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8.9 p.m.

Lord Cobbold rose to call attention to the long-term effectiveness of current national and international policies on drugs; and to move for Papers.

The noble Lord said: My Lords, I raise this subject with some trepidation. It is an emotive issue on which almost everyone has strong opinions. Personally, I have little experience of either the use of drugs or of dealing with the consequence of drug use in others. I have in the past occasionally encountered cannabis, both wittingly and unwittingly, but that is all. I am fortunate in that all my four children have eschewed the drug habit. But I have close friends who have lost

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a much-loved child from drugs, so I understand full well the horrors and the misery that drug use can cause. I do not smoke, but I would be very reluctant to do without my wine and my whisky.

I do not in any sense belittle the danger and damage caused by drugs. My reason for raising the subject is that our present policies on drugs seem to be in conflict with common sense. The Home Office's Updated Drug Strategy 2002 states on page 40:

    "Society as a whole pays a high price for drug misuse. The total economic cost each year, including the cost to the health service, courts, prisons and other parts of the criminal justice system, and the benefits system is estimated at between 2.9 billion and 5.3 billion. When social costs such as the costs to crime victims are added, the total rises to between 10.1 billion and 17.4 billion".

That is a cost of nearly 18 billion per annum.

That contrasts with excise revenues from tobacco and alcohol, which provide the Government with an income of 14 billion per annum—a revenue stream that is admittedly offset by the costs of alcohol misuse and smoking related healthcare provision. But the revenue is also available to finance advertising and educational campaigns warning of the dangers of smoking and alcoholism. The campaign against smoking has been particularly effective in recent times.

We are also told that we have the highest rate of drug usage in Europe and that more than 50 per cent of those in our overcrowded prisons are there for drug-related crimes. The war on drugs by any measure that one cares to take is not being won. One has to ask: is it indeed winnable with present policies?

I was brought up with stories of Al Capone and alcohol prohibition in Chicago in the 1920s and 1930s. Prima facie, it seems that there are lessons to be learnt from that experience. Indeed, to the casual observer, today's drug scene looks even worse than Chicago. We are told that there are now about 250,000 problematic drug users in this country, compared with only about 5,000 in 1971, and that the 250,000 heroin and crack addicts are responsible for 99 per cent of the nearly 18 billion annual social and economic costs to which I have already referred.

Then there are the strong links between problematic drug use and crime. According to the Government's Updated Drug Strategy 2002, around three quarters of crack and heroin users claim to be committing crime to feed their habit. But drug usage is not confined to the 250,000 problematic drug users. Around 4 million people, we are told, use at least one illicit drug each year, and around 1 million people use at least one of the most dangerous drugs that are classified as class A. All those people are therefore criminals. Does that make sense? One has to ask to what extent it is the responsibility of the state to protect individuals from damaging themselves. We live in an age when the nanny state interferes more and more in individual liberty. Has it gone one step too far in the case of drug laws? It is clearly the duty of the state to prevent injury and damage to third parties and to property, but our current drugs laws manifestly fail to do that.

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Prohibition is supposed to restrict supply, but clearly it does not. It benefits only the criminal gangs which dominate the trade. Common sense suggest to me at least that it would be more sensible to treat drugs in the same way as we treat alcohol and tobacco. Supply would be regulated and subject to tax and, very importantly, to quality control. Tax revenues could be applied to healthcare and educational campaigns on the dangers of drug use. The laws which already operate in the sphere of alcohol abuse could be extended easily to cover drug abuse.

But, as we all know, it is not as simple as that. Even if decriminalisation were accepted in this country—which it is not—it is not a one-country problem; it is global. That brings me to consideration of the national framework in which we operate.

Noble Lords will be aware that the main instrument for drugs control in the United Kingdom is the Misuse of Drugs Act 1971. Noble Lords are probably also aware that this Act was the means by which the United Kingdom sought to meet its international obligations as a signatory to three United Nations conventions. In explaining the background to the legal position, I am indebted to the excellent report, Drugs and the Law 2000, commissioned by the Police Federation under the chairmanship of Dame Ruth Runciman.

The relationship between our domestic law and international agreements goes back to the early years of the 20th century—The Hague convention of 1912 and the Shanghai commission of 1909, to be precise. The pattern has been for United Kingdom legislation to emerge from international agreements, although it has always been possible for the United Kingdom, as for other countries, to take action separately from international conventions.

There are in fact three United Nations conventions on international co-operation in the drugs field, dating from 1961, 1971 and 1988. The 1988 convention supplements and strengthens the earlier two. Among other things, the conventions provide the basis for controlling the availability of drugs for legitimate medical and scientific purpose and for making the possession of drugs for personal consumption a criminal offence under domestic law in all member countries.

The conventions were further consolidated in June 1988 at the United Nations 20th General Assembly Special Session (UNGASS) on the world drug problem. In its political declaration, the special session reaffirmed its,

    "unwavering determination and commitment to overcoming the world drug problem through domestic and international strategies to reduce both the illicit supply of and demand for drugs".

The session set itself a range of ambitious targets to be achieved, among which were, first,

    "eliminating or reducing significantly the illicit cultivation of the coca bush, the cannabis plant and the opium poppy by the year 2008".


    "achieving significant and measurable results in the field of demand reduction by the year 2008".

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And, thirdly,

    "eliminating or reducing significantly the illicit manufacture, marketing and trafficking of psychotropic substances, including synthetic drugs".

This 10-year programme was to be the subject of review after five years. This five-year review actually took place at a conference in Vienna on 16th and 17th April this year.

The meeting coincided with the war in Iraq and therefore received little or no coverage in the world press. The lack of publicity was in all probability welcomed by participants because it is self-evident that no progress whatever has been achieved in meeting the ambitious targets set in 1998. Drug production and use is at least as prevalent, and probably more so, than it was in 1998.

The Economist, in its issue of 5th April this year ahead of the Vienna meeting, wrote:

    "This gathering will hear that the world is no closer to meeting its goals than it was five years ago. But instead of asking such questions as whether the whole project may be misguided, the meeting will almost certainly decide to redouble international efforts to achieve the unachievable".

The prediction of the Economist seems to have been fulfilled. The joint ministerial statement issued following the meeting makes no attempt to measure progress against the target set at the UNGASS session five years ago. The statement simply reviews the commitment to the principles established by UNGASS. It concedes that,

    "drug abuse remains at an unacceptably high level",

and expresses concern at,

    "the rapid and widespread increase in the illicit production and abuse of narcotic drugs and psychotropic substances".

Finally, the statement closes the door on any more radical discussions when it states:

    "We are gravely concerned about policies and activities in favour of the legalisation of illicit narcotic drugs and psychotropic substances that are not in accordance with international drug control treaties and that might jeopardise the international drug programme".

That sentiment is echoed in the Home Secretary's foreword to his Updated Drug Strategy 2002, where he stated that

    "all controlled drugs are harmful and will remain illegal".

For those who support current policies that will be a matter of relief. But for those who would like to see a radical rethink of our policy on drugs the way ahead looks arduous, at both the national and international levels. The forces of zero tolerance are firmly entrenched.

What, if anything, can be done in the meantime? Are there any positive measures that can be taken within the existing legal framework? There are a number of research institutes, such as the Transform Drug Policy Institute and Forward Thinking on Drugs, which are actively promoting a change in the law. Nacro has said in its most recent report that,

    "the war on drugs is over—we lost".

Many other excellent bodies promote work in the drug field and are doing a fantastic job.

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Noble Lords will be aware of the moves to transfer cannabis to Class C and to decriminalise its possession for personal consumption. These are welcome moves. Another area in which benefits can be achieved is harm reduction schemes. Such schemes are controversial, but they definitely help to reduce drug-related crime and the transmission of diseases, such as hepatitis and HIV. The Government's Updated Drug Strategy states in page 10:

    "Treatment works. It is the key to reducing the harm that drugs cause to users, family and communities. Investment in treatment is cost effective—for each 1 spent, an estimated 3 is saved in criminal justice costs alone".

But, however effective and desirable treatment and harm-reduction schemes may be—and, of course, they should be encouraged—they are but a response to an existing crisis. They throw no light on the reasons for the crisis.

There appears to be a sort of official stalemate. On the one hand, the Chief Constable of North Wales Police, Richard Brunstrom, can say at a recent Edinburgh conference:

    "We have given control of the most dangerous substances in our society to armed criminals. This cannot be sensible policy".

