§ 4.11 p.m.
§ Debate resumed.
My Lords, may I bring you back to the subject of the misuse of drugs? We have heard two very interesting speeches from both sites of the House which have given us the facts of drug dependence and drug misuse. The facts, briefly, are that we are faced with an alarming increase in the use of drugs 1295 and that most of this alarming increase is by people under the age of 30. Your Lordships have also heard the noble Lord, Lord Stonham, say that legislation alone could not cope with the problem. I want to look at it from the angle of legislation alone not being able to deal with this problem.
I think it would be useful if we tried to find out what it is, what particular malaise in our urban and industrial society it is that makes people want to take drugs. I do not think that it is altogether escapism, because so far as the young are concerned—and this applies to everybody else—the world we live in now is infinitely more attractive for most people than it has ever been. But I think it is a sort of frustration—so near and yet so far. We are on the verge of being richer, with more leisure and with a more delightful society in every way than ever before, yet somehow it is just out of our grasp. I think that this leads to a sort of flight from reason: that over the last 300 years by the use of reason, and by deductions made from it, we have achieved a material society in the space of a very short time which is quite extraordinary. Yet this material society has failed to produce the one thing that we feel that life is worth living for; it has gone sour on us, it has defeated its own objects. I think that it is this flight from reason that we see in political violence in all its aspects; the feeling that reason is not enough.
I think that this has led many people to feel, and properly, that reason is not the only activity of the human mind by which you can find the answers, and that you can find truth by methods other than reason alone. Because drugs sometimes help to do this, it has led a great many people to use drugs to try to help them to make their minds get at those things that they feel that reason has failed them over. I think there is a great deal in this way of thinking which has caused people to turn to drugs (and young people in particular) in this quite alarming way, and suddenly and so quickly; because I do not think it is really just for "kicks" alone that the young have turned towards drugs. It is for something much deeper. I have an idea that the reasons that I am putting forward are the kind of reasons, if we are going to master this problem, 1296 that we must look into closely; because, as has been said, we are not going to be able to cope with it entirely by legislation alone. I have the feeling that trying to look at it in this way, trying to find out what are the springs that cause people in this sudden way to turn to drugs, will help us to solve the problem and will help us to find some sort of social philosophy about it.
Prince Vladimir of Kiev, when Kiev was the most powerful State of all the Russias, about 1,000 years ago was considering what religion he should recommend to his people. He was much taken with Mohammedanism, but he knew that if you were a Mohammedan you would have to foreswear alcohol; and so he adopted Christianity, because he felt that no one should be asked to live in Russia without alcohol. We adopted the same sort of approach to life in the worst days of our own industrial beginnings about 100 years ago. The rum ration for a sailor was a pint a day. A pint of rum is a large amount of alcohol to drink; and if you have it as a matter of course, with the blessing of the Government, it suggests an inordinate degree of misery, does it not? The same applied to the submerged urban tenth; that they were sodden with gin which was bought for far less than even beer fifty years ago; their babies were sodden with laudanum, a derivative of opium. We, too, in the 19th century were rather following the Prince Vladimir of Kiev line.
My Lords, what now? What about the 20th century? We have, it seems to me, a problem even more acute. We have this kind of emotional, psychological, spiritual malaise which is upsetting us to such a degree that we are searching for new drugs and for some way of trying, through their help, to arrive at the truth. What are we going to do about it? Are we going to substitute pot for alcohol and tobacco? Could we substitute pot for alcohol and tobacco? We can add it to our drugs, but I do not know that we can just substitute it, even if there is a case for saying that pot is less damaging than alcohol. Should we sit back and do our best not to let things escalate into hereoin; or are we to hope that some new drug will be devised which will give us all we want with no side effects at all? I do not know. But at any rate we have to make 1297 up our minds how we are going to approach the problem.
Are we to approach drugs from the point of view of Prince Vladimir, that they are an anodyne, or from the other point of view, which is the one that I think is so attractive to a great many people and which, for want of a better example I might call the Aldous Huxley approach; that is, that by taking certain drugs (which one hopes in a modern way will have no side-effects) one will have heightened perception and will be assisted to arrive at the truth. I do not know. I am suggesting that if we try to examine the problems behind drug taking, what makes our modern society want drugs, this will help us to find a way of using and not misusing these drugs and to evolve some social philosophy about the whole problem.
My Lords, there are very few matters of fact that I want to touch upon. Most of these have already been exhaustively dealt with by the two noble Lords who preceded me. The first is the question of enforcement. We are shortly to have drugs manufactured very nearly on the do-it-yourself principle; or, at any rate, if not as easily as that, they will be so easy to produce that the police will be almost incapable of coping with enforcement. This makes one feel the need for a double-pronged approach, the approach of trying to make it as easy as possible for the police to prevent misuse but at the same time providing a very considerable degree of education to make people realise that by taking drugs you almost always defeat your own ends: that you do not in the long run get better perception, you do not make yourself happier, and you do not see God—and I use "God" as a shorthand term to embrace all those things which even the most dedicated atheist would also accept.
Next, there is the question of commercial interest, which I regard as a very important point. I do not mean just the commercial interest of the drug pedlar or pusher; I mean the kind of organised commercial interest. I do not wish to say what I do not mean about the drug industry, which has served us very well. The drug industry is a great and a sensible industry which does not wish to do damage. Nevertheless, even with the best will in the world, accidents can happen because drugs are being comer- 1298 cially pressed, in the way in which thalidomide was, without due care and attention. I think this is a very important point to watch. We have heard already about the "pot lobby". I am not suggesting that "pot lobbyists" are the sort of people who are comm2rcially interested: I do not think that they are. I believe that a great many of them are people who rather like to feel "with it", and these are just the sort of people who are wide open to being used by commercial interests in a way in which they should not be.
Lastly, my Lords, there is the question of the international interests. This is one of the matters in which we cannot "go it alone". I was extremely interested to hear what the noble Lord, Lord Stonham, told us, about what the Government are thinking and doing, and I shall be most interested to hear what the noble Baroness Lady Serota, has to say at the end of this debate. I also hope that noble Lords like the right reverend Prelate the Bishop of Chester, the noble Lord, Lord Soper, and the noble Lord, Lord Sandford, who are particularly interested in the aspect of the matter on which I touched before, will themselves have something to say about it.
§ 4.22 p.m.
THE LORD BISHOP OF CHESTER
My Lords, I wish first of all to add my voice to those who have expressed the gratitude of this House to the noble Earl, Lord Jellicoe, for giving us the opportunity to debate this subject and for introducing it with the comprehensive survey that he presented to us. I feel that the debates in this House have a special significance when we are concerned with the health of the society in which we live and the happiness of the individuals who compose it. There are few matters which concern the stability of society more closely than the problem of drug dependence; therefore this is entirely a proper matter for your Lordships' House to discuss.
Yet, as one comes to study the subject in preparation for it, one appreciates how difficult it is to have a debate on such a subject as this, since the horizons that it presents are so wide, the literature on the subject is so voluminous and the ramifications are so widespread that it is impossible to do justice to the subject in the course of a debate lasting for a few hours. Nor, indeed, ought we to try to 1299 categorise this subject into neat compartments, for it does not lend itself to that treatment. If we try to do so we shall not be covering the matter in the way we ought. Therefore I would begin what I have to say to your Lordships by asking your forbearance if I touch on two or three matters which are relevant, without necessarily trying to say something about everything. I hope that if I and other noble Lords follow this course, as the debate goes on the picture will build up and we shall be able to see the whole problem in its wide range.
First, in order that we may get this subject in the right perspective, I think it important that your Lordships should appreciate that it is no new problem. The noble Lord, Lord Henley, has already reminded us of that. But the problem goes back a good deal further than Prince Vladimir and the unusual reasons he advanced for converting the Russians to the Christian faith. It goes back, I think, as far as the beginnings of man; for he has never been able to equate himself with the circumstances of the life in which he finds himself and he has had to resort to outside aids in order to make life tolerable in certain circumstances. Sometimes the aid has been very innocuous, like the Psalmist's glass of wine, "that maketh glad the heart of man", or the pipe of tobacco which some people find a useful sedative when they are working.
My Lords, it has also gone on to matters of far greater moment. The noble Lord, Lord Henley, reminded us that it is not so very long ago since gin palaces thrived in this country and thousands of people resorted to the drug alcohol in order to achieve a short time of escape from the miseries of life which they could not bear. So it is not a new problem that we are having to face at this time, but undoubtedly it is a problem with new acuteness. It is, of course, impossible to analyse altogether the reasons why in our day and generation this is so pressing a problem. I think there are at least two factors: one is the greater tension under which we all live and the other is the discovery of synthetic drugs, by the ingenuity of the pharmaceutical industry, with their immediate potency and with their much greater availability for everybody.
1300 The second point which I think we ought to bear in mind in getting a full view of this problem is that it is not only a problem for teenagers and for adolescents, though it is generally presented as such. In fact, it is a problem for the whole of our society, and I venture to think that the atmosphere in which we have all been involved, and for which we are all partly responsible, is responsible for many of the more obvious cases of drug dependence among young people.
A lady who is very much experienced in the treatment of drug dependence used to me the phrase that our society is "pill happy", and doctors whom I have consulted have borne out this judgment upon our condition. They pointed out that the old quasi-priestly function of the family doctor has gone, simply because the doctor no longer has the time to be the counsellor of the family, able to give to the members of it much advice and consideration. At the same time patients are becoming more sophisticated. They are no longer satisfied if the doctor just gives them a bottle of medicine; they demand drugs that will bring quick results. And so, as a doctor has said to me, many doctors feel that they are trapped and that, to a large extent, patients regard their doctor as a kind of grocer who will deal out to them the pills which they think they need. This, certainly, is a phenomenon of our society and our experience, and I think it is one of the things which has high-lighted the particular problems which apply to our young people.
The third matter I wish to urge upon your Lordships is that in thinking about this problem, especially as regards young people, we should adopt a very compassionate attitude towards their problems. In the first place, we should appreciate how easy it is for them to get into trouble and to find themselves enmeshed in the coils of this problem of drug dependence. We all know the difficulties that were high-lighted for us in the case of Sweet v. Parsley. Many of us were profoundly grateful to the noble Lords of this House who produced a judgment in that case which seemed to accord with reason and common sense. But that is not the only way in which unsuspecting and quite innocent people can become involved in this problem. Some noble Lords may have teenage children who are 1301 living by themselves. They will know how easy it is for the children to entertain a few friends and, before they know where they are, find that a "pot session" has started in which they are involved. And they feel a sense of guilt at what has happened. Again, we have to recognise the pressure of the sub-culture in which so many young people live to-day. The "pop" culture or "hippy" culture—whatever you may call it—has its characteristics, one of which is the taking of drugs, either for fun or for "kicks", or for intellectual curiosity. Those who are enjoying many of the features of this sub-culture find themselves caught up with drugs in this way.
Thirdly, we ought to remember the tensions which particularly afflict so many young people. I think of those who are in the public eye in show business, who have to bear with the adulation of thousands of people—a pressure upon their lives which not many of us would feel strong enough ourselves to carry—and whose work makes great demands upon them. It is very unfortunate that, just because they are in the public eye, their experience in using cannabis, for instance, becomes high-lighted, and their sense of responsibility is not as it should be. But they are under great tension. Equally so are the young people, for instance, at the universities, who know that the consequences to them if they fail their examinations will be far greater than to us in our generation. It is only natural and easy for them to become dependent upon drugs in order to keep themselves awake and to work, or to recover from the effect of having taken such stimulants. So my third point is that although I hope we shall treat with the utmost severity those who are responsible for peddling these things, yet we shall bring a spirit of compassion to bear upon those who have become victims of this scourge.
That leads me on to say something about the question of cannabis. There is no one in this House who commands greater respect than the noble Baroness, Lady Wootton of Abinger, and we regard her experience and her voice with the greatest of authority. It was therefore with almost incredulity that we read of the views that were attributed to her when the Press published the outcome of the Report on Cannabis. My tutor at Oxford always used to exhort me to go 1302 back to my sources, and therefore I did what the noble Earl, Lord Jellicoe, has exhorted us to do. I have read the Report, and I appreciate from that that the noble Baroness has been the victim of quite unnecessary misrepresentation. She is quite able to look after herself, but I feel bound to point out some of the things which I think have been utterly unreasonable in the public judgment en this Report.
