Examination of Witnesses (Questions 220
- 227)
TUESDAY 20 OCTOBER 2009
JOHN MANN
MP, DR EVAN
HARRIS MP AND
LORD MANCROFT
Q220 Chairman: Lord Mancroft?
Lord Mancroft: Can I just start
with the issue of cocaine itself? Cocaine is different from other
drugs. Drugs are basically in two groups: there are uppers and
downers. Heroin is a downer. It makes people dreamy and sleepy
but it slows them down. Cocaine is exactly the opposite: it makes
people feel as if they can rule the world, they feel very energetic,
over-excited, but the more of it you take the more of it you have
to take, and the high is quite a short time in terms of time,
so you are taking more and more. As for the relationship between
crack and cocaine, they come from the same drug. The only way
I can define it in layman's terms is that it is the same as the
relationship between port and claret. It is reinforced; it is
rather stronger, considerably stronger. The difficulty when it
comes to treatment terms is that if you take a heroin addict who
has a very high level of addiction, is taking a lot of drugs,
a treatment facility will get that person's feet back on the ground
and get them relatively normal where you can have proper conversations
and they are relatively okay in a matter of days, a week or two.
For somebody who has been using a lot of cocaine or a lot of crack
over quite along period of time they are going to have very difficult
psychiatric or psychological problems and it sometimes takes quite
a long time to get them to where you can actually start advancing
their life again. That is the difference between the two, but
the treatment is the same—a very good treatment facility
and counsellors, recognise the differences, work out how to do
them and they are treated alongside. As I said, they are all poly-addicts
nowadays anyway. They have all got alcohol problems, they all
take other drugs. It does not help to focus on the differences.
It is much more important to focus on the similarities when it
comes to health care. Going back to the issues where you started
asking us about public policy, there are problems of addiction
in South America; of course there are. It is interesting to note
that they have increased after our problems. The increase in the
trade to provide for our market has created bigger addiction problems
in South America. I have been involved for some time with programmes
in Colombia. They did not really have a drug problem 20 years
ago inside the country, although I am sure they did in places,
but now it is a significant problem, created by the existence
of the trade and everything that goes on around it. It is interesting
for me because 30 years ago I lived in South America and I lived
in Argentina, which had in the seventies, under the military junta,
virtually no drug problem. The reason for that was that there
was a policeman with a pump-action shotgun on every street corner,
armoured cars all over the place, and if somebody got caught with
a joint they did not go before the magistrate; they were found
in a ditch the next morning with a bullet in the back of their
head. That is really effective; you can do that. I think if we
were to suggest doing that in this country it would not be acceptable;
none of us would put up with that. The Chinese and the Thais have
tried it too. They have strung up and shot an enormous amount
of people, usually publicly, to try and suppress it. Actually,
it has not even worked doing that. The reality is that there is
no example of any country in the world that has suppressed its
drug problem by use of prohibition. We do not actually have prohibition
here in this country. We have something which pretends to be prohibition.
We do not really put people in jail and throw away the key. My
God, you have got to do a lot of dealing to get a decent drug
sentence in this country. The pop star Pete Docherty, who managed
to get himself all over the newspapers a year or so back, you
will remember, four times was convicted of class A drugs before
they would even consider a custodial sentence, so this is not
prohibition. The other side of the coin is not, as my colleague,
Mr Mann, just suggested, unlimited use. That would be a disaster;
he is quite right. What we have at the moment is controlled drugs
in this country. I have history here, Chairman, because my father
was the minister not responsible for not banning heroin at the
Home Office in 1953 and because of the way his son turned out
he rather regretted it, I think, but there we go; that is the
way the world works. We have controlled drugs in this country
but you only have to walk within a mile of this palace to realise
that the controls do not work, because anywhere on the streets
of London you can buy any of these drugs, at a price. The suggestion
that I would make is not that we go from failed prohibition to
a completely unrestricted free market; what we need to do is look
at the current controls that we have, which are 35 years old,
and redo them so they work. There are a lot of dangerous things
in this world and drugs are very dangerous things and if we all
take the view that they are then it is right that the state and
not armed criminals should control them, as currently happens
in this country. The way forward therefore is a range somewhere
from the way we control alcohol, or, indeed, the most dangerous
object in our everyday lives, the motorcar. If you go outside
here in the street and step in front of a moving motorcar you
will find out just how dangerous it is, so what do we do? We do
not prohibit it. We license the vehicle, we license the users;
we make them pass a test, we make them have insurance so if they
damage anybody they have to pay up, we tell them how fast they
can use it, on which side of the road, where they stop, where
they park it, what they do with it. That is control.
