Dáil Éireann debate -
Thursday, 20 Feb 1975

Vol. 278 No. 6

Misuse of Drugs Bill, 1973: Second Stage (Resumed).

Question again proposed: "That the Bill be now read a second time".

Dr. O'Connell

I was pointing out before the debate was adjourned that a drug education programme could be of tremendous advantage. Such a programme could be arranged through the media, especially television and radio. Adults could be informed on the use of drugs, on the dangers of them and on a healthy approach to drug-taking. I am talking now of the psycho-active drugs. There should be a very cautious attitude by people towards drugs and a well-presented programme would achieve a great deal in this respect.

Parents and teachers should be informed so that children could be brought up in a climate in which they would have an understanding of the nature of drugs, why they are used and why they should not necessarily become part of one's life. A healthy attitude would help. It would mean an enormous saving to the Exchequer. I have worked out that we probably spend £27 million a year on drugs. I base my calculation on the fact that £9.5 million are spent on drugs for medical card patients. That was the sum spent in the past year. That represents 34 per cent of the patients. Based on that figure, one can conservatively estimate that the bill for prescribable drugs amounts to about £25 million to £27 million a year. That does not, of course, take into account the enormous sums spent on across-the-counter drugs, on the various panaceas available. If the same money were spent on education in relation to drugs a very big dividend might be earned.

Misuse of drugs does not necessarily mean misuse in general. If we had a proper programme of education that might encourage more courses in our schools on anatomy and physiology and the nature of the human mind and body our children would grow up not conditioned into thinking drugs are necessary for every headache or every pain. That would be of great advantage. It would inculcate in the young a greater sense of responsibility towards drugs. If that attitude prevailed, it would serve a more useful purpose than all the legislation passed here because convictions and punishments will not solve the problem of drug addiction any more than it solved the problem of alcoholism in the United States in the days of Prohibition.

This Bill goes some of the way towards solving the problem. The question is what are we to do with the drug abuser? He is harming no one but himself. Have we the right to pass judgment on him and put him in prison? A much better approach would be providing treatment for him. Have we the right to put the alcoholic found with a bottle of whiskey in his pocket in jail? Is whiskey less dangerous than the refer or the joint? Is it right that there should be a term of five years imprisonment for having cannabis and no punishment at all for having alcohol? There is something wrong there.

I should like to see an amendment to this Bill. Should we not concentrate on the pushers? We may be wrong in our approach if we punish people who, through no fault of their own, become addicts. We have no right to go into a bar and take out a person who is drinking too much. No one suggests we should do that but we are suggesting doing exactly that in the case of a person who has become dependent on a drug. We should think about this again. Should we amend this Bill? I am not too happy about it as it stands. I am not convinced prison is the answer. I am not convinced one should put the drug addict in jail. That will not solve the problem. We are thinking as they did in the Middle Ages when men went to jail for kissing their wives on Sunday. The puritans were moralising. That was the way they thought.

Mr. Haughey

They went to jail for what?

Dr. O'Connell

For kissing their wives on Sunday.

Mr. Haughey

A man was hanged in Loughrea for stealing a turnip.

Dr. O'Connell

That was not enlightened thinking. This is no different. If tomorrow the Parliamentary Secretary, as a result of a prolonged stay in hospital, comes out dependent on barbituates, and if he needs more than the doctor can supply him with, and he is caught with some on him which have not been legally prescribed, he can go to jail. If he elects to be tried by a jury and is found guilty, he can spend five years in jail under this Bill. Perhaps I am wrong but that is the way I see it. That is not enlightened legislation.

This morning I said I liked the enlightened aspects of the Bill, the emphasis on treatment. There is an emphasis on treatment but it does not debar a court from committing a man to prison for being illegally in possession of drugs. To me that is not good law and we should not have it. Perhaps I am a little inverted in my thinking. I may be a non-conformist. We should look at this seriously. What do we want to do to the victim? Are we to punish him further?

We must protect him against himself. You do not protect a man against himself by putting him in prison. Five years' imprisonment will not help him, especially when our drug-orientated society may have caused drug abuse on the part of a particularly vulnerable individual whose personality does not enable him to cope with the problems of life. There are weak-willed people who cannot face stress and strain, who find they need something and inadvertently resort to drugs. I am against punishing them.

Instead of talking about imprisonment for drug abusers, could we not talk in terms of compulsory treatment? If we insist on imprisonment we might as well go the whole hog and include alcoholism in this list. Can you imagine the ludicrous situation if we were to employ the same measures against alcoholics? Our prisons would be full. People are sympathetic towards alcoholism. We are ready to forgive the alcoholic for what he does. We do not adopt that attitude to drug abusers. Perhaps that is because our legislators never had the experience of drugs and fail to understand the circumstances that prompt people to resort to drugs. I cannot see that punishment will ever eradicate this problem. It has failed in other countries.

