|Previous Section||Index||Home Page|
The second issue is transparency. We recommended that the ACMD should take steps to increase the transparency of its processes by publishing its agendas and minutes and holding meetings in public. The ACMD accepted that recommendation and the Government said that they would encourage the council to increase
transparency. We have looked at the ACMDs website, and there is little to demonstrate any change in its practices. Does the Minister know what the councils intentions are in that area?
Thirdly, I wish to follow up our recommendation that the Home Office should regularly commission independent reviews of the ACMD. The Government accepted that recommendation in principle and said that the Makeham review of Home Office public bodies would include the ACMD. We understand that Peter Makeham was due to report in April and that the target has been met. Will the Minister comment on the conclusions of that review in relation to the ACMD?
Finally, I will turn to the issue of research. We heard during our inquiry that UK expenditure on addiction research was an embarrassment and that there was a thousandfold differential between UK and US public expenditure on such research. The recent UK Drug Policy Commission report also emphasised the importance of research. It said that the
current shortage of research means that policy makers have to operate partially blind in this field.
We recommend that the Home Office and the ACMD should develop better relationships with the research councils, particularly the Medical Research Council and the Economic and Social Research Council. The Government and ACMD both accepted that recommendation, and I am keen to hear from the Minister what action has been taken in that area.
Finally, this is an important area of public policy. It is therefore disturbing that the very basis on which drugs policy is builtthe classification systemhas serious failings. It is also disturbing that the Government are not prepared to either find the evidence to support their view or to look for changes. I hope, however, that the Minister will enlighten us this afternoon and that we will all go home happy.
Dr. Brian Iddon (Bolton, South-East) (Lab): It is a pleasure to serve under your chairmanship for the first time, Mr. Bercow. The misuse and abuse of drugs is one of the most significant social problems of our time. The previous Government recognised that the situation was out of control and began to take some action, but it was the present Government who invested huge sums in a drugs strategy. In 1997, I campaigned for easier access to treatment for those most affected by the misuse of drugs and I am pleased by the progress on that the Government have made. I am also extremely pleased by recent announcements that the National Treatment Agency is considering the quality and choice of treatment as well as the quantity. Nevertheless, as the Chairman of the Committee, the hon. Member for Harrogate and Knaresborough (Mr. Willis), has reminded us, out of all European countries, Britain is still the one most badly affected by the harm caused by the misuse of drugs.
Since my election to Parliament in 1997, I have been disappointed that so little Government time has been devoted to debating the issue. When the drugs tsar wrote his annual reports, at least we were given the opportunity to debate them on the Floor of the House,
but that now seems like a long time ago. I very much welcome this debate, which is quite narrowly focused on the ABC classification. As the chairman of the all-party group on drugs misuse, I am a little shackled today and my mind cannot meander in the directions that it would like to.
Our laws on the use of illicit drugs stem from the single convention on narcotic drugs of 1961, as amended by the 1972 protocol, and the convention on psychotropic substances of 1971, both of which were negotiated by the United Nations and, worldwide, have 185 signatories to date. They were implemented in this country by the Misuse of Drugs Act 1971, which has remained largely intact for more than 36 years, although it has been amended several times. The Advisory Council on the Misuse of Drugs was set up following that Act and the ABC classification of illicit drugs also arose from it.
It is the 21st century and, after 36 years, I ask the Minister whether the time has come to review the legislation, or at least the way in which we apply it in this country. It would be timely to do so because of the review that is pending of the Governments 10-year drugs strategy that was launched in 1998. Britain has applied such legislation more strictly than many of our partners in Europe, especially in recent times. The Netherlands, Portugal and Sweden are three countries that have recently seemed more radical than the UK when dealing with the problem of drugs misuse.
Illicit or controlled drugs are classified as class A, B or C on the basis of the harm that they cause to the individual and to societythe ratio is about 50:50according to the ACMD and others. Drugs that are new to misuse may be placed in one of those three classifications, as recently happened with ketamine. Drugs may be moved from one classification to another; for example, methamphetaminecrystal methhas recently been reclassified as a class A drug, which is the most harmful category.
In 2004, cannabis was controversially moved from class B to C. I supported that reclassification and still do. Previously, more than 100,000 peoplemainly young peoplereceived criminal records for being caught in possession of small amounts of cannabis. They suffered the consequences of that because, for example, they had to declare it on a job or visa application form. Before cannabis was reclassified, there was a further problem that police forces acted inconsistently.
The ABC classification system also takes account of the route of administration of some drugs. Intravenous injection causes secondary harm. For example, it spreads blood-borne diseases such as Hepatitis C and HIV/AIDS.
The classification of a drug has several consequences. In particular, it determines the legal penalties for importation, supply and possession, and the degree of police effort targeted at restricting its use. According to Blakemore:
The current classification system has evolved in an unsystematic way from somewhat arbitrary foundations with seemingly little scientific basis.
