§ Motion made, and Question proposed, That this House do now adjourn. — [Mr. Jamieson.]
§ 10 pm
§ Ms Gisela Stuart (Birmingham, Edgbaston)I am glad to have the opportunity to talk about illegal drugs, and especially their long-term harmful effects. Those drugs are deemed to be illegal substances because they damage the individual to such an extent that what seems to be a private choice to begin with becomes a public choice. That happens when their use leads either to anti-social behaviour or long-term damage to the individual, so that society as a whole deems such use to be unacceptable.
There is a continued increase in the incidence of drug taking. The evidence shows that between 1989 to 1995 nationwide drug usage increased by two and a half times, but in Birmingham it increased ninefold. We find also that young people take drugs in increased numbers and that such young people are getting younger and younger. Drug incidents in primary schools are by no means unknown.
The debate was sparked by yet another piece of research on the permanent brain damage that is caused by Ecstasy, which is often referred to as a recreational drug. I find that terminology extremely misleading and dangerous, and that is not merely a matter of semantics.
I refer my hon. Friend the Minister to several press reports. The most recent one appeared in the New Scientist. It tells us that the brain scans of drug users reveal the first direct evidence that Ecstasy or MDMA can trigger long-lasting changes in the human brain, which cause memory impairment and depression.
The year before the article to which I have referred appeared, an article—again in the New Scientist—in June reported, following a study among students, that a weekend dose of Ecstasy can lead to forgetfulness, poor concentration and midweek blues that are severe enough to qualify the sufferer for clinical treatment.
The Parliamentary Office of Science and Technology made an important observation in March when it told us that, in contrast to such drugs as cannabis, on which there is research literature stretching back 25 years or more, the relatively recent emergence of Ecstasy means that there is much less research on its potential psychological and health effects.
We have information on long-term drug damage that is fairly generic. Prolonged exposure to most drugs can lead to tolerance where the user develops a form of immunity and needs higher doses to produce a given effect. Most drugs cause some dependence if taken for prolonged periods. I am particularly concerned about their psychological effects, because those are much more difficult to measure. If drug use leads to long-term psychiatric effects, we as a society should be extremely concerned. Long-term use of Ecstasy causes a massive release of the neuro-transmitter serotonin by causing the stored neuro-transmitter to be released and inhibiting its re-uptake, so that its effect is increased and prolonged.
I shall make a point that we often tend to forget. Young people, who are most at danger, make very rational decisions. They make much more sophisticated risk assessments. We have a problem because, as parents, we encourage our children as they grow up to take risks, 428 to try things. When a child will not eat spinach, we say, "How do you know that you don't like spinach if you've never tried it?" Five or six years later, we say, "Here's something that you mustn't try." We need very good evidence and facts to convince our children when we warn them about the long-term danger.
I talked to DASH—the drugs and sexual health project in Birmingham—and asked for its experience of Ecstasy. In the first two years it recorded face-to-face contact with 3,400 drug users, particularly in clubs. Thirty-one per cent. of inquiries came from Ecstasy users wanting more information about the drug. The standard profile of an Ecstasy user is likely to be male, but we should not underestimate the number of young women who take Ecstasy; they simply seem to use it less.
Users are likely to be in their early twenties and use Ecstasy in addition to a range of other drugs, notably alcohol, cannabis and amphetamines. They make choices about the substance on which to get high on a particular night. They will consume one or two Es one or two nights per week, almost every week, for much of the year. Usage may continue for between two and four years. It is a social group activity which they grow out of. However, if it results in long-term or permanent brain damage, we cannot take it as something that is part of the club scene and just tolerate it.
Young people express concern about the long-term effects of drug usage, but when they assess the risk they have difficulty in finding the facts. I sent my researcher to a library yesterday to find some facts about the various long-term effects, and asked her to pretend to be a member of the public. She came back very surprised and said, "I found some very old medical text books with information on LSD, but I knew that it was not telling me the whole picture." We tend to overlook how difficult it is for youngsters and parents to find the facts, unless they are already in certain schemes.
We also face the difficulty that we want to spell out the realities very starkly to youngsters while not frightening the parents too much, so that they can handle the situation. Parents face the double problem of a teenager who is difficult at the best of times and a teenager who is taking drugs.
