Home Affairs Committee - Drugs: Breaking the CycleWritten evidence submitted by Angelus Foundation (DP088)

Summary

The Angelus Foundation is dedicated to combating the huge increase in use of legal highs/party drugs in UK in recent years. This submission is restricted to addressing that specific (and related) points of the Committee’s terms of reference (“the availability of ‘legal highs’ and the challenges associated with adapting the legal framework to deal with new substances”).

These drugs are particularly attractive to our young people given their price and purity—the UK market is one of the biggest in the world and growing rapidly. Taking these drugs damages lives, costs society millions and current limited interventions are struggling to have any effect.

No one knows what the harms of the new drugs (legal and some now illegal) because there is insufficient laboratory data nor has the little knowledge we have been effectively communicated through health messages to the users and their families.

Memorandum

The first priority for Government must be to ensure the establishment of a world class analysis laboratory to establish the harms of these drugs There must a demonstrable commitment to drugs education including adding it to PHSE.

The Misuse of Drugs Act 1971 has not shown it can be used to reduce prevalence of the new drugs—it should be fully reviewed.

The vital co-ordination between Departments needed to make an effective long-term Drugs Strategy is lacking. Consideration should given to establishing a dedicated cross Departmental Agency answering directly to Prime Minister (similar to MILDT in France).

Introduction

The Angelus Foundation was founded in 2009 by Maryon Stewart, the well-known health practitioner, author and broadcaster. Her 21 year-old daughter Hester, a medical student and athlete, passed away after consuming a legal high (GBL) in April 2009. The Foundation has since attracted a group of world-class experts, known as the Angelus Advisory Group, who bring together expertise from chemical, medical and behavioural sciences, as well as having considerable expertise in both the areas of enforcement and misuse of social substances.

Our Mission Statement

To help society understand the dangers of ‘legal high’ (unclassified substances), to reduce the harm they cause to young people and their families, and to save lives.

Our Aims and Objectives

We aim to become the acknowledged expert and knowledge centre on the subject of the dangers of legal highs and to maximise public understanding of the risks.

The Foundation’s Work

We are planning, subject to adequate funding, internal and external projects which will:

scope the problem;

raise awareness of legal highs;

educate about the risk;

detect and analyse new unclassified substances and their impact on the human body;

make the use of party drugs less socially acceptable;

enable parents to have informed conversations with their children on the use of legal highs;

empower young people to make more responsible lifestyle choices; and

improve the understanding of the physiological and psychological impact of these substances on the human body and mind.

Angelus Foundation is committed to help raise awareness about the dangers of legal highs and party drugs and now have a group of 20 world class experts to advise on its work programme. We now know that simply adding substances to the list of controlled drugs is not the solution: each time something is banned the chemists just tweak the molecules and put something else on the market.

We have had many joined up meetings with Ministers for Education, Health and Work and Pensions as well as their senior Civil Servants. While there was broad agreement that the issues were urgent and needed addressing in a co-ordinated manner that has unfortunately not become a reality.

Potential Dangers

Young people are using potentially very dangerous substances, due to:

Misleading labelling and marketing; long lists of herbal and vitamin ingredients obscure the fact that the active ingredient is actually far from natural.

Unregulated manufacturing leads to products of extremely variable quality and purity.

Price—most are cheaper than alcohol.

Constant manipulation of the substance’s composition keeps manufacturers ahead of the law and makes legal intervention highly problematical.

Substances have been found to contain fertiliser, plant food, rat poison and some traces of Class B drug.

Reported side effects include panic attacks, respiratory problems, nose bleeds, paranoia, depression, anxiety, suicidal thoughts and aggression.

Our mission is to help society to understand the dangers of legal highs, to reduce the harm caused to young people and to save lives. The Foundation is the only charity in the UK with this specific remit.

Cost Associated with Abuse of Social Substances

The potential for real harm to individual users either physically or psychologically is ever present. But it is not just the impact on the individual which is of concern:

It costs £250 per ambulance call out, £500 for a night in hospital and £3,000–£4,000 for an Intensive Care Unit (ICU) bed per night. This means just 100 ambulance call outs per week as well as 100 nights in hospital per week cost £3.9 million per year—100 ICU nights per week cost at least another £15.6 million per year as well as taking up valuable medical resources.

Research shows the financial cost to society of children who become serious drug users is likely to be in the region of £1 million each by the time they reach 30.

It is estimated that NEETs (16–18 year olds who do not engage with education or training), who are more likely to experiment with toxic substances, will cost society over £31 billion during their lifetimes.

The Foundation’s Work Programme

The projects are grouped into four programmes:

Problem scoping

Populus or a similar research group will carry out quantitative surveys of parents, educators and young people.

Focus groups with young people and parents to determine which messages are most likely to encourage wiser choices.

Work with statisticians to determine the measurement of outcomes.

Raising awareness

Films outlining new developments.

Tips for wise conversations in the form of downloadable material and films by young people, experts and celebrities enabling parents to discuss their children’s drug use.

The production of a “Wise Up” campaign and materials for both young people and parents which will be tried and tested by the Angelus Foundation and partnering charities prior to broad dissemination.

Workshops and online resources in eight different modules for GPs and nurses.

