Select Committee on Home Affairs Minutes of Evidence

Examination of Witnesses (Questions 440 - 459)



  440. Do you think that should be indulged without any imposed reduction on dose, for example?
  (Mr Wilkinson) It is a very interesting point because it is one that bothers doctors. If you just take a patient centred approach and look at the individual you try and get the individual off, but if you look at the public health effects of criminalising heroin, because that is what we have done, if anybody wants heroin they have to get it on the criminal market except for a tiny number that is so insignificant it is not worth talking about, then the public health effects of that in terms of hepatitis, in terms of impurities in the supply they get, in terms of the people it is passed on to who do not know what they are getting and overdose, are much worse. The public health effects of our current policy result in a lot more deaths than supplying clean heroin. Overdosing on clean heroin is almost unheard of.

  441. Would you accept that any user's own habit is harmful to others in as much as they are likely to make themselves ill and, therefore, will need health treatment and we have other people waiting for new knees or whatever?
  (Mr Wilkinson) I quite understand the argument and that is why I think tobacco advertising is such a bad thing, but does that mean we make a law saying it is illegal to smoke cigarettes? I do not think it does.

  442. It would be difficult to do that retrospectively.
  (Mr Wilkinson) Of course, it is different, yes, and so we admit defeat, or whatever. I do not believe with the extent of cannabis use at present that it is sensible to say we are simply going to pretend that it is illegal and people must not do it.

  Chairman: Now Mrs Dean has some questions for Mr Ogden, who has been waiting patiently.

Mrs Dean

  443. Mr Ogden, you have been very patient and I am sure there have been lots of comments made that you would disagree with from your earlier point. I understand that in general you believe the strategy is working?
  (Mr Ogden) It is starting to work. It is certainly starting to work in my area although there needs to be some improvement of it. It is the first time in 30 years of British drugs policy that the strands of enforcement, education and health have been brought together. I disagree strongly with Mr Wilkinson, the only way we can reduce the number of heroin users is by vigorous enforcement, extremely effective treatment and first class drug education and prevention. That is what is the National Drugs Strategy. If it has not worked over the three years it is because it has had some people along the way who have actually undermined that strategy in some of the debate we have had. I think we really have to take it forward and make it work with the right sort of resources properly co-ordinated and properly commissioned.

  444. What would you say the success is that you are having already in the East Riding and Hull DAT?
  (Mr Ogden) First of all, it has been extremely difficult to pull together all departments of local government in the same way that Keith Hellawell had difficulty pulling together all departments of central government. We have had the same problem but we have got there. We have got combined commissioning, we have got core budgets. We have got a vigorous drug education prevention programme that not only does drug education through the national curriculum of science and personal social health education but other programmes that go into schools in support of that. The evidence we are getting from young people from local surveys, not properly evaluated yet because we have got a long way to go, is that less young people are now drifting new into class A substances, it is not cool—to use the expression—to be a smackhead, but it is cool to take cannabis because it is going to be legalised shortly. That is the view that young people have. When the Home Secretary made his announcement before this Committee as your first witness, I was inundated by head teachers ringing my office asking "what is going on?" I circulated the Home Secretary's press statement which put more balance to that to head teachers, "this is what the Home Secretary is saying". That is how concerned they are about it. I think the National Drugs Strategy can work. We have had a real problem with treatment. Treatment historically has been poor, poorly commissioned, poorly co-ordinated. We have wasted millions of pounds over the years with treatment. You have had evidence from Paul Hayes, the Chief Executive of the National Treatment Agency, and it is a massive progressive step to put some real standards into effective treatment. We have really got to give that a chance to work and we think it will do.

  445. Have you, in your area, got enough treatment facilities now?
  (Mr Ogden) No. We are having to apply the principles of shared care because we have to move away from agencies referring to one single agency. The problem with treatment is everybody refers everybody to a specialist, they want GPs. We want every GP's practice to have the confidence, the ability and the training to be able to treat drug users as they are able with somebody going with the flu or with a broken arm. They are known as generalists. We then want to have, and we have got them, specialist generalists, GPs who are trained to a higher standard who want to specialise in it. Those GPs will be supported by nursing staff, by councillors, dealing with more problematic drug use. The third tier is the really chaotic drug user who almost needs daily titration clinics, possibly to prescribe diamorphine in larger quantities than it is at the moment. That is the way that we are moving. Before we spend any more money on it we have to make sure that the money that is there now is sharply focused because until these last few years it was not, it was all over the place. Methadone was being prescribed in vast quantities in some parts of the country, even in my area, and it was killing people. A prescribed drug was killing people because there was no co-ordination. It took four years for the clinical guidelines on methadone to be produced. People died in that time. A third of the deaths that I reviewed involved people who had taken methadone and other drugs. We are getting there.

