which is probably a mistake.
Drug trafficking not only damages our health, but seriously damages the country's economy. Most of the profit, after laundering, flows out to offshore tax havens. For many years it has been my considered opinion that the only way to deal with that problem is to collapse the financial pyramids by removing the profit incentive or by reducing profits to the levels of other industries. Whether we like it or not, to do that we would have to consider decriminalisation or even, if United Nations conventions would allow it, legalisation of illicit substances.
I am pleased to say that that right-wing newspaper, the Daily Mail, in its editorial on 26 May 1997, made the point, with which I agree, that if, in future, current Government policies do not work--like others I am prepared to give those policies a chance--we will have to return to the problem and consider decriminalisation or even legalisation. Surveys demonstrate, however, that at the moment the general public would not agree to such a radical approach, but things are changing, as the Daily Mail editorial reveals.
Before 1971, the general public accepted the idea of legalising substances such as heroin. Following the abandonment of the British system of dealing with abusers and addicts and the adoption of the American system, an ever-increasing proportion of our society has misused substances. I include alcohol in my definition of those substances.
Until this year, it was costing £1.4 billion to deal with the fall-out from drug abuse, and a high proportion of that money is being targeted at misusers, or users, of cannabis. I call for the decriminalisation of cannabis to release those valuable resources so that we can tackle the real problems, which are the evil use and sale of heroin, as well as other drugs such as cocaine and amphetamines.
| Next Section
| Index | Home Page |