Cannabis is perhaps the drug most commonly abused. Could some central agency examine the problem of cannabis? I am afraid that young people will have to carry for life the stigma of a prison record because they were tempted to experiment with cannabis. Here we are talking of people as young as 12, 13, 14, 15 or 16 years of age who could find themselves in trouble. Everything is all right if we have a good head of the drugs squad but there is no guarantee that people will be sympathetic. This law may be employed rigidly.

Under Category II on indictment for simple possession a person is liable to a fine of £1,000, or five years, or both. To me that is very serious. I hope the Shadow Minister for Health will adopt an enlightened attitude and move or support amendments to the Bill particularly in relation to a drug such as cannabis. We do not want to be harsh or unjust to people who have no intention of breaking the law.

Would it be possible for the National Drugs Advisory Board or a section of the Department of Health to issue a booklet on this problem for public use? There is a dearth of information on the subject. There is a certain mystique about it. The Department should seriously consider issuing a booklet for use in the schools to enlighten people on the position with regard to drugs. What do we offer young people as an alternative? We have to talk about providing alternatives for young people so they will become useful citizens.

The Department of Health have conducted no survey into the incidence of drug abuse. There have been random samples. The Minister said that the numbers charged with drug offences in 1972 were 201, in 1973, 270, and that the provisional figure for 1974 is 294. That is no indication of the extent of the problem. The Department should carry out a survey into the incidence, the extent, the nature of drug abuse, the drugs which are most often abused, and the age group of the people involved. We should be doing this.

We should like to see them sponsor this. We could then have some indication of what the problem really is. A few years ago we had scare headlines about it. Let us put it into proper perspective and get proper information. Those figures are not an indication of the extent or incidence of drug abuse. Perhaps the Minister or the Parliamentary Secretary would urge the Department to sponsor or promote this in some way and get up-to-date information on it.

A point I omitted to mention earlier in regard to doctors is the question of the involvement of the medical profession. The Report of the Working Party on Drug Abuse spoke of a small number of doctors supplying maintenance doses to persons dependent on drugs. They also mentioned several instances of drugs liable to abuse being made available in excessive quantities through over-prescribing. First, the Department could ask the doctors to exercise the greatest caution in regard to drug addicts and where any doctor comes across a case of drug abuse or a drug abuser I do not think he should take on the job himself. It is too big a task and too time-consuming and leaves a doctor open to all sorts of pressures from the person concerned. This matter should be considered by doctors. It involves not merely the doctor but the whole team of experts.

Doctors might be persuaded—and I think the Department should do this —to refer such cases to the appropriate agency so that the full background to the abuse, the extent of it, the control, the drug register and all other factors involved can be investigated. This could relieve doctors of the burden and onus of treating such patients and also of the pressures. If a doctor is soft-hearted and a patient is very persuasive the doctor, out of kindness, might write a prescription for a few extra. He is then liable to prosecution; he is not helping the situation because this drug abuser can then go to the doctor down the road. I have been fooled by drug abusers on a few occasions coming in on all sorts of pretexts and telling phony stories. I have been caught about three times. But I would not undertake the treatment of a drug abuser. I think it is unfair to me and to the patient. If I do it, I may not be helping him because somebody down the road may be doing the same thing unknown to me. Why cannot doctors, when they see this happens, forget about sentiment, even if reluctantly, and if they wish to follow the case closely they can make sure that it goes to the proper agency, Jervis Street drug centre? They can get reports on the case which will maintain their interest, or go down and see how the patient is going on. To take on the treatment themselves is an injustice to themselves and to the patient and an encouragement to further abuse. Therefore, I think general practitioners should be asked to pass over such cases to the appropriate agency and in doing so they will be fulfilling a very useful function and they would be relieved of responsibility and we would not have this section here operating.

I think this section is dangerous; it leaves a doctor open to all sorts of problems. He can find himself in real trouble. He can appeal to the Supreme Court. But there is no need for all that. If the simple advice were given or even if a directive were given by the medical organisations and the Department of Health, it would avoid all these problems. I could see many problems arising under those sections, sections 6 and 21 and the other sections. There is even a case where a doctor can be punished twice, once by the court and again by the Minister. There is a particular section which does not contain provisions whereby a doctor may make representations before such a direction is given. There are problems involved. If we could change that section on Committee Stage and instead direct family doctors not to treat these cases, great difficulty would be avoided. They have sufficient problems in other ways. Drug addicts pose a chronic problem; it is an on-going problem; it is not a simple matter of giving a drug and forgetting about the case. It involves much more than that.