While on the other hand, the Government's Updated Drug Strategy 2002 states that,

    "we will prevent young people from using drugs by maintaining prohibition which deters use".

Prohibition, it appears, is accepted as a given.

In its excellent report of May 2002, the House of Commons Home Affairs Committee made 24 recommendations, to which the Government responded formally in July last year. The final recommendation was:

    "We recommend that the Government initiates a discussion within the [United Nations] Commission on Narcotic Drugs of alternative ways— including the possibility of legislation and regulation—to tackle the global drugs dilemma".

The Government responded:

    "The Government does not accept this recommendation. We do not accept that legalisation and regulation is now, or will be in the future, an acceptable response to the presence of drugs."

I ask the Minister to confirm that that is still the Government's policy. Could he also tell us whether the Government believe that their policies are working, and that they are winning the war on drugs? Most important, can he explain why the Government appear unwilling even to discuss the pros and cons of decriminalisation versus prohibition?

For those who believe in legalisation and regulation the future looks bleak. Given the Government's current position and the United Nations convention, the chances of making any progress within the foreseeable future are extremely remote. But let me assume for a moment that the Government could be persuaded to change their mind. What then might happen?

There could be no rapid change since we would remain bound by the United Nations convention, and the only conceivable way of changing its terms, when they come up for review again in five years' time, would be for a group of like-minded nations to present

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a common view. There is clearly a mounting desire among some nations, particularly European nations, to pursue pragmatic strategies to address illegal drug use.

The Government might first pursue more actively the quiet path currently being followed by the Netherlands, Switzerland, Portugal, Spain, Italy, Belgium and Germany, and elsewhere by, for example, Canada and Australia. It is perhaps a situation in which Europe could take the lead, but it would not be plain sailing. France and Sweden would be strongly against any such moves, while the United States is the ultimate protagonist of zero tolerance, which seems strange given its experience of alcohol prohibition in the past.

But I fear that this is the land of make-believe. The best that we can hope for is that the Government might agree to sponsor an objective, cost-benefit audit of the pros and cons of legalisation and regulation. I hope that the Minister will give serious consideration to this suggestion.

As I said at the beginning of my remarks, we are dealing with an emotive topic on which most people have strong views one way or the other. In raising the issue, I felt that a reasoned and objective debate on the subject was desirable and that your Lordships' House, with its unique wealth of experience, expertise, wisdom and, above all, common sense, was the best possible place in the world to have such a discussion.

8.26 p.m.

Baroness Massey of Darwen: My Lords, I thank the noble Lord, Lord Cobbold, for securing this debate, which is both timely and important. It is of particular interest to me because I must declare an interest as the chair of the National Treatment Agency for Substance Misuse, a special health authority set up in 2001 to oversee the delivery of drug treatment services to double the numbers in treatment from 100,000 in 2001 to 200,000 in 2008 and to bring down waiting times. I must also declare an interest as a member of the board of the Advisory Council on Alcohol and Drug Education.

This is a wide-ranging debate, but I shall focus on the issue of drug treatment in England and how we can improve its long-term effectiveness. I am fortunate in my role as chair of the National Treatment Agency in that it gives me the opportunity to travel around the country, visiting treatment programmes of many kinds and talking to providers, users and carers in a number of settings such as, for example, prisons, community settings and women's groups. I see both successes and problems.

Treatment is relevant to both the health agenda and the criminal justice agenda. There is no contradiction in that. Drug misuse devastates the lives and health of individuals and families. Drug misuse is linked to crime in communities. The noble Lord, Lord Cobbold, referred to the success of treatment in saving money: 1 spent on treatment means that 3 is saved to the criminal justice system. But treatment has to be made effective; people have to be enabled to access the right

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treatment, be retained in treatment for long enough to help them to recover, and be given support after treatment in order to help them to stay drug free. Such support must relate not only to their drug habit, but to appropriate education, employment and housing.

In order to achieve long-term effectiveness, there must be sustained government policy and strategy for delivery; there must be effective local strategy for planning and implementation; there must be clear guidance on best practice; there must be attention paid to the needs of diverse groups such as young people, women, black and minority ethnic groups, and those living in rural areas; there must be involvement in planning by service users and carers; there must be community ownership of programmes; and there must be research to define what is needed in practice, as well as training to improve staffing capacity.

First, I turn to government policy. The updated drug strategy mentioned already by the noble Lord, Lord Cobbold, has sections on prevention, reducing drug supply, reducing drug-related crime and treatment. New record investment is being made to tackle drug misuse, rising to 1.5 billion in 2006, with 300 million for the treatment budget. A drug worker in Manchester said to me recently:

    "It is a good time to be working in drug treatment—there are new initiatives and more money around, and more emphasis on planning and monitoring by the National Treatment Agency".

As to guidance, a national service framework equivalent entitled "Models of Care" supports professionals in delivering appropriate treatment and through-care.

Planning and implementation of strategy is carried out at a local level in England by drug action teams, DATs, of which there are 149, supported and monitored by my organisation. On a drug action team typically there will be representatives from education, the police, the prison service, probation, and so on. Partnership and joined-up action is vital. The Government Offices in the Regions now have a variety of teams working across communities. Each drug action team should ensure that drug users have access to a range of treatment, for example, detoxification, GP services, community drug treatment and residential rehabilitation.

A few drug action teams are still not performing at optimum level, but there are spectacular success stories. For example, in South Gloucestershire a dynamic co-ordinator has within two years developed action plans across treatment services involving the community, and including users and carers. Dramatic improvements in services are evident. I have seen many drug action team plans which are systematic and impressive. All should be equally so.

Nowadays, there are many different drugs and many different users. Addressing diversity is essential. Young people, women, and black and minority ethnic users have specific needs. Young people may be experimenters rather than hardened addicts and need more counselling and education. Women may be fearful of coming into treatment because of childcare

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issues or difficult domestic circumstances. Black and minority ethnic users may be stigmatised in the system or have little family support because of cultural reluctance to accept the drug use.

I have said that involving users and carers in developing programmes is essential. There are now organised user and carer networks at national and local level: their voice is becoming stronger. Their insights about treatment systems are invaluable.

Research into practice is key to developing good services. My organisation produces and disseminates briefing developed by expert groups on issues of concern, for example, prescribing. An example of community-based research can be seen in a remarkable programme funded by the Department of Health and developed by the University of Central Lancashire. They have trained community groups to do their own research into the needs of black and minority ethnic users. The research has highlighted gaps such as language barriers and family constraints, and will continue with further funding. Communities can identify their needs to develop action plans. Policy makers should listen.

There are many new initiatives being carried out in the area of drug treatment. One such is the National Treatment Agency and the National Institute for Mental Health "Opening Doors" programme, which is working with 30 drug action teams to improve access to drug treatment and reduce waiting times. Teams at a local level have worked to identify blockages and possible ways through them, and not always costly ways. It has been described by a joint commissioner as,

    "perhaps the most exciting and dynamic thing I can remember happening to drug services since I came into the field".

Waiting times in many of those areas have fallen dramatically.

The introduction of integrated criminal justice teams in 25 high crime drug action team areas provides a unique opportunity to consolidate recent initiatives like arrest referral schemes, drug treatment and testing orders and counselling, assessment, referral, advice and throughcare services and to develop a system that is capable of engaging and retaining offenders with drug misuse problems in treatment.

Workforce capacity is vital to delivering any service. The workforce in drug services is increasing ahead of schedule and exciting schemes are under way to engage young black and minority ethnic staff through the National Treatment Association apprenticeship scheme.

Monitoring performance is absolutely essential, and the NTA and the Department of Health are working to strengthen monitoring systems to give a better picture of both successes and problems.

In summary, treatment has been a Cinderella service. With new money, dynamic programmes and exciting initiatives at local level, we are getting somewhere. I hope that the Minister will agree with that. I do not pretend that all is well; many challenges still exist. As the noble Lord, Lord Cobbold, said, it is not at all simple.

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I have tried to give examples of what is needed for long-term effectiveness in one area of drug policy treatment. I am sure that there will be similarities in other policy areas. I look forward to further discussions with noble Lords on these issues about treatment. Once again I thank the noble Lord, Lord Cobbold, for his enterprise in raising this question.

8.35 p.m.

Lord Chadlington: My Lords, I, too, thank the noble Lord, Lord Cobbold, for introducing this important debate and for his excellent contribution. For my part, I wish to review some of the government initiatives addressing drug problems in this country and, looking to the longer term, suggest how some of them may be improved. I want to review a couple of successful initiatives from continental Europe and add a grace-note on the long-term problems associated with changes in the law regarding drug use.