In any debate such as this, it is important to put facts in context. Although an estimated 3.5 million people misuse controlled drugs, 12 million people smoke
tobacco and 43 million use alcohol. Far more people die as a result of using alcohol and tobacco than through the misuse of controlled drugs. Some 90 per cent. of all drug-related deaths are attributed to alcohol and tobacco. More people die in this country from the use of licit drugs than illicit drugs.
A 2006 report from the UN International Narcotics Control Board shows that there has been a significant rise in the misuse of prescriptionlegaldrugs. According to that report, the abuse of prescription drugs throughout the world, including here in Britain, now outstrips that of controlled drugs, with the possible exception of cannabis in some countries. In this area of policy, we have to be careful that the application of the law, or the creation of new laws, does not merely displace a person from one type of behaviour to another, such as from misusing illicit drugs to misusing over-the-counter products or prescription drugs.
The ABC classification system has come in for a lot of criticism recently from not only our Committee, but, as we have heard from the Committee Chairman, the RSA commission on illegal drugs, communities and public policy, which published a report entitled Drugsfacing facts this year. Our Committee concluded that there are
significant anomalies in the classification of individual drugs and a regrettable lack of consistency in the rationale used to make classification decisions.
the current classification system is not fit for purpose and should be replaced with a more scientifically based scale of harm, decoupled from penalties for possession and trafficking.
The evidence that we collected suggested that the ABC classification had no deterrent effect, as we have heard. Indeed, it is highly probable that the great majority of drugs misusers are not aware of the classification system, although constant drugs misusers will of course be aware of the harm caused by individual drugs. I dare to suggest that many in the police are not fully conversant with the classification system either, unless they are involved directly in drugs teams. Our Committee recommended that abused substances, including alcohol and tobacco, should be arranged on a spectrum according to the harm that they cause on the basis of scientific evidence.
As the Committee Chairman just stated, our report on the ABC classification system was part of an overarching investigation. The Government claim that their policies are evidence-based and we do not want to lose sight of that in this debate. Fortunately, in a paper published in volume 369 of The Lanceton 24 March of this year, Professor Colin Blakemore and his colleagues, the names of whom have been read out already, provided
a rational scale to assess the harm of drugs of potential misuse
heroin (most harmful), cocaine, barbiturates, street methadone, alcohol, ketamine, benzodiazepines, amphetamine, tobacco, buprenorphine, cannabis, solvents, 4-MTA, LSD, methyphenidate (Ritalin), anabolic steroids, GHB, ecstasy, amyl nitrites (poppers'), and khat (least harmful).
The scale includes five legal drugs that are misused and oneketaminethat was classified only recently. They are included for reference purposes. I emphasise the position of alcohol, tobacco and ecstasy in that scale of harm, as did the Committee Chairman.
Blakemore et al established a nine-parameter matrix by dividing the three categories of harmphysical harm, dependency and social harminto three sub-categories against which each drug was scored on a scale of zero to three by people working in this policy area. The important conclusion from that work was that the scale of harm differed significantly from that represented by the ABC classification system. Although the two substances with the highest harm ratingsheroin and cocaineare class A drugs, there was a surprisingly poor correlation overall between a drugs classification under the ABC system and its harm score according to Blakemore et al.
Blakemore et al concluded that if the Government were to retain a three-category classification system, drugs with harm scores equal to or greater than that of alcohol should be class A drugs, while cannabis and drugs with lesser harm scores than it should be in class C. Of course, that gives rise to the important question of whether our citizens are receiving justice through the application of the ABC classification system. I have to conclude that the answer is no, they are not.
Unfortunately, Blakemore et al have not provided us with harm scores for psilocin or its ester, psilocybin, which are both class A drugs that are constituents of so-called magic mushrooms. I have been unable to get a proper explanation from anybody of why those two chemicals are class A drugs. I have never known them sold on the streets or met people who have used them.
Although the use of magic mushroomsprepared and, especially, freshhas increased in recent years, I know of only one death caused by them. On 1 March last year, I questioned the chairman of the ACMD, Professor Michael Rawlins, about the classification of fresh magic mushrooms as a class A substance. When I referred to the classification of psilocin and psilocybin, he said:
I have no idea what was going through the minds of the people who put them in Class A in 1970 and 1971.
If we remember that drugs are classified as A, B or C according to the harm that they cause to the individual and to society, it is hard to understand why magic mushrooms, either prepared or fresh, are class A substances. Professor Rawlins admitted that there have been few publications on the properties of psilocin or psilocybin in recent years and that there was little research to support their classification as class A drugs. In his evidence to the Committee on 22 November, Professor Nutt told us that the evidence for placing those substances in class A was not strong.
I was a member of the Standing Committee that considered the Bill that became the Drugs Act 2005. The Bill was rushed through Parliament ahead of the 2005 general election and as far as I am aware, it was never scrutinised properly by the House of Lords. My understanding was that the Crown was trying to conduct two prosecutions for the sale of magic mushrooms that had been stored in freezers to keep them fresh on the ground that the shopkeeper was selling prepared magic mushrooms, which were already
class A substances. Obviously, the Crown was concerned that the prosecutions would fail if that legislation was not rushed through Parliament before the 2005 general election. That is not exactly the way to make evidence-based policy.