Dr Harris: And you tax it.
Lord Mancroft: You tax it. You
cannot do drugs in exactly the same way but I think that the idea
that you can go on and on throwing this enormous amount of cash
at it for absolutely no benefit. If we look at the evidence that
Dr Harris was talking about, prohibition does not work. What we
do not want to do therefore is throw the baby out with the bathwater.
What we want to do is look at the controls under the Misuse of
Drugs Act and redo them and tighten them and make them work.
Q221 Tom Brake: Mr Mann, earlier
I think you described disrupting cocaine supply and pushing the
price up as being a win-win situation, but is it not the case,
as we have heard from other witnesses, that it would drive users
to cheaper drugs, such as crack cocaine, and therefore might have
some very serious consequences rather than a win-win?
John Mann: No, it would not; exactly
the opposite, because the market for crack cocaine only came about
because there was a surfeit of cocaine around. If you can make—and
you can—more money out of cocaine powder than crack cocaine
there are no economics that would suggest that you would add an
additional manufacturing cost for a cheaper product with a lower
mark-up than the more expensive product. It is exactly the opposite.
Crack came in when there was such a surfeit of cocaine and the
price was forced right down. Both my colleagues here have dipped
into, interestingly, throwing in heroin at the same time. This
is the fundamental point I hope you will not lose. The two drugs
are entirely different. Heroin is physically addictive. The way
it works on the receptors in the brain is physically addictive;
therefore, there are treatment strategies, medical strategies,
that are proven to have success and every addiction centre in
the world has got countless research papers on precisely how and
when that works. I have met them, I have read their stuff. I do
not see any evidence of treatment on cocaine because the physical
addiction is not there. To emphasise that, to illustrate it in
layman's terms, if someone takes a large amount of cocaine one
night that does not make them more liable to be addicted to cocaine,
in exactly the same way that if any of you excessively drink,
say, wine or whisky one night, that does not make you automatically
addicted to alcohol. Excess consumption with cocaine is not automatically
addictive. That is quite unlike what happens physically with heroin
and that is why there is a huge difference in how the two drugs
should be seen and dealt with policy-wise.
Q222 Tom Brake: Could I just ask
the other two witnesses about their views on treatment and whether,
as Mr Mann is suggesting, there are treatments for heroin because
it is a physical addiction, whereas with cocaine it is not a physical
addiction and therefore there are no treatments that work?
Dr Harris: I repeat my first answer,
that you should go directly to the experts for the answers on
all these questions, and I am sure they will be able to supply
you with a proper review. You would not get a "yes"
or a "no"; you would get a systematic review of the
evidence with conclusions that have been peer reviewed in the
formulation of the research project and then peer reviewed prior
to publication and then commented upon, and that is far better
than ad hoc answers. Dependency will arise not just from a single
use, and I do not think even Mr Mann is arguing that, so if one
is a regular user of cocaine one can get dependent, both physically
in terms of the stimulation because it is an active drug and psychologically
on the feeling that it gives you, and you can make a habit of
it as well. Dependency is a complex matter and I do not think
you can have a group of things that say, "This is physically
addictive or induces physical dependence; therefore it is addictive,
and this does not", even if it does not, and therefore it
is not. It is far more complex than that, and that is why I think
that the evidence you will get, the proper evidence rather than
submissions, will show that treatment is a relevant issue in your
inquiry. I have got one point that I want to make and I did not
make earlier, if I may, Chairman.