In doing so, as I have on other occasions, I declare an interest as chairman of Action on Addiction, the charity which specialises in research into the causes of addiction of all kinds.

First, perhaps I too may underscore the progress that is being made in the fight against drug use. Of course, no initiatives are ever enough, but the Government deserve praise for many of the recent steps they have taken. Several of these initiatives have, by almost any short-term measure, been a success and are continuing to make inroads. The drug action teams, already mentioned, Positive Futures and Progress to Work are practical programmes which should be welcomed on all sides of the House. The variety of treatments on offer is also being expanded with considerable and consistent effect.

Further, the Government have continued to increase the budget in the fight against drugs. Although I would of course like to see much more money being spent, there is still a significant uplift in expenditure compared with three or four years ago. For long-term success, however, that investment must continue to increase.

In reviewing the overall policy, will the Minister please turn his mind to one or two areas in which improvements could be made? First, the long-term success of these policies is ultimately dependent on them becoming a part of local community life. Drug addiction hits at the local community, not only in the breakdown of family life but, as has been mentioned, with the 7.5 million crimes a year directly attributable to drug use. Could we not make these programmes more locally specific—managed, organised and, importantly, evaluated locally? To me, long-term success means genuine delegation to local communities, particularly in inner cities, to deal with the implementation and evaluation of the programmes, with central government holding a broad monitoring role.

Secondly, if this policy of delegation was actively pursued vigorously, the problems of bureaucracy which bedevil so many initiatives may in part be eliminated. The Guardian newspaper recently reported

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a DAT in Bristol where the budget was 3.5 million, where there was a staff of six and a local client base of several thousand—but where staff spent 40 per cent of their time producing paper plans and reports for Whitehall.

Thirdly, will the Minister also consider giving attention to the evaluation of these initiatives? Evaluation currently has too much to do with inputs—usually financial inputs—and not enough about outputs, how behaviour and attitudes are being changed in both the short and the longer term.

Let me give an example. The Ofsted report on drug, alcohol and tobacco education in schools shows a marked improvement. In 1997, 86 per cent of secondary and 61 per cent of primary schools had drug, alcohol and tobacco education. By 1999, this had risen to 93 per cent and 75 per cent respectively.

We do not know what effect this is having on either behaviour or attitudes. An evaluatory approach applies to all these initiatives. Output evaluation in the short and long term will enable us to direct our limited funds into the most productive areas. It will also help us to determine what does and does not work.

I turn now to a couple of initiatives which I should like the Minister to address. I am actively involved in the problems associated with drugs in prisons and work with the Howard League in a number of these areas. Thirty per cent of prisoners on short sentences are heroin or former heroin addicts. There is still not enough being done to help in the transitional phase between prison and reintegration into the community. The Minister may well reply that "through care" and other initiatives are improving matters. They are, but not fast enough. The drugs-crime/drugs-crime cycle is getting worse. Heroin users who leave prison are 10 times more at risk of death from overdose on leaving prison, either because of lower tolerance or bingeing. That could be reduced in the medium and longer term, first, with better pre-release training, and, secondly, by making the antidote Naxalone more readily available.

The second area which I should like the Minister to consider is that of injectable prescribing clinics. In both Switzerland and Holland those clinics have had some success. Containment should be an effective part of the Government's armoury in fighting addiction in the longer term. It is cheaper—as has been pointed out, three times cheaper—to pay for treatment, even if it does not lead to a drug-free life, than is a life of crime spent in and out of penal institutions.

The third area is that of motivational interviewing in schools. A pilot study was carried out among 200 sixth-formers who were Ecstasy and cannabis users—the majority daily users of cannabis. The success of the scheme was to reduce usage by up to 50 per cent. That is now a well documented, output-evaluated technique which could have real long-term benefit among the young of today.

Time allows me a final grace-note about the easement of the laws regarding drugs. I do not think that we know enough about the long-term effects of so-called "leisure drugs" such as cannabis to take that huge step forward. I have listened to, among others,

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the noble Baroness, Lady Greenfield, on the subject of cannabis use, and I have been convinced that there are real questions which still require answers. Will the Minister tell the House how the Government might initiate much needed research in this area so that we can make a wise, informed and considered decision? If such a conservative, research-based approach could precede changes in the law, we may save unnecessary suffering and that alone would make it an approach worth taking.

8.42 p.m.

Lord Alton of Liverpool: My Lords, in associating myself strongly with and endorsing everything that the noble Lord, Lord Chadlington, has said, I welcome also the initiative of my noble friend Lord Cobbold in securing this debate. It is, I think, the first on this subject in your Lordships' House since 1994.

The University of York, in research for the Home Office, says that drug use and misuse, and the associated crime, costs the United Kingdom between 11 billion and 18 billion a year. If the economic costs are awesome they pale alongside the social and human costs.

For 25 years, as a local councillor or Member of Parliament in another place, I represented wards and constituencies in the city of Liverpool where I saw drugs destroy whole communities. One response, echoed today, has been to call for legalisation. However, as the United Nations International Narcotics Board has observed acutely,

    "persons in favour of legalising illicit drug use argue that drug abusers should not have their basic rights violated; it does not seem to have occurred to them that drug abusers themselves violate the basic rights of their own family members and society. Families and society also have rights that should be respected and upheld".

That is just another illustration of the clash between claimed rights and their consequences.

Just six months ago in Liverpool I attended the funeral of a young man, a heroin user, in his mid-twenties. I have known his family for the best part of 20 years. His is not an isolated case. A few weeks earlier a 10 year-old girl from Ellel in Lancashire died after taking Ecstasy. Joseph began with cannabis and ended with heroin. Legalisation would not have saved his life.

The American Academy of Paediatrics says that weekly users of cannabis are 60 times more likely to progress to harder drugs and that almost 100 per cent of heroin addicts started on cannabis. Joseph's mother is a supporter of the Coalition Against Cannabis, whose submission to the Home Affairs Committee in another place makes for sobering reading. Its submission and the learned views expressed during a symposium that I chaired in the Moses Room last year are underlined in the report Hidden Harm, which estimates that some 300,000 children are now being damaged by their parents' drug habit. We should not simply give in and go easy on drug misuse merely because it is so prevalent. We should abandon the

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dangerous sophistry of harm reduction and adopt instead a focused and coherent preventative strategy committed to a drugs free society.

According to a survey by Life Education Centres, 86 per cent of primary school children believe that, following reclassification, cannabis is now legal; 79 per cent believed it was safe. Muddled and confused messages are putting children's lives at risk. The fact is that cannabis today is, on average, 10 times stronger than in the 1960s. The psychoactive ingredient of cannabis has increased from 0.5 per cent to over 5 per cent and brain cells are never clear of cannabis. The British Medical Journal suggests that cannabis increases the risk of developing mental illness, including schizophrenia, psychosis, depression, suicidal behaviour and anxiety. The risk of suicidal disorder is almost tripled. The same research suggests that young male users are five times more likely to be violent. Smoking it during pregnancy also harms unborn children.

Professor Griffith Edwards of the National Addiction Centre says:

    "There is enough evidence now to make one seriously worried about the possibility of cannabis producing long-term impairment of brain function".

The British Lung Foundation's 2002 report entitled Cannabis: A Smoking Gun? pointed to the level of carcinogens in cannabis. There are 50 per cent more than in tobacco smoke. As compared with smoking tobacco, smoking cannabis causes a threefold increase in tar inhaled. The report says that lung, head and neck cancers have been observed in young cannabis users. Those cancers usually occur in cigarette smokers in their 60s. Last month, Professor John Henry and other doctors from Imperial College in St Mary's Hospital said cannabis could be a major contributor to United Kingdom deaths, possibly killing more than 30,000 smokers each year. Our noble friend Lady Greenfield, in an article entitled The real dangers of Cannabis has pointed to the loss of educational opportunities caused as concentration, attention span, damage to brain cells, loss of interest and dampened potential, all emerge as the sad sequelae of cannabis use.

The effects of the misuse of drugs on public health was well summed up by Philip Emafo, President of the United Nations International Narcotics Board. He said:

    "Cannabis is not a harmless drug as advocates of its legalisation tend to portray".

