AIDS and Drug Misuse (Hansard, 29 March 1988)

§ Mr. Newton

We have today published the first report on AIDS and drug misuse from the Advisory Council on the Misuse of Drugs (ACMD). The Government welcome the ACMD's advice on a subject which has serious and wide-ranging public health implications. The spread of the AIDS virus through shared injecting equipment adds a new dimension to drug misuse. It presents a grave threat, not only to drug misusers themselves, but to the babies of infected mothers, to the sexual partners of drug misusers and from them to a wider population.

The report is concerned with measures to prevent the spread of infection. As it makes clear, the prevention of drug misuse is now more important than ever before. It is self-evident that if people do not start using drugs in the first place they do not put themselves at risk of infection through this route. We remain, therefore, determined to prevent the misuse of drugs, both through tough law enforcement measures to reduce the supply of illicit drugs, and through effective education and information to make it less likely that young people will be tempted to try them. Our strategy will continue to be taken forward through the ministerial group on the misuse of drugs.

But we must recognise that there is a population currently at risk of acquiring the AIDS virus through their injecting drug misuse, and I accept the ACMD's advice that services should be developed in order to make contact with as many of that population as possible. In recent years we have invested in a significant expansion of drug misuse services, and emphasised the need for the community-based response which the report endorses.

The report makes a number of recommendations on ways in which services might seek to attract drug misusers, to keep them in contact, and to change their behaviour away from practices which might result in their becoming infected, or passing on infection. Services should be prepared as necessary to advise and encourage drug misusers to reduce the health risks associated with their drug misuse to themselves and to others — as an intermediate goal in getting them to stop drug misuse altogether. Some of the recommendations will require detailed consultation with interested agencies, but in the meantime I am making copies of the report available to health and local authorities in England. My right hon. and learned Friend the Secretary of State for Scotland and my right hon. Friend the Secretary of State for Wales will be taking parallel action for health and local authorities in those countries.

The ACMD recommends that sterile injecting equipment should be widely available, through an expansion of syringe exchange schemes, and sales through pharmacies. We have considered this recommendation carefully in conjunction with the preliminary findings of an evaluation of 15 "pilot" syringe exchange schemes around the country. While the evaluation points to some promising features of such schemes, we do not consider that we yet have sufficient evidence to recommend an expansion of schemes in England. I accept however that some local agencies in England and Wales have already decided to set up their own exchange schemes, and that more may do so. In order that such schemes should operate as effectively and responsibly as possible, I intend to make available guidance based upon the principles underlying the pilot schemes and drawing on the early lessons of the evaluation. Similar action will be taken in Wales, and further consideration will be given there to the 455W place of needle exchange in broader projects of treatment, counselling and rehabilitation with appropriate professional support.

The report also deal with the treatment of drug misusers in prison, and welcomes the policy statement issued to prison medical officers and others concerned in September 1987. My right hon. Friend the Home Secretary and my right hon. and learned Friend the Secretary of State for Scotland have considered the ACMD's recommendation concerning the availability of condoms in prison, but believe that it fails to take account of all the relevant factors, including the effect which a resulting increase in homosexual activities would have in terms of risk of HIV infection and otherwise. They do not intend to make any change in present policy in this respect.

We endorse the ACMD's view that there will be a continuing need for national and local publicity about the link between AIDS and drug misuse. Last year we launched two parallel campaigns designed to deter young people from starting to use drugs, and to warn of the particular dangers—of which AIDS is the most serious — of injecting drug misuse. We are evaluating those campaigns and will be considering future information needs in the light of the evaluation findings.

The measures advocated by the report will require that all professionals and other staff in contact with drug misusers are adequately trained to deal with the new demands made upon them. We will be discussing with the relevant training bodies how best to ensure this. In Wales, the Welsh Committee on Drug Misuse will be consulted on the way ahead as regards both training and publicity aspects.

Finally, we intend to monitor carefully the measures we are taking, to assess their effectiveness.