Thus, for instance, one sentence has been lifted out of paragraph 29, in which the Committee say that:The long-term consumption of cannabis in moderate doses has no harmful effects.That is simply quoting, or re-quoting, the opinion of two authoritative bodies, the Indian Hemp Drugs Commission and the Mayor of New York's Committee on Marijuana. Indeed, the Report would have been culpable if it had not drawn our attention to those views. We have not been reminded, as we should have been, of the many pages in the Report, some 17, at least, which drew attention to the grave dangers which cannabis can bring.
Also, we have been reminded of the opinion of the Committee that the association in legislation of cannabis with heroin and other opiates is inappropriate. I think that opinion struck a very sympathetic note in the minds of most of us. At the same time, we felt the dilemma mentioned by the noble Earl, Lord Jellicoe, because none of us, I believe, would want to give the impression publicly that there ought to be any relaxation in the censure which society passes upon the use of this drug, cannabis, which can be very dangerous indeed. At the same time, one appreciates that both in justice and in expediency it is unwise to link the penalties for the use of this drug with the penalties which are attached to drugs which are far more dangerous. Therefore I hope that the suggestion which the noble Earl has made, that there should be a re-examination of this drug in such a way that the abhorrence of society about its use is in no way diminished, will be acted upon while a more rational situation is created. I hope that the noble Baroness will not mind my having referred to this matter in this way. As I have said, she is quite well able to look after herself, but I thought that someone from these Benches ought to say that 1303 there has been a serious misrepresentation which ought to be put right.
There are one or two matters about which I should like to comment in detail, which have already been touched upon directly or indirectly in the debate but about which those who are concerned with the problem are particularly anxious that something should be said. The first is that there are a good many proprietary products which are still very dangerous. I will not mention them because I do not think that it would be responsible to do so. But I understand that there is one reputable sleeping pill which can be easily obtained on prescription and which, taken in large amounts, can be dangerous, and particularly dangerous when, as I understand, the practice is growing up of taking this particular drug with alcohol, for this results in severe poisoning and in severe hallucinations.
The noble Lord, Lord Stonham, has mentioned the danger of the drug physeptone. Getting heroin, of course, is becoming difficult because of the opening of the clinics, but physeptone is used in order to wean heroin addicts away from the more dangerous drug. I am told that physeptone, which in the United States is known as methedone, is very dangerous. It is an injectible substitute and needs to be very carefully watched.
What is to be done in order to minimise this great danger to society? As the noble Lord, Lord Henley, has pointed out, prevention is extremely difficult. It is very difficult to prevent smuggling, and I understand that some of these drugs can already be made by those with a minimum of knowledge of the science of chemistry. Therefore, the greatest bastion that we can build against this danger is, first, education and then social service. I hope, therefore, that it will be possible, through whatever means might be best suited, in the schools and universities, to make known to young people how gravely dangerous these things are; that they are not to be played about with and not to be used for intellectual curiosity, for so easily and so unsuspectingly can people become their victims.
Next let us step up as best we can the after-care of addicts. Again, those who know about after-care tell me that it is very important that lengthy rehabili- 1304 tation should be provided so that the addict can be given a real opportunity of recovery before he or she is restored to society. But generally the great thing is that we should educate society into understanding this problem, being sympathetic and compassionate and doing something to help in rehabilitation. We are already involved in that exercise in re-educating society to understand the real nature of mental ill-health and of receiving back into its midst those who are making the very difficult journey back from mental hospital to society.
Much can be done in local areas to aid this work. For instance, in my own cathedral city of Chester it is on the initiative of the doctors that a local conference is to be held of all those who are concerned. I am told by those who have experience of this subject that one of the things they need most is the knowledge of stable, healthy homes where some of these young people, possibly deprived of any home background, can be introduced during this period of rehabilitation, so that they can find their feet again within a healthy society. They need to know of such families all over the country, so that those who possibly gravitated towards London and have become drug addicts here can be restored to their own home area, and within responsible and healthy conditions.
Moreover, my Lords, I am told that there is a great need for psychiatric treatment centres, not necessarily devoted directly to the treatment of drug addicts, because a good many of these drug addicts have become so as a result of a deeper and more basic trouble. I have been given evidence, for instance, of a young man who was a homosexual and who took the drugs because of his own personal troubles. I was told that the worst thing that could happen to him was that he should go to a centre directed solely to the treatment of drug addicts, since he might there pick up with other people and get himself more deeply into trouble because his basic trouble was not being treated.
I want to end with two points, one a question and one a commendation. The first is a question about amphetamines, which have been referred to both by the noble Earl, Lord Jellicoe, and by the noble Lord, Lord Stonham. I understand that there is no legal control over 1305 the manufacture, the distribution or prescription of amphetamines. The noble Lord, Lord Stonham, spoke about the danger of methedrine. There was a very serious epidemic—and no doubt it is still serious, though I understand that a good deal of the impetus has moved away to other things. But if it is the case that the Government are powerless to do anything about the control of amphetamines, surely this is something that ought to be remedied. I hope that the noble Baroness, Lady Serota, will be able to tell us that the Government have some plans in mind in order to control this matter.
My last point is a commendation. I think the House ought to recognise and be grateful for those people who are doing such selfless and admirable work in the care and rehabilitation of those who are drug addicts. I think, in my own Communion, of the Reverend Kenneth Leach, working in the parish of St. Anne's, Soho, who has made himself a real expert in this subject. I think also of the Wantage Sisters at Spelthorne St. Mary, a home which for many years has been dealing with women drug addicts. I want also to reiterate the gratitude which I have heard expressed by those who are concerned in this field to the Home Office Drugs Branch, a body which has made itself very much available to all who are in trouble. It cannot often be said of a Government Department that it can claim the confidence of young people who are in trouble. Yet, so I am told, that is the position which those who are responsible for the Home Office Drugs Branch have created for themselves. One who has great experience in this said, "They are absolutely marvellous". My Lords, if there can be that spirit which is motivating the top, and if that can go down through the whole of society, then we shall create a sympathetic public opinion which is perhaps the best way of helping us to control and overcome this dreadful scourge.
§ 4.45 p.m.
§ BARONESS WOOTTON OF ABINGER
My Lords, I too am grateful to the noble Earl, Lord Jellicoe, for having introduced this debate, and I have particular reason for gratitude inasmuch as he very kindly postponed the date of the debate until I could return from an assignment overseas. I should like, further, to express my warm appreciation of the generous 1306 references that have been made in this debate to myself and my colleagues on the Cannabis Sub-Committee. The right reverend Prelate who has just sat, down said that I was well able to take care of myself. But it appears to me that there is no need for me to take care of myself in a community where I have so many and gallant defenders. I hope, however, that your Lordships will bear with me for a short time if I say something purely on the subject of cannabis and the Report of the Cannabis Sub-Committee.
I think it will be agreed that the Report of this Sub-Committee provoked what can only be called an hysterical reaction from a great part of the Press, from a considerable part of the public, and, I regret to say, apart from one or two outstanding exceptions, in the discussions in another place. I think the causes for this hysteria are quite familiar to students of social psychology. They occur also in other connections, particularly in relation to sexual crimes, and they are always liable to occur when the public senses that some critical and objective study threatens to block an outlet for indulgence in the pleasures of moral indignation. It is an occasion for very grave concern when young people ruin their health by taking drugs, without knowledge of the consequences or without regard for the consequences; but it is not a subject for hysteria.
I very much appreciate that this hysterical atmosphere has in no way penetrated into your Lordships' House, and that this debate has so far been conducted, and I am sure will continue to be conducted, on a plane of rational and thoughtful appreciation, and in an attempt to understand the real difficulties of the situation. I was therefore particularly glad when my right honourable friend the Home Secretary, in the course of the debate in another place, said that it would be as well if there were a cool and dispassionate consideration of the approach that we should make of this complex problem of the use of drugs. Whether his own speech measured up to that standard is a matter for everybody's individual judgment; but certainly I shall do my best to maintain this cool and dispassionate approach, while at the same time not minimisin3 the grave concern that any serious parson must feel about a problem of this order.
1307 I should like briefly to summarise, for the benefit of those of your Lordships who have not taken the advice of the noble Earl, Lord Jellicoe, and read this Report, what the Report said, what it did not say, and who said it; and I should like to take those points in the reverse order. First of all, as to who said it, the Report, one would gather from the Press, was the diseased brain-child of my own disordered and, in the opinion of some papers, senile imagination. But I would remind your Lordships that it was nothing of the kind. Among the signatories to this Report were some extremely distinguished medical men with specialist knowledge in this field, notably Professor Sir Aubrey Lewis, Emeritus Professor of Psychology in the University of London, and formerly head of the Maudsley Hospital; Dr. Philip Connell, a member of the World Health Organisation's Expert Committee on Drug Dependence and himself a specialist in the treatment of and research into questions of drug dependence; Dr. Thomas Bewley, also a psychiatric consultant specialising in this field; Dr. Nicholas Malleson, the head of the University of London Student Health Service, who is naturally very closely connected with the undergraduates in the university who may be liable to be interested in drug taking; and Mr. Kenneth Barraclough, a stipendiary magistrate in the London courts, who naturally sees before him a large number of cases of people of all ages charged with drug offences. I might even perhaps, at the bottom of that list, mention my own experience as the senior justice of the peace in the County of London, where I too have had to deal with a considerable number of drug charges. These distinguished gentlemen were not only signatories of this Report; they also contributed to its content and its shape far more than any layman like myself could possibly hope to do. So much, then, for who said it.
Next, what did it not say? I am extremely grateful to the noble Earl, Lord Jellicoe, for pointing out that it did not say that the sale of cannabis should be legalised. It did in fact say the exact opposite. I think I may save your Lordships the trouble of hearing again paragraph 71, in which the opposite was said, which the noble Earl quoted in the course 1308 of his speech. At the same time, there are serious arguments in favour of legalisation. I think that this Committee would have failed in their duty if they had not given those arguments very considerable and careful attention. I suppose the most fundamental of these arguments is the argument from personal liberty; the argument that adult men and women—juveniles are another matter—should be allowed to decide for themselves what substances they will consume, and that the State has no cause to interfere except when it can clearly demonstrate that damage is done to other people. In this connection, the Sub-Committee have been widely accused of taking yet a further step in the direction of what is nowadays called the "permissive society". Apart from one small point, which has not yet been mentioned and which I will come to later, I might say that this Report did not propose to make anything permissible which is not permissible already. There was no proposal to widen the area of permitted action, with one small exception which I will come to.
Here I should like to interpose a protest against the current habit of using the term "permissive society" with sinister undertones. I should have thought that any society which valued personal liberty would feel that the onus of proof was upon those who wished to restrict liberties rather than upon those who wished to preserve or extend them. This surely is the more important in view of the fact that a very large and varied number of restrictions upon personal behaviour are demonstrably and indisputably required by the complexities of our modern society. This, surely, is ground for looking with increased attention at, and scrutinising particularly carefully, any further proposals to restrict the liberties of personal behaviour.
The second argument in favour of legalisation is that so long as cannabis is a prohibited substance, anyone who consumes it breaks the law and, by necessity, associates with law-breakers; and he may associate with persons whose interest in this is far more sinister than his own. His own purpose may be purely experimental—rash and foolish, but difficult to describe as criminal. This is where the one serious danger of progression from cannabis to other drugs occurs. There is no physiological ground for 1309 supposing that such progression must take place. Indeed, there is a good deal of evidence that cannabis, unlike most other drugs, or many other drugs, does not induce a tolerance so that more and more has to be taken as time goes on in order to produce the desired effects, with the result that the person who is taking the substance loses his appreciation of it and turns to look for something else. Actually, in the case of cannabis there is some evidence of a reverse tolerance, a negative tolerance, and the desired effects are produced by smaller doses as the taker becomes accustomed to the substance, instead of demanding that the dosage should be increased. But so long as cannabis is illegal there may be social pressures which lead those who are taking cannabis into forming acquaintance and experimenting with more dangerous drugs.
This is the one serious ground for supposing that there may be progression, and even this has been rather considerably exaggerated, since it is clear that it is after all only a minority of those who use cannabis who ever progress to the use of the opiates. The argument the reverse way round, that every heroin user has probably at some time taken cannabis, is no proof at all. What one wants to know is how many of the cannabis users do or do not go on to heroin; and it is perfectly clear, although we cannot give exact figures, that the great majority do not progress. Those, then, are the two solid arguments in favour of legalisation, and they deserve to be considered.