There are some very good organisations. One in particular that I have come across in Birmingham is Parents for Prevention. It is extremely useful. It is mainly for parents who are concerned about drugs or who face problems with their children: they either suspect that they are drug abusers or know that they are. Parents for Prevention educates parents about the drug culture and the effect of drugs, but in particular it enables them to cope with the situation so that it does not escalate. In the first 12 months of operation, its helpline had contact with some 2,600 parents and professionals. Most callers were mothers, and their main concerns related to cannabis, amphetamines, LSD, solvents and heroin.
The organisation provides continuing support for parents, visiting and befriending them. The system involves parents helping other parents. It also organises courses that all of us with teenage children should welcome—the "living with teenagers" programme. It recognises that a joint approach is essential.
What I welcome particularly about the Parents for Prevention campaign is that its funding is currently also a joint effort. The campaign is financed by the Home Office 429 and the drug prevention initiative, but also by the local authority action trust and Birmingham health authority, which recognises that dealing with drugs must be a cross-institutional initiative. The ultimate aim is to set up groups across the city that help parents to help other parents.
Once people's children are taking drugs, we have embarked on the dangerous debate about harm reduction and minimisation. We must recognise that once we have implemented harm reduction measures such as licensing requirements for drugs, it is, in a sense, too late: the young people have already started taking drugs. Although such measures are essential, they should not be the sole aim; we should not accept that we have to live with the problem.
My main purpose is to plead for much more research and much more evidence-based information. Youngsters respond to that. The more hard facts we have, the more they will follow those facts. The approach to the heart does not work, as we saw in the Leah Betts case: that did not, in a sense, reduce the attraction of Ecstasy.
A report produced by the Parliamentary Office of Science and Technology in May 1996 gave a good summary of the position. It stated;
Given the inherently psychoactive nature of these drugs, the major potential problem area is the definition of psychology/psychiatry. Here there are many research targets. At the basic level, the natural function of the cannabis receptor is not yet known, even though it is one of the more common types in the brain. Secondly, there are differences of view over the extent to which current psychiatric problem derive from illegal drugs.The report asks for more information that influences behaviour.I am often concerned when I hear the argument that the only kids who suffer from long-term exposure to drugs such as Ecstasy were already prone to some other addiction. That is simply a recognition that some groups are more vulnerable; it should not be used as an excuse for not emphasising the dangers of Ecstasy.
We need to recognise the existence of drug dependency, and accept that some groups of people have dependent or addictive natures. Again, that is no excuse for taking no action: it simply means that a different way of tackling the problem may be needed. I remember talking to a mother who said, "I have two kids. One is not a risk-taker, but the other is." The messages not to take drugs would be very different for those two children. Both messages must recognise their separate psychological dispositions, but both must be based on fact.
The most dangerous thing is conflicting information: young people in particular pick up inconsistencies, and the illogical arguments of adults, much faster than anyone else. If the case that we advance is not credible, they will not listen to us.
We need better information about patterns of use and about the mixture of various drugs. It is very unhelpful, for example, to say that only so many cases are related purely to Ecstasy. That does not help if we know that a mixture of drugs is causing the problem. Since 1972, the United States drug abuse warning network has provided the US Government with consistent sets of statistics on the harmful effects of drugs gathered from hospital accident and emergency departments and drug-related deaths.
430 Large-scale epidemiological surveys have examined the socio-economic aspect—which groups of children are more likely to use certain drugs. There is an argument that Ecstasy is taken mostly by young people who earn a lot and take it at weekends. That is no excuse for not taking the matter seriously.
My plea to the Minister is that we need more evidence-based information. I should like to ask my hon. Friend the Member for Bolton, South-East (Dr. Iddon) to give the scientist's view of this problem.
§ Mr. Deputy Speaker (Sir Alan Haselhurst)Order. It is not for the hon. Member to determine who should speak. An hon. Member may catch my eye.
§ Dr. Brian Iddon (Bolton, South-East)I thank my hon. Friend the Member for Birmingham, Edgbaston (Ms Stuart) for requesting this timely debate, and for allowing me to participate, albeit briefly. I listened with interest to her comments, and agree with them all.