The temptation has been to accommodate the drug in the hope that it might regulate drug misuse generally. It is instructive that, over the past 25 years, Sweden and Holland have followed diametrically opposed approaches. The UN Office for Drug Control noted that in Holland, acceptance of cannabis has seen,

    "hard drug use doubled. The strongest growth was observed for ecstasy".

Holland's approach of harm reduction has led to usage rising from 15 per cent to 44 per cent among 18 to 20 year-olds. That point was made by the Home Office in the evidence submitted to the Select Committee in another place. Holland is also now perceived as a safe

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haven for drugs racketeers, and it is estimated that 80 per cent of heroin seized in the UK and France has passed through the Netherlands.

By contrast, Sweden's drugs policy is based on the goal of creating a drug-free society. Drug prevention, education and the criminal justice system all work together to limit any use of illegal drugs. In Sweden, this radical approach has led to a much lower use of drugs of all kinds than in Holland. The overall lifetime prevalence of drug abuse among 15 to 16 year-olds is about 29 per cent in Holland and just 8 per cent in Sweden.

Since the Lambeth experiment and reclassification, there have been reports of children as young as 10 getting stoned before going to school. The use of cannabis among teenage boys has risen from 19 per cent to 29 per cent—a staggering jump of 50 per cent. Some 79 per cent of teachers say that reclassification has made drug prevention more difficult.

Having 48 different funding streams for drug treatment creates administrative overload. Eighty per cent of criminals in prison have drug problems and still have them when they leave. We even have drugs charities—such as Lifeline, funded by lottery grants—offering advice to young people about how to conceal drug taking from their parents and telling them how to inject heroin. The logo reads:

    "Better hits, healthier veins, healthier body".

That is downright irreponsible, and I for one would like to know what the Government are going to do about it.

So-called drug education can actually encourage drug use—and is no substitute for a programme of drug prevention. Deirdre Boyd, chief executive and editor of Addiction Today says:

    "Current drug education is at best worthless and at worse probably exacerbates drug use. Drug prevention work hardly exists".

Public policy has sent out a worrying array of contradictory and confusing messages. There is nothing soft about drugs. They have harsh and often lethal consequences. Harm reduction does not work; working for prevention and a drugs free society does.

8.50 p.m.

Lord Rea: My Lords, I would like to extend a warm welcome to the noble Lord, Lord Cobbold, in joining the growing number of Members of both Houses who are prepared to engage in rational debate on drugs policy and to thank him for his well informed speech.

I have several credentials for speaking in this debate. Apart from having been a GP in an area with substantial drug problems and co-operating with my local drug treatment unit over many years, I now have the privilege of being the honorary treasurer of the All-Party Group on Drugs Misuse. This is not an onerous job since the group has no money! I also think that I have spoken in most, if not all, debates on drugs in your Lordships' House over the past decade or more—I have lost count of exactly how many times that is.

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The last time was in February 2001, in a debate introduced by the noble Lord, Lord McNally, on the Runciman report.

I cannot reply in detail to the noble Lord, Lord Alton. There is no time to challenge all his points. Suffice it to say that there are counter-arguments to almost every one of them. Many of the points that he set out as facts are not accurate. As regards the intellectual impairment of children, perhaps the noble Lord can say why it is that, every year, we see improved and improving A-level results when we know that up to 50 per cent of our children have been using cannabis.

The Motion asks whether present policies have been effective. If that refers to a reduction in the numbers of drug users or abusers nationally, the answer is: well, no; certainly not yet. There may be a little flattening of the curve of increase, but this could simply be due to approaching saturation point rather than to any effect of policy. And internationally? Again, the answer is no—in fact, the illicit trade in drugs, both in manufacturing and in supply, is as buoyant as ever, especially in opiates in Afghanistan now that the Taliban has lost power, and also, I understand, in Morocco, until now better known for its cannabis resin.

While there is no reduction in the supply of drugs reaching the country, judging by street prices, there have been some hopeful developments in treatment. My noble friend Lady Massey, who is chairperson of the National Treatment Agency, has described the rather encouraging developments in some of the 149 drug action teams that she is looking after. The criticism that I have of these is that they mainly have different funding streams, which can cause an enormous amount of confusion and sometimes delay in instituting desirable policies.

In the treatment area, there is also a greater acceptance that the majority of opiate users who come into treatment are not ready to start a methadone reduction regime immediately, perhaps not for several years—and, in the case of a few, never.

Long-term maintenance, sometimes on heroin itself, is necessary while attention is paid to underlying social problems, including housing, employment and the need for counselling about family problems by trained health and social workers. Interestingly, the fatalities associated with methadone are often associated with receiving an inadequate dose so that the user supplements the methadone with heroin, which may lead to an overdose. I am afraid that there are plenty of examples of the inadequate availability of treatment other than treatment for offenders. Their treatment, for now, is more readily available.

In an article in the Big Issue two months ago, several homeless drug users in Bristol were reported to have considered getting arrested in order to get treatment for their addiction. Can my noble friend give us a bulletin on how drug testing and treatment orders are working? How many accept the option? How many of those complete the treatment offered and how many are still drug free six months or a year later?

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I welcome the relaxation of the law, which will enable certain GPs to prescribe heroin. However, that should be done only where the support services that I mentioned are readily available. Some GPs are already providing an excellent service in their practice for drug abusers. The treatment of problematic heroin users in that way has been shown in several studies—for example, in Switzerland and the Netherlands—to have great benefits both for the individuals and families concerned and for the community in that there is less crime and fewer hospital admissions. It has already been pointed out, as it was in our previous drugs debate, that the national treatment outcomes research study showed that for every 1 spent on specialist treatment, 3 was saved by society in healthcare costs, social security and prison places, let alone the value of the items that would otherwise have been stolen.

Giving evidence to the House of Commons Home Affairs Committee last year, Professor Strang, who is professor of addictions and director of the National Addiction Centre, said:

    "With some types of treatment for some types of drug problems you have treatments which more than pay for themselves for each day the person is in treatment. This is the equivalent of the Post Office or the Bank of England releasing bonds which you can buy for one pound each and cash them in the afternoon for a fiver. I have to say that if that happened I would go out and I would buy, buy, buy. It is beyond understanding why that approach is not adopted with those bits of treatment where there is a rock sold evidence base that the benefit more than pays for the costs".

However, apart from those going into treatment, there are many other heroin users out there who do not seek treatment. In this regard, I have a different set of beliefs from that of the noble Lord, Lord Alton. To don my legalising hat, I would argue that even more benefit could be achieved for society if all serious heroin addicts could obtain their supplies in the form of the pure product in known doses that were administered with clean needles from controlled legal outlets. That was possible, by prescription from certain GPs, in the days before the current Misuse of Drugs Act came into force 30 years ago. It is worth reiterating that when given in that way, heroin has remarkably few ill effects.

On 30th October 2001, Rosemary Jenkins, who was then acting head of drugs and alcohol misuse at the Department of Health, said to the Commons Select Committee,

    "clean heroin is not in itself particularly dangerous except of course for the area we all know about which is that it is highly addictive and produces dependence".

One could certainly say the same about cigarettes, which, however, cause much harm even when they are being used perfectly legally.

It is interesting that heroin, which is thought by most people to be the most dangerous controlled drug, is actually one of the least harmful if administered safely. At present, the supply is in the hands of criminals who supply it in variable strength and purity. If injected, it is often given through contaminated needles risking HIV or hepatitis C infection. To that I simply say, "Long live needle exchange centres!". Cocaine and crack cocaine are likewise "pushed" in

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unknown strength, with consequent increased danger to the cardiovascular system. Deaths from cocaine and crack have risen rapidly in the past two to three years. There is a need for considerably more research into how best to treat addiction to these stimulant substances, of which crack is the most problematic.

There is still an unhappy drug scene in prisons. It would be interesting to know what proportion of the prison population are there directly as a result of offences under the Misuse of Drugs Act. It would be even more interesting to know the proportion who are there as a result of crime committed as a result of an addict's need to buy drugs. What is the breakdown?

That brings me to the international drug scene and to the Vienna meeting of the UN Commission. There, as has been said, the United Kingdom was criticised for relaxing its policy on police practice regarding cannabis possession. The UN Commission clearly upholds the American initiated "War on Drugs" which has been so singularly unsuccessful.

I shall skip to my final paragraph. My noble friend may be aware that tomorrow a mass protest will be held by drug users' support groups outside the Thai Embassy and its consulates in many countries against the escalation in the killing of drug addicts in Thailand. Apparently, nearly 2,300 have been killed this year—42 by the police and the rest extra-judicially by persons unknown but thought possibly to be government inspired—in a campaign to,

    "eliminate all drugs by December 2nd".

