HC Deb 12 July 1995 vol 263 cc921-9 1.59 pm
Mr. Paul Flynn (Newport, West)

This is a matter of enormous importance because it affects the suffering of many thousands of people in Britain. By a simple decision made now by the Minister, we can today not take any path that is new or daring but go back to the position that existed in 1971. By doing so, we will decriminalise not the recreational use of cannabis but many people who use cannabis now because they regard it as essential for their needs or their family needs. Those people will stop being branded as criminals. Now they seem to be breaking the law.

Perhaps it is best to say what we are not proposing or debating this afternoon. There is no question of any proposal to decriminalise cannabis or increase its availability as a recreational drug. Neither is there a proposal to make cannabis available as a medicine on every chemist's counter for every minor complaint such as headaches, stomach aches or whatever. We are urging the Minister and the Government today to allow cannabis to be prescribed for a certain number of identifiable conditions that are all serious. Those conditions are multiple sclerosis, glaucoma, the effects of chemotherapy, cerebral palsy, spasm and terminal illnesses.

We know that a strong demand for decriminalisation is coming from the association that has been set up to make the point. The demand rightly comes not from politicians but from patients, from the families of patients and from the medical profession. We are debating the matter today because a meeting of the Alliance for Cannabis Therapeutics took place in October last year at which I believe that the Minister was present. He answered questions at the meeting and he has answered parliamentary questions on the matter.

We want to take the issue forward from what was said at that meeting. I understand that it was a friendly meeting and people shared a great deal of common ground. An all-party group went along to the meeting. It included members of two parties and a letter of support was sent by a third party. Today I have received expressions of support from hon. Members in all parties in the House. So the matter is not party political.

The Government agree with our main case, which is that cannabis is effective in relieving pain. There is a wealth of evidence that for certain patients afflicted by one of the illnesses that I have mentioned cannabis provides a unique palliative for the torments of pain. The measures that we advocate can be introduced without interfering with Government policy. We accept the reality of Government policy on all drugs, but we believe that our argument today chimes precisely with Government policies on drugs, Home Office policies and even the Government's policies on deregulation and choice.

At the meeting with the alliance, the Government side accepted the therapeutic qualities of drugs. Their objections included one from the Home Office that any move to allow cannabis to be prescribed therapeutically would send a wrong signal to the rest of the country. The Government representatives also said that the Department of Health did not want to give any approval to smoking. I believe that those arguments can be answered well.

Cannabis was prescribed until 1971. Whatever signal was given then had no apparent effect. There was not a sudden rash of cannabis taking or abuse because it was prescribed to a small number of people, just as it would be prescribed if our plea today was accepted. There is clearly an understanding in the minds of the public and the medical profession of the distinction between cannabis for recreational use and cannabis for therapeutic use.

No poll of any great merit has ever suggested that recreational use of cannabis is regarded by the majority of the public as desirable. However, a poll in The Independent some time ago showed that 75 per cent. of all doctors and 70 per cent. of the general public wanted to see cannabis prescribed therapeutically. So the distinction exists in people's minds. We do not have to worry about wrong signals.

I agree entirely with Ministers about smoking. No one in the House wants to increase the number of smokers of anything—herbs, tobacco or cannabis. Smoking any substance brings the same problems of bronchitis and heart disease, even if not cancer, but that is not the point. We know that cannabis can be used in a variety of ways. A vaporiser is used in America. There are inhalers. Cannabis can be taken in the form of a food, a drink, a patch or a tincture. Those are all acceptable ways to divorce therapeutic use from the recreational use of cannabis. So smoking is not the problem.

Distinguished scientists attended the meeting at the Department of Health. Professor Wall, a distinguished scientist at St. Thomas's, gave interesting evidence on which he has since enlarged on—I hesitate to use the word—endogenous receptors in the brain. He made the point that the arguments were not the same old arguments which were about in the 1970s and 1960s. When cannabis was withdrawn, it was not because it was thought that prescribing it sent the wrong signals but because it was used only as a sedative at that time. Various other sedatives were available, so there was no need to prescribe cannabis as a sedative.