Against them, on the other hand, are other arguments, and the Sub-Committee over which I had the honour to preside felt that the weight of these other arguments was greater than that of those I have just mentioned. First of all, cannabis is a very tricky drug. It is in some respects like alcohol. It is like alcohol in that it is usually consumed as an aid to social intercourse. Like alcohol also, its effect upon individuals is very variable, and its effect on the same individual at different times may be very variable; but this variability in the case of cannabis appears to be very much greater than it is in the case of alcohol. Some people undoubtedly take moderate amounts of cannabis quite safely over considerable periods, but immoderate usage, equally clearly, has 1310 considerable dangers. It might well be said that we have had quite enough trouble with alcohol, quite a large number of human wrecks who have become complete alcoholics, to warn us against extending the use of substances which might produce similar results, and unless and until it can be shown that cannabis is less dangerous than alcohol and would be an effective substitute for alcohol, it is far better to keep it on the danger list and let it remain prohibited.
The second reason relates to the very important question of road traffic legislation. We have found it necessary to lay down a maximum concentration of alcohol in the blood with which it is permissible for a person to drive a motor car. Unfortunately, up till now it is not possible to detect the presence of cannabis in the body fluids, and it is likely that since the consumption of cannabis distorts the sense of space and time it is extremely dangerous if taken by someone who is going to drive a motor car. Thirdly, we know very little about the really long-term effects. It was, after all, a very long time before we discovered the dangers of tobacco; and having had these warnings, the warning from tobacco and the warning from alcohol, it would, I think, be foolhardy at the present moment, with our knowledge in its present state, deliberately to expose ourselves to this substance which is relatively new to us.
Why then did we propose to lower the penalties? We proposed to lower the penalties partly on the principle which I think runs through the whole of our criminal law: that the maximum penalty that may be imposed bears some relation to the gravity of the offence. We wanted to make clear that cannabis is not heroin and that it is quite inappropriate that it should be bracketed in law with heroin and that the penalties for possession or sale of both these substances should be the same. We are interested to learn, since we produced our Report, that Dr. Dale Cameron, the Secretary of the World Health Organisation's Expert Committee on Drug Dependence, is reported to have given it as his personal opinion that to impose the same penalties for cannabis as for the opiates is to defy logic. I am sorry that I have not his exact words, but the effect is that it is monstrous that a 1311 pot smoker should be imprisoned for years and years. Just as in the case of the motoring laws speeding carries lower penalties than drunken driving, so we think it appropriate that the consumption of cannabis should carry lower penalties than the consumption of the more dangerous opiates.
Secondly, we were concerned that this difference was not apparently fully appreciated. We were concerned that whereas nine out of ten of the persons convicted of the possession or sale of cannabis were found with only small quantities in their possession—less than 30 grammes—nevertheless, one quarter of all the persons convicted of these offences are sentenced to prison, or, in the case of juveniles, to the equivalent places of detention. Seventeen per cent. of the first offenders in 1967 have also been subject to prison sentences. A prison sentence is a serious thing, and it is particularly serious in the case of a young person, if only because it is an absolute bar to certain professions.
We were asked further why we did not discriminate between the trafficker and the possessor. If your Lordships will refer to paragraph 84 of our Report you will find that we wanted very much to be able to make a distinction of this kind, and we did recommend that the possibility of such a distinction should be further considered by the Home Secretary. But at present, after looking at the practical aspects of the matter, we thought a test of intent would produce further uncertainty in the law, which in fact it was our wish to remove. That is why we did not recommend that that distinction should be made, much as we should have liked it to be effectively made. We felt that the best we could do was to leave a two-level penalty, one in the magistrates' courts and the other higher penalties on indictment. Prosecutions in the higher courts require the consent of either the Attorney General or the Director of Public Prosecutions. We thought we must leave it to those officers and those Departments, in the knowledge that it is difficult in an Act of Parliament to sort out who were likely to be traffickers and who were only relatively harmless users.
It has also been said that we know all that we need to know about the dangers of this drug and it is quite unnecessary 1312 to have further research. Anyone who has read the Appendix to our Report, so ably compiled by Sir Aubrey Lewis, will appreciate that further research is extremely necessary, since from that survey of the literature it is possible to quote instances of diametrically opposite views on practically every aspect of the taking of cannabis. I would refer your Lordships to some of the more valuable researches that have been initiated, more particularly in the United States of America.
I would mention particularly the researches of Professor Zinberg, who has made a serious attempt to make a completely objective study, with a control group, of the effects of cannabis upon volunteers. He has had two sets of volunteers, some whom were accustomed to cannabis and others who were, as he put it, "cannabis naïve", who had never taken it. These two sets of volunteers were supplied with a high-dose cigarette, a low-dose cigarette and a cigarette which contained no cannabis at all—a placebo. This was a double-blind test, in the sense that neither the recipients nor the researchers knew which of the subjects had received which type of cigarette. Immediately afterwards they were tested by various psychological tests on their skill at performing the kind of tricks which psychological tests expect you to perform, and no difference was found in the performance of these two groups. Professor Zinberg's own conclusion is that cannabis appears to be a relatively mild intoxicant, and one of its features is that those who use it and are subject to its effects are better able to suppress those effects, if they want to, than are the users of alcohol; and this he thinks is an aspect of the subject that deserves further examination.
My Lords, I think I can speak for my Committee without any hesitation when I say that we were glad to hear from the Home Secretary, and again from my noble friend Lord Stonham to-day, that it is proposed to have a complete overhaul of the drugs legislation at the earliest possible moment, and that it is proposed that we should adopt some form of legislation which will give us greater flexibility. At the same time, I would throw out a warning that the sanctions of the criminal law have not yet proved very effective in this field, and I have great 1313 sympathy with the points that were put by the noble Lord, Lord Henley, as to the remoter causes of the addiction of the present generation to the consumption of these particular substances. This has not only been the experience of our own country but is the experience even in countries where the criminal sanctions against the consumption of cannabis and other drugs are infinitely more severe than they are in this country at the present time. In all parts of the world it seems that the consumption is increasing, and it is clear, therefore, that whatever may be done with the criminal law this will not of itself be enough.
I hope that I have not taken too much of your Lordships' time in summarising the Report, which I think you will agree has been represented in very distorted terms in the public Press. My contributions to your Lordships' debates are not very frequent, and I think they have generally been fairly brief. If I have outdistanced my normal time I hope that I may be forgiven, on the ground that this is a matter of very great public importance and, indeed, of some personal importance to myself.
Perhaps I may conclude upon a slightly lighter note, one that will illustrate to your Lordships the extreme difficulty of arriving at accurate opinions as to the effects of various drugs. I am going to refer to a drug which was known early in Chinese history and was then commended as:highly prized for possessing the virtues of relieving fatigue, delighting the soul, strengthening the will and repairing the eyesight.A good many centuries later—namely, at the beginning of the present century—the same drug was referred to, in a standard medical textbook by the then Regius Professor of Medicine in the University of Cambridge—a distinguished-looking old gentleman whom I can just remember from my own childhood. In that textbook it was said of this particular drug:It is especially efficient in producing nightmares, with hallucinations which may be alarming in their intensity. Another peculiar quality of this drug is to produce a strange and extreme degree of physical depression. An hour or two after it has been taken, a grievous sinking may seize upon the sufferer so that to speak is an effort. Speech may become weak and vague. By miseries such as these the best years of life may be spoilt.My Lords, I regret to say that this is a drug to which all the evidence shows your 1314 Lordships' House is seriously addicted; and the drug in question is tea.
§ 5.10 p.m.
§ LORD O'HAGAN
My Lords, I should like to thank the noble Earl, Lord Jellicoe, for bringing up this subject in your Lordships' House and, if I may do so, for the way he did it. I have little to pontificate about—that is particularly lucky for someone who has to follow the noble Baroness, Lady Wootton, with her deep knowledge of the subject. I hope noble Lords of wider experience and knowledge will correct me if I have my facts wrong, but it may be of some use if I, as a 23 year-old, attempt to examine how the problems of drug dependence relate to young people.
At the risk of vain repetition, I would remind your Lordships that cannabis convictions in 1960 amounted to 255, in 1964 to 544, in 1965 to 626, in 1966 to 1,119 and in 1967 to 2,393. I would accept the view of the Wootton Report that the rise is in part due to the increased formation of drug squads. Yet we should also look at the growth of the total number of heroin addicts under 20 known to the Home Office. As the noble Earl, Lord Jellicoe, reminded us, in 1960 there was one, in 1964 40, in 1965 145, in 1966 329 and in 1967 395. I could get figures only as far as 1967, but I believe the noble Lord, Lord Jellicoe, said that in 1968 the number was over 800. The numbers are not large, but once one has started on heroin the chances of getting off it are very low. The long-term cure rate in the U.S.A. is about 5 per cent. I believe.
The mortality rate of the British male heroin addict is nearly twenty times as high as that of a normal cross-section of similar age. And each new addict is a source of infection to others. Convictions under Section 1 of the Drugs (Prevention of Misuse) Act 1964 amounted to approximately 1,017 in 1965 and 1,330 in 1966. For 1967 there are figures available for adults and minors separately. Adults accounted for 857 convictions, while minors provided 1,059, more than the total for all convictions only two years before. The position is not improving, to say the least. Young people are increasingly drawn to drug abuse.
1315 In some ways it could be said that Her Majesty's Governments have been to blame. The climate of opinion is a nebulous thing, but when the general feeling is "Feel ill, take a pill", people grow used to filling themselves up with all sorts of substances. Many very powerful drugs are readily available on a prescription, which can be obtained at little cost and effort. Amphetamine abusers sometimes find, or used to find, a doctor with a blind spot and have access to large supplies. I am not, of course, suggesting that National Health Service doctors deliberately contribute to the problems of drug dependence, but they habituate people's minds to taking stimuli. I am here touching on some of the points made by the right reverend Prelate the Bishop of Chester.
The public has become used to being given powerful drugs on medical advice. The old-fashioned and ignorant pride over never going to the doctor has been stood on its head. I gather that 4,000 million tablets of acetylsalicyclic acid were sold last year in this country. I cannot believe that all those aspirins were really necessary. Every day new drugs come on the market. Many of them can be abused. One pill looks like another. And if the general public is so used to mucking about with their bodies and minds young persons in uncertainty or rebellion may well go further.
But still, drug dependence in the limited sense I have been talking about is not as serious in this country as dependence on alcohol. As your Lordships will know, there are some 200,000 alcoholics in this country. But alcohol is not so trendy as, for example, cannabis. Why is cannabis trendy? Partly because of its pleasant effects, but more importantly because of its social implications. Here I endorse much of what the right reverend Prelate had to say. Cannabis is a relatively new phenomenon for most people here and therefore the subject of curiosity. It has a mystique, not the mystique of Dennis Wheatley or Khubla Khan, although its image is exotic. It is perhaps held to be the key to a secret garden full of special beautiful people. The young cannabis abuser may not enjoy his experiences at first, or at all. But he feels, in Francis Thompson's phrase, an "elect outcast". Perhaps we can liken 1316 the young cannabis abusing groups to the schoolboy gangs that smoke up the chimney; there is the thrill of joint forbidden activity. Each individual has proved to the others that he is one of the boys, one of the hard men.
Cannabis abuse among the young tends to be a social activity, a group pastime. This is in part due to the conformity of teenage groups. The code, dialect and appearance of the "hippy" was as rigidly prescribed as that of an army officer, at least in some cases. The embryo drug abuser has often discarded many usual standards and chosen new ones. So the abuse of cannabis is a secret sign, a private caste mark, an act that demonstrates independence from generally held views. Two other linked factors add further attraction; constant publicity and the connection of the "pop" world with drug abuse. And, as with the schoolboy, some of the attraction is the opposition of the authorities.
The law is not my province, but I must touch on it briefly, if only to extend my analysis of the social causes of drug abuse among the young. The seriousness of legal penalties influences the attitudes of parents and educational authorities, who may be ignorant of the true nature of the dangers of drug abuse. But if they know nothing else about drug abuse, they know that it is illegal, and as a result cannabis abuse becomes even more of a "Here I stand" for the young experimenter. It is not desirable to make it easier for the 16-year old, or the 14- or 12-year old, or younger, to start on the road to heroin. If I may say so, with all respect, I found the Wootton Report's section on progression (paragraphs 48 to 51) rather unsatisfactory, although I was somewhat reassured by the speech of the noble Baroness this afternoon.
Again I echo the views of the noble Earl, Lord Jellicoe. We know that psychic or psychological dependence on cannabis can help alienate the abuser from society. Furthermore, my view follows that of the World Health Organisation as expressed by Mr. N. B. Eddy in their fifth bulletin of 1965—and I may be out of date—which says:Abuse of cannabis facilitates the association with social groups and sub-cultures involved with more dangerous drugs, such as 1317 opiates or barbiturates. Transition to the use of such drugs would be a consequence of this association rather than an inherent effect of cannabis. The harm to society derived from the abuse of cannabis rests in the economic consequences of the impairment of the individual's social functions and his enhanced proneness to asocial and anti-social behaviour.Progression is still debatable. Changes in the law must not fail to take this into account.