I suppose that could be regarded as a way to reduce demand, but I hope that Her Majesty's Government will register their condemnation of those barbaric acts and urge the Thai Government to bring to justice the killers as evidence of their non-involvement.

9.1 p.m.

Lord Mancroft: My Lords, I, too, am grateful to the noble Lord, Lord Cobbold, for introducing the debate. I think the noble Lord, Lord Alton, told us that this is the first time that your Lordships have had an opportunity to debate the subject since 1994.

As the noble Lord told us, there really are only two things that governments can do about drugs. They can either try to control the supply or try to reduce the demand. From the late 1960s onwards, Her Majesty's Government did both, but with an overwhelming emphasis—90 per cent—on the control of the supply. As the noble Lord told us, the main weapon was the Misuse of Drugs Act 1971. That remains largely unchanged today. If your Lordships regard drugs, as I do, as the greatest social problem facing the country today, and one accepts that the world has changed quite a lot over the past 30 years, it is quite unusual still to be relying on a 30-year old piece of experimental legislation—because that is what it was—to deal with this very difficult problem. Most other governments in Europe and the United States followed our lead. We were the leaders at that time.

As we have also heard, the international difficulties with the problem were recognised with the three United Nations treaties that we signed up to in 1961,

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1971 and 1988. But the Government also recognised that they needed to provide healthcare. They did so, even though when it started it was fairly primitive, moralistic, psychiatric and so on. There was of course in those days no drug education and no drug prevention. Drug prevention had not even been heard of.

Thirty years later the situation has changed. The noble Lord, Lord Cobbold, gave us some of the figures. Drugs are now the biggest social problem here in the UK. Heroin addiction has increased 100-fold; we have the highest number of drug deaths in Europe; 2 million people take Ecstasy every single week; and 25 per cent of our children have tried cannabis by the time they are 16 years old.

The international drugs trade is worth 500 billion a year. That makes it the second largest industry in the world. As the noble Lord told us, York University research for the Home Office shows that it costs you and me—the British taxpayer—between 11 billion and 18 billion every year. However, it is worth noting that 88 per cent of that is the cost of drug-related crime.

The international situation is as follows. The situation in the United States is worse than here and, interestingly enough, wheat has been replaced by cannabis as its biggest cash crop. The noble Lord, Lord Rea, told us about Thailand. Democracy in Colombia and Jamaica has been virtually destroyed. Those two countries have been brought to their knees by the war on drugs. Afghanistan is the largest producer of the opium poppy. All heroin on the streets of London comes from Afghanistan. The effect of the fall of the Taliban and the arrival of western troops is that the poppy crop has doubled—not an overwhelming success.

There is a knock-on effect. During the past six years, gun crime in this country doubled to 21,000 offences by April last year—60 a day—of which 90 per cent are drug-related. Gang crime is 90 per cent drug-related. Black-on-black crime is 90 per cent drug-related. We have the largest prison population ever in this country—we have debated that in your Lordships' House three times since 1997. Well over 50 per cent of inmates are there for drug-related offences. We must remember that the Home Office was still denying the link between drugs and crime until the early 1990s.

There is only one conclusion: drug prohibition has failed to reduce or eliminate drug use; it is still increasing. The Scottish Police Federation stated:

    "To many officers it is clear that outright prohibition under the Misuse of Drugs Act has been staggeringly unsuccessful".

The failure of prohibition has led to the creation of the largest black market the world has ever seen, which has been the single biggest cause of crime in the Western world during my lifetime.

The noble Lord, Lord Cobbold, told us that other countries have recognised that. Belgium, Luxembourg and Switzerland now accept cannabis use; Portugal, Spain and Italy have decriminalised it for personal possession; Canada, Australia and New Zealand are

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heading in that direction. Only the United Kingdom and the United States are pursuing policies in the opposite direction.

Eighty per cent of government money is still devoted to prohibition; I am delighted to say that 20 per cent is devoted to a policy to reduce demand for drugs. As we have been told, money for treatment has increased from 120 million to more than 400 million a year. We welcome the creation of the National Treatment Agency.

However, I must say that my chairmanship of the Addiction Recovery Foundation during the past 16 years leads me to believe that, although much improvement has been made, there is not really a great increase in places. There are 48 different funding streams for drug treatment in this country; how on earth can people find their way through that?

I chair a day-care facility for drug addicts in Westminster. We contract to 32 local authorities across London. I think that we provide very good care. At present, 30 per cent of our budget is debt from local authorities that do not pay their bills, which means that we rely on bank overdrafts. That is unsatisfactory. I do not know whether the articles in the Guardian to which my noble friend referred are accurate, but if we really spent 3.5 million in Bristol getting 26 people from a possible market of 4,500 addicts off drugs, we cannot call that a success.

There are some obvious reasons for that. Far too much treatment is channelled through the criminal justice system. I have absolutely no idea why anyone thinks that the Home Office should be in charge of healthcare. That is a ludicrous concept. Apart from that, it must be said that neither the Department of Health nor local authorities seem to know anything about drug treatment, which is why the care standards produced by the Department of Health last year had to be torn up. If they had been implemented, half the treatment facilities in this country would have closed overnight. That is not very satisfactory.

We do not have enough aftercare—that is improving, but there is still not enough. Waiting times are improving but are still far too long. The noble Lord, Lord Rea, mentioned inappropriate prescribing; there is much too much of that. There is a lack of clarity. The Government are still the only organisation in the world who regard alcohol and drug treatment as different. No one else does. There is chaotic referral—most GPs still do not really know anything about it.

Treatment works—it can work really well—but at present, for most people in this country, there is little chance of them entering treatment. If they get there, they will come out of the other end, end up back on the street and they will use. That is still the reality, but it may improve, and I must say that the Government are trying their best to improve it.

The most important thing is prevention. If we can prevent people from starting to take drugs or delay the onset of use, that is a real step forward. I chair Mentor UK, which is the British branch of the leading drug prevention organisation in the world. Despite some

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encouraging meetings with government during the past three or four years, I must tell your Lordships that we are making little progress—well, we are making a little, but it is perilously slow. If the Government do not really start putting their back behind the issue, we shall have no hope of making progress.

We need good, evidence-based, well researched prevention. The Government must give a lead, and they are not at present. The Government also need to work out that drug education is not drug prevention. As has been said, education by itself may even lead to an increase in drug use.

What is the conclusion? Present policies are not delivering. Prohibition has not reduced or eliminated drug use and has created a massive black market and all the associated crime. Only the Government fail to recognise that. Other European countries, the British media, and public opinion increasingly believe that. The Government are still trying to use the criminal justice system as the primary tool to solve the health and social problem.

However, we can agree about many things. All drugs are bad and we ought to reduce them. The one way that one does not deal with something that is dangerous and bad is to hand it lock stock and barrel to organised crime. That is what the Misuse of Drugs Act 1971 does. The problem is not prohibition, the problem is the failure of prohibition. The only way that one can control a dangerous commodity or any commodity is to bring it within the law. We need to repeal the Misuse of Drugs Act 1971 and replace it with a better and more appropriate tool that allows us to control the market in those incredibly dangerous commodities. At that stage we can remove the profit, remove the crime and devote all of our resources and energies to providing better treatment and real prevention. At the moment we are not doing that, and we shall not if the Government continue down their present path.

Regarding what parents want—they worry about schools, their children's health and their futures. However, their main worry throughout the world is about drugs. Parents are not interested in Ministers being tough on drugs, they want Ministers to be effective on drugs. Parents want programmes to dissuade our children from taking drugs, and effective and accessible healthcare. We do not want our children treated as criminals. When they or their friends develop those problems we want healthcare and support. At the same time we are bored with the levels of acquisitive and violent crime which are a direct consequence of the Government's own failed policies and make it difficult to raise children in what is already a very nasty world.

9.11 p.m.

The Earl of Listowel: My Lords, I also thank my noble friend Lord Cobbold for introducing this important debate. The subject is a matter that is not often raised in your Lordships' House. I shall concentrate my remarks on looked after children—

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children in public care—and how a policy can prevent them from becoming involved with the drug culture, the prevention to which the noble Lord, Lord Mancroft, referred. Before doing so, I welcome Her Majesty's Government's acknowledgement in their Updated Drugs Strategy 2002 of the special vulnerability of care leavers to problematic drug use and the commissioning of a study into that area.