Q223 Chairman: Yes, please.
Dr Harris: That is this issue
which I have heard about sending a message in terms of drug policy.
One thing I would urge you to do is to have zero tolerance of
anyone saying that a conclusion of a select committee or a reclassification
of a drug would send the wrong message. If any message was sent,
for example, with the continued classification of ecstasy as class
A, it is that heroin and cocaine are no worse than ecstasy, which
many more people have had contact with. If there is a message,
it is a damaging message as to the dangers of other class A drugs
which are clearly more dangerous in health terms than ecstasy
use. The second point is that we could not find on the Science
and Technology Select Committee in our inquiry, Drug Classification:
Making a Hash of It, published in 2006, any good evidence that
there is a message sent by classification. All it has the danger
of is distorting police priorities in an unhelpful way. In fact,
there is at least some evidence for this if you look at what happened
with cannabis, because when it was declassified from B to C use
went down, not up, and that is why the ACMD argued very clearly
and very strongly that it should be left in class C, given that
we have a classification system, and what I think is the most
depressing thing about the way drugs policy is dealt with is that
the ACMD, which collects all the expertise, not just scientific
expertise, has its two main reports not accepted by government,
nor indeed by the political parties. It makes me wonder what the
point is of having evidence-based policy talked about in the Home
Office or by political parties.
Q224 Gwyn Prosser: Lord Mancroft,
you have made it very clear that in your view there should be
a shift from the emphasis at the moment on the criminal justice
system of dealing with the drug problem to the treatment of it.
What treatments are available to people going into the criminal
justice system, going into prison?
Lord Mancroft: Few and far between
and patchy. The best treatment available in prison now has got
to be the Rehabilitation of Addicted Prisoners Trust, which this
Committee has not spoken to and should undoubtedly do so. The
treatment in this country is incredibly patchy and it is extremely
badly funded; in other words, I mean incompetently funded. I regret
to say that the National Treatment Agency, although a great idea,
has been extremely disappointing. Although it spends £850
million of taxpayers' money every year, I suspect the vast majority
of it, 80-90%, is wasted. The best treatment in this country exists
within the absolute model treatment known as 12-step treatment.
There are about 20 or 30, maybe 40 now, treatment centres doing
it. You can go and see Clouds House in Wiltshire, Broadway Lodge,
Broadreach, Nelson House Trust, which has just won a prize, at
Stroud in Gloucestershire. Also, if you are very interested to
talk more about maintenance treatment, Professor Strang of Action
on Addiction is just completing his research which will be published
on the prescribing of heroin which has been going on in about
six or seven different locations across the UK for the last few
years. Of course, maintenance prescribing, methadone, which has
been used in this country for the last 30 years and personally
I am not in favour of because it is badly done, does not apply
to cocaine. You cannot maintain cocaine addicts. In that way Mr
Mann is entirely correct. I do not accept that you cannot treat
cocaine addicts; you can and you do, and people do extremely successfully
every day. They are difficult to treat. The point about it is
that people do not understand. Drug addiction is a relapsing condition.
Addicts relapse. It is part of the condition. When they relapse
you put them back into treatment. Eventually you and they get
it right and they build their lives up again. That is only part
of it. We have not got time today to go into all the great things
of treatment but there is great treatment going on in this country.
It is very good and it needs to be encouraged and it includes
in those treatment centres—go and see them—lots of
people whose primary drug abuse is cocaine. This debate about
whether cocaine is physically addictive has been going on for
30 or 40 years in academic magazines which come out every month;
you can read them, pages and pages and chapters and chapters on
it. The point about it is this. If you take a heroin addict, and
heroin is very physically addictive, you detox him off it, so
in a week, two or three weeks' time, he is not addicted to heroin.