How do we make drug abuse less attractive? As is generally known, cannabis is not physically addictive; one does not acquire a tolerance, or so it seems likely; harmful side effects have not yet been proved. Indeed these points encourage the hesitating to try: "Go on, it does not harm you". Much more research is needed, as the noble Lord, Lord Stonham, and the noble Baroness, Lady Wootton, pointed out, although I was glad to hear what the noble Baroness had to say about developments in the United States. But so far as I can tell there are no carefully controlled clinical studies of the effects of cannabis on the central and other nervous systems.
I hope that this and other important areas of ignorance will be explored by the three working parties set up to study the problems of drug dependence and by the new Institute for the Study of Drug Dependence which were mentioned in the Wootton Report. If possible, the results of tests on the effects of drugs on artists should be published and publicized. Would-be creators think that drugs may help them. The young often believe this and think that they will be the next Rimbaud if they have a few puffs of cannabis. Is this true? Kenneth Allsop, in a recent article in Encounter, noted that the perceptions, poetic or otherwise, induced by a particular drug do not vary widely from one person to another; the visions are all much the same. But this is tentative. Another view to which I incline needs exploration. I think that many drugs, whatever they do for the creative urge, dissipate the self-control needed for effective artistic creation. The technical skills and the power of direction seem to be dissipated. Miss Alithea Hayter, in her Opium and the Romantic Imagination, when she was talking of Coleridge, de Quincey and others and their dependence on opium, said:Many of these writers felt that they had been endowed with an exceptional insight into 1318 the secrets of the universe and could reveal its philosophical framework for the enlightenment of mankind; but the great work could never be finished, because the power to hold things together had gone, everything disintegrated, fell away into fragments.I suspect that this statement applies to other people too.
Professor Bergel, F.R.S., whose help I should like to acknowledge, had a letter in The Times on January 22 of this year. His attitude on the problems of drug dependence and misuse is mine, but he puts it better than I can, so I hope that your Lordships will bear with yet another quotation. He said this:I am convinced that the main approach to the whole drug problem should be an intensification of the education of all age groups, by giving them as much information as is available. In my humble opinion, far more imaginative and convincing discussion by educators, youth leaders, friends, former addicts, and, last but not least, parents should take place to help urgently all who are exposed to fashionable temptations. This can be supported by equitable penalties, which however, cannot adequately replace instruction s and educational programmes, backed by physicians, surgeons and general practitioners. As the American Committees say"—he was referring to the Council of Mental Health Committee on Alcoholism and Drug Dependence of the American Medical Association and the Committee on Problems of Drug Dependence of the National Research Council—an informed citizenry is the most elective deterrent of all.By all means, my Lords, let us be generous to the youthful experimenter who gets caught and by one piece of folly may prejudice his whole career, but let us stop him reaching the point where temptation is too strong. To present the facts, and to make drugs, especially the commonest, like the amphetamines, cannabis, and the nasty LSD, seem ordinary, unnecessary and, if possible, boring is the best answer. I think a good approach is that healthy people do not need drugs. Little ground will be gained by glutinous appeals to morality or by inveighing against drug takers. Pupils may admire Charlie Parker or de Quincey (to name only the dead) more than their headmaster.
The legal and medical position must be made clear. The glamour will be reduced if the squalor is made obvious. Some local authorities are sending round films. This is a vivid way of explaining the pitfalls. But the aim should not be, 1319 "Terrify them!". Information, frightening information, too, must be presented, yet it is condescending to think that terror alone will work. Inside the school, which apart from the home is the best avenue for deterrence, a combination of several approaches must be tried. Discussions on the medical facts, led by a respected teacher, will probably be more effective than a lecture from an outsider. Both techniques could be used, with films and leaflets providing ballast. Ex-drug addicts could come and talk. Prefects must be briefed properly, and the whole process should start quite young—at least in the 14 to 15 year old age group, if not before.
I have made private investigations into the paths which the schools are pursuing to deal with the problems of drug abuse among the young. It is vitally important, for the young abuser, if he continues, will be a pocket of infection in the society of the future: and from experimenting he may end in dependence. The fashion must be stopped before it gets any nearer to being endemic. While some schools—and I sampled both private and State schools—were realistic in their outlook, some can be described only as shortsighted, complacent or foolhardy. In some cases the underlying attitude seemed to be "it would not happen to our pupils". In others, the problem was thought to affect only the more senior boys. This is not good enough. In this country young abusers tend to be the better educated, or so I gather: the reverse of the situation in the U.S.A. Drug abuse is prevalent at places of further education. Without wishing to sound elitist, I would say that it is surely undesirable that those who are capable of advanced courses of study should be handicapped by drug abuse which could have been prevented by a better system of health education in its widest sense. Otherwise, what a waste of money! What a waste of talent! What a waste, too, perhaps, of life!
Your Lordships may have read a rather highly coloured article in the Daily Express of March 11 of this year. A Dr. Blum, of San Fransico, was reported as saying:In the last eight years we have watched the age level of drug users in California drop from adults to elementary school children.1320 The Report said that Dr. Blum had found that many 10 and 11 year olds were being exposed to cannabis. My Lords, there is no need for panic. But all social workers, youth leaders, teachers—anyone who has responsibility for the young—must be provided with the right information, so that curiosity and inquisitiveness are satisfied before the pressure to be "one of the gang" leads young people to experiment with drugs. I understand that in Jersey a standing group under the education authority, and consisting of one or two parents, one or two teachers, one or two lawyers, and one or two doctors especially interested in drugs, will be set up shortly. This sort of corporate effort can do nothing but good, especially if it brings in the parents as well, for a good home is the best safeguard of all. So the better informed the parents are, the better for the children.
It was only in 1961 that the first Brain Report found that the taking of habit-forming drugs was not increasing in this country. As was pointed out by the noble Earl, Lord Jellicoe, they soon had to think again. The situation must not be allowed to grow any worse any faster. Let us try to limit the drug habitués' menu. The pusher must be dealt with severely, and when young people are tempted they must know what these attractive-sounding items really involve.
§ 5.28 p.m.
§ THE EARL OF HUNTINGDON
My Lords, I think that in this House we should all agree about the danger of drug addiction and the horrifying effects it has on the wretched addict, particularly the addiction to heroin and cocaine which are absolute killers. At the same time, I should like to endorse what the noble Baroness, Lady Wootton, has said, that we must not become hysterical over this matter. It is a matter which we should examine carefully and coldly in order that we may take the best course of action and get the best results. I am afraid that if the prevailing hysteria is carried further we may take steps which ultimately would make the results far worse than the present situation.
I should like to add how much I, too, regret that the Report being discussed this afternoon was received in such an adverse manner. It seems an extremely good and fair Report, for which I am sure all your Lordships are most grateful, as 1321 you will also be for the speech of the noble Baroness which was most enlightening and helpful to us in our discussion on this subject. I am frightened as a result of the experiences I had in America before the War. I was there for about three and a half years, mainly during the prohibition period. There was the same sort of hysteria and the same fear generally spread throughout the United States after the First World War as we have here. It resulted, as we all know, in legislation which totally prohibited the sale of alcohol in any State.
This legislation was brought in by the most well-intentioned people to try to stamp out a great deal of drunkenness which was endemic in America at that time. I can assure your Lordships, from my own experience, that the results were absolutely catastrophic. Not only was there far more alcohol consumed, but drunkenness increased enormously, and as a side effect in many cities gangsters practically took over and ran whole districts. Worse still was the spread of corruption all through society, including even the police and, in some cases, city councillors.
There were two reasons for this spread of corruption. One was that public opinion did not respect the law; people did not really believe that such a law was right; they were determined to have their drink and they thought they were entitled to it. The other cause was the profitability of selling liquor of all kinds on the black market. There was an enormous black market with ramifications spread all through the States bringing really the most ghastly results. There was the selling of bad liquor which made people blind—they literally lost their sight—and there was the spreading of ill-health and alcoholism everywhere. Incidentally a very peculiar phenomenon arose, in that towards the end of prohibition there was this strange alliance, an undercover alliance you might say, between the prohibitionists, the people of good intention, and the bootleggers and those manufacturers of what they call "soft drinks", who naturally profited by prohibition, who were all working together to keep prohibition going. There was a great deal of difficulty in repealing the legislation because unfortunately it was written into the Constitution.
I have mentioned this example only because I think that the danger we have 1322 to guard against is the spread of a black market in drugs, which could very easily happen. Once there is a profitable black market the whole situation becomes infinitely worse almost overnight. So much has been said that there is very little one wants to add, but I personally hope that in this future legislation—which I am glad to hear is to be considered—drugs will be divided into the different categories, and that such drugs as heroin, cocaine, and so on will be separated from the milder drugs such as cannabis.
In the past few years I have lived for quite some time in North Africa, in Morocco, and there the smoking of what they call kief, which is the equivalent of cannabis, is almost universal. I believe that one of the reasons for the start of the habit—a habit which has been going on for a very long time—is that the Koran forbids the consumption of any alcohol, and that therefore instead of alcohol kief is smoked. I have spoken to many people, both Moroccans and foreigners living there, and so far as I could see—although there were obviously some terrible cases of real drug addiction—on the whole the effects were not as bad as the result from alcohol in this country. There were a few cases of people consuming to excess with unfortunate results, but I do not think it affected the mass of the population so very seriously. That is one of the reasons why we should make the punishments much less for the milder drugs, and possibly even consider legalising them in due course.
I should like to support two things which have been said this afternoon: the extreme importance of research in order to find out what causes people to want to take drugs, what the effects of the drugs are and how these can be coped with. I believe that very little research has been done in relation to the amount which is needed. I think a great deal more money and attention should be devoted to that question and obviously a great deal more can be done in education. I think the one hope of checking this very serious state of affairs is by educating the young in order to get a climate of opinion which appreciates the danger from drugs and which would encourage people to reform and not to take them. As has been mentioned, highlighting the idols of the young, the "pop" singers, and 1323 trying to make spectacular cases of them, is having exactly the reverse effect to what is intended: it is making them glamorous and making drug-taking glamorous instead of discouraging it. But I agree that this may be a matter of opinion.
The last point I wish to make is that I think it is very important to keep the good relations between the public and the police. If you give too much indiscriminate power to the police I think you not only hit at the liberty of the subject—which we are all trying to preserve—but you might well alter this good fellowship, this co-operation which I think we get in this country and which is so vitally important to us. I do not want to take up any more of your Lordships' time, but I would plead that in any review of legislation we should examine this matter rather more calmly and scientifically in order that the best results should follow.
§ 5.36 p.m.
§ LORD AUCKLAND
My Lords, at a time when "drug" is becoming almost an emotive word it is fitting that we should discuss this very vital and serious social problem, invoking the wisdom of your Lordships' House. My noble friend Lord Jellicoe (whose speech I unfortunately missed, as I had to go to Essex to a school prizegiving; and I apologise to the House for being late in arriving here for that reason) has performed a most useful service in bringing this problem before your Lordships' House.
I would endorse what has been said about the Report of the Committee presided over by the noble Baroness, Lady Wootton of Abinger, although I think the Press were not quite so unfair as has been made out. I think there was one particular section about which they were critical, and that is paragraph 89, when it came to the subject of penalties. The person responsible for the Reservation, Mr. Peter Brodie, the Assistant Commissioner of Police for the City of London—I believe I have the title right—is a man I have known for some years. I knew him, when he was Chief Constable of Stirlingshire, as a man of much wisdom and experience, and I think his Reservation was one of restraint and wisdom, because there is no doubt that those who peddle drugs, particularly 1324 cannabis and the like, must face the full blast of the law if this particular aspect of the problem is to be solved.
I have given the noble Baroness notice of two or three questions that I wish to ask. The first is on the subject of education, already touched upon by a number of noble Lords, and particularly by the noble Lord, Lord O'Hagan, whose very wise speech I am sure we all listened to with the greatest interest. It is very important that a person of his age should be able to make his views known on a subject of this kind, particularly when done with such knowledge and wisdom.
I should like to know whether in schools and technical colleges, where one can reach the older children and youths, regular lectures and talks on this subject are given by those qualified to do so. Doctors and magistrates could be put to good use by going round some of these schools and talking about this problem; and they could perhaps illustrate their remarks by pictures since children are always more impressed by picture than by word of mouth. Older children should be visited also by representatives of the pharmaceutical industry. There may be a danger that drugs are regarded as evil and undesirable (as indeed they are if misused and put in the wrong hands), but many people owe their lives to the enormous amount of research that has been carried out, not only by the pharmaceutical industry but by all the people who are concerned in the matter, into the manufacture and testing of drugs. This aspect of the matter needs to be put on record.