  446. What percentage of drug users who are in treatment in your area are being treated with methadone?
  (Mr Ogden) I would think about 70 per cent of those who are in treatment are on some sort of methadone programme but it is not now just a methadone programme. I really wish that when people refer to treatment they would not put that word "methadone" in front of it because methadone is not a panacea. If you apply the principles of sorting their lives out, sorting their accommodation out, their employment, their financial situation, even some education, take a holistic approach to treatment, then it will work. Methadone on its own without anything else will not work. That is what we are trying to introduce.

  447. We have been told that there are more deaths of people on methadone than on heroin in some instances. You favour the prescribing of heroin rather than methadone, do you?
  (Mr Ogden) Not necessarily. I would not favour prescribing heroin in many cases. This is something that the National Treatment Agency has got to come to grips with, that for people who are extremely chaotic users it may well be that the prescribing of diamorphine in a very specialised clinic is necessary but we really have to move people away from intravenous use of drugs full stop through effective treatment. When I first started to review deaths four years ago, a third of those people who died had died of methadone overdoses. I have not reviewed a methadone overdose death for over two years because most methadone now is taken under supervised conditions in pharmacists. We have got to work on that.

  448. That has improved that. Although you say you believe the strategy is working, what changes do you think are still needed to improve it?
  (Mr Ogden) I have read Keith Hellawell's evidence. I think the targets and the objectives were right when he produced the national strategy. We have all got some difficulty with the numbers of young people under 25 moving to Class A drugs, we have to look at that particular target. We have got to put more resources into enforcement. I have heard the figure that 62 per cent of all budgets is spent on enforcement. That was the case in 1998 but it is now much less than that in the overall scheme of things. We have got to look at what happens with the importation of drugs. We certainly need more resources with Customs and Excise. I am very worried about the attitude to money laundering. I am very pleased that money laundering is now an issue but, sadly, it took 11 September to raise the profile of money laundering. Bureaux de change and travel agencies have been laundering money for years and no-one has taken any notice of it. Those people who whinge and complain about drugs are actually probably involved to some extent with aspects of money laundering. Until we have high ethical standards in business and people properly reporting money laundering to the National Criminal Intelligence Service, particularly retailers, we are not going to get all that far with getting at the money launderers and getting the right sort of intelligence to get to the middle and top tier dealers. Customs and Excise need more support and Customs and Excise, which is part of the Exchequer—drug trafficking is now back with the Home Office, before it was with the Cabinet Office—probably need to look at the prosecution side of things because most prosecutions are through Customs and Excise lawyers and not through the Crown Prosecution Service. We need specialised lawyers, I think, within the CPS to prosecute drug cases.

  449. You obviously are not in favour of decriminalisation or legalisation from what you have already said, but what do you see as the main dangers of such a move?
  (Mr Ogden) Further use. We have already got quite enough problems with alcohol, with under-age drinking, with binge drinking, with bootleg tobacco, with bootleg alcohol, let us not make the situation worse with drugs legally available. We have got a national strategy. It is very difficult pulling together all those agencies but I think we can get there and we would have moderate use. We have seen it now with cannabis, that just by the announcement that cannabis may well move from Class B to C young people think "that is cool" and will carry on using it. It is not good because in a developing brain it causes very significant problems.

  450. Is not one of the arguments for prescribing heroin more widely that you then take up the need, as we have heard others say here today, for them to sell it on and thereby reduce the number of people coming on-stream as users?
  (Mr Ogden) I think this really does need very careful looking at. When I say prescribe it more widely, I think very specialist agencies can probably increase the number of people who prescribe diamorphine on the premises, not to go away and inject it in shooting galleries, which is something that I would not support and my Drug Action Team would not support.