There are no safe drugs, legal or illegal. Society must weigh the advantages of the use of drugs against the disadvantages. Ecstasy, MDMA is an amphetamine with the chemical name 3,4-methylenedioxy-a-methylamphetamine, from where the abbreviation comes. It is almost certainly neurotoxic: the report to which my hon. Friend referred contains evidence to support that view, and I have been preaching that for many years.
When I told my students that, if they took Ecstasy—probably some did—it could be neurotoxic, they expressed great surprise and asked me what "neurotoxic" meant. It means damage to the central nervous system that is considered irreversible. I hope that, as a result of students being told about the health risks, those who took Ecstasy were deterred from taking it ever again.
If a given age group took Ecstasy over a prolonged period, it is conceivable that at some time in the future a generation of people would exhibit Alzheimer-type symptoms at a much earlier age than is usual now. However, I do not think that that is probable, because the taking of Ecstasy is a phase in young people's lives. The November edition of The Big Issue, which is sold in London, suggests that the drug culture on the rave scene is changing, and that people are moving off Ecstasy. Goodness knows what will be the next rave drug. Fashions change, and we must keep an eye on that.
Ecstasy's dehydration effects are well known. I condemn those nightclubs and rave clubs that turn off the natural water taps. That is happening on quite a scale across Britain. It has happened in my own town, and Bolton council has taken action against clubs that have turned off the mains water at source to force young people to pay more than £2 for bottled water at the bar. I draw the Minister's attention to that practice, because it must be stopped.
I want to refer briefly to the impurity of street drugs. It is often not the MDMA that causes the problem, including death in a very few cases; it is mainly the impurities that are present in street drugs. Such drugs are made under poor conditions, often in back-street garages, with no analytical control: certainly not the analytical control that is prevalent in the pharmaceutical industry. I do not think that young people who buy street drugs 431 realise what they are buying. In most cases, they are buying not a pure drug, but highly contaminated materials from irresponsible people.
I implore the Minister to study the harm-reduction programmes that other countries have undertaken, including the Netherlands, which is the leader in this area. I refer to simple, analytical kits, which are cheap, so that users can prevent themselves from being damaged.
I also want to refer to the serious business of polydrugs. In Bolton, young people are taking not only one drug, but a multitude of drugs, even on the same night. There is no research on the synergistic effects, which is the action of one drug on another. We must point out to young people that they put themselves at great risk when they take a combination of drugs, because they may have powerful, synergistic effects. We know nothing about the polydrug scene, which is very damaging. I draw that to the Minister's attention.
§ The Minister for Public Health (Ms Tessa Jowell)I congratulate my hon. Friend the Member for Birmingham, Edgbaston (Ms Stuart) on securing an opportunity to raise these important issues. I thank my hon. Friend the Member for Bolton, South-East (Dr. Iddon) for his contribution.
The Government are well aware of the effects of drug misuse not only on the drug takers and, often, their families but on society as a whole. One of our manifesto commitments was to appoint an anti-drugs supremo to co-ordinate our battle against drugs and as a symbol of our commitment to tackle the modern menace of drugs in many communities. We have fulfilled that commitment by appointing Keith Hellawell as the UK anti-drugs co-ordinator and Mike Trace as his deputy. That is not an end in itself, and across government, under the leadership of my right hon. Friend the Leader of the House, we will work closely with Mr. Hellawell and Mr. Trace to develop our strategy to tackle the misuse of drugs.
While awaiting the arrival of Mr. Hellawell and Mr. Trace, we have continued to undertake activity in relation to a range of problems. A wide range of drug initiatives is under way. Some 79 innovative local anti-drugs projects have been supported through the drugs challenge fund. Plans for a reduction in front-line customs staff have been reversed; proposals have been brought forward for a drug testing treatment order; and a cross-departmental review is under way to assess the resources that are available for action against drugs. That is evidence of the Government's recognition that effective action against the threat posed by drugs to our young people and to society as a whole needs to be waged on a number of fronts.