New knowledge about cannabis has been discovered in the past 25 years. According to the theory of endogenous receptors, our brains can produce one of the active elements in cannabis. We are all familiar with the odd moments of unexplained joy and euphoria that we have from time to time—frequently in the House, of course. Our bodies are remarkably clever machines. They can produce all kinds of chemicals, including many painkillers. So we know that there is a natural source of an element of cannabis in our bodies.

One of the objections, strangely enough, to the derivative of cannabis that has been used—nabaline—is that, although it is a part of cannabis, it has caused more problems than natural cannabis. So there is a strong case for using cannabis in its natural state. Dr. William Northcott, who is an expert in treatment of pain and runs a pain clinic, said that he saw many patients who did not respond in any way to conventional medicine, but who obtained relief as a result of cannabis, which he could not prescribe, although he routinely prescribed much more powerful and addictive drugs, including heroine and cocaine. So the mild, non-addictive drug is banned and the more powerful addictive drugs are permitted—and used in enormous quantities.

The Government have used the argument about willow bark, which is an interesting one. They say that cannabis is a complex substance, and it is indeed complex. There was a time when people sucked willow bark to obtain the active substance in it, which is aspirin. We can go on from there and say that we cannot delay any longer removing the ban on cannabis. It is used today by thousands of people. It has been used since the time of the Assyrians. It has been used for at least 5,000 years. The people who built the pyramids in Egypt knew that cannabis was good for eyes. It was used for what is now known as glaucoma. It reduces the pressure in the eyes by as much as a third. The Egyptians knew that then. We lost that knowledge. It was a forgotten medicine, but we know about it now. It was used by tens of millions of people in every continent for thousands of years. There is not one case of anyone being poisoned by it or having a toxic reaction to it.

We need more research. I am sure that the Minister will say that in his speech. We need to understand which of the substances in cannabis are psychoactive and which are analgesic. But that is no excuse for delaying allowing cannabis to be used in its natural form.

Mr. Austin Mitchell (Great Grimsby)

I do not oppose my hon. Friend's argument. Indeed, I strongly support it and I took a delegation to the Minister at the end of last year. My hon. Friend is exactly on the point. Cannabis should be available on prescription under medical supervision for the relief of pain for certain specified conditions. That is all that we ask. Even if the Government's reason for the long delay in considering that proposal is that more research is needed, it will be difficult to carry out research unless cannabis is available, as it was before 1973, for the treatment of those specific conditions. The research is conditional on the availability.

Mr. Flynn

My hon. Friend is right. There have been strict limits on availability. At the time of the meeting it was not available at all.

It is fascinating that pain specialists have pointed out that they are well used to using drugs which have not been formally trialed or even licensed. The gentleman to whom I referred previously said that, with the majority of his patients, only single trials are conducted before a treatment is introduced. If that did not happen, the treatment that he gives in his pain clinic would be stopped in its tracks. He has to continue to use drugs such as amitriptoline, depo-medrone, sodium valproate, clobazam and flecainide which are unlicensed for use in pain relief. If that can be justified, so can the use of cannabis in its present form.

The most persuasive evidence does not come from the great litany of experts and bodies of chemists who want this change and whom I could spend the rest of the afternoon quoting. More persuasive is the evidence of people who are criminals in the eyes of the law, who are listening to us now and whose lives have been affected by cannabis.

One of the most moving articles that I have ever read was by Carol Howard, who is listening to me now, about the death of her daughter Sara, Sara was in her 20s and died of a rare cancer. She was nursed by her mother. She suffered chemotherapy in the final period of her life and her mother writes movingly in a searing document about her. Her mother used cannabis to help that young woman and has told me within the last hour of that fact. She says that cannabis was the only drug that provided any true or lasting relief. However, in the final phase of her illness that young person was filled with heroin and morphine in a form that has a devastating effect on people. If the choice is between morphine, which often turns people in addition to their health problems into zombies and using a drug which allows them to continue to converse and communicate with loved ones into their final hours, why on earth can we not allow people to continue to use it?

There is another lady who uses the drug. She is the mother of two teenage children and finds that the only relief that she can have from multiple sclerosis and its many symptoms is to use cannabis.

