Examination of Witness (Questions 1340
TUESDAY 12 FEBRUARY 2002
1340. That is the point, harm minimisation is
not in the strategy and it ought to be in my view. I worry about
how it might clash with some of other things and how you are going
to arrange them. I am not sure that has been thought through.
(Mr Ainsworth) I do not think there is
a clash, I really do not think there is a clash. I think it is
essential from the other point of view, in terms of infections,
it is part of reducing demand. Obviously if it is done in an unacceptable
way, an uncontrolled way and there is massive leakage into the
illegal market then, yes, you are going to be acting against some
of your other aims in the drug strategy. That is why we need effective
controls to try to minimise, if we cannot eliminate, that kind
Mr Cameron: Thank you.
1341. Going back to the business of the safe
injecting rooms, could I ask you to have a think about that and
send us a note about the government's position on that.
We are not talking about places where the drug is
made available but just in terms of getting the habit off the
street so that the needles are not thrown away into street, but
so that the addicts can administer the drug in a safe environment.
The other point that was mentioned a moment ago, we did have evidence
from an organisation called Action on hepatitis C, which said
"United Kingdom guidelines two, three and four"I
do not know if this is from the Department of Health"on
the treatment of hepatitis C excludes current injecting drug users".
The evidence went on, "This is a major concern because drug
users form the greatest number of those with HCV". Would
you just check that point and send us a note.
(Mr Ainsworth) I will. The main issue
that they have raised with me is protection for people in the
prison environment against the spread of hepatitis C, and that
goes far wider than injection behaviour, it is from tattooing
to sex, and whatever have you. Those are the main issues they
were concerned about when they raised them with me. I will look
at those issues, as I agreed. I can understand the benefits in
terms of keeping the paraphernalia off the streets and in safe,
disposable areas. The potential downside of that is that we drive
people back on to the market if they are not prepared to use drug
in those environments. Let me look at that and give you a note.
See Appendix, Ev226-7.
1342. What you need to look at is the example
of what goes on in Germany and see whether that has improved things
or made them worse?
(Mr Ainsworth) Yes.
1343. I wonder if I can just add to one of the
questions that you have left the Minister with in relation to
safe, clean places for people to inject off the street. Would
you say whether implied in that there should be withdrawal treatment
or is it your intention to simply maintain drug addicts' habits?
(Mr Ainsworth) There is no desire to
leave people with a habit that leaves them vulnerable at any point
that they cannot continue to use the treatment that is available
to the illegal market and to drive them back to the harm and the
traffickers and the dealers. Any treatment has to be tailored
to reducing the harm and reducing the addiction of the particular
individual. With regard to crack cocaine addicts one of the biggest
problems is even getting them in the door. We had to undertake
Out Reach to go out and try and persuade them to come into treatment
centres in the first place, they feel very threatened and they
feel there is nothing being offered to them, so non-threatening
treatment, such as calming them with acupuncture, and things like
that, is what is offered by some centres in order to get them
in, establish contact with them, calm them down so they can start
talking to them about some of these underlying issues. At certain
phases in any treatment, the aim of which is to try and help the
person to reduce the addiction, there may be a period of maintenance
that is absolutely essential that is part of that.
1344. Cure would be the ultimate goal?
(Mr Ainsworth) Where there is any alternative
I do not think there is any desire from anybody to continue to
maintain an addiction.
Angela Watkinson: That was my point.
Chairman: Going back to those guidelines I referred
to, they are not Department of Health guidelines, Minister, they
are National Institute for Clinical Excellence guidance on the
use of ribavirin and interferon for hepatitis C. I believe the
other one was the British Society of Gastroenterology Clinical
Guidelines for the management of hepatitis C.
Those are the ones referred to. Minister, thank you very much,
you have been answering questions patiently for two and a half
hours and we are extremely grateful to you. This session is closed.
4 See Appendix, Ev227. Back