§ Motion made, and Question proposed, That this House do now adjourn.—[Mr. R. W. Brown.]
§ 11.50 p.m.
§ Mrs. Renée Short (Wolverhampton, South-East)I am glad to have the opportunity to raise this very important matter in the House. In order to get the material for this debate, I have interviewed psychiatrists, journalists, and drug addicts, and I should like to express my thanks to them all for the help and interest which they have shown.
This is a melancholy and hellish story of escalation from pep pills to main line heroin, an escalation which can change an apparently happy, balanced, open-faced youngster into a furtive liar willing to cheat and commit violence, or to prostitute himself—or herself—in order to get the drugs which he craves physically and psychologically with such dreadful compulsion.
I know that Members on both sides of the House, and a large number of people working in the field outside, are gravely concerned at the apparent lack of activity on the part of the Government. Many of us have put down Questions, and been dissatisfied with the kind of replies which we have had, from the Prime Minister down, and even the simple business of setting up the advisory committee which was recommended by the Brain Report has not been carried out, so we feel that it is urgently necessary to raise this matter here.
I welcome the statement which was made by my right hon. Friend the Minister of Health, and the suggestion that he is preparing legislation on the lines of some of the recommendations of the Brain Report. I first had my attention directed to this urgent problem by a series of articles in the Wolverhampton Express a year ago, which literally took the lid off the situation in the Midlands, where the pushers are doing extremely good business.
At All Saints Hospital, Birmingham, about 10 per cent. of the heroin addicts in the country are being treated, and they are getting about a hundred new referrales every three months, addicted to drugs of all kinds. It is an ugly and 644 deteriorating situation. In 1959 there were 454 addicts known to the Home Office, most of them addicted as a result of taking morphine for medicinal reasons. In 1964 there were 753 addicts on the Home Office list, nearly half of them on heroin, a drug which is not often now used for therapeutic purposes. But what is terrifying about these official figures is the growing number of teen-agers on the official list. In 1960 there was one. In 1965 there were 64, and 8 of them were only 15 years old. The number of addicts is increasing, and the age is getting lower each year.
This is only the tip of the iceberg. These are only the ones who are so completely hooked that they have to get their supplies from their doctors. There are thousands of young people, from the ages of 11 and 12 upwards, on drugs of all kinds—amphetamines, barbiturates and hard drugs, pills, purple hearts, black bombers, pot, heroin, cocaine, and LSD. It is regarded as the "in" thing in many of the circles which young people frequent. Unfortunately many "pop" stars are addicted to drugs, and some of the television programmes which we have seen recently, particularly the one on LSD, have not helped at all those who are trying to combat this dreadful menace.
It affects young people from all kinds of backgrounds, and from widely differing family circumstances. Indeed, many highly intelligent and talented young people, at university, for example, are experimenting with drugs, and we know that there are drug rings in grammar schools and in secondary schools. We know, too, that a large number of the youngsters who come under the care of borstal institutions are under the influence of drugs.
How do young people get hold of pills and hard drugs? I am sorry to say that it is all too easy. Certainly we do not know enough about why young people take to drugs, but we know that there are enormous pressures on adolescents, and that in the places where they meet, in the youth clubs, even in the seemingly respectable ones, in coffee bars, in jazz clubs, in all-night bowling alleys, in cafés, and the rest, the contacts are made. Unless the Government act quickly, in five years the situation will be as dangerous as that in America, 645 where the gangs are moving in on the traffic of drugs, crime, prostitution, which all form part of this ghastly picture. Undoubtedly, theft and burglary provide many of the drugs sold openly in the places I mentioned. Thefts are made from pharmacists, warehouses and manufacturing chemists. One chemist in Birmingham, for example, had 10,000 purple hearts and phenobarbitone tablets stolen in one robbery, and this is happening in different parts of the country.
The use of stolen and false prescription forms is another source. There is a good deal of smuggled imports, particularly of marijuana, and during the seamen's strike, supplies were beginning to get tight. In 1965, there were 2 million prescriptions for pep pills, 400,000 more than in 1964, and prescriptions for tranquillisers went up by 1,900,000 to 9 million. Pushers can make as much as £40 a week selling pills. An 18-year-old youth who was recently caught in Oxford selling purple hearts in pubs paid £30 a thousand and sold them for £64 10s., which was a considerable profit.
In 1963, the report of the director of the Borstal Division of the Central After-Care Association said that 30 per cent. of boys under the supervision of their welfare officers in London were using drugs and more than 10 per cent. were using them in excess. Whereas the medicinal dose of drinamyl—purple hearts—is two or three tablets a day, addicts are taking 40 or 50 a day. In the "lost weekends" which many young people spend with their friends, some take as many as 120 or 150.