Children often enter care against their will. The people who should have most cared for them, their parents, have often either neglected them or sought to harm them, either physically or sexually. Their parents may well have been unable to give them the ordinary love and attention that most of us have received. Those parents are often emotionally-maimed themselves. For example, the inquiry by the Advisory Council on the Misuse of Drugs concluded that around two to three per cent of children in England and Wales had parents who were problem drug misusers. My noble friend Lord Alton alluded to that fact.

Children cannot normally allow themselves to believe that they are unloved by their parents. A child might say that when his father beats him, he is not his father. When his mother beats him, she is not his mother for the duration of the beating. Such children may harbour great mistrust of the adult world. They are normally unable to channel their resentments directly at their parents. However, when they arrive in public care, looked after children often feel no such inhibitions with respect to their new carers. They can continue to idealise their own parents, their abusive or neglectful parents, while they find fault with, attack or provoke their new carers.

A child may have lost not only his parents, but also his siblings, his friends, his school, or even his home country. He may feel pain and a sense of being neglected by those who should have most cared for him. He may experience rage, because the love that is so easily available to other children is not so to him. All of those fears and complex feelings may find vent in behaviour antagonistic to his foster carer, adoptive parent or residential social workers.

Such a child needs trustworthiness and consistency above all from his new caretakers. Yet that child's very neediness, arising from his past neglect or abuse, may make him uncontainable and may cause the placement to collapse. Then, the original experience of rejection is repeated and the child's sense of worthlessness is reinforced. It is no wonder, therefore, that such children are at increased risk of involvement in drugs while in care or, later, as care leavers. They may take drugs to offend the adult world, to help them forget the pain of rejection or to harm or punish themselves—for they must often feel that they are bad and wicked if all those who should naturally have cared for them have rejected them.

What then are the Government doing to support the caretakers of these children to prevent further breakdown of relationship and thereby to decrease the likelihood that such children will choose to take drugs? I welcome the work of the Choice Protects review under the Secretary of State, Jacqui Smith, with its

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objective of reducing placement breakdowns by improving placement choice. I am delighted that a 113 million Choice Protects grant has been secured to cover this year and the following two years, with the purpose of expanding and strengthening fostering services.

Through statute and investment, the Government have demonstrated over the past six years an enduring commitment to these children. I salute the Government's efforts, which should have the effect of ensuring that more looked after children benefit from a secure attachment and a consistent, caring relationship with a particular adult during their experience of care. That is one vital element, together with access to education, in preventing so many care leavers falling prey to problem drug use.

Once a child leaves care it is far more difficult to assist him. The containment implicit in care allows the fostering of a close relationship with a responsible adult. Children who have only known close relationships with adults to be tainted by bitterness may do all in their power to flee such relationships thereafter. A care leaver may be impossible to engage. It was depressing to read, in preparing for this debate, the comments on public care of the Advisory Council on the Misuse of Drugs. The council states:

    "There is also a high level of drug misuse and pregnancy among teenagers in care. It"


    "should therefore be considered the option of last resort".

Before concluding on this particular strand, I should like to stretch the discussion a little wider. My comments on children in care might be equally well applied to many of the other groups at particular risk of drug dependency. So I would offer this observation to the wider discussion of an effective long-term national drug policy. Treatment after the fact is very important, and the correct intervention beforehand is also important. However, any policy should at least acknowledge the emotional deficits common to many problem drug users and should indicate how policy fits with work to address the emotional deficits of at-risk groups. For example, it would be helpful to have a few short paragraphs indicating the importance of good parenting, of parenting support, of Sure Start and of the need to improve maternity services; and, indeed, to work generally to facilitate secure attachments and to improve early years provision.

Is the Minister aware that there are far better outcomes for children in public care in some of the continental countries, with Germany ensuring that most of its looked after children receive the equivalent of a good clutch of our A-levels? Will he emphasise to his colleagues the continuing need for increasing public investment in this area, and to keeping improvements in services for looked after children at the top of Her Majesty's Government's agenda? To be effective in the long term, drugs policy should address the special vulnerability of children in public care.

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9.20 p.m.

Lord Best: My Lords, I thank the noble Lord, Lord Cobbold, for this debate, and for his important speech. I want to explore one small aspect of government policy on illicit drugs. It relates to the growing of cannabis by the people who consume it here in the UK.

First, I declare my interest as director of the Joseph Rowntree Foundation, which funds a programme of research on issues relating to drug and alcohol abuse. My foundation supported the recent inquiry led by Dame Ruth Runciman, to which the noble Lord, Lord Cobbold, referred. My trustees have now agreed to allocate approximately 1 million for additional research in this field, not least because in an area of intense controversy we see a need for independent, impartial analysis outside campaigns for or against legalising or decriminalising aspects of drug misuse.

While sharing the widespread concern for the individuals who suffer from drug addiction, we have a special interest in the impact of illegal drugs on local communities. Research points consistently to the destructive impact on local communities of drug dealing and drug dealers.

When Joseph Rowntree set out the tasks to be pursued in spending his large charitable endowment he specifically mentioned the social evil of opium trafficking. Although I feel sure that he would have disapproved of the consumption of opium in the same way as he was a supporter of the temperance movement against alcohol, it was actually the trafficking to which he drew attention.

In that context, I want to report to your Lordships the recent research that my foundation has funded on the slightly surprising subject of home-grown cannabis. Earlier this year we published A Growing Market: The Domestic Cultivation of Cannabis by the eminent Professor Mike Hough and his colleagues.

It appears that as much as half the cannabis consumed in the UK may actually be produced in this country. While there are no firm figures, we know that a large proportion of the 50 per cent that is UK-grown is grown in people's own homes for non-commercial, personal consumption.

The Home Office has announced that this particular drug is to be reclassified and its possession will be regarded as a less serious offence than in the past. The simple act of having cannabis in one's possession—surveys show that almost half the population under the age of 30 have consumed cannabis at some stage in their lives—will in future usually attract an on-the-spot warning, and the drug will be confiscated. But the user will not be arrested and will not, therefore, acquire the stigma of a criminal record. The maximum sentence for those charged with the most serious offences of possession will be two years' imprisonment. However, growing cannabis will continue to be a much more serious offence, punishable with a potential prison sentence of up to 14 years. If growers are charged with the offence of production, as often happens even for small numbers of plants, they will face a mandatory seven-year sentence for the third offence.

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While many offences will continue to be cautioned, or if prosecuted, fined, offenders in such cases will all receive a criminal record, as they do now. It is also worth noting that even a first offence involving cultivation for use and sale to one's friends—a frequent situation—is likely to result in imprisonment.

A final important issue revealed in the report is the extent of confusion and variation surrounding the criminal justice processing of cultivation cases. The available guidance from the Association of Chief Police Officers appears to be unknown or ignored by many police forces, resulting in disparities in charging and prosecution. There is also evidence that similar offences are being dealt with very differently by the courts.

The question I am posing therefore is whether the offence of growing small amounts of the cannabis plant should be regarded as less serious than at present. The research report from the Joseph Rowntree Foundation did not set out to draw conclusions of this kind, only to point out the facts. But in reading this document, I see a convincing case for taking a less harsh stand on the issue than is currently adopted. My reason relates primarily to the social evils associated with the international trade in illicit drugs and the drug dealing which brings very large numbers of, mostly younger, people into direct contact with the criminal dealers or pushers. While it is not true that all those who sell drugs are from the world of gangland and organised crime—and many are the addicts who are themselves victims of the process—nevertheless, all these drug dealers are part of a chain which quickly links back to the criminal underworld. Association with this network is not healthy.

Acquiring cannabis on the streets, or in the clubs, from dealers and pushers can have a much more sinister outcome: it can lead to the individual being introduced to the far more damaging, very much more addictive, drugs of heroin and crack cocaine. Dealing in the so-called "soft" or "recreational" drug of cannabis can be used by dealers to secure addiction to the hard drugs which create a vicious dependency: this leads not only to the human misery of the individual but often to the waves of crime necessary to feed addiction on a daily basis, as many noble Lords have mentioned.