Outreach programmes for higher education and university campuses.

Outreach support programmes, including staff training for social scene venues.

Laboratory Services

Testing to identify substances, the cornerstone of the Angelus Foundation work, will be the establishment of a laboratory with the aim of monitoring new synthetic drugs.

A dedicated, specialised laboratory will plug this much needed gap. Its facilities will enable toxicologists to provide new information on a regular basis on the toxic substances which make up each new legal high as it emerges onto the market so that there is broad understanding and knowledge of the harms of these substances.

The laboratory work will be complemented by the establishment of a “novel substance assessment” team will undertake studies of the physical impact of the new drugs on the human body and systematically record their findings to produce a definitive reference source—the first of its kind in the country. This will provide valuable information to medical professionals in Accident and Emergency departments who are presented with cases of acute harm (“toxicity”) associated with novel recreational drugs. There will be continued analysis of newly confiscated items and test-purchasing legal highs from suppliers to detect new substances on the market. This vital facility, the basis for saving lives, does not currently exist anywhere in the world.

Positive interventions include

Evaluate current family therapy and early intervention programmes used in the USA.

Pilot a project to assess the impact of functional family therapy on 100 young drug users in the UK.

Do we need to add in the education programmes like Preventure and Climate here?

Points for the Committee on Drugs Strategy

The Foundation’s founder Maryon Stewart has met several times with Government ministers and senior officials, particularly in the Home Office. There initially seemed to be some good momentum in getting to grips with legal highs when James Brokenshire was drugs minister in 2010.

However he since been replaced twice which means there have been eight drugs ministers in as many years. Most drug ministers in recent years have little or no previous experience of drug issues and have only approached the point of useful knowledge when they are moved on.

Departmental Co-operation

There has also been a discernible deterioration in departmental co-operation on drug strategy matters since 2010. The Home Office have concentrated their efforts on a legal change (Temporary Orders) which may have no bearing on prevalence at all. There was no regulatory impact assessment carried out to defend the Government’s policy principle that the illegality of a drug will reduce demand for it.

The vital co-ordination between Departments needed to make an effective long-term Drugs Strategy is lacking. Consideration should given to establishing a dedicated cross Departmental Agency answering directly to Prime Minister (similar to MILDT in France)

The Department of Education has a vital role to play in prescribing a National Curriculum for PSHE with proved positive outcomes—currently drugs education is implemented on by region and on an ad hoc basis, often with negative outcomes as a result of inexperience and lack of knowledge.

The Home Office and the Departments of Education and Health should therefore work closely together to guarantee best practice.

Review of the Act

The Misuse of Drugs Act 1971 was drafted in a very different era for drug misuse. The pace of change cannot be sustained by the legislation The Angelus Foundation advocates a review of the act similar to the one carried out by in New Zealand by their Law Commission.

Laboratory Analysis

In 2010 there were 41 new substances introduced into the UK but there is no dedicated laboratory to assess the harms of these drugs and get basic information out to practitioners. This scale of drug innovation is clearly too much to ask the unpaid advisors of the ACMD to carry out. Due to cutbacks in test purchasing in 2011 because of budgetary constraints it is not known how many new substances entered the market, but it is known that there were 20 detected in the first four months of the year.

Education

The educational need in the UK on advertising the potential dangers of the new party drugs is acute but the Department for Education have not made any significant contribution to preventing harms by giving young people simple additional advice (for example on what drugs can be fatal if mixed with alcohol).

Every stakeholder agrees we are in the midst of a revolution in drug taking yet DE has not responded with anything like the necessary resources. There does not appear to be any acknowledgement by that department of the seriousness of the situation and their responsibilities in addressing it.

There is no PHSE on the National Curriculum which means that drug education is not compulsory. When it is taught, there is no measurement of its efficacy.

The Government is not giving any direction to the regions from central Government to steer them towards the proven successful initiatives. There have been negative interventions in schools in the recent past which have resulted in worsening outcomes.

The Drugs Education Forum, which is the umbrella body that is committed to improving the practice and profile of drugs education in the UK, has no funding in place for 2012 and faces closure.

Conclusion

Legal Highs through the internet, have transformed the market for drugs in just three or four years. Government ministers, although committed to tackling this potential social tragedy, have been slow to deploy effective measures. This is partly because often the only lever they feel they can pull is a legislative one. The Misuse of Drugs Act is not equipped to deal with such rapid change in the drugs landscape and research on Mephedrone prevalence shows simply illegalising a drug does not reduce prevalence and harms. Temporary Orders are simply a stop-gap for that out-dated process.

The main point about the new wave of party drugs is the harms are unknown to science, practitioners users and their parents. The best response would be to:

(i)Gather as much scientific and clinical knowledge as possible which would mean establishing a dedicated laboratory (the ACMD is not sufficiently resourced to carry this out).

(ii)A comprehensive programme of education for the population on the harms of these drugs.

At present there is little to suggest the Government accepts this revolution in drug-taking merits an exceptional response. Nor are Departments working in a co-ordinated fashion to implement the current strategy and a restructuring may be overdue. Angelus Foundation wants to work with ministers and officials to address the perilous situation but first all parties/stakeholders must agree how urgent the situation is.

January 2012

Prepared 8th December 2012