Last November, the Brain Report was published. Its terms of reference, of course, were far too restricted. It was concerned mainly with the prescribing of narcotics by doctors and ignored completely the social aspects of drug addiction. It was not concerned with the pushers and took no evidence from the addicts themselves. Had it done so, the Report could not have claimed that there was no evidence of a significant traffic in dangerous drugs stolen or smuggled into the country.
There is plenty of evidence of theft, as I mentioned. Marijuana is being smuggled from many sources. Many young 646 people start on pills and pot—marijuana—and escalate to heroin and other hard drugs because these are usually obtainable from the same source and the same supplier. The Report said that the Committee doubted whether doctors had contributed much to the quantity of drugs available to addicts by over-prescribing or giving new prescriptions in the false belief that the original one had been lost or damaged and concluded that only six doctors had prescribed very large amounts to addicts.
I believe that this is not correct. Addicts are driven to doctors in the end to get more supplies than they can afford on the illicit market. They tell them that they need a certain quantity of heroin and cocaine and the only way that doctors can tell what the proper dose is for their state of addiction is to put them in a hospital and watch the withdrawal symptoms carefully under controlled dosage.
One psychiatrist has described the scene outside one all-night chemist in London as a tourist attraction something like the changing of the guard, as youngsters congregate outside to buy drugs from those with prescriptions. How would they be able to sell some of their prescription if they had not been prescribed more than they need?
In this small piece of silver paper, I have six harmless-looking little white tablets. This is a pound's worth of heroin. I obtained it illicitly. I was not given a prescription. But it is easy to get, if one knows where to go and has the contacts. Young people can do the same. The Report says that addiction is not serious outside London. This is not correct. I have mentioned the situation in the Midlands, in Birmingham and in my constituency, but Manchester, Liverpool, Bradford, Newcastle, Edinburgh and Northern Ireland all have this problem. This is known to the police and doctors working in these areas. It is not only in the large towns and cities that this is happening. The Annual Conference of Women's Institutes, for example, expressed very great concern at signs of teen-age parties in villages in Oxfordshire where drugs had been taken.
What should we do in these circumstances? First, we must ensure that all drugs are under the control of qualified pharmacists—and we should remember 647 that any drug store operated by an unqualified person who has an account with a wholesale chemist can be supplied with amphetamines and barbiturates. Legislation should be introduced at once to make it illegal for any supplier of Schedule 4 poisons to supply anyone except a qualified person. There should be much stricter control at chemists' shops and places where drugs are stored or manufactured. Chemists should be required to keep all such drugs locked in a safe place and amphetamines should be placed on the drugs list.
As long as doctors are allowed to prescribe for addicts, until legislation is introduced, they should be educated in the proper use of drugs. Parents should be much more alive to the indications of drug addiction in their children and more ready to seek medical help. If their boys and girls show character changes, lose their appetites for prolonged periods, stay out frequently over weekends or become scruffy and of dirty appearance, they should check to find out where they really spend their time and what they are doing.
Teachers, too, should be instructed and taught to recognise the signs of addiction so that cases can be reported at once to the school medical officer. Where cases are discovered, it should be routine to check the rest of the children. A urine test will show, even three days after, when drugs have been taken and it is incomprehensible in this context to think that in a recent case, where a drug ring was discovered in a grammer school, the education authority of London refused to co-operate in making these tests. Children found to be using drugs must be treated at once in hospital.
The drug squads of every police force in the towns and cities where this menace is known need reinforcement. I believe that we could get the co-operation of young people to volunteer to work in places where young people congregate, and so help the police in this respect. The police should be given powers to enter and inspect teenage clubs, coffee bars, dance halls and so on and these should be licensed annually. Consideration should be given to the banning of all-night clubs for young people. Brewers could be more co-operative. Many 648 publicans have cleaned up their premises in this respect and have refused to allow admittance to people who are known to be selling drugs or to be under the influence of drugs, although many have closed their eyes to what is going on under their noses.
Legislation must be introduced to make treatment compulsory for patients once they are in hospital, as the Brain Report recommends. Then there must be treatment centres set up, as that Report further recommends, in addition to day and long-term treatment centres. We do not have enough hospitals in London to treat drug addicts, remembering, too, that they are difficult patients. These treatment centres must be set up not only in London but in other towns and cities.
Because time is short I have had to go at considerable speed through these points. I suggest that to investigate this matter properly a pilot scheme should be established as soon as possible at one of the London hospitals so that this whole problem of the treatment of drug addiction can be gone into thoroughly to give us an example of how to deal with it in the rest of the country.