Although it is but a small part of the story of drug misuse in this country, I suggest that as the Home Office considers its policies towards the possession and sale of drugs, it may wish to look at the law relating to home-grown cannabis. The imminent legislative changes on cannabis signal a clear distinction between possessing and dealing in the drug, with possession offences moving down the sentencing tariff and dealing moving up-tariff, attracting a maximum sentence of 14 years. If we want the 4 million current cannabis users in this country to stop buying their drugs from criminals and feeding the international trade in illicit drugs, perhaps we should recognise that

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it may not be so bad for them to grow it themselves. Some degree of decriminalisation would not offend the UN convention to which the UK is a signatory.

A measure which underlines the link between cannabis and the pushing of the much more pernicious drugs such as heroin and crack cocaine would seem well worth exploring. Perhaps the Minister could comment on that.

9.28 p.m.

Baroness Walmsley: My Lords, I thank the noble Lord, Lord Cobbold, for introducing this important debate. I congratulate him on his masterly exposition of the problems associated with prohibition and the state of the international law. I also associate myself with most of the remarks of the noble Lords, Lord Rea, Lord Mancroft and Lord Best.

This has been a very good debate. Many of your Lordships have pointed out what a vitally important factor hard drug misuse is in the fight against crime and how many lives are destroyed by it. Certainly, despite their good intentions and the hard work of thousands of drug workers on the ground, the Government's drug policies are failing abysmally.

To their credit, the Government have increased the funding for the fight against drugs. For example, the budget for treatment has risen from 120 million to 438 million during the past three years. Sadly, however, much of this money is not reaching actual treatment, but I shall return to that matter later.

The fundamental problem is the collision between the dramatic rise in the use of drugs and a policy that prohibits them. I say to the noble Lord, Lord Alton, that drug users impinge on the rights of other people only when they steal, and they have to do that only because of prohibition.

As the Guardian pointed out recently, there are two ways of reducing the drugs market: reducing the supply and reducing the demand. Unfortunately, despite the most basic principles of economics, the Government are concentrating on reducing the supply and punishing, by putting in prison, those who use drugs and steal to support their habit. Once in prison, they do not even receive effective treatment.

The efforts by Customs and Excise at major ports and airports sometimes result in a large drugs haul, but Customs and Excise has admitted that it has no idea how effective it is being at stemming the tide. There certainly seems to be no shortage of drugs on the streets of even the smallest, sleepiest town or village in this country.

However, even when the supply is reduced, that serves only to increase the price, because demand is not falling. Then the users have to steal even more to pay for their drugs, and crime goes up. Here is an example that was quoted in the Guardian. The National Economic Research Council two years ago estimated that the street market in crack cocaine was worth 1.8 billion and that users fund about 48 per cent of it through stealing goods, which are sold on the black market for about 20 per cent of their value. In other words, crack users are stealing at least 3.45 billion in

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property each year. On that basis, if the Home Office succeeds in reducing the supply of crack so that the price goes up by just 5 per cent it will inflict an extra 172.5 million-worth of property crime on the community it pretends to protect. Logic shows that that is not the way to do it. Reducing supply will be a disaster unless we also reduce demand.

How can we reduce demand? There are two ways: prevention and treatment. I shall look first at prevention. It is vital that we do something effective to protect our children from the drugs culture. Indeed, Article 33 of the UN Convention on the Rights of the Child obliges us to do so. There is much evidence that drug use does not occur in isolation. It is therefore vital to target vulnerable young people and, as the noble Earl, Lord Listowel, said, to address the underlying social problems of poverty and deprivation that lead to drug misuse. The Government's revised drug strategy acknowledges that. However, as the noble Lord, Lord Chadlington, mentioned, it does not emphasise the importance of measuring and evaluating prevention efforts and intervention, and it does not commit enough resources to it.

There is evidence from the Addiction Recovery Foundation that didactic lessons about drugs may be counter-productive and that it is time the Government adopted evidence-based strategies. Government bodies talk about advice from user groups, but these are usually composed of current users waiting for treatment. How much more effective drug education would be if it were delivered by former users who have recovered and learned from their effective treatment! We should be training more of them to deliver drug education, and we should be implementing more programmes such as those carried out by the organisation Mentor UK, chaired by the noble Lord, Lord Mancroft.

The Government are currently spending 3 million on the "talktofrank" website, which offers information and stories from family members, but not one story from someone who has actually used and recovered from drugs.

That brings me to talk about treatment. Where do I start? It is in a terrible mess. Despite the increase in funding in the past three years, the number of beds has not increased. In fact, it has increased only marginally over the past 10 years. I understand that during the 1990s Turning Point closed four houses containing around 80 beds.

As the noble Lord, Lord Cobbold, said, there is much evidence that good quality treatment works, and that residential treatment works best. Here I must declare an interest, as a trustee of Adapt, a drug and alcohol treatment and rehabilitation charity, which delivers excellent results.

The problem with drug treatment in the community is that the addicts are still surrounded by all the pressures and the pushers that got them into drug abuse in the first place. If we can get them away and through detox, when their heads are clear they are able to face the problems in their lives that made them turn to drugs in the first place. Through counselling and

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therapy they can begin to make sense of their lives and learn coping strategies which will stand them in good stead when they eventually go back into normal life. That should be done through a carefully graded set of stages, providing lighter and lighter support until the former addict manages a drug-free life on his or her own.

Unfortunately, that kind of treatment is superficially expensive. I say "superficially" because if it works, which it does, it is much cheaper than 10 other cheaper programmes that do not. Unfortunately, there are nowhere near enough beds available for that sort of work. The capital funding to bring beds into operation is not available because all the money has been divided up among local drug action teams and probation services; and none of those is going to fund the 0.5 million it will take to bring into operation 45 extra beds at Adapt's Princess of Wales Treatment Centre at Mundesley in Norfolk since these would serve patients from all over the country.

Where do we go to find the money to enable us to provide more of this much needed service? If noble Lords have any ideas, I would be glad to hear about them. The noble Baroness, Lady Massey, is nodding her head; I am most encouraged.

Despite Adapt's excellent reputation and results, our beds are not full. Why not? We have heard about the complete mess that some of the drug action teams are in. There are 48 different funding streams for drug treatment. The DATs have an incredibly complex management structure. I was amazed when I saw this one from the Suffolk Drug Action Team, which is one of the best. It costs about 1 million. The teams spend much of their time collating data, reporting to the Government and the funders, and meeting targets. A DAT such as the one in Bristol quoted in the Guardian article that met its targets for the number of patients "participating in treatment" means nothing if none of those patients is successfully completing the treatment and leading a clean life.

Despite the fact that research has shown that residential treatment is by far the most effective, there are still some DATs that will not pay for it. That is because of arbitrary targets and situations such as that which pertains in Nottingham Probation Service, whose money is held by the social services department. It has imposed an arbitrary limit on what can be spent, which cuts out good quality residential treatment altogether. Do we want just any treatment or do we want good treatment that works? It is all very well for the Government to announce increases in funding, but if it is being spent on management and bureaucracy rather than on treatment, it is a complete waste of money.

It is ludicrous that the DATs report to the Home Office instead of the NHS, even though their money is held by the local PCTs. Drugs are a health and social problem, but they are being treated as a crime problem. If we treated drug addicts as patients rather than criminals, things would be different. I am sure

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that NICE would assess quality residential treatment as being a more effective way of spending money than producing more and more managers.

One ray of light can be seen in the drug treatment and testing orders, although recently they have come in for much criticism in the press. They can work well so long as the ex-offenders are sent into a suitable treatment programme. Unfortunately, they have gained a bad reputation because some of them are operating in a very idiosyncratic way. For example, in Southend, in order to get into treatment, an ex-offender has to maintain a clean and stable lifestyle in the community for three months before he can obtain treatment. That means reporting in regularly and remaining drug free. Usually those people are living in hostels, while some are of no fixed address. The hurdle is far too high. One might think that if someone can get over it, they do not actually need treatment any more.

Philosophically I was against coercion until I saw the results being achieved at Adapt with clients on DTTOs. They are better than those of other clients. I suppose because they all have the carrot of a better life, the DTTO clients also have the stick of going to prison if they do not stick with the treatment and succeed.

Finally, I shall say a quick word about heroin prescribing, mentioned by the noble Lord, Lord Rea. I was delighted to hear that the Home Secretary was going to learn from the enormous success they have had in Switzerland with heroin prescribing, but devastated to learn that the proposal is to hedge it around with so much bureaucracy and regulation that only around 4,500 out of a potential 100,000 people who might benefit from this treatment will receive it. What a terrible missed opportunity.

To summarise, I believe that we need to ensure that the funding streams are simplified and concentrate on intervention that has been proved to work rather than prohibition and punishment.