Before I turn to the specific issues that my hon. Friend has raised, I should like to put in context much of the media speculation about the extent of drug misuse in this country. Drug misuse is not the normal majority pattern among young people. Authoritative figures published in September from the 1996 British crime survey showing that while about half of our young people have taken prohibited drugs in their lifetimes, only one in seven could be said to take drugs on anything remotely like a regular basis. That is a similar picture to the one of two years ago, but it is no grounds for complacency, because the figures are still worryingly high. However, it is important to put the issue in context.
432 Many young people who are offered drugs choose to decline. The Health Education Authority commissioned a survey of 5,000 young people in the autumn of 1995 and found that, while 70 per cent., reported that they had been offered drugs at some time in their lives, only 45 per cent. had actually taken them. That is a hopeful sign that young people are capable of making informed choices. It underlines the importance of our powerful health education and health promotion messages about the risks of drug taking.
I shall now deal with the impact of drug taking and its link to crime. Another aspect of drug misuse that many choose to overlook is that, as well as its effect on the person who takes drugs, it has wide-ranging effects on the society in which we live. Many people are damaged. Estimates for the level of drug-related crime vary. They include one by West Yorkshire police that up to 70 per cent. of acquisitive crime is drug-related. I am sure that my hon. Friends would testify to that from their constituency experience. We all know that crimes have victims. They may be those whose homes are burgled, and businesses also experience loss due to crime. Every one of those victims would be only too willing to testify to the damage caused to society by the effects of drug misuse.
Then there is the fear of crime—its unquantifiable effect on many people, rendering elderly people, in particular, prisoners in their own homes. Reducing drug-related crime is a key objective for police forces in the coming year. The Government will pilot a drug testing and treatment order to enable courts to impose treatment for seriously addicted offenders, and we shall make widely available what we learn from the work of local projects in implementing and evaluating drug interventions at different points in the criminal justice system and in different parts of the United Kingdom.
In that context, I strongly endorse the comments of my hon. Friend the Member for Edgbaston about the importance of proceeding on the basis of evidence, understanding what works and acting on the basis of what we know to be effective.
Hon. Members may be aware that, at the end of October, I announced that health authorities would receive more than £41 million next year for drug treatment services. That is an extra £3 million, and represents a real-terms increase of 8 per cent. over the 1997–98 figure. It will allow the national health service to continue the development of effective treatment services for drug misusers. It will also enable health authorities to build on their existing services and to develop them on the lines of carefully tested guidance sent out by the Department earlier this year on purchasing effective treatment and care for drug misusers, again concentrating heavily on building on good practice.
I take on board the concern that my hon. Friend the Member for Bolton, South-East raised about young people in clubs who may have taken Ecstasy and have to buy water, rather than be able to drink it from the tap. That is a dangerous practice on which we want to take action. It is another example of a specific step that must be taken as part of a comprehensive approach to tackling drugs. My right hon. Friend the Leader of the House will give the whole drugs programme high priority during our presidency of the European Union next year.
433 My hon. Friend the Member for Edgbaston talked about the long-term effects of Ecstasy, referring to research, reported in the New Scientist, at the university of Baltimore. She suggested that Ecstasy use permanently damaged brain function. Although we have yet to study the detail of that research, its conclusions are broadly in line with existing knowledge about Ecstasy's dangers. It causes massive release of serotonin and inhibits the brain nerve cells' ability to absorb the serotonin, so that the drug's effect is both increased and prolonged. It gives a boost well outside the range of normal emotions, accounting for the intense empathy and mood change while under the influence of the drug.
434 Of course we know that those short-term mood changes can have long-term, damaging persistent effects. We need to make that clear in ways that they will accept to young people who choose to risk taking Ecstasy; they need to understand that we are on their side.
The Government are funding a three-year campaign by the Health Education Authority to inform young people of the risks of drug misuse. I make it clear that we insist that all materials are tested for effectiveness with young people. If the messages are anodyne, suitable for grown-ups and lost on young people, the message will be ineffective and will fail the important test that my hon. Friend the Member for Edgbaston offered: measures should be proved to be effective.
§ Question put and agreed to.
§ Adjourned accordingly at twenty-nine minutes past Ten o'clock.