This is a very grave problem and thousands of young people are at risk. They will not kick the heroin habit themselves. Many of them will die for it, and for every one who dies two or three more will be waiting in the queue to start the whole dreary, dangerous cycle again.
§ 12.5 a.m.
§ The Minister of State, Home Office (Miss Alice Bacon)My hon. Friend the Member for Wolverhampton, North-East (Mrs. Renée Short) has, as she knows, raised matters that are the concern of my right hon. Friends the Minister of Health, the Secretary of State for Education and Science, and the Home Secretary, and I will endeavour as far as I can to reply to the points, even though they affect Departments other than my own Department.
I am sure that everyone must be greatly concerned at the sudden increase in drug taking in recent years, and appalled by the fact that some people are making profit out of selling drugs to teenagers. There are, as my hon. Friend realises, two main problems here, although the two are not unrelated. First 649 there is the increase in the number of addicts to heroin and cocaine and, secondly, the vogue for taking amphetamine drugs, particularly among young people.
The facts about the first are fairly clear, because the Home Office has for many years collected information about prescriptions for narcotics, and with the help of regional medical officers and doctors generally has tried to identify all cases of addiction. The number of addicts known to the Home Office has risen from 454 in 1959 to 927 in 1965. The number of those who have become addicts for reasons other than the taking of drugs to relieve pain has greatly increased, and unfortunately the number of known addicts under the age of 20 has also increased. In 1959, we knew of no addicts under the age of 20, and in 1965 there were 145 under that age. It may be that these figures do not tell the whole story, as there are probably other addicts who have not yet come to notice.
When the first signs of growing heroin and cocaine addiction were seen, the Government reconvened the Brain Committee on Drug Addiction, and its second Report was issued in November, 1965. The Committee concluded that the main source of supply of these hard drugs was their over-prescribing by a small number of doctors. It gave an example of one doctor alone prescribing 600,000 tablets of heroin in one year, and gave other disturbing examples of single prescription of a thousand tablets. To counteract this, the Committee recommended that there should be compulsory notification of addicts to a central authority, that special treatment centres should be set up, and that the prescribing of heroin and cocaine should be restricted, except in emergencies, to doctors at treatment centres.
My right hon. Friend the Minister of Health announced yesterday what legislation the Government are preparing to deal with this problem.
The Brain Committee also recommended the appointment of a standing advisory committee on drug addiction, and my right hon. Friend the Minister of Health recently announced that Lord Brain had accepted an invitation to be chairman of a committee, with appropriate terms of reference. It is intended that the committee should have a broad 650 balance of medical and lay membership competent to advise on social and preventive as well as medical aspects of the problem. It is hoped to announce the membership soon.
The second problem, as my hon. Friend has said, is the practice amongst young people of taking amphetamine drugs, and the risk that some may be encouraged by pushers to experiment with and become dependent on more dangerous drugs like heroin or cocaine.
Where do these drugs come from? My hon. Friend has mentioned some of the places. Clearly, some may come from the factories where they are produced. There is over-prescribing. There is theft in transit. There is stealing from hospitals and warehouses. There are many places from which these drugs come.
The Drugs (Prevention of Misuse) Act, which came into operation at the end of 1964, made it an offence for anyone to be in authorised possession of these drugs, unless they were held on prescription by a doctor. Therefore, anyone in possession of a flood of these drugs, not even of the dangerous kind which my hon. Friend has in her possession now, but even of the amphetamine type, could risk prosecution.
So far, since the end of 1964 there have been 1,600 prosecutions and 1,500 convictions for unauthorised possession of amphetamines, the majority of these being in London. We have asked every firm registered under the 1964 Act to give a written statement of its security arrangements. This they have done and their replies are being examined to see if safeguards already adopted by some firms could be more generally used. We are also reviewing, with the help of the Pharmaceutical Society, the problem of security in pharmacies.
Amphetamines present a very difficult problem of security because of the numbers of the tablets which are involved. In 1965 the number of National Health Service prescriptions for amphetamines alone was 3.8 million, which probably covered something of the order of 100 million tablets. We are talking in terms of hundreds of millions of these tablets. The number of National Health Service prescriptions for amphetamines has in fact been falling since 1965, but at 651 the same time prescriptions for tranquillisers and anti-depressants have been rising.
With heroin and cocaine, which are strictly controlled under the Dangerous Drugs Act, 1965, all supplies have to be carefully recorded from manufacturer to pharmacy. Clearly it would be a very difficult task indeed to apply control of this kind to amphetamines, with the colossal number of tablets which are involved.