  451. On what premises?
  (Mr Ogden) On the premises of the specialist agency, the third tier of the very specialist agencies with all the clinical support available for them at that time. That occurs now and maybe there is a chance to extend that, but I would not advocate wider use of that because we have got to move people away from this intravenous drug using culture that this country, and certainly my area, has had since the early 1980s.

Mr Watson

  452. Mr Ogden, you have put a very robust case in defence of the National Drugs Strategy and if I could focus on the prevention and education side of that. You said that the reclassification announcement has increased cannabis use amongst young people. Have you any evidence to show that?
  (Mr Ogden) The word on the street for a long time about cannabis is the youngsters think it is going to be legalised—

  453. That is anecdotal.
  (Mr Ogden)—so it is cool to use it. More recently, head teachers contacted me immediately after the Home Secretary gave evidence to this Committee expressing their concern.

  454. It has been said that the problem with the existing messages that Government and agencies of Government are giving out on drugs in their education programmes, is, for example, we are saying that ecstasy, being a class A drug, is as harmful as heroin, being a class A drug, and that patently is not the case.
  (Mr Ogden) I do not agree with that. If you have got good drug education, and good drug education starts at the age of five when you talk to a youngster about what a fantastic human machine the body is and what you put into it pollutes it and then you build on that through the national curriculum on personal social health education, if you have got effective drug education as youngsters get older you will deal with specific drugs and give them the facts about specific drugs, about the harm that those drugs will do. They have then got to make their informed choices on it. We would not say heroin and ecstasy are the same, we would go through the symptoms and effects with them in a very structured drug education way.

  455. Nevertheless, the classification of drugs does put them in the same category. One thing that we have had a large amount of evidence on is that there is confusion amongst young people and they do not believe the messages that are being presented to them because they know through their own anecdotal evidence and their own experiences that ecstasy is less harmful than heroin, cannabis is less harmful than ecstasy. Other people have said to us that the reclassification of cannabis is actually sending a clearer signal out about the harm different drugs can do to you.
  (Mr Ogden) We would not agree with that. I just go back to what I said previously. If you have good drug education you explain the effects that those particular drugs would give. The reason that the Government in 1971 decided to put ecstasy in class A in the same way as they put cannabis in class B was cannabis in 1971 was far milder in THC content than it is in 2001. Cannabis oil is still, I presume, going to be a class A drug because it is very strong and yet some of the cannabis that is now around blows your mind because of the strength of it. How do we know that if you are just going to warn them on the street and take no further action without saying "What exactly was that? Was it skunk? Was it Northern Lights? What was the strength? What else have they got back at their house?"

  456. So there is a case for reclassifying some derivatives of cannabis, maybe increasing the classification of some and possibly decreasing—
  (Mr Ogden) Possibly. This is something the Advisory Council needs to take a very, very close look at because it may be slightly different now and some cannabis may well need to be higher in classification.

  457. You are not against the principle of reclassification?
  (Mr Ogden) I personally think that the whole thing wants looking at very, very carefully. I do not think it has been and there has not been an informed debate on this. We were very surprised when the Home Secretary made his announcement before this Committee.

Mr Cameron

  458. I am just very surprised at this point about children saying "it is going to be legal so it is cool to take it". Have you met any teenagers who have said something like that?
  (Mr Ogden) Yes. These are the myths. Head teachers asked us to give more information on cannabis and we have provided a lot of information for them. This is what youngsters are saying: "It cleans out the lungs. It helps you concentrate. It is no different from smoking cigarettes. It is not as harmful as alcohol. It is going to be legalised. It is legal in Holland. Cannabis does not make you aggressive like alcohol. It is okay to drive on cannabis. Cannabis does not have any long-term effects. It is not addictive. It is not physically addictive. I know what I am doing when I take cannabis. It calms the baby down if you smoke when you are pregnant. It helps in exams. It helps you lose weight. It does not cause cancer". All wrong.

  459. Is this an argument for education or prohibition?
  (Mr Ogden) It is an argument for education, but by suggesting that cannabis is less harmful than it was in 1971 when it is more harmful than it was in 1971 we believe undermines the drug education programmes that many, many Drug Action Teams have now got in place in a very comprehensive manner.

  Mr Cameron: Thank you.

previous page contents next page

House of Commons home page Parliament home page House of Lords home page search page enquiries index

© Parliamentary copyright 2002
Prepared 22 May 2002