Mr. Michael Connarty (Falkirk, East)

I am grateful to my hon. Friend and congratulate him on obtaining a debate on this very important subject. It has been said that beta interferon, which people are pleading to have available on prescription in this country for sufferers from multiple sclerosis, will not be available until it has been through trials. People find that they can get relief from some of the most dangerous and soul-destroying tremors of MS by using cannabis. If the Government are determined to trial beta interferon and probably delay its use for another decade, they should hear this plea for the use of cannabis as a prescribed drug for MS.

Mr. Flynn

My hon. Friend is right. I wrote an article recently in The Independent about drugs in general. As someone who is fanatically opposed to the taking of medicinal drugs, I tried to make the point that there are only two sorts of drugs: those that we know have very nasty side-effects and those whose nasty side-effects we have yet to discover. We know that there are problems with every possible drug that we can discuss. No drug that civilisation has encountered has had the trial in practical circumstances that cannabis sativa has had. It has been used by many people over a period of years without the reactions which have occurred with thalidomide, eraldin, opren and a whole host of other drugs which have made a lot of money for the drugs trade but have poisoned and killed many people.

Mrs. Teresa Gorman (Billericay)

I sympathise with the hon. Gentleman's point. That is why I have come to hear the debate. I apologise for being a little late. Is it not true that hemp drugs such as cannabis, which are widely used in the east, especially in India, are natural drugs and that the opiates which are widely used in and China and the far east are natural substances? We tolerate alcohol and tobacco, which are acceptable drugs in our society. Is there not a big difference between such substances, which have been used for centuries and about which we know a lot, and the sort of artificial chemicals that the hon. Gentleman has described, which can devastate bodies because they are not natural?

Mr. Flynn

The hon. Lady is right. That is precisely what happened with the derivative of cannabis that has been used as a substitute in hospitals. There have been problems with that which have never occurred with cannabis in its natural state, which comprises 64 different elements.

Mr. John Austin-Walker (Woolwich)

Will my hon. Friend also confirm that cannabis is non-addictive, unlike tobacco, alcohol and some of the other drugs mentioned?

Mr. Flynn

Indeed. It is clear from a wealth of medical evidence that cannabis is not an addictive drug.

I must mention some other cases. I find myself greatly moved by the personal circumstances of many people who have nursed relatives who are terminally ill and the beautiful stories of how radiance came back into their faces after taking cannabis—a radiance absent when they were on conventional drugs. I see also the pain on other faces—of people who bravely say that they are taking cannabis or giving it to relatives. The law says that those people should be thrown into gaol or fined £2,500 and criminalised. There can be no sense in continuing with such nonsense in respect of a mild, benign drug. But that is the law.

One case involved a man who was looking after his 48-year-old wife who was in the prime years of life. He was visited by Customs and Excise, although the matter was not pursued as far as a charge. Another case involved a doctor who prescribed cannabis for her seriously ill daughter. That case went to court. The law is unenforceable. There is not a judge or jury in the country who would dare act against someone behaving in a humanitarian way to their loved ones. The law is stupid and no one can defend it.

The Minister cannot hide behind the nonsense of saying that we need more research, which is his defence. We need more research into every possible aspect of medicinal drugs. There is no drug like cannabis which has had such a trial over the centuries. As we heard from the hon. Member for Billericay (Mrs. Gorman) said, who has a background in chemistry, in its natural form it is acceptable and safe.

We know that there are problems. Cannabis should not be given to people suffering from schizophrenia or those who are engaged in driving or other activities which might be affected by the psychoactive parts of the drug. Such circumstances must be taken into account by anyone prescribing it. However, there is overwhelming evidence from thousands of patients that for glaucoma, multiple sclerosis, cerebral palsy, spasm and muscular illnesses cannabis is the only drug that can be used.

The case of chemotherapy has recently come up. Many people taking that terrible treatment suffer from continuous nausea. Conventional medicines do not work, but cannabis has been found to be effective in many cases. Who dares to deny those people that medicine? Many hon. Members in this House would never dream of breaking the law on anything, but any of us would recommend it if our relatives were suffering such nausea and there was no alternative. What do people do now to get the drug? They can only get it on the street or grow it themselves. One brave lady from Cardiff, who is not 100 yards away from me—

Mr. Deputy Speaker (Sir Geoffrey Lofthouse)

Order. The hon. Gentleman must not refer to people in the Gallery.