There is also a danger that the extent of the problem of the numbers who get hooked on these drugs may be exaggerated. One does not want to minimise the problem. Anybody who has served on a hospital committee (I serve on a hospital committee in Epsom, an area in which there are a number of drug addicts) and who has seen, as I have, a young person hopelessly hooked on a drug of this kind, will not easily forget the problem or seek to minimise it. Similarly, magistrates will always remember those hopelessly addicted to drugs who appear before them in the courts. I do not think that the number of such people is large, but that does not make the problem any less distressing.
1325 I turn to the question of security, which is a vital matter in our hospitals. I do not know whether there have been any instances of serious thefts or robberies from hospital pharmacies where large quantities of drugs are stored. I am thinking particularly of mental hospitals, where at night the main gate may be manned by only one person. It would be comparatively easy for a gang to overpower that man and to gain access to the hospital and possibly to the drug cupboard. I do not wish to make a great issue of this point, but in the context of this debate it needs to be looked into. Is the noble Baroness who is to reply able to give any information about security measures contemplated in the new legislation which is foreshadowed for the whole of the drug industry?
The pharmaceutical companies, a number of which I have visited, go to considerable lengths to ensure that neither their employees nor visitors get hold of drugs, and particularly the amphetamines. To quote one example, when my wife and I visited a large pharmaceutical factory in Hertfordshire, we handled one of the "purple hearts", as they are popularly called. As soon as we had handled it, the person who was showing us round took it from my hand, threw it on the ground, and stamped on it. We were bluntly told that whoever goes round the factory has that kind of treatment meted out to him, and it is right that that should be the procedure. Such caution can help to give people in general the right sort of attitude. Then there is the danger of the hi-jacking of lorries on the motorways on which drugs are carried. Serious problems undoubtedly occur if these drugs get into the wrong hands. The industry has a very good record in security matters, and I believe that its labelling procedures have greatly improved.
In the matter, of drug dependence one must differentiate between those who take drugs for therapeutic reasons (and a large number of people fall into this category) and those who simply take them and get hooked on them. Then can the noble Baroness say anything about the number of hospital beds which are at present occupied by those receiving long-term treatment for drug effects? This is a serious problem at a time of serious shortage of hospital beds. Legislation in this matter is urgent. Finally, could we 1326 be told when the names of the personnel of the Medicines Commission will be announced? Have the Government any idea what is the situation following the important legislation emanating from the Medicines Act?
§ 5.48 p.m.
§ LORD SOPER
My Lords, I am tempted to follow the invitation of the noble Lord, Lord Henley, to speculate on the particular and profound reasons why this increase in drug-taking has taken place. Because I wish to devote my speech almost entirely to what seems to me to be the most penetrating of all the aspects of the case as presented to your Lordships by the noble Earl who introduced the debate, I will mention only two which bear on the topic on which I wish to say something.
I believe that we need to look with much greater care at the rehabilitation of those who are affected by drug addiction. In the largest sense of rehabilitation, we must address ourselves to the whole attitude, the Weltanschauung, of older people and younger people to-day. There seems to be a profound difference between the reasons for the addiction to alcohol (which John Wesley described, with fluency and accuracy, as "Two-pennyworth of gin to get out of Manchester") and the reasons for so many young and older people to-day being addicted to drugs. In the past, for many of those who resorted to alcohol it was an escape from misery. To-day, it is an aspect almost of affluence for many of those who resort to drugs. Far from thinking that most of them begin this activity by reason of some deep-seated motive, I suspect that a great many of them start for nothing more profound than the "kicks". Having no taboo or religious principle to deter them, they see no ethical problem in treating any new adventure as perfectly acceptable.
To this there may be added one other characteristic which seems to me to be fairly prevalent to-day, and that is the almost complete breakdown in the minds of many young people of the 19th century aberration from truth which asserted the general progression and inevitability of moral and intellectual progress. Many of the youngsters with whom I have to deal—and I do not pretend to be one of them—profess an interest in to-day because they have very little confidence in 1327 to-morrow. If we are to rehabilitate those who have become the victims of either of these attitudes, then how right the noble Earl was in saying that at one stage in this process we must seek the means of the hostel of one kind or another! I shall not delay your Lordships long, but I would point out straight away that there are three sorts of custodial, or semi-custodial, treatment which may supervene upon an earlier period of compulsory segregation; and to this matter I have no doubt my noble friend Lord Donaldson of Kingsbridge will address himself.
There is, in the first instance, the clearing house, the short-term residence for those who can be taken off the streets, or those who have wandered in in a vagrant fashion to the centres of drug addiction, many of which are not far from your Lordships' House. This has to be a very short-term exercise, but unless there is somewhere to which, immediately, the drug addict who is prepared at least to consider such domiciliary residence can be taken, it is highly likely that with his bird-like mind and attitude of vagrancy he will not in fact submit to a longer-term rehabilitation process. It so happens that I was within half-an-inch of acquiring such premises, which must be in the centre of the area where the drug addict is likely to be found. I shall come to that in a moment, because the reason why it failed is very germane to your Lordships' concern.
The second kind of hostel is the hostel required where the prospect of rehabilitation is fairly high. This would probably have more to do with those who have not yet matriculated from the softer drugs to the harder and more potent drugs. Here it would be necessary to mingle an atmosphere of friendship and of community with all the technical skills that would be required to wean the young—and particularly the young—would-be addict at the stage at which he is amenable to discipline. Unless he can be so domesticated, it is idle to think that most of such young addicts will subscribe for any length of time to the outside extra-mural opportunities which will be offered to them. It is a matter of absolute cardinal importance, in my experience, that, unless you have a reasonable hold which is both voluntary and yet stringent upon them in the earlier 1328 stages, it is foolish to think that your hostels will be filled; and it is even more foolish to think that the rehabilitation process will be successful.
But I am afraid there is a third group. We have talked a good deal about the rehabilitation of the drug addict. I wonder how many of them will never be rehabilitated but can be brought to a certain stage of convalescence. But if they are to make any "fist" of the remaining years of their lives—which may not be very many—these derelicts who have lost many of the dimensions of recovery will need assisted housing of a very radical kind. If we are to face this problem with any sense of rigour and urgency, then this type of hostel must be considered as part of our programme; a hostel in which we must be prepared to see for very long periods the recidivist addict at least protected from the worst aspects of his addiction. Those are the three kinds of hostels.
Are they to be voluntary? I am sure they must be. If they are to be voluntary, why are there not more of them in existence now? When it was found that the particular hostel in Soho, in which I and friends of mine were interested, was to be a hostel for addicts, there was immediately a brouhaha. Indeed, there was more than that; there was such violent, immediate and uncritical opposition that the whole project fell to the ground. I was disagreeably reminded of precisely what happened in the last days of the L.C.C., when we were concerned to try to find a hostel for the poor relations of the alcoholics, the spirit drinkers; of how we found an excellent hostel in another part of London, and of how, as soon as it became known that it was to be such a hostel, there was a similar programme of antagonism, uncritical, most of it visceral rather than cerebral—the kind of opposition which made it completely impossible for us to go forward. We had acquired two other sets of premises only last week. These premises also have been unattainable for precisely the same reason.
I have great sympathy for those who fear that such hostels next door to their residences would prove sources of infection and of all kinds of disagreeable conduct and performance. But I should like to tell your Lordships that, having been responsible for a hostel for alco- 1329 holics in a crowded part of South-East London, I cannot record in the last ten years more than one complaint by residents of behaviour that was detrimental to the amenities of the particular area. In any case, the community in which we live must take a greater measure of responsibility, particularly because one of the reasons for drug addiction is the cultivated indifference of so many people to the welfare of those who live near to them.
Therefore, my Lords, I very much hope that there will be a greater sense of responsibility among people who perhaps would have to face a little inconvenience. I also hope that there will be a much more determined effort on the part of voluntary societies to find the kind of accommodation which is sufficiently remote to offer at least an answer to those who would profess that such accommodation was unacceptable to them. Of one thing there is no reasonable doubt at all; and that is that a process of education, which is imperative—a process, I think, of the rehabilitation of idealism—and which is also peremptory, will have little effect unless we can create in the addict who has become a lone wolf the new sense that he belongs to a community which does not condone his vice but understands his condition, and which is, above all, concerned to seek his rehabilitation.
§ 5.58 p.m.
§ LORD DONALDSON OF KINGS-BRIDGE
My Lords, I think I can be very brief in what I have to say. I shall confine myself to the question of heroin, to the matter of treatment and aftercare, and to the experience of the Prison Department in this respect. Curiously, this subject has been left out of the debate this afternoon. Most of the people we have been talking about end up, sooner or later, in front of a prison doctor, so this is not an experience to be ignored.
It seems to me that there are three stages. There has to be a drying-out stage, which can be, or which certainly used to be, a very terrible stage with hard drugs. Then there has to be a long stage of complete separation between the addict and the drug. Thirdly, there has to be the stage of support outside. I went this morning to the drug addict unit of Brixton Prison and talked to the doctors 1330 and to one or two of the people receiving treatment there. The doctors surprised me by saying that they are now quite capable of weaning any addict from his drug by use of the alternative drug, physeptone, of which we have already heard. It is obviously a dangerous and difficult drug, but it is administered under 100 per cent. medical supervision. The men are in a ward with a nurse, and are dealt with by a doctor. I saw a man who had been on full drugs up to 48 hours ago. He had been weaned straight across, and although he complained of feeling rather uncomfortable and not very happy he was no worse than that. This apparently is standard, as a matter of weaning. If the weaning can be done as efficiently as this in prison, it leaves us with the usual problem we always meet when we turn people out of prison, namely, that after that they are left to float, and all the good is undone.
I think it is worth looking at some figures. Last year, 235 heroin addicts passed through this unit. Each one was successfully weaned and no heroin was administered at all, although the unit has the right to do so. They reckon to see about one-third of the total of male heroin addicts, and Holloway reckons to see about one-third of the total of female heroin addicts. There is one rather interesting point there. Although the females in prison comprise 3 per cent. of the total population, the females under the addiction of heroin comprise between 20 and 25 per cent. of the heroin-addicted population, which is rather a terrifying thought.
A year or two ago, 94 heroin addicts passed through this unit—they go there on remand—and Dr. James, who is in charge, made a record of what had happened to them afterwards. It is quite interesting: 25 were conditionally discharged, 19 were put on probation, 24 were put on probation with attendance at a hospital as a condition, and 8 were given a suspended sentence. Only 24 went to prison. Of those 94, in my view the only ones who had the faintest chance of surviving were the 24 who went to prison, because there was nothing to keep the others away from Piccadilly Circus. I think there is absolutely no hope that people who have been properly addicted can, after three or four days' 1331 weaning, look after themselves. Therefore, it seems to me perfectly clear that there must be a sentence which includes the weaning period and a period of something like eighteen months or two years, where, under perfectly tolerable conditions but maximum security in relation to drugs, these people can be cured. After that, we come to the suggestions of my noble friend Lord Soper, but I would hesitate to send drug addicts to him until they had reached the end of the second year, or that sort of period, because I think their chances are otherwise very slim.
I consider that it is most important that the Home Office and the Ministry of Health between them should lay down what they want in the way of after-care centres. If they do that, people like Lord Soper and other friends that we have will provide for them. There is no particular difficulty in this matter. What we do not know is what is required or how to deal with it. So I think there is a three-fold sentence required. I should like to see a man sentenced to a period under anti-drug detention, or whatever it may be called—semi-penal detention—with a parole period afterwards of compulsory after-care in some kind of hostel. I should not hesitate to use compulsion. I have always been bitterly opposed to compulsion in the cases of other categories of prisoners. I do not believe in compulsion for inadequates, homosexuals or anybody else; I do not think it works. On the other hand, I do not believe that in these cases anything else works.
My Lords, there are two other points that I should like to make. The first and main one is to support my noble friend in his remarks about the difficulty in finding a site. He quoted his own case and another case in which the neighbours objected. But most of us here know of the case of the Simon Community, where it was the local authority who objected. They objected because they said that "meth" drinkers were being brought into the area, whereas in fact the Community were picking up "meth" drinkers who were lying about in the area. It is hopeless if people of good will get so little encouragement. I know that the Ministry of Health or the Home Office cannot give advice directly to local 1332 authorities, but I feel that if, somehow or other, they could give some sage advice it might make all our lives rather easier.
