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8 Jun 2005 : Column 183WH—continued
Khat
4 pm
Mike Gapes (Ilford, South) (Lab/Co-op): I draw attention to this issue because of constituency reasons. Eight weeks ago, I was on a tube train on the Jubilee line in central London in the middle of a weekday afternoon when three young men who were probably 14, 15 or 16 years old got on to the train, carrying between them a large plastic bag containing stalks with leaves. They proceeded to spend the whole journey picking the leaves and chewing them. It was the first time that I had ever seen that on a tube train, and I wondered what the significance of it was. The three young men were clearly intoxicated and in their own world, taking part in something that was important to them.
The young men were Somali. During the recent election campaign, I had lots of discussions with members of my local Somali community. After that, I thought that it was important to raise this issue as early as possible in this Parliament. People in my Somali community in Ilford tell me that the consumption of khat—there are at least 40 different words for the substance in different languages—is a growing social and community problem. It is not just a problem for the Somali community, because it is not only Somalis who are chewing the leaves of this shrub. It is a wider problem, which could become serious unless the Government take some action to deal with it.
What is khat? It grows throughout the Arab peninsula, north-east Africa and other parts of the world. It is a shrub that grows 6 to 12 ft high and is known scientifically as Catha edulis. It goes by 40 different street names, including qat, kat, chat, gat, tohai, tschat and mirra. It has been grown interspersed with coffee in many countries and is very profitable for the producers. It has been suggested to me that in war-ravaged, divided Somalia, the production, sale and export of the plant are as valuable as the heroin poppy in parts of Afghanistan. That raises big questions about what will happen.
Chewed in moderation, as it has been for centuries, khat alleviates fatigue and reduces appetite. It can create among people a social environment and mild intoxication, and that is why, for centuries, men in Muslim societies in the middle east and Africa have often enjoyed chewing it. I am told that it has an effect similar to amphetamines, which are sold illegally and sometimes legally in many parts of the world. However, if it is chewed for long periods—several hours—it can result in manic behaviour, grandiose delusions, paranoia, hallucinations and other effects. It is also believed—and there are studies to back this up—that it can have carcinogenic effects on the mouth, that it increases the possibility of heart attacks, and that it has other effects, including very serious psychotic ones, on numbers of individuals.
Yet khat is perfectly legal in this country. There are no restrictions on its sale. One can walk through certain areas and find little shops that advertise its sale in the window. That is not the case in all parts of the world. It is regarded as a schedule 1 drug in the United States, and it is controlled and banned in several European countries, Canada and New Zealand. We must therefore ask why this country has not taken action against it up to now.
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Some people would say that there are cultural and community questions and sensitivities to be considered. Yes, there are, but, as the Somaliland Forum says on its website:
"This drug is eating at the fabric of society at every level. It is an economic drain as well as a social ill that has a devastating effect on the nucleus of the society—the family. What once was considered leisure has now become a necessity, like food. Its use is spreading faster than AIDS because it is accepted by society as harmless, and even those who understand its harm do not strive to educate the public of its ills."
That is from a publication in Somaliland, the northern part of Somalia.
Another publication, The Somaliland Times, carried a very long article by Abdul Halim M. Mussa, entitled, "The Problems of Qat for Society and Health", on the front page of issue 59. The article details the damage that khat has done in Kenya, Ethiopia, Yemen, Djibouti and Somalia.
Another issue reports the discussions on a peace treaty in Somalia in 2004, and quotes one woman, Eng Rukia Osman Mahmoud, who was involved in the negotiations:
"Our men have become lazy over the years because of the widespread trade that forces them to just sit and enjoy the product. Our children have nothing to eat, let alone go to school, because their fathers cannot work".
"about 75 per cent. of the eight million people in Somalia chew khat, with men and boys accounting for the largest percentage",
"Women and children have suffered for so long, and now that peace is in the air we have to look at ways of reconstructing the country in all aspects . . . This will have to involve everyone, including men, and may be more effective only if a ban has been imposed on the khat trade, because trading in this commodity poses a challenge to rebuilding efforts."