I come to the Medical Registration Council a body with which I have been in strong disagreement on numerous occasions. Here they are given power to follow up. I wonder if the Minister would look into the whole matter of the Medical Registration Council and update their powers and functions because they are archaic, as are some of the members. The Minister might consider if we could bring their functions and powers up to date. We are adding to their powers. New legislation was promised in respect of the Medical Registration Council. If I am right in that I should like to see this legislation but it has not come to light yet. I wonder how often the Medical Registration Council which deal with matters like this will meet. The members are involved in so many other activities that I wonder if they have time to meet. If I ever ask a question of the council it takes weeks before I get a reply. This is a further indication that the Medical Registration Council are not operating properly and are certainly not up-to-date in their thinking. If they take on this work, they will need a complete overhaul.

I ask the Minister and his advisers to consider again the categories of controlled drugs. It is important that they should be known. I think it is important to look at what is in Category III of controlled drugs. I think the majority of those should be incorporated in Category II. I spoke on this problem when the previous Bill was before the House and I mentioned the barbiturates and their potency. Barbiturate addiction is as dangerous as addiction to opium or its derivative. So, how we come to have barbiturates in Category III is beyond me and I should be glad to be enlightened on it. I have not been enlightened so far. I wonder who advised the Minister as to the category in which these drugs should be placed.

I would ask him as a particular favour to explain this and to explain who advised him in respect of this. He should go one step further because to most Members of the House this is Greek. They should be given information about each drug and its purpose. We are all legislators here and we all want to be properly informed. There should be an explanatory leaflet supplied about the drugs. It is simple for me but to how many other Members is it simple? I do not understand Bills on other matters and I would like to understand them. Each legislator is entitled to as much information as possible.

Notice taken that 20 Members were not present; House counted and 20 Members being present,

Dr. O'Connell

I have had my attention drawn by Deputy Desmond to a worthwhile extract from the 1971 Report of the Working Party on Drug Abuse. It is obvious that the Department have not taken this recommendation into account. I quote from page 21 of the report:

Possession of a small amount of cannabis other than for peddling or pushing should not normally be regarded as a crime to be punished by imprisonment.

This is important because there is a provision in this Bill making it a crime to be in possession of this drug. We should seriously take into consideration the conclusion of this working party. They spent a long time working on this and considered it in great detail. The British Wootton Committee said that the long-term consumption of cannabis in moderate doses has no harmful effects. We know it has not got harmful effects. We know it does not lead to physical dependence.

In the light of that, is it fair or just to give powers to a judge to imprison a young person who is caught with a reefer, a "joint" or "grass" in his pocket for up to five years? I hope that will be changed on Committee Stage. I hope I can persuade the Minister that his advisers have advised him wrongly in putting this in Category II. We should consider putting it into a special category— Category IV—and say that where there is evidence of continued and chronic abuse of this drug by an individual there will be an obligation on him to undergo treatment. If we were to do this we would be seen by our neighbours to be far-seeing. They all recognise the fact but have not taken the initiative. If we took this initiative we would perhaps be the most advanced country in Europe in this regard. There is nothing worse than a law that is constantly broken and this, if it comes into effect, will be constantly broken by young, immature people. The other way would solve the problem. We would not have so many potential criminals. The percentage of people who have taken cannabis and who have become chronic is negligible.

It would be less than 0.1 per cent so that we would not be involving the State in any great task in undertaking treatment of these. People try cannabis for a very short time and discard it. It is part of the growing up. The real problem about it is that those who take it are the immature people and when they come up with a problem they are tempted to smoke this to overcome the problem. The process of maturing, of growing up, involves facing up to problems. By overcoming them one matures.

My argument against cannabis is that if one is to resort to it when faced with a problem one would never face any problem and, consequently, would not properly mature. That is the biggest problem. The chronic cannabis smokers are very few and if we were to incorporate this in a special section of the Bill we would stop the transgression of the law and we would help the young people and provide treatment for those who are given to chronic use or abuse of this drug.

I was concerned at the fact that a particular barbiturate was removed from Category III and I should like to know why it was left out. The answer I get will probably show up my ignorance, but I should like to know why Butobarbitone and the cyclo-barbitone are omitted. I should also like to know why the adviser to the Minister could not have included the general term, barbiturates in all forms, instead of spelling out four types. They all have the same degree of addictive properties and why barbiturates, in general, were not substituted for these particular types I do not know. I cannot understand the rationale or the reasoning behind it.