I understand from what my noble friend Lord Stonham said that there are one or two drugs of the LSD type which ought to be on the index (or whatever it is called) in the Schedule to the 1965 Act and which are not. He said that the authorities cannot put them on. I think that is absolutely absurd. If they cannot be put on, then let us have a short Bill—it would take a quarter of an hour—and do it in that way. Nobody can think that drugs of the LSD type ought to be easily available. I have not actually taken mescal for about forty years, but when I did it was in company with the Knightsbridge Professor of Philosophy at Cambridge and under the soothing and careful supervision of my noble friend Lord Adrian, who sometimes sits on the Cross-Benches. But the result was absolutely awful. I did it twice, and each time it was the most beastly experience—quite as bad as that which my noble friend Lady Wootton reports of the regius professor when he drank tea. One had a feeling of appalling and universal depression. It is a very terrible thing. It is perfectly clear that anything which can change one's personality in that sort of way must not be let loose on people, even though some people see new colours—which is what we were hoping to do at that age but did not. But that is no excuse.
My Lords, that is all I want to say. I feel that there is a three-fold form of treatment and after-care which is absolutely obvious, so please let us administer it. It will mean legislation, I believe—I do not know—but, if not, it is perfectly clear that nothing else is much good. Secondly, if really dangerous drugs cannot be listed in an existing Act, may we please have a Bill in which to put them?
§ 6.7 p.m.
§ LORD FERRIER
My Lords, when I was 14 years of age a friend came to stay with my widowed mother and brought her husband with her. This shadow of a man was the holder of the Victoria Cross, which he had won as an officer in the R.A.M.C. for tending the wounded under fire. He was a hopeless morphia addict. He had been, I understand, a particularly strong character, 1333 physically and in every way, and he had picked up the addiction through giving himself stimulative shots during his arduous duties in hospitals during the South African War, believing that he could resist the hooks of addiction. This he failed to do. He had also, as so often is the case, become somewhat addicted to the bottle; and I shall never forget that, as a boy of that age, I was frightened by this great, big, quiet figure moving about the house, sometimes at night, mumbling and singing below his breath, and so on. In fact, this has had an effect upon my attitude towards this question of drug addiction all my life.
For some years, not so long ago, I was connected with a company manufacturing opiates, and I was consequently continually in contact with people who knew about the subject and who handled their problems and the stuff itself as part of their daily lives. I was particularly impressed with what the noble Lord, Lord Auckland, said as to his impressions of a pharmaceutical establishment. One of the things that impressed me was that these people, who were in close contact with the whole matter, had the most rigid code of discipline—not only the discipline of the parade ground, as it were, but a discipline of the mind arising out of the respect which they had come to have for the terrible dangers of drug addiction. In the course of that connection I also had occasion to have dealings with the Home Office, and I should like to reiterate what has already been said by other speakers about the great respect in which they are held in the industry and about the wonderful work which they do in connection with protecting our community from this dreadful drug problem.
So, my Lords, at the two ends of the scale I have reason to be deeply impressed by the problem which confronts us; and, as the father of a family, I have warned and warned again that no one should ever experiment with a drug of addiction. No "new adventure"!—these were the words used by the noble Lord, Lord Soper. It is not every experimenter who might be as lucky as the noble Earl, Lord Jellicoe, who got one of the effects of hashish. Another, I understand, is loquacious euphoria.
§ LORD FERRIER
My Lords, I was going on to that. I believe that it is. Despite what the noble Baroness has said, I believe that no society should permit such experiments, and I agree very much with the right reverend Prelate—
§ BARONESS WOOTTON OF ABINGER
My Lords, will the noble Lord forgive me if I point out that I never said, and neither did my Committee, that such experiments should be legalised?
§ LORD FERRIER
My Lords, I was going to confirm what the noble Baroness has said. I agree. I am simply saying that it should never be legalised. I agree with the right reverend Prelate, with the noble Lord, Lord O'Hagan, and others who emphasised the importance of education in this matter—not only education from the schools, from travelling experts and the like, but education in the family. Right from the beginning of children's up-bringing they should be made conscious of these dangers. I think it a pity that the Press do not play as strong a part as they might in this particular problem. Let there be more "sheer defiance" against the resorting to drugs of addiction. I use the words from the noble Earl's speech in which he said (and he is right) that it is possible that with a youth you can provoke sheer defiance by being unreasonable. But this is a reasonable objection.
Because of the many years that I spent in India, I believe that bhang, chharas, hashish, by whatever name it is called, (and from the word "hashish" stems the word "assassin") is recognised as a drug. It is true that the Report quoted what was said by the Indian Hemp Commission about hemp drugs and general health, but anyone who has been in contact with people, and particularly the less educated, who have been addicted to it—although it may not strictly be a drug of progressive addiction, which was pointed out by the noble Baroness—got pretty sharp at spotting somebody who was inclined to take it. One could not help seeing that while perhaps physically they were perfectly well, mentally they were not. In India the problem is different from here. In that climate cannabis grows luxuriantly, as it does in Australia. I was interested to hear the noble Baroness talking of the connection between heroin and cannabis, if any. I heard only the day before 1335 yesterday from a daughter of mine in Australia that in that country it is more or less recognised that "junkies" grow cannabis which they market under the counter in order to pay for their own particular addiction. This was new to me.
But the problem is different here in that the plant does not grow luxuriantly. Therefore I think we can say fairly that we can approach the problem of cannabis here in a different way. As I have said, I believe that it is more than possible that once the "new adventure" has been taken with cannabis, a certain fibre is not as firm as it might be and the "new adventure" might then lead to a really hard drug. Therefore, I believe that we should set our face against the "new adventure" of whatever sort.
So, with other noble Lords who have spoken, I welcome the promise of comprehensive legislation. I roundly support what the noble Lord, Lord Auckland, said; but I would go further. I would ask the Government this question. Need we wait all the time that is obviously necessary to prepare a really comprehensive drug law before putting up the penalties for those who possess cannabis for supplying to other people? Would it not be possible—and this point was made by the noble Earl in his opening speech—no matter that it would be what the noble Lord, Lord Stonham, called piecemeal legislation, to do that now so that what the noble Baroness said—
§ BARONESS WOOTTON OF ABINGER
My Lords, does the noble Lord seriously suggest that we should put up the penalties for possesing and trafficking in cannabis above 10 years imprisonment, plus a £1,000 fine?
§ LORD FERRIER
My Lords, the noble Baroness is correct in drawing attention to that. I did not mean so much the penalties for that offence but for being in possession with intent to sell. This is not in the existing legislation. That is the point I wanted to make; and it is the point made by the noble Earl. It is not just being in possession but being in possession in order to corrupt others.
§ BARONESS WOOTTON OF ABINGER
My Lords, may I ask the noble Lord whether he really suggests that even those people should be subject to more than 10 years in prison plus a £1,000 fine?
§ LORD FERRIER
My Lords, that I leave to people wiser than myself. The fact is that the noble Earl made this suggestion. As in the case of robbery generally, where it beats me why we cannot get at the fences, so, in connection with drugs, I feel that the sinners are the people who corrupt others.
My Lords, I gave Lady Serota notice of a question on the subject of heroin. Can she tell us whether all the heroin used in this country (except for a comparatively insignificant quantity which may be stolen from manufacturers, stockists or hospitals) is either on prescription or else imported? If the latter, does it follow that it is smuggled? I ask this because, like the noble Earl, I was upset by the article in The Times this morning. I was confused because I was under the impression (and I hope the noble Baroness will be able to make it clear) that heroin which is used other than on prescription in this country must inevitably have been imported or stolen. I set aside the heroin which is consumed on a forged prescription. But this brings me again to the fence. Where does this stuff come from? Is it from Syria, the Middle East, the Far East, South America? Do we know from where it is pouring into this country? Can the Press or public opinion, or the United Nations, do more than they are doing at the moment to limit the source or trace the people who are undoubtedly making a small fortune out of this vile trade? Of course there are those in this country (I am not one of them) who say, as I mentioned earlier, that there may be an international underground power that is only too glad to see our society subverted by means of drugs of this nature.
My Lords, I would end on a more trivial though not altogether frivolous note. In the course of this debate no-one has mentioned the drug of noise, of din. This drug is something of which one of my young people talked to me the other day: it has a curious effect on the mind. Surely this eternal canned music from "tannoys", in stations and aircraft, the amplifiers on the guitars, and double basses, and so on, is quite unreasonable. This is not altogether a frivolous remark because, as your Lordships can see in paragraph 26 of the Report, an inability to appreciate volume of sound 1337 appears to be one of the effects of cannabis. My Lords, I believe that this has been a most interesting debate, and I am grateful to the noble Earl for initiating it. I look forward with great interest to what will be said by the speakers who will wind up the debate.
§ 6.20 p.m.
§ LORD SANDFORD
My Lords, as one who from this Box had some responsibility for the passage of the Dangerous Drugs Act 1967 through your Lordships' House my first and particular interest was to hear from the noble Lord, Lord Stonham, how the addiction centres, which formed the central part of the provisions in that Act, had been developing. I believe, with him, that it would be true to say that the system of addiction centres established under the Act is succeeding, at any rate for the time being, in containing heroin addiction, and that the centres have brought some order into what was, a year ago, a thoroughly disturbing and chaotic situation in which there was a rapidly developing problem.
I think this is the moment to thank and to pay tribute to those who contribute to the smooth working of the centres. None of the psychiatrists, doctors and nurses, or the social workers who support them, had any previous experience of operating such centres and it is very much to their credit that they have so quickly reached the stage which has been achieved. But I would agree with the noble Lord, Lord Soper, and many others, that the next step is further to develop these centres from what they are at present, which is not much more than prescribing centres, into what will be truly treatment centres, providing a firm cure and leading on to full rehabilitation.
The difficulties here—and I do not think that enough has been made of them—are that the needs of these addicts cannot, in my judgment, be given priority over the needs of other patients who have as much right (many would say more right) to the services of skilled doctors, psychiatrists and social workers, and hospital and clinic facilities, all of which are to-day in short supply. This, I think, supports the argument adduced by the noble Lord, Lord Donaldson of Kings-bridge: that if by applying compulsion to addicts to complete their treatment we could make better use of the facilities 1338 available, then for heaven's sake! let us make use of it. I know that there are some who feel that there are enough powers under the Mental Health Acts to compel addicts who are being treated and rehabilitated to go through with their treatment. If this is so, it would be nice to have confirmation of it from the noble Baroness, Lady Serota, when she replies to the debate.
The other problem facing the development and treatment centres is that if the cure and rehabilitation of old addicts does not keep pace with, or overtake, the hooking of new, unregistered addicts on heroin, the demand for illicit heroin may come to exceed the supply by a large enough amount to encourage a thriving black market. This has been the danger from the beginning, and now we have to watch it rather carefully. The article already alluded to by my noble friend Lord Jellicoe makes that point, too. There is quite a danger that we shall be suffering in the future from heroin smuggled in by crooks in the same way that we suffered from heroin being over-prescribed by doctors. Apropos the treatment centres, I think that the House would be interested to hear from the noble Baroness, Lady Serota, what machinery is in use, or has been established, or is to be established at central Government level, for coping with the difficult problems of judgment in the use of these centres.
I should like now to turn to the question of drugs and the law. This has been mentioned by several noble Lords, and there is not a great deal more to be said. I agree with the noble Lord, Lord Stonham, that there is scope for tidying up the whole of our legislation on drugs and making it more comprehensive and flexible. I do not think a case has been made for relaxing any part of it in isolation, and I believe that the courts should be able to discriminate in respect of penalties between the drug-pushers and their victims. Fresh regulations under Section 5 of the Dangerous Drugs Act 1967 for the safe keeping of dangerous drugs in factories, warehouses and shops will be welcome, and perhaps one could say that it is time they were produced, though it is true to say that the present arrangement, resting on voluntary action by the pharmaceutical industry and retailers, seems to be working quite well.
1339 My Lords, I do not believe that there is any case for making changes in the police powers of search and arrest until this problem has been examined in much greater depth, as I understand is being done. I think that the proposal from my noble friend Lord Jellicoe for a White Paper on this subject is something that would be well worth looking into; but I suggest that it should be a White Paper not concerned solely with legislation but dealing with the whole question of drug abuse and how it may be tackled.
So I conclude, my Lords, that most, but not all, of what can be done to combat drug abuse by statutory and legislative action has, for the time being, been done. I believe, with many other noble Lords—I think that the noble Lord, Lord Henley, was the first to mention it—that our strategy now calls for preventive action by the community in the community, and within the laws we have. This falls into two categories: first, action by the pharmaceutical industry which, on the whole, has I think been pretty effective, although it may be possible to buttress this by regulations; and secondly, action by the medical profession. I think it most unfortunate, if I may say so, that not a single doctor (and there are a fair number in your Lordships' House) has taken part in this debate.