Clearly, the Somali community in this country has grown. There are also people here from Yemen and other countries in which khat is chewed and is prevalent in the culture and in society. These are difficult issues, but we usually have some control over substances that make young men in this country clearly seriously intoxicated during the day. We do not allow tobacco or alcohol to be sold to people under a certain age. We do not allow unrestricted access—in fact, we ban or strictly control access—to amphetamines, for example.
Although a few critics might say that we should, it is generally not acceptable in this country to argue for a deregulatory free-for-all in which anybody can buy and take anything that they like, regardless of the social and human costs, let alone the medical consequences for the individuals concerned and their families. Yet, khat is not controlled, and we must wonder why. People in this country can buy limitless quantities and chew the substance for hours without any control: no regulation, quality control, tax or other measures. Other countries have a different attitude.
The Government are aware of the problem, and there have been a number of parliamentary questions on the matter. My hon. Friend the Member for Birmingham, Edgbaston (Ms Stuart) asked a question in 2004 and
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received a written answer from the then Home Office Minister, my hon. Friend the Member for Don Valley (Caroline Flint), which stated:
"The Advisory Council on the Misuse of Drugs keeps the situation in respect of all controlled drugs under review. At its meeting on 2 October 2003, the Advisory Council's sub-committee the Technical Committee considered the impact of Khat. The Committee concluded that further research needed to be carried out before any informed decisions could be made.
The Home Office is in the process of commissioning a piece of research into Khat use in the United Kingdom. We expect the research to be completed by the summer of 2005." —[Official Report, 30 March 2004; Vol. 419, c. 1347W.]
It is almost midsummer 2005, so where is the research? I want to know, so I have been doing some digging. I have been on the Home Office website and had help from the Library, and something very interesting has happened.
On 27 May, the Home Office website, under the heading "Diversity Research", listed a report published by Turning Point called "Khat use in Somali, Ethiopian and Yemeni communities in England: issues and solutions". The website said:
"This report was commissioned to explore khat use and treatment issues in England, and to make good practice recommendations. The report interviewed individuals and carried out focus groups in the communities concerned, and consulted a range of professional drug treatment specialists".
There was a button to download the report, and we tried, but the report was not there because it had not yet been published. I went online again last night, to see whether it had been published, but found that the passage had disappeared. I do not know why it was taken off the website, but that is strange.
Today, the Library helpfully sent me an e-mail that said that the parliamentary and briefing delivery unit of the Home Office had informed it that
I wonder whether the report is finished. I do not know the reason for the delay, and I wonder whether something is going on internally. Will the Minister explain what is happening and why there has suddenly been a memory hole? The report has disappeared, and I do not know why.
More seriously, when the report is published—I hope that it will be soon, in the autumn and not later in the year or next year—I hope that the Government will give serious consideration to all the growing scientific evidence. I refer them to an article on the BioMed Central website entitled "Khat use as risk factor for psychotic disorders: A cross-sectional and case-control study in Somalia". I refer them also to the British Journal of Clinical Pharmacology in May 2005, and the article entitled "Khat chewing is a risk factor for acute myocardial infarction: a case-control study". There is lots of growing evidence about the damaging effects on health, and we have also heard evidence from the community. In the words of one of my constituents speaking about Khat yesterday,
That Somali-British mother is aware of the issues and the damage that is being caused in our communities.
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Paul Flynn (Newport, West) (Lab): Will my hon. Friend give way?
I believe strongly that the Government must now give serious consideration to the reports in their possession and to any forthcoming reports. The potential damage must be considered, because there is growing evidence of khat being exported. I have been studying the local press. A newspaper in Milton Keynes reported on 3 February that people from Milton Keynes had been arrested in the United States. It said:
"Travellers from Milton Keynes have been turned back at US airports after trying to smuggle in the drug qat . . .
It is understood armed American customs officers caught at least five "mules"—recruited in Milton Keynes—with the leafy narcotic in their luggage during the last 12 months."
People try to fly the drug across the world because its potency when fresh lasts only for about 48 hours.
Paul Flynn : It is illegal in the United States.
Mike Gapes : It is illegal in the United States, and I am glad that it is. If my hon. Friend wants his own debate on the subject he is entitled to ask Mr. Speaker for one, but I am not giving way at the moment, however many times he tries to interrupt me.