I was disappointed, as I think were other Committee members, that the views of the ACMD were not sought formally before fresh magic mushrooms were considered as class A substances, although I accept that doing so was not a statutory requirement. Furthermore, there is always a danger that as the Government get tough on people misusing or abusing one substance, those people will merely start using something else instead. Making magic mushrooms class A substances has displaced people into using alternative substances that might be more dangerous, such as fly agaric.
I put it to the Minister that the classification of psilocin, psilocybin and prepared or fresh magic mushrooms as class A substances has not been carried out with an evidence-based approach. Will he ask the ACMD to classify those substances properly? I hope that he agrees that if the ABC classification of drugs is to be seen as credible by the general public and the penalties for using a drug are to be seen to be just, drugs should be classified according to the best available evidence of the day.
Now that the scale of harm to which I referred has been published in The Lancet, does the Minister expect advice on it to come to him formally from the ACMD in the not-too-distant future? In January 2006, the then Home Secretary, my right hon. Friend the Member for Norwich, South (Mr. Clarke), indicated that he thought that the ABC classification system should be reviewed. Professor David Nutt, chairman of the ACMDs technical committee, expressed his dissatisfaction
Dr. Iddon: I had just mentioned, before the Division, that a former Home Secretary had implied that there might be a review of the ABC classification system, and that Professor David Nutt, the chairman of the ACMDs technical committee, had several times before the Committee expressed dissatisfaction with the present tripartite system. Even my hon. Friend the Minister, when he took up his post, suggested that that review might go ahead. Somewhere along the line the Home Office has changed its mind, and it has not given clear reasons, as far as I am aware. Will the Minister, especially in the light of our report and the recent RSA report, which expressed a view on the classification system similar to the Committees, reconsider the Home Office position and make it clear to the House? I think that the answer will probably be no, on the ground that that might detract from pursuing all other aspects of the Governments current 10-year drug strategy, but I hope that my hon. Friend will not give that answer.
Perhaps more controversial than the classification of magic mushrooms has been the classificationand, indeed, the recent reclassificationof cannabis; but what is cannabis? There appear to be upwards of 100 varieties of the cannabis sativa plant, with more than 20 in commercial production. The strength of the main psychoactive ingredient, delta-9-tetrahydrocannabinol, or THC, varies according to the species of plant and the part of the plant that is harvested, from about 5 per cent. to about 20 per cent. In recent years the terms skunk and superskunk have been widely used by the media to describe the varieties of cannabis containing particularly high concentrations of THC. Politicians and othersincluding me, occasionallyhave repeated the often quoted statement that cannabis on sale on the streets today is much stronger than the cannabis that was on sale in the 60s. However, I have been in correspondence recently with quite a few regular users of cannabisI did not solicit the correspondence; it was sent to me voluntarilyand my correspondents include a member of the Cannabis Assembly. They tell me that when politicians and the media make those statements, the regular users of cannabis merely laugh at us. The fact is that virtually no research has been done on street cannabis to establish either what is on sale or the concentration of THC in it.
The flowering tops of unfertilised female cannabis plants, sensimilla, have always been a source of higher potency cannabis, so there is nothing new about high-strength cannabis. Why is that relevant? Those who want cannabis to be reclassified yet again from C to B argue that there is a link between that much stronger cannabis and the apparently increasing incidence of mental disease among cannabis users. Some years ago, the all-party group on drugs misuse conducted an inquiry into dual diagnosis, long before that became accepted by most professionals in the treatment arena. Obviously, a person who is mentally ill and is also a serious drug misuser needs holistic treatment, for both conditions. Previously patients had to be treated for one or other condition, but not both at the same time, which was highly unsatisfactory, and often failed. It is now generally recognised that about half of the relevant group of people become mentally ill from their abuse of drugs, licit or illicitincluding alcoholand that the rest turn to abusing drugs because they are mentally ill.
In my opinion the jury is still out on whether cannabis causes mental illness. One thing is clear: we need a lot more research to establish the facts clearly. However, I am told that about 4 million people in Britain today use cannabis of one form or another from week to weeksome of them from day to day. Very few of those, by comparison, become mentally ill. For users who do become mentally ill, a causal link has not yet been established between the use of cannabis and the mental illness.
The plain fact is that since cannabis was reclassified as a class C drug, the use of all forms of cannabis has declined, especially among young people, contrary to the predictions made by those who opposed its reclassification during heated debates in the period between the announcement in 2002 and the reclassification in 2004. Is that not some proof that the
classification given to a drug is unimportant? What is important is that the harm that all drugs cause should be publicised to everyone.
The position is as follows. While the Select Committee was collecting its evidence, which shows that the ABC classification systema table of harms that drugs causeis not fit for purpose, the chairman of the ACMD and the chairman of its technical committee were defending the status quo while knowingly, behind the scenes, receiving evidence of which the Government, too, must have been well aware, that a much better scale of harm was possible, based on scientific evidence. I put it to the Minister: does that not put the Government in an extremely difficult position?
|Next Section||Index||Home Page|