Frightful damage has been done by the notorious doctors Petro and Swann. I live in a county the middle of which has been ravaged by the former. There has been damage to the lives of all those reached by the excessive drugs which they prescribed and also, I submit, to the reputation of the medical profession. No profession is without its black sheep, but a profession the members of which have the lives of men in their hands must be capable of dealing with its black sheep better than these two were dealt with. Unprofessional and infamous conduct went on undetected for so long before the criminal law could get them.
My Lords, in his second Report of 1965, the late Lord Brain recommended that the Disciplinary Committee of the General Medical Council should take some responsibility for the black sheep of the medical profession. To be precise, he recommended that if the Disciplinary Committee were satisfied that a doctor 1340 had been over-prescribing restricted, dangerous drugs, the Committee should have the power to withdraw from that doctor authority to prescribe, supply and administer those restricted, dangerous drugs. All that is set out in paragraphs 35 and 36 of the second Brain Report. In the Report, it was said that legislation would be necessary for it to be possible for the Disciplinary Committee to do this. However, in the event, the Dangerous Drugs Act 1967 provided different legislation. Authority to prescribe heroin to a registered heroin addict was withdrawn from all but specially licensed doctors, and it became a criminal offence, not profesional misconduct, for any other doctor to prescribe drugs to these people without authority.
That deals with the over-prescribing of heroin, but there is still a good deal of over-prescribing of many dangerous drugs that are open to abuse by many people. To check it by further legislation on the previous pattern—and this they do not seem to be able to appreciate—would seriously erode the freedom of doctors to prescribe. Powers of control could be given, of course, to the Minister of Health, but I should have thought that that was the last thing we wanted. Surely it would be much better for the independence, the reputation and the freedom of the medical profession for its own General Medical Council to be given the powers it needs. The late Lord Brain and his experienced Committee thought that the Council should have these powers. I believe that it is time to look at this again and if necessary bring forward the small amount of legislation which would be necessary to give effect to this recommendation. Perhaps the noble Baroness, when she replies, will give us the view of Her Majesty's Government.
I turn now to the final point I want to make, about preventive strategy. If it is true that the growth of heroin addiction has been contained, it is by no means true that the abuse of other drugs has been contained, though there has been progress in two fields. Here I think we owe our thanks to all those concerned working in each local situation, but where I think thanks are chiefly due is to the police, particularly to the local drug squads where they have been formed, for the accurate information 1341 which they are making available to all the other people who need to get to grips with this problem. I hope that other areas are as lucky as we are in Hertfordshire with our drug squad, which does not hesitate to pass on to all concerned the information which is at their disposal. I dread to think where we would be if information the police had gleaned had not been made available to schoolmasters, probation officers, psychiatrists and so on.
As a result of this spread of information, I think it is true to say that public attitudes are now developing from a fear of an unknown problem—and it was this fear which produced the public reaction to the Report of the noble Baroness about which we have heard this afternoon—and from a powerful desire to believe that the problem does not exist, to an awareness, an alertness and a willingness to expose and to face the facts, though I would agree with the noble Lord, Lord Soper, that in the public attitude there is a great deal of cultivated indifference still to be overcome.
In this connection, your Lordships may be interested in a few extracts from a routine bulletin which covers one health and welfare division in the Home Counties, which, as I say, is still suffering from the attentions of Dr. Petro. It says:Heroin. The original hard core of heroin takers (40 to 60) … has largely been contained. Most confirmed addicts now on regular physeptone following treatment in hospital and addict centre attendance. An unstable and unreliable group showing recurring breakdowns needing admission to hospital and intensive follow-up. Heroin now very scarce due to legislation limiting prescribing and high price.Note the high prices; sooner or later this attracts the crook.Amphetamines … still available but not so freely passed or used in colleges as a year ago. Not so freely available although still widely prescribed by G.P.s. Tendency for former heroin users to use methadrine … does not seem to be extending.This seems to be due to the voluntary action of the pharmaceutical industry restricting supplies to hospitals.Fewer young people using syringes. Tendency for young persons … to experiment with barbiturates…Cannabis. Week-end reefer parties still reported throughout area …1342 Two groups in two towns which were specially prone to cannabis parties in the Autumn of 1968—now largely stopped as a result of police and youth leader actionNote the "youth leader".Frequent prosecution of young persons in possession of cannabis—usually known drug takers.L.S.D. not used …Thank goodness ! Then follow statistics of the details of the developing supporting services, and a section which I mention particularly as it was raised by the noble Lord, Lord O'Hagan:Programme of Parent-Teacher discussions arranged for all secondary schools. Attended by divisional medical officer anda consultant psychiatrist.Discussions with staffs of secondary schools on the main aspects of addiction. To be included in discussions on topics of personal relationships and social disciplines commencing when children 13 years of age.That is the sort of thing we want to see.
§ LORD SANDFORD
My Lords, this refers to January of this year.
I should like to run through the group of people who are responsible for compiling and sharing this kind of information. They comprise two psychiatrists from local hospitals, three general practitioners from local towns, a headmistress, headmaster, youth employment officer, divisional education officer, divisional medical officer, divisional social work organiser, divisional child care officer, senior probation officer, representatives of the Association of Youth Clubs, the local scouts, and the police drug squad, a local magistrate and two community development officers. I believe that progress in the next phase of the war against drug abuse will be made through local groups like these. There is, of course, scope for more central research and study, for more flexible and more comprehensive legislation, and for the further development of addiction centres and their supporting services. But I wholeheartedly agree with the right reverend Prelate the Bishop of Chester, with the noble Lord, Lord O'Hagan, and many others, that in the end the curbing of drug abuse will come about through more enlightened, more 1343 understanding and more responsible public opinion at all age levels. And it is local groups like the one I have just described which will help, and I hope will increasingly help, to form it.
§ 6.38 p.m.
§ BARONESS SEROTA
My Lords, the subject of to-day's debate has served to highlight the tragic and disastrous effects which drug misuse and drug dependence can have particularly on the younger generation. It is right therefore that we should have given this subject the close and careful attention it has had in the House to-day and I join all noble Lords who have spoken in thanking the noble Earl, Lord Jellicoe, for giving us the opportunity, on the Motion he has put down, of discussing this grave social problem.
I would not attempt a comprehensive survey of what has been an extremely complex and informed debate, but I should like to take up the number of points that your Lordships have touched on during the course of our discussion and indicate some of the areas which I regard as vital, in relation to both our present thought and future action, and at the same time indicate the thinking of Her Majesty's Government on particular aspects of this difficult field. The one area of the debate which I feel I would not presume to comment upon is that relating to the Wootton Report on Cannabis. All of us who know, admire and, if I may say so, love the noble Baroness have the greatest admiration for her intellectual integrity and ability. I would only add that, if she has a fault, it is perhaps that she is too clear-headed and too clear-sighted, and is generally some twenty years in advance of her time. I fear that for this quality she sometimes has to suffer.
I was grateful that the noble Earl, Lord Huntingdon, reminded us that we should try to keep these matters in perspective. Fortunately, the drug problem in this country is, relatively speaking, small compared with the problem in other countries. I would venture to disagree with both the right reverend Prelate the Bishop of Chester and the noble Lord, Lord Henley, when they say that this is not a new problem. It is not perhaps new in itself, but I think it is fair to say that it is new in its present form. If your Lordships had 1344 been discussing drug dependency in this country some ten years ago, we should have been concerned with the middle-aged and the middle class. The difference in the last eight to ten years, as I think the noble Earl pointed out, is that this is now concentrated in our larger towns and cities, and mostly among the younger age groups, between 18 and 25.
I think we should also bear in mind, as the noble Lord, Lord Auckland, reminded us, that the vast majority of young people to-day do not in fact take drugs, other than for medical reasons. We must remember that drug misuse, also, is not an isolated condition—and I listened carefully to the words of the noble Earl on this matter when he introduced the Motion. It is but one manifestation, among others, of wider social difficulties that could well lead to other forms of anti-social behaviour and to delinquency. It is also, I believe, as well to remind ourselves that not everyone who decides to swallow a few pills to obtain a stimulus will necessarily become dependent on drugs. The vast majority, even of illicit drug takers, reject the idea of persistent use. Nevertheless, drug misuse can, and sometimes does, progress into drug dependency. There is, therefore, a very real problem to be tackled. It is, after all, as the debate has shown, our children and young people who are at the greatest risk in the current drug scene, which the right reverend Prelate the Bishop of Chester and the noble Lord, Lord O'Hagan, described to us, I thought, so vividly and effectively in compassionate and balanced speeches.
My Lords, as I listened to the debate, which has already gone on now for almost four hours, it seemed to me that there were four main streams of thought emerging from it. I think that every noble Lord who has spoken has discussed the need for prevention, be it in the context of short-term prevention by restriction and control, or long-term prevention in the field of education. Treatment also has been a major theme in the debate, followed by rehabilitation and community support; and, finally, the need for more research and more knowledge. I propose to reply to points made by noble Lords under those main headings.
In the first place, in relation to long-term education—long-term prevention, if 1345 I can put it in this way, remembering that the young are those at the greatest risk—the Government entirely share the views expressed by several noble Lords of the importance of education, including health education, as a means of preventing the spread of drug taking. In the last three years, none of us could fail to be aware of the considerable publicity, not always, I am afraid, of the most helpful kind, that has been given in the Press, on radio and television, to the problems of drugs and drug misuse. There are indeed few people who are unaware of the existence of the problems associated with drugs in this country. We do, however, need to advance with particular caution (again, this point has been made in the debate) in considering extensive and indiscriminate publicity in this field, because of our present uncertainty as to the most appropriate and effective campaign to counter the problem.
Since this new social problem has developed and concentrated in these age groups, local authorities and voluntary organisations in different parts of the country, as many noble Lords will be aware, have employed a variety of specific methods and preventive techniques, including in-service training of staff, film strips, symposiums, film shows and pamphlets. The Advisory Committee on Drug Dependence set up a Committee on Health Education and Publicity, and reported to the Ministers their view that there was not at present a realistic basis for a mass preventive campaign against the misuse of drugs. But they did recommend that there should be a pamphlet containing factual information for the benefit of young people and such groups of adults as teachers and youth leaders, probation officers and, of course, parents. As it happens, this particular recommendation of the Advisory Committee came at a time when other bodies, such as the British Medical Association, had already decided to issue pamphlets of this kind. And noble Lords will be aware that, following the recommendations of the Cohen Committee, the Government last Year set up a new central body, the Health Education Council, to develop the existing health education promotional activities of the Department of Health and Social Security, and that of the Central Council for Health Education.
1346 I am sure your Lordships will wish to congratulate the noble Baroness, Lady Birk, on her appointment as the new Chairman of this body, and you will want to join with me in wishing her every success in this vital new work. Here I must make a confession of guilt. It was unfortunate that the Council should have been without a permanent Chairman during recent months, since my own departure. That is something I deeply regret. But they have been particularly fortunate in working under the able acting chairmanship of Dr. Fletcher, who was originally my Vice-Chairman on the Council; and I am glad to know that they will now be working at full vigour, with a Chairman, Vice-Chairman and their new Director.
Another point that has emerged throughout the debate (several noble Lords have mentioned it, and I repeat it now) is that we do not at the moment know enough about the factors which influence the attitudes and behaviour of the drug dependent, and more research is needed in this area, particularly in the field of education. I understand that the Council's future programme will include research to assess the effects of various techniques currently used in health education, and to develop new forms of communication. The Report of the Advisory Committee to which I have referred was sent to the Council when it was received by the Government. I am informed that the Council consider that as a first step, in view of the exposure of children to various media giving information about drug misuse and dependence, a start should be made on carrying out research into the effectiveness of such visual aids to see what reaction they are provoking, and to see what methods of health education are most suitable in this sensitive field. I believe that the research design has already been discussed, and I hope that the project on a pilot basis will go forward in the near future.
§ BARONESS WOOTTON OF ABINGER
My Lords, will the noble Baroness forgive me for interrupting? Could she tell us whether it is proposed to make possible research into cannabis, which is at the moment impossible, because although cannabis may be supplied to accredited medical research workers, it cannot be used owing to the present restrictions on the use of premises?
§ BARONESS SEROTA
I was trying at the moment to cover the need for research into the field of communications. Perhaps a little later I will try to deal with the noble Baroness's rather wider point on medical research into cannabis use.