Mr. Flynn

Clearly, there is no one here but the lady might be listening to me on the radio. I shall not refer to her again. However, the lady in question bought a cannabis plant. She does not have the dexterity to roll her cannabis cigarettes herself but keeps them in a lovely silver cigarette case that she has placed near a bust of Queen Victoria because Queen Victoria took cannabis every month of her adult life and lived to a great age, thus demonstrating the drug's lack of ill effects. Many other people took the drug at that time.

The Government cannot continue to hide behind the claim that additional research is needed. Research could continue for many years and might produce a result only in five, 10, or 20 years. The argument needs to be resolved now. The Minister is known to be a humane and compassionate man who is respected by every hon. Member. He has the possibility to do something that all politicians would love to do—he can relieve the pain of hundreds of thousands of people, stop many people being criminals and take a major step towards the provision of respite.

Many patients cannot be treated for their terrible illnesses with the proper medicines that doctors would like to use. That charade must be stopped. On behalf of the many law-abiding people who are nevertheless breaking the law, those who are denied the best treatment, those who are in pain but cannot get relief, and those who see others in terrible pain, I appeal to the Minister to announce a minor change in the law and a return to what it was in 1971.

2.21 pm
Mr. Tony Banks (Newham, North-West)

I am grateful to my hon. Friend the Member for Newport, West (Mr. Flynn) for his eloquent summary of the arguments. I endorse the sentiments that he expressed. The Minister is known to be a compassionate man: indeed, I regard him as the acceptable face of Conservative extremism. Is there any conflict between the Department of Health and the Home Office? Is it not a fact that the real problem lies with the Home Office rather than with the Minister's Department?

This morning I took part in a phone-in on the BBC. The hon. Member for Dover (Mr. Shaw) and I were asked how we would tell a person suffering from multiple sclerosis and who was in a wheelchair and in great pain that cannabis was to be denied to them because it was illegal for a doctor to prescribe it. I invite the Minister to contemplate that question when he replies. I am sure that in his heart he is persuaded by our arguments. We should all be grateful to hear him say so from the Dispatch Box.

2.22 pm
The Parliamentary Under-Secretary of State for Health (Mr. John Bowis)

I am grateful to the hon. Member for Newport, West (Mr. Flynn) for raising the issue and to hon. Members of both parties for chipping in. I am also grateful for the kind comments which I imagine have something to do with those moments of high joy and ecstasy that the human brain can experience and to which reference has been made.

This is a serious matter which affects many people. There is a great deal of pain, but there is also a great deal of hope that cannabis may become available as a prescribed drug. I understand that, but, in the short time available, I must set out the Government's position. I shall not dwell on the recreational misuse of cannabis. On the basis of what the hon. Member for Newport, West said, I think that he and I agree about that. I shall deal with the therapeutic use of cannabis.

We have received a number of representations claiming that cannabis is effective in treating some of the symptoms of multiple sclerosis and other conditions, some of which the hon. Gentleman mentioned. In October, I met the hon. Member for Great Grimsby (Mr. Mitchell), Lord Whaddon and representatives of the Alliance for Cannabis Therapeutics to hear the case that cannabis should be made available for medicinal use. I agreed then to give careful consideration to the points put to me. Since then, the hon. Gentleman has written to me and acknowledged that it is not something to be rushed, although we need to move as fast as is sensible.

The therapeutic use of cannabis is a complex issue. It may be helpful if I deal more fully with some of the important considerations related to it. Under section 7 of the Misuse of Drugs Act 1971, cannabis and certain other controlled drugs, such as raw opium and coca leaf, have been designated as drugs which it is in the public interest for their production, supply and possession to be either wholly unlawful or unlawful except for the purpose of research or other special purposes, or for it to be unlawful for doctors to prescribe or supply except under licence from the Home Secretary. The controls imposed by the Act conform with the international restrictions covering those drugs.