Why does he go back and take it again a few days or weeks later?
Because addiction is a psychological problem. It is the thing
in people's make-up that makes them go out and do it again. It
is the jay walker syndrome. You get them out of the traffic, put
them back safely on the sidewalk and what do they do? They climb
straight back into the traffic. That is an addict. It does not
matter what they are addicted to.
Q225 Gwyn Prosser: On that question
of addiction or dependency, I am not an expert on these matters
but the witness who was sitting in your seat earlier on, Sarah
Graham, was taking cocaine as a powder for nine years and it took
her eight months in The Priory to come off that what I would call
addiction or dependency, so no matter what scientific evidence
might be out there or might not be out there the anecdotal evidence
which we see in our everyday lives in our towns and cities certainly
emphasises the point that it is dependency or it is an addiction
and it needs addressing.
Dr Harris: But it is the medical
evidence you must look at. If you are going to Holland you should
meet the Trimbos Institute, you should meet the Amsterdam Center
for Drug Research.
Q226 Chairman: We are going to Amsterdam.
Dr Harris: The Trimbos Institute,
for an example, you should meet. If you go and meet the people
running the drugs systems there what you will find, interestingly,
is that The Netherlands, which is liberal, and prohibition Sweden,
when it comes to treatment, have got an identical policy. The
difference—and this is quite critical with cocaine—is
that there are people with problems of addiction, addictive personalities.
You could take evidence from Rampton Hospital in my constituency
where Dr Mike Harris, the Director, will point out that there
are some people who go in who have got such a personality that
they will take in excess whatever is available, be it boot polish,
be it meths, be it cocaine, be it anything, whatever is there.
It is not the cocaine that is the physical addiction, that is
the point, and therefore the issue is treating the person there.
With heroin, the heroin is physically addictive and The Netherlands
is a good example of a country that has got its treatment regime
in place. A good example is one that the older generation might
understand more, including myself. All the students who took speed
to get through university courses 20-25 years ago and now take
either speed or a bit of cocaine now and then are not, 30 years
on, addicted; they are not. Those who start taking heroin build
a physical addiction that, unless it is treated, is impossible
to break, and that is why there has to be a very different policy.
Mr Winnick: Lord Mancroft, you have given
us your own personal position based on a great deal of experience,
as indeed have your two colleagues at the table. Bearing in mind
the furore which occurred over cannabis reclassification, do you
really have much hope that there is going to be a change of policy
if the Opposition were so furious with the Government accusing
them of being soft? What hope is there that there will be a change
of policy by either of the two main parties along the lines that
you clearly—
Q227 Chairman: Could we have a very
brief answer from each of you?
Lord Mancroft: That is an incredibly
broad question and a very difficult question. It also slightly
goes back to the question you asked the previous people giving
evidence about the way the press handles it. Most people in this
country, it seems to me, and one should be very careful in politics
of making generalisations, know that this policy that we do now
does not work, and increasingly people are going on and on about
it. This Home Affairs Select Committee would not have held this
inquiry 20 years ago; time does move on, and I suspect, looking
at the faces in this room, a lot of people are beginning to start
thinking that the two things we have got to get away from is,
one, every time drugs come into the newspapers they are treated
sensationally, at every level, whether it is an under-privileged
person or an over-privileged celebrity. Those two words are so
destructive, so trying to get the press to handle it in a responsible
way is a step forward. The other thing is that I turn it back
on you. It comes out of our House and the real problem lies in
your House, ladies and gentlemen, which is that every time drugs
are talked about somebody on the Front Bench of either party says,
"I am tougher than you". Actually, the general public
are bored with people being tough. What they would like is senior
politicians to be honest and effective; that is the key thing.
At the moment all the policies of both major parties are completely
ineffectual.
Chairman: Mr Mann, Dr Harris, Lord Mancroft,
thank you very much. If there is any further information you wish
to put before the Committee, any recommendations as to where we
should visit, please let us know.
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