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Drugs Policy

That is an interesting observation. Yes. If the Government are serious about tackling drug abuse they also need to tackle inequality. Turning people with a medical problem into criminals, and burdening them with a whole new set of obstacles to overcome, seems particularly perverse and counter-productive. As well as tackling some of the social factors that contribute to drug use, we should tightly regulate the production, supply and use of drugs, as that is the most effective way to reduce drug harm. Legal regulation of potentially risky goods is the bread and butter of Government, so it is logical and consistent to apply the same principles to drugs as those applied to alcohol and cigarettes, for example, or to imported toys and hair dyes. The Government are there to regulate potentially risky goods. Some of the most useful work on this issue that I have come across is from the Transform Drug Policy Foundation, which has published a ““Blueprint for Regulation””. It starts by saying that it is helpful to know what regulation would actually look like, so that we can begin to outline different kinds of supply models. For example, it suggests prescription as one particular model, or pharmacies that have restrictions according to buyer age, the quantity of drug being bought, and the case specific concerns relating to potential misuse. One particularly appealing aspect of that approach is the scope to require pharmacists or licensed suppliers to offer advice about harm reduction, safer use and treatment services where appropriate. I have had the privilege of visiting the RIOTT—randomised injecting opioid treatment trial—programme in my constituency. In case hon. Members have not heard of it, it is one of three trials to examine the effectiveness and cost-effectiveness of treatment with injected opioids, such as methadone and heroin, for patients who were dependent on heroin but did not respond to conventional methadone substitution treatment. Some 150 people receiving oral methadone substitution treatment and injecting illicit heroin on a regular basis were recruited to the trial. Fifty of them were provided with optimised methadone medicine to take orally, and 50 were given supervised injected long-acting methadone treatment. The remaining 50 were given supervised injected heroin, with access to doses of oral methadone. They also received—this is absolutely crucial—one-to-one personal support and had people who worked with them, got to know them and gave them advice and support. All participants were followed-up for six months to enable researchers to compare the effectiveness and cost-effectiveness of the three treatments. The main measure of the trial's effectiveness was the proportion of participants who stopped using illicit heroin. In other words, they stopped trying to get dirty heroin from the streets. Laboratory urine tests allowed researchers to check if the heroin used had been prescribed or had come from the streets. Researchers also collected information about other illicit drug use, injecting behaviour, health and social functioning, criminal activity and so on. The results and the strength of the conclusion were amazing. They suggested that pharmaceutical heroin was far more effective in helping to stabilise people's lives, get them off the illicit heroin and, crucially, to begin to reduce their overall drug use. The treatment was not just about keeping people on a particular dosage for ever, it was about enabling them to withdraw from ongoing drug use. I met participants on the trial who told me that it had saved their lives. It had given them back control of their lives, allowed them to kick crime, find their families again and, over time, reduce their drug use. Professor Strang from King's College London, one of the leading academics on the study, described its outcomes as follows:"““The RIOTT study shows that previously unresponsive patients can achieve major reductions in their use of street heroin and, impressively, these outcomes were seen within six weeks. Our work offers Government robust evidence to support the expansion of this treatment, so that more patients can benefit.””" I am pleased that the drugs strategy foresees a role for substitute prescribing. I call on the Home Office and the Home Secretary to ensure that the results of the RIOTT programmes are properly factored into the analysis, and that such programmes are made more available across the country. The trials are an example of the regulated use of a drug that is otherwise prohibited. They provide a useful, albeit limited, example of how regulation can enable users to become prescribed users, rather than street users, thereby illustrating some of the benefits of regularising the supply route and decriminalising drug use. I would like to address the issue of cost, which has been mentioned several times. Some people argue that programmes such as RIOTT are extremely expensive, but I would like to look at the other side of the equation. Given the cost of following up drug-related crime to the police, or the cost to the NHS, approaches such as that of the RIOTT programmes are far more cost-effective than the continuing prohibition that we see today.