It has of course been claimed—and it may be so—that specific medical conditions could be improved by the use of cannabis, but everyone agrees that we need to consider such a claim carefully before deciding to allow the use of cannabis as a prescribed drug. As for any other unlicensed product, the supporting data would need to be presented to the Medicines Control Agency, which in the usual way would evaluate any application made to it by a sponsor seeking a product licence. I understand, that if a product licence were issued by the MCA, the 1971 Act controls could be modified to make such a medicine available to patients. Any change in the controls would not, of course, extend to non-medical use.

I have heard it said that cannabis was available for many centuries, and certainly for medicinal use prior to 1973, so its legal use could simply be reinstated. That is not possible. The decision to stop the medicinal use of cannabis was based on the evidence available at the time, which was that cannabis was no more effective than other available drugs and followed on from the advice of the World Health Organisation at the time. Since 1973, all drugs currently on prescription have undergone a stringent review of their safety, efficacy and quality, and it would be wrong simply to reinstate cannabis without such a review being undertaken. A company seeking a product licence would therefore have to present evidence of the drug's safety, efficacy and quality to the MCA in the usual way.

There are side effects from the use of cannabis. There is convincing evidence that for some people cannabis gives rise to acute and transient mental disturbance and may be implicated in drug-induced serious mental—or psychotic—illness. For regular long-term users, there is some research evidence of damage to the testes, liver and lungs. It is not a matter of dispute that in the short term cannabis can make users light-headed and unable to concentrate, which can affect their ability to drive a vehicle, operate machinery or make sound decisions affecting work, leisure or daily living. The more potent version of cannabis—skunk cannabis—has a higher level of tetrahydro-cannabinol. Because THC is fat-soluble, it tends to accumulate and can damage organs.

Most drugs have side effects, and a relevant consideration—

Mr. Flynn

rose—

Mr. Bowis

I must press on in an attempt to deal with the points that have been made.

A relevant consideration is whether the benefits of the drug are sufficient to outweigh the risks, which is why companies seeking to market drugs have to provide evidence of their safety, efficacy and quality.

The form in which cannabis would need to be available for use as a medicinal product in a controlled dose is another consideration. As the hon. Member for Newport, West said, nobody wants to see reefers being prescribed. The matter of form is also in the first instance for a company seeking to market such a product.

The representations that I have received include a wealth of anecdotal evidence of the efficacy of cannabis in treating some of the symptoms of multiple sclerosis and other conditions. In matters as important as those affecting people's health, however, scientific research-based evidence is what we need. Although the hon. Gentleman predicted that I would say that we needed more research, such a statement has to be right. As yet, conclusions of available research are not very convincing owing to the limited scope of the projects, the use of small cohort groups or the lack of suitable scientific methodology.

It may be that further research is needed, and I understand that the Multiple Sclerosis Society of Great Britain and Northern Ireland is taking positive steps to encourage trials by offering support to researchers. The main agency through which the Government sponsor medical research—the Medical Research Council—is always willing to consider scientifically sound proposals.

It may be helpful if I also remind the hon. Gentleman that current legislation does not prevent research into the medicinal use of cannabis, provided that a Home Office licence has been obtained for that purpose. I can tell the hon. Gentleman that there is no difference between the Home Office and the Department of Health on this matter. For the purposes of a clinical trial which involves the sale or supply of medicinal products and various other specified activities, a clinical trial certificate or a clinical trial certificate exemption would also have to be obtained from the Medicines Control Agency.

We are aware of the distress experienced by people suffering from multiple sclerosis and other conditions and we have been carefully considering the representations that have been made. I remind the hon. Gentleman, however, that we are committed to ensuring that patients receive the drugs that they need to treat their clinical conditions. If a medicine is brought forward and approved by the MCA, the controls under the Misuse of Drugs Act—for which the Home Office is responsible—could be modified to make such a medicine available to patients. If the regulations were amended, the decision to prescribe a particular drug would depend on the clinical judgment of the doctor concerned. The trouble is that we have not yet reached either of those two stages, but I assure the hon. Gentleman that we shall watch developments carefully and fairly.

It being half-past Two o'clock, the Motion for the Adjournment of the House lapsed, pursuant to Order [19 December].