The noble Lord, Lord Auckland, and other noble Lords, raised the question of health education in schools and colleges of further education. The Department of Education and Science, of course, offer to education authorities and others information and advice in this field; and the noble Lord may have seen that their latest handbook on health education covers this question of giving to schoolchildren and to students factual information about drug abuse and drug dependency. It is of course a matter for local education authorities to undertake their own responsibilities in this field. But it is the general view of the Department—and I think it is one on which noble Lords will probably agree—that one should not, in the context of general education, treat drug abuse as a subject in isolation. Nor should it be approached from an emotional or a moral standpoint. Any approach to young people poses special problems and dangers, and the Government feel that school children should be informed of the risks of experimenting with drugs in the same factual way as they should, for example, be warned of the risks of cigarette smoking and alcohol.
I now turn to this question of what I called at the outset short-term prevention. A number of noble Lords have raised specific points about the control of drugs and also the prescribing by doctors. May I deal first with the specific point raised by the right reverend Prelate in his remarks, asking whether the Government propose to control the manufacture, distribution and prescription of amphetamines. The answer to this question must be given in three parts. First, there are no statutory powers at present available under which control of the kind the right reverend Prelate was envisaging could be imposed. Secondly, as my noble friend Lord Stonham explained, the Government intend to bring forward proposals for recasting and strengthening the present law; and one aim of the measures my 1348 noble friend and my right honourable friend the Secretary of State for Home Affairs have in mind would be to abolish the rigid barriers between the so-called "soft" and "hard" drugs and permit each drug to be controlled on its merits. Thirdly, the question of whether amphetamines generally or selectively would then be placed under more stringent control would depend on what view the Government formed after consultation with the various interests, taking into account the advice the noble Baroness and her colleagues may have to offer when their present study is completed.
The noble Lord, Lord Auckland, asked about secure control of drugs, particularly in mental hospitals. I think that when he reads the speech of my noble friend Lord Stonham at the outset of the debate, which Lord Auckland unfortunately could not attend owing to a prior engagement, he will find that this point was dealt with. In passing, I may say that my right honourable friend the Secretary of State is in process of considering appointments for the new Medicines Commission under the new Medicines Act. I myself have seen the papers recently, so I can assure the noble Lord that an announcement will be made as soon as the necessary consultations have taken place. Another specific point on drug control. The noble Lord, Lord Ferrier, asked about heroin. I can inform him that with the exception of thefts and the Chinese heroin that my noble friend Lord Stonham dealt with a little earlier in the debate arising from the mention in The Times to-day, we believe that all the heroin used in the United Kingdom comes from legitimate prescriptions.
This brings me on to the general point about misuse and prescribing. The noble Lord, Lord O'Hagan, made it clear to us in the debate that some of the drugs, although not all of them, which are used by young people are still derived from doctors. What, several noble Lords have asked, can we do to counter this? I would suggest that there are three things that are both possible and appropriate: first, greater self-discipline by doctors—and here I join the noble Lord, Lord Sandford, in his thinking; second, action under the National Health Service, and third, action by the General Medical Council—and I will deal with those three 1349 points in turn, because of the great importance I know the House attaches to them.
No doctor who is practising medicine to-day can be unaware of the risks inherent in the use of certain drugs. Any doctor contemplating prescribing one of these for a therapeutic purpose ought certainly to weigh his decision very carefully, and if he regards a drug as essential for his patient's treatment should limit the quantity strictly to the amount his patient will require to the immediate purpose of his treatment. Doctors, rightly, and with the support I know of your Lordships' House, set very great store by their freedom to prescribe, but it is a freedom which surely can be maintained only if it is responsibly exercised.
Under the National Health Service regulations my right honourable friend has a power to refer to the judgment of his own local medical committee a doctor the cost of whose prescriptions, whether by reason of their character or quality, appears to be in excess of what is reasonably necessary for the proper treatment of his patients. In the event of the committee finding the case proved there are provisions for withholding remuneration from the practitioner concerned. In our view, of course, such action should never be resorted to lightly but should be used in cases of flagrant over-prescribing. In any case, it relates primarily to over-prescribing generally rather than to excessive prescription of individual undesirable drugs by a doctor whose general prescribing costs are not excessive.
Turning now to action by the General Medical Council—a point that was powerfully stressed by the noble Lord, Lord Sandford, towards the end of the debate—I would say that this would be appropriate only in those cases where the motives of the doctor are open to such serious question that the subject of infamous conduct arises. Noble Lords may be aware that the General Medical Council have stated in a pamphlet issued to all doctors that disciplinary proceedings have been instituted by the Council in cases in which a doctor is alleged to have purveyed drugs to persons other than in the course of bona fide treatment. Here I think we are all deeply sorry that the noble Lord, Lord Cohen of Birkenhead, President of the General Medical 1350 Council, so well known to and respected by your Lordships, has been unable himself to come here to-day to speak on this matter, which he regards as of such great importance. But I understand from the discussions that have taken place that the Council are very willing to consider the evidence in cases of this sort. My right honourable friend the Secretary of State for Health and Social Services has accordingly asked our Department to report the facts to the Council in any cases involving grossly excessive or irresponsible prescribing that come to their notice; and I have every confidence that these cases will be carefully considered.
The noble Lord, Lord Sandford, however, pointed out to us that even after disciplinary proceedings before the General Medical Council a doctor's right to prescribe drugs of misuse continues undiminished during the period allowed for appeal to the Privy Council and such further period as is required for determination of his appeal. I am aware of the great public concern that has been evident over certain recent cases. This time lag, if I may put it in this way, is a consequence of one of the safeguards provided by the Medical Act in disciplinary procedures, but I share the concern expressed by noble Lords in this matter, as does my right honourable friend, and we are already consulting the General Medical Council to see what steps can be taken to deal with this very difficult situation.
I now turn to this question of treatment, and to the issue of compulsory treatment, which was raised by the noble Lords, Lord Sandford and Lord Donaldson, in particular. Noble Lords will be familiar with the various arguments for and against compulsion and will also know that psychiatrists working in this particular field prefer to work in a voluntary situation. Under the Mental Health Act there is no provision for detention or compulsory treatment of an addict simply for his addiction. In some cases however, and especially where the addict's life is severely disorganised by his addiction, there will often be other evidence of a psychopathic character or of depression or other form of mental illness, and such symptoms could justify consideration of compulsory admission of the addict to hospital under Section 25 of the Act. The noble Lord, Lord 1351 Donaldson, referred to the interaction between the treatment in the mental hospital situation and in prison. In this context I should like to inform the House that one of the most valuable recommendations that will be coming shortly to us in the Advisory Council's Report on Rehabilitation is that, in an attempt to add to our knowledge in this particular field of difficulty, there should be mounted a comparative study of the effects of compulsory treatment in prison and voluntary treatment in a mental hospital.
Similarly, this Report will commend to the appropriate statutory authorities the next steps, if I may put it in this way, of the campaign. There is no doubt that in these developments voluntary organisations and individual volunteers have a very important part to play; and here I join with all noble Lords in stressing the need for their services, particularly when the addict requires support while he is trying to re-establish himself or to maintain himself in the community. I would again point out here that in the view of the Government these organisations need not necessarily be ones that concern themselves exclusively with drug problems.
The noble Lord, Lord Soper, and the noble Lord, Lord Donaldson of Kings-bridge, mentioned the need for hostels. I hope that my noble friend Lord Stonham and I will be able to put our heads together here. It was suggested that there was a need for central assistance and direction. In this particular field, however, one must be continually conscious of the fact that drug dependence is a difficult, sensitive and sometimes disheartening problem, and therefore it is vital that the hospitals, the local authorities and the voluntary organisations in the community should work closely together in a planned and co-ordinated way. Therefore I would urge the voluntary organisations that are working, or hoping to work, in this field to get together with the statutory authorities to plan their ideas and to pool their experience from the early stages of these developments.
We then came to the point of the support of the community, which several 1352 noble Lords have mentioned. Here I think the Government would welcome the kind of developments of bringing together people in the field, both organisations and individuals, in the way mentioned by the noble Lord, Lord Sandford. The right reverend Prelate told us of the experience on his home ground, and I also understand that in Bradford, for example, there is a liaison committee some 20 strong, with the Chief Constable in the chair, comprising representatives of hospital staffs, police, general practitioners, local authorities, probation officers, courts, universities, local education authorities, children's departments, youth departments, in fact all the agencies, both statutory and voluntary, working together, meeting together, discussing together and, above all, exchanging knowledge and experience in a field where in fact we know so little.
My Lords, the hour is late and I have spoken for longer than I care to speak at this Dispatch Box. But I am sure that this debate, which has ranged so widely, has provided a most valuable opportunity to the House to record the progress which has taken place so far in this field and also to pinpoint some of the intractable and difficult problems that still exist. Although I was glad that from every corner of the House to-day there was a general consensus that the hospital treatment clinics have produced order out of chaos and done much to reverse the disturbing upward trend in the field of heroin addiction, the debate has been valuable in identifying those areas of prevention, treatment, rehabilitation and community support which we shall need to tackle further.
Like the noble Lord, Lord Sandford, I would not wish to resume my seat without placing on record the appreciation of the Government for the work of the doctors, the nurses, the social workers and research workers in voluntary organisations, be they individuals or groups, who are working steadily in what is really an uncharted area and which some of their colleagues, I am sure, find an unattractive and unrewarding one. The debate has also revealed how much there is still to do, and I would suggest to the House that the pressing need in this field is to spread existing knowledge and to acquire more 1353 to assist the future development of means and facilities to meet this.
My noble friend Lady Wootton made a point about research in the cannabis field. I take note of that and I will refer it to my noble friend Lord Stonham and the Secretary of State for Home Affairs to take further. We also need to investigate further the sociological and psychological aspects of the causes of addiction. We need to understand much more the needs of those who misuse but who are not yet dependent on drugs, and we surely need still to continue to examine the efficiency of what we, as a community, provide in the way of facilities for treatment and the rehabilitation of those who become dependent on drugs. All this knowledge is essential, as well as taking action on the lines which have been indicated by several noble Lords, if we are to help the most vulnerable group of young people in our society who are at present either in danger or at risk. This, my Lords, is surely a task which can be successful only if carried out by cooperative efforts on the part of the Government, universities, local authorities and voluntary organisations. That is the theme which has gone right through this debate, and in the last resort we can only provide what society demands for these young people.
§ LORD FERRIER
My Lords, before the noble Baroness sits down, I hesitate to interrupt, but I am unhappy about her reply and I think the point is important. Perhaps my question was not properly couched. She said that all the heroin used in this country was manufactured here. I take it that she means all the heroin that is legitimately used. My question arose out of the article in The Times this morning, and my impression is that the heroin used by "junkies", other than what is stolen or over-prescribed, is all imported now, and therefore smuggled.
§ BARONESS SEROTA
My Lords, I am sorry if I have not been able to satisfy the noble Lord. My feeling is that the House would like to go home and perhaps we can discuss this subject afterwards.
§ 7.6 p.m.
My Lords, at the conclusion of what has been a constructive and worthwhile debate it is something more than a courtesy to thank all noble Lords who have contributed to the discussion. In the unavoidable absence of the noble Lord, Lord Cohen of Birkenhead, I am sad that it was not possible for another member of the medical profession to take part, seeing how much these matters have borne on professional medical interests.
I am particularly indebted to my noble friend Lord Sandford for saying at the conclusion of this debate, from this Box, all the things that I should have said at the start. He always speaks with clarity and authority, but I think that this evening he spoke with special clarity and authority, as well as from a very deep knowledge and experience of this matter. When I thank the noble Lord, Lord Stonham, and the noble Baroness, Lady Serota, for their comprehensive and (I hate to use the word, but I must), very competent replies, that is more than a formality. If I may express one disappointment, it is that they were not able to translate their experience of this problem, and their determination to get on top of it, into a more positive response on the question of rehabilitation and the hostels. I hope that when they 1,o to their offices at 8.15 tomorrow morning they will tell their colleagues and their officials of what I think was a universal feeling expressed in this debate, that this is an area which needs more effort and more drive—and more money, possibly.
Of course it was very valuable that the noble Baroness, Lady Wootton of Abinger, was able to take part it this debate, which has borne very much upon her Report, and I am sure your Lordships will all agree that the noble lioness has defended her lion cub of a Report with that lucid, maternal ferocity which one would expect of her. Finally, may I say how much I personally enjoyed the thoughtful and penetrating comments of the noble Lord, Lord O'Hagan. I think it was valuable that we heard a rather younger voice speaking with such penetration on this subject to-day. My Lords, with those words, I beg leave to withdraw my Motion.
§ Motion for Papers, by leave, withdrawn.