The Minister needs sufficient time to respond, so I will conclude with a plea that the Government have widespread consultation with Somali and other communities in this country and listen to the views of clinical psychologists, the medical profession and those who can see the damaging consequences of khat consumption in this country and internationally. There is growing evidence of those consequences and we must not be in the position of other countries taking action to deal with the problem when we have not.
4.17 pm
The Parliamentary Under-Secretary of State for the Home Department (Paul Goggins) : I congratulate my hon. Friend the Member for Ilford, South (Mike Gapes) on securing this debate. Assiduous as he always is, he has brought his constituents' concerns to Parliament and I am delighted that he has had an early opportunity to raise those concerns. He may have known about the matter in detail for only a short period, but he has clearly become something of an expert already and I am sure that he will continue to make his views known in Parliament.
As my hon. Friend explained, khat is a leaf that is traditionally chewed, although it can be made into a tea. It is grown only in east Africa and the southern Arabian peninsula, mainly Yemen. The plant has been used for centuries in that region and has traditionally been used by some Muslims to enhance religious meetings dedicated to praying and reading the Koran. Khat gives the user a mild amphetamine-like euphoria and takes half an hour or so of chewing before taking effect. Users report feeling more alert and talkative, with increased energy levels. It is said to increase self-esteem and create a sensation of well-being.
Typically, in those communities where khat use is prevalent—primarily Somalia, but also Yemen and Ethiopia—the older males of the family chew the plant
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for some hours. That can be significantly disruptive to lifestyle and we know that khat use has associated physical health problems due to lack of sleep and food intake, related oral infections and, anecdotally, an increase in aggression levels. Mental health issues from longer-term use should also be considered.
Crucially, there are also wider social issues. Wives of habitual chewers report having effectively been made lone parents by their husbands' spells in khat dens. It is reported that teenage boys as young as 15—perhaps similar to the boys whom my hon. Friend saw on the tube—are chewing khat because it is the only way to communicate with their fathers. There are also suggestions that women are increasingly using khat, although that is said to be socially unacceptable and to take place in secret.
Evidence suggests that individuals using khat excessively are at an increased risk of losing their role in the community and becoming isolated. Prolonged daily use often means absence from family life, unemployment and social exclusion. There are also considerable social costs to the rest of the family in terms of poverty and sometimes, regrettably, domestic violence. It can also affect communities as a whole, leading to a lack of male role models and community cohesion, and increased exclusion from the wider community.
That raises important questions about what can be done. Treatment is similar to that for other stimulants. The National Treatment Agency for Substance Misuse is leading the development of a range of service provisions for non-opiate drug misuse—including stimulants—and is encouraging the development of treatment in the context of assessed need. Drug action teams are expected to review the provision of services and ensure that they commission services that are appropriate and relevant to the communities that they serve. In theory, therefore, where a local primary care trust or a drug action team identifies a particular need on behalf of khat misusers, local commissioning should be able to address that.
However, the greatest impact may be social rather than physical. As I have already explained, khat use may result in the frequent absence of the man in the house from family life. As with other substance misuse, if the individual is a regular user, it is also likely that they may have difficulties securing employment or maintaining sustainable full-time employment. That often causes tremendous domestic tension—something that my hon. Friend referred to—especially when spending money on khat becomes an economic drain on the family's income. Heavy khat use can cause increased aggression in the individual, which I know my hon. Friend is also concerned about. Given that common family tension, regrettably, as I said before, the result is sometimes domestic violence.
I hope that I can reassure my hon. Friend that the Home Office keeps a close eye on the situation. He referred to the Home Office website and difficulties he had in finding some information that he had previously managed to locate. He was kind enough to alert me to that earlier and I reassure him that I have already set in train an investigation to find out precisely what happened. I assure him that by the end of this week the
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Home Office website will be fully updated with all the information that we have about this issue, including the ongoing studies and the Hansard transcript of this debate. I will certainly ensure that all the information that we have is freely available on the website.
As I said, the Home Office keeps a close eye on the patterns of khat misuse in this country. The Government have funded and supported two separate pieces of research by Turning Point and the National Association for the Care and Resettlement of Offenders into the impact of khat misuse. Those two reports will hopefully be published in the next few months and certainly by the end of the year—whether in the autumn or slightly earlier remains to be seen.