9.39 p.m.

Viscount Bridgeman: My Lords, I should like to add my thanks to the noble Lord, Lord Cobbold, for initiating this very interesting debate, which we are aware was well overdue in your Lordships' House. In agreeing with so much of what has been said by noble Lords, may I suggest an approach from a different angle, which nevertheless would be in many ways complementary? I am putting forward proposals first outlined on behalf of my party last October by my right honourable friend Oliver Letwin.

We propose to address the problem of hard drug addiction by targeting not so much the existing users, but the new entrants which, of course, means young people. In formulating these proposals we have drawn heavily on the drug policies of two of the success stories of the European Union, namely, Sweden and the Netherlands. I am aware that I may not necessarily be singing from the same factual hymn sheet as the noble Lord, Lord Alton, but I pray in aid the report of the National Drug Monitor of Utrecht for 2001 covering hard drug users in the European Union plus

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Norway, in which the Netherlands comes third, Sweden fifth and, sadly, the United Kingdom is exceeded only by Italy and rather surprisingly, Luxembourg.

As the noble Lord has said, treatment in the two countries is different, but they have three things in common. First, in both countries there is a strong consensus, including among the young, that the use of hard drugs is utterly destructive. Secondly, both countries have highly developed and highly accessible facilities for the treatment and rehabilitation of young offenders. Thirdly, in both countries coercive treatment is used. I was very interested in the remarks of the noble Baroness, Lady Walmsley.

Turning to the first point, there is universal appreciation of the appalling dangers which arise from the use of hard drugs. But if there is awareness that heroin and cocaine are "loser drugs", and if that awareness can be sewn into the culture of the young, then the natural result will be that the number of new users will fall away. I am informed that in the Netherlands the average age of heroin addicts is rising by the year every year. If that statistic is correct, it means that that country is getting to grips with stifling the number of young people entering the habit.

Our proposals for achieving the same results in the United Kingdom are two-fold and they are closely linked. The first is to replace the current de facto policy under which the use of hard drugs is effectively ignored unless it is related to other crime. We propose that a young heroin or cocaine addict is given the choice between undergoing treatment or facing criminal proceedings. The rehabilitation programme will include specific targets for the drug user to judge its success, and the young person's commitment to it. It will be followed by adequate aftercare. Failure to complete the programme will be punishable through the legal process in conformity with current drug laws. On completion of the rehabilitation scheme the minor will not have a criminal record. Even the hopefully small number who refuse treatment and are sent to gaol will have their record wiped clean at the age of 18 to allow them a fresh start

All this is dependent on and closely linked to the second part of our proposals, which is the supply of a sufficient number of treatment centres. Sweden and the Netherlands each has 10 times the per capita supply of treatment centres available in the United Kingdom. It is a matter of urgency to increase the number of drug rehabilitation centres.

We are attracted by the Minnesota model in the United States. There is a great deal of evidence that this approach actually works. It gets large numbers of people off drugs; it is widely used in the US, in the main by private providers. As its name implies, it was developed in the state of Minnesota which, not coincidentally, is heavily influenced by Swedish Americans.

The model is based on the same 12-step programme that underpins Alcoholics Anonymous world-wide. Those key features include aims for the complete abstinence from all drugs except tobacco and caffeine;

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to end drug use completely at a discrete moment—that is to say, no weaning; intensive medical support for an initial period, usually one to three weeks. That is followed by intensive in-patient psychological support for a further four to 12 weeks and at least six months of less intensive support in the community. Finally, a social and expert support network is available for the rest of the participant's life.

It is significant that one of the most successful of the institutions on the Minnesota model is Castle Craig in Scotland. That is private, but its clients are a small number of Scottish and English health boards or PCTs, and some foreign governments. Sadly, a large number of local authorities will not, as a matter of principle, refer patients to private or even voluntary institutions, choosing instead to refer them to the overloaded NHS where the facilities are limited. We would like to see a large expansion of centres under this model. We would certainly want to encourage participation by a large number of local authorities in the private and voluntary facilities.

Concurrent with the expansion of treatment facilities we propose to launch a campaign to encourage parents, teachers and social workers to inform the relevant agencies when they encounter a minor who they believe is addicted to heroin or cocaine. We recognise that this will put a new onus on these groups to intervene at an early stage, but early intervention is crucial if we are to stop young people from joining the conveyor belt to crime.

We do not expect to implement such a shift in attitude or resources immediately. Instead, we intend to run a large number of pilot projects to test the most effective ways of running such a programme. This piloting programme will be the world's first systematic testing of which drug treatments work and which do not. It will involve rigorous testing of all the various methods of treatment and extensive consultation with all relevant bodies.

What will be the cost? At present, the average total unit cost of NHS in-patient treatment is 147 per patient per day, or 53,600 a year. This figure is derived from the Centre of the Economics of Mental Health. To achieve a tenfold increase in youth provision we shall need approximately 10,500 places, an increase of 8,600 beds at a cost of 462 million. This figure has been factored into our health budget. It will be to some degree self-financing through the saving in costs of treating illness associated with drug problems, and there will be indirect savings, as the noble Lord, Lord Cobbold said, in criminal justice expenses.

We offer this policy as a radical way of tackling the drug problem of this country at the point of entry. I shall be interested to hear the Minister's comments.

9.47 p.m.

The Parliamentary Under-Secretary of State, Home Office (Lord Filkin): My Lords, it has been a fascinating debate. It has shown the House at its best and the depth of experience that there is in the Chamber on these issues. I did not notice a consensus on the problems or the solutions—apart from the

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usual consensus that the Government have not yet cracked the problem and need to do more. That is to be expected.

The noble Lord, Lord Cobbold, clearly set out the social and economic costs of drug misuse, which are estimated at between 10 billion and 18 billion a year in England and Wales. That graphically illustrates the scale of the problem.

Drawing on evidence of what appears to work, the updated drugs strategy seeks to concentrate on the most dangerous drugs and the most damaged communities, recognising that 99 per cent of costs are accounted for by a quarter of a million problem drug users. The Government are tackling the drugs problem using a full range of measures based on what works—or, rather, what at this stage appears to work best given that there are no simple or easy answers.

The essence of our strategy is to focus on young people. We want particularly to reduce the number of class A drug users and the frequent use of any illicit drugs by all young people under the age of 25, especially by the most vulnerable young people signalled by the noble Earl, Lord Listowel.

In communities, we are trying to drive down drug-related crime by expanding and developing criminal justice interventions and the capacity of communities themselves to work to reduce illegality and drug taking. I shall return to this issue later.

I do not believe that progress in tackling the supply of drugs is as impossible a goal as the noble Baroness, Lady Walmsley, signalled. Making some sustained impact on the drug crimes business at international, national and local level has to be part of a balanced strategy.

As to the issue of treatment, which is massively important, the participation of problem drug users in drug treatment programmes will rise substantially over the coming years. There is a range of measures through which we have made progress but time will not allow me to cover many of them. Already 4,500 drug treatment testing orders have been made in the most recent year; mandatory drug testing in prisons is showing positive results, with a drop from 24 to 11 per cent in the last year of figures; and there has been a major increase in direct annual funding underpinning the commitment to tackling drugs.

The noble Lord, Lord Chadlington, and others, spoke of the importance of increasing funding, wisely spent. Funding will rise from just over 1 billion for the last year to nearly 1.5 billion from April 2005, an increase of 44 per cent.

We have clearly to inform our drug strategy by evaluation and evidence, and understanding the effectiveness of the drug policies, or different components of it at both national and local level. The first challenge to the Government's drugs policy—there were a number today—was by the noble Lord, Lord Cobbold. To legalise rather than to prohibit was one of the central debates. We are opposed to legalisation because all the evidence that we can see points to the fact that a massive increase in use would

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result. I shall not go into the evidence in the limited time, but where that has been tried that is what has occurred.

The reverse evidence is that prohibition appears to have a deterrent effect. The survey evidence from MORI and others demonstrates that some people are deterred by the fact that it is illegal. Therefore, for those two fundamental reasons, we are opposed to it. We do not believe that it would lead to a reduction in organised crime; and a free-for-all, with drugs available to everyone, seems to us to be a nightmare.

One should also recognise that these are not substances which have no effect on people's lives. Fifteen hundred-plus people died from drug-related deaths last year. Over and above that, drug use wrecks lives. It wrecks people's ability to work. It wrecks relationships in homes, families and communities. It is not a damage-free—

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