My hon. Friend mentioned the drug LSD-25. She will be pleased to learn that my right hon. Friend the Home Secretary a few days ago made a Statutory Instrument adding LSD-25 to the Schedule to the Drugs (Prevention of Misuse) Act, 1964. I shall move the approval of this Order on Friday of this week.
My hon. Friend also asked for a greater effort to be made to check trafficking. The figures I have given of convictions under the 1964 Act show that the police have taken vigilant action under this Act. Last year the police and the Customs seized over 1,000 kgs. of cannabis—Indian hemp—and there were 614 convictions for illegal possession.
We have established at Scotland Yard a Dangerous Drugs Squad. More officers have been added to the squad and, if necessary, we shall add even more. A number of forces have been using special groups on drugs work with success. We hope for more development on these lines.
My hon. Friend particularly stressed the influence upon drug trafficking that may be exerted by undesirable clubs. As I think she will know, the Government have decided to give full assistance to the Lord Chief Justice over the Private Member's Bill he has introduced in another place providing for stricter control of clubs.
My hon. Friend also asked me about getting at the root causes of drug misuse and obtaining better knowledge of its extent. This is very important. The Brain Committee's proposals for compulsory notification should help to measure trends in narcotic addiction. The need for comprehensive treatment for those who are already dependent on drugs was stressed by my hon. Friend. This is a matter for my right hon. Friend 652 the Minister of Health, to whose attention I shall bring the points that my hon. Friend has made. The House will not expect me to deal with that matter in very great detail at this time, for I have not very much time to reply to the debate. The National Health Service already provides specialist treatment for addicts in some 160 psychiatric hospitals or psychiatric units in general hospitals. The London area is served by about 30 of these hospitals, including four specialised treatment units.
I understand that it is the intention of my right hon. Friend the Minister of Health to improve and extend treatment facilities. As he said on Tuesday, steps are being taken to set up a unit in which research can be undertaken into the problems of drug dependency, and there is to be a conference of doctors who are experts in the treatment of these problems. By these means, the hospital services for the treatment of drug dependency will be improved in the light of medical knowledge and will be extended to meet such increasing demand as may arise.
My hon. Friend asked about limiting doctors' authority to prescribe or supply drugs.
§ Mr. Reginald Eyre (Birmingham, Hall Green)Would the right hon. Lady bear in mind the unfortunate necessity of compelling young people to undergo the full course of treatment, because they tend to go away just when they are within reasonable distance of making a full recovery?
§ Miss BaconThat is a point which I shall draw to the attention of my right hon. Friend the Minister of Health.
I was saying that any question of prescribing and the doctor's authority to supply or prescribe drugs always raises difficult problems, because patients must not be deprived of essential treatment. Both heroin and cocaine are regarded by many doctors as clinically irreplaceable for certain limited purposes, and amphetamines, barbiturates and tranquillisers all have a wide range of clinical use. It would be impracticable to attempt to define a maximum quantity of heroin or cocaine which could be dispensed on one prescription.
653 The Committee's proposals for limitation are on a different basis. The Brain Committee proposed to limit to doctors on the staff of treatment centres the authority to prescribe or supply heroin or cocaine to addicts while leaving all doctors free to prescribe or supply for patients for whom they are necessary for the relief of pain. I have already explained the action on this which the Government are preparing, in consultation with the medical profession.
As regards other types of drugs, again I think it must be left to the doctor to decide on the requirements of the individual patient. But I am sure that in prescribing doctors will take heed of the warnings in the Brain Report about the dangers of over-prescribing. This is not only wasteful in pure money terms, but the existence of unused drugs provides temptation to unscrupulous persons to use them for the wrong purposes. I am sure that on the shelves of many households today there are many of these drugs within the reach of young people, and everyone ought to be very careful about these things.
654 My hon. Friend made a specific suggestion about the rôle of teachers in this matter, and I shall bring that to the notice of my right hon. Friend the Secretary of State for Education and Science. I understand that his Department is preparing a new edition of a pamphlet issued in 1956 on "Health Education" for teachers, local authorities and students, which included limited advice on drugs and alcohol, in which it is intended to amplify the advice on these matters.
In the short time at my disposal, I have tried to indicate the Government's views on the very important matters raised by my hon. Friend. We recognise that the country is faced with a serious growth in drug taking, as many highly industrial nations are——
§ The Question having been proposed after Ten o'clock on Wednesday evening and the debate having continued for half an hour, Mr. DEPUTY-SPEAKER adjourned the House without Question put, pursuant to the Standing Order.
§ Adjourned at twenty minutes past Twelve o'clock.