Paul Flynn : Will my hon. Friend give way?
Paul Goggins : I am reluctant to give way because the tradition of the House is that that is done with the agreement of the Member who secured the debate and the Minister. My hon. Friend the Member for Ilford, South was clearly not happy to accept an intervention, so although I often make interventions myself, I regret that on this occasion I do not feel that I ought to accept one. The Member who secured the Adjournment debate has to be happy about interventions and agree to them.
The work by Turning Point was commissioned specifically to map users' needs in terms of service provision. It will identify the treatment services currently provided, establish where there are gaps in service provision and consider examples of good practice—not just by drug agencies—in supporting khat users. The report will help the Home Office to address the concerns of the Somali community in respect of khat misuse as part of our wider diversity strategy. It will include a review of the availability of appropriate drug-prevention materials and information to raise awareness among practitioners and the community. Ultimately, the work should help local drug action teams and treatment services to develop good practice and support systems to deal with the real and current problems presented by khat misuse.
The NACRO research is a longer-term piece of work and will look specifically at the impact of khat use among Somali communities living in the UK. That follows up a study carried out by Paul Griffiths for the Home Office in 1998, which was called "Qat use in London: a study of qat use among a sample of Somalis living in London." That publication may be of interest to my hon. Friend the Member for Ilford, South.
The new study will examine the issue in more depth and in particular will investigate levels of khat use, changes in level of use and any associations with other types of substance misuse, the relationship between khat use and crack use by some Somali women, and any offending behaviour associated with khat use. Some members of the Somali community have suggested that the misuse of khat is symptomatic of the social isolation of Somalis in Britain. Since the bulk of the community began arriving 12 years ago, the population has roughly trebled in size but continues to be segregated, living in our inner city areas.
The community appears to be divided fairly evenly on whether khat should be a controlled substance. There are concerns about the lack of treatment for khat use
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and a lack of support for associated mental health problems, which we are now addressing by way of the research that I have mentioned already. However, there are also concerns about the underlying causes of khat misuse. For example, poor housing and overcrowding are said to be common among Somali families, making young people reluctant to go home and causing them to feel vulnerable.
There are higher levels of unemployment in the Somali community and there is a lack of recognition for professional and educational qualifications obtained in Somalia. We know that a disproportionately low number of Somali young people obtain the grades necessary to attend university, which can lead to low self-esteem and a perceived need to use stimulants as a form of escapism. Those issues will be covered by NACRO and Turning Point in their research, and we look forward to the publication of the relevant papers.
On the question of whether khat ought to be brought under the control of the Misuse of Drugs Act 1971, the Government look to the Advisory Council on the Misuse of Drugs for advice on whether to classify substances as controlled drugs. The ACMD last formally considered the misuse of khat in 1988 and advised that there was not sufficient evidence at that time of a social problem arising from its misuse in the United Kingdom to justify bringing the plant under the controls of the 1971 Act.
The minutes of the ACMD's technical committee meeting from 11 January 1988 stated that an international conference in Madagascar in 1983 first raised global concerns about khat. The minute went on to note that the ACMD had been advised that although the plant grew naturally in east Africa, it had been informed by the Royal Botanic Gardens, Kew that it might be possible to grow the crop in greenhouse conditions and in the warmer climate of the south-west—for example, on the Isles of Scilly. I am pleased to say that domestic production has not become a reality, and I am sure that my hon. Friend is grateful for that.
As I said, the ACMD concluded in 1988 that khat misuse was not a problem in the UK and that therefore controls under the 1971 Act were not justified. I know that the ACMD has kept a watching brief over the issue of khat in more recent years. Before the general election, during consideration of the Drugs Bill, the Opposition tabled amendments to have khat classified as a class A drug. The then Minister, my hon. Friend the Member for Don Valley (Caroline Flint), resisted the move during the debate, but undertook to write to the ACMD to request a comprehensive study of khat, especially in the light of the research to which I have already referred. I am reliably informed that during its last meeting on 19 May, the ACMD formally established a khat working group to consider the matter and carry out that important work. I am sure that my hon. Friend looks forward to the further deliberations of the ACMD, and I promise to ensure that his concerns and a transcript of this debate are brought to the attention of the advisory council.
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