For the benefit of all the legislators the Department should, when this Bill reaches Committee Stage, provide an explanatory leaflet or stencilled sheet about particular drugs, their mode of action, what they are for, what category they are included in and why they are included in that category. This is important because every Member must know what he is legislating on. If a Member is to legislate on a problem such as this what does he know about Phendimetrazine but if he was told what it was for and its use he would be in a better position to legislate. Members, for instance, should be informed that that is a weight reducing drug. In the light of information contained in such an explanatory leaflet they would be in a position to make recommendations or put forward amendments as to which category they should be incorporated in.

There are a number of drugs which by any stretch of the imagination would never find their way here. I know that in legislating we must provide for all eventualities and situations which are not relevant at present but may be at some future date but, nevertheless, Members are not aware of the uses of some of the drugs mentioned. I may be asking too much but it is not for my information; it is for the information of the Deputies who do not have a medical background. For instance, in Category I the drug cannabinol is mentioned but, in my view, there is an obligation to inform Deputies that this drug is the active ingredient of cannabis. I can see a situation arising in the future when cannabinol will find its place into the pharmacopoeia and may well be in regular use here for a particular complaint. In my view Deputies should be informed of the work being carried out in America on this drug. It could become a very useful drug.

Cannabis was included in the pharmacopoeia up to 1954. Up to then it could be bought in a chemist shop and it could even be obtained over the counter. It was only removed from it because of the fact that the cannabis was of such varying potency that a doctor could not be sure whether the person was getting the right potent drug or what. That is an important point to bear in mind. That drug was used for arthritis and various pains and ailments. I believe it was an Irishman who brought it back to Britain to be used in medicine. I have dwelt so much on this because there are strong emotions in the public mind. Before I became knowledgeable in medicine I had a fierce dread of reefers and marijuana even though I did not know much about them. We should know that it had a medical use, and the way they are working in the research laboratory in California at the moment the active ingredient of it may find a place in the pharmacological armamentarium of doctors. I cannot figure out why this is included with the opium derivatives which are dangerous drugs. I cannot see the logic of it. Methadone, another powerful drug of addiction, and all the opium derivatives are included with this and I should like to know why. Many of the cannabis derivatives are so weak and so impure that they would not be as powerful or as potent as an ordinary cigarette.

Did the Department take into account in the preparation of this Bill, the anomalous situation that arises where this drug amphetamine, is completely banned here and is available in Britain. What would happen to people who come from Britain with such a drug in their possession but without a prescription? Will they land in jail? It is the provision in this regard that I fear and for that reason I should like to know if the EEC Commission have considered this point.

I should also like to know the position in other EEC countries and if it is the intention of the EEC drug commission to harmonise the law in respect of this? If not it will create a lot of problems with the free movement of people between the EEC countries, especially between Britain and here. We should know what the law is and if there is harmonisation of the law in respect of these particular drugs. The Department of Health are the best people to inform us what the law is in each of the EEC countries. When we have this information we will be in a better position to make up our minds on the Bill.

Do the provisions in this Bill result from a directive from the EEC countries or the Council of Ministers? Are we taking the measures ourselves, irrespective of what is happening in the other countries? Is there any liaison with the EEC countries or the Council of Ministers in respect of these drugs? Do the same laws apply in all the EEC countries?

Mr. Kenny

That is right.

Dr. O'Connell

What is the purpose of liaison if the laws are different in each of the EEC countries? Where anomalies arise, where people are in danger of being imprisoned, is it not obligatory on us to ensure there is harmonisation of our laws? I would like those questions answered. It is obligatory on us to know this in view of the gravity of the offences in the Bill. We are not very well informed on EEC affairs. Perhaps the Department might provide every one of us with that information as soon as possible. We will then know if we are making up our minds ourselves in respect of this or if we are just following the directive of the EEC Council of Ministers.

As far as I can see there is no effort at harmonising the laws in respect of drugs. I would like to know if we are guided by the World Health Organisation regulations. Is there liaison between them and the EEC Commission? Have we considered having discussions with the British Minister for Health in respect of the amphetamine drugs? In view of the fact that this drug is banned here and is available in Britain we are likely to be faced with a serious problem. Irish people returning from Britain may have this drug in their pockets and may not be able to produce a prescription in support of the fact that they got it legitimately. Many containers lose their labels and a person on holiday here from Britain may have amphetamine drugs in a bottle with no label on it although he knows how to take them because he has been doing so for a while. If he has not got the prescription he could find himself in serious trouble and having to serve a term of imprisonment for legitimately having this drug in his possession.

We should either decide to use our influence with the EEC Commission or the World Health Organisation to establish some standard of uniformity or harmonisation with regard to drugs. We could also confer with our opposite number in Britain about this drug and also a number of other drugs in Category II. I can see at least four drugs in Category II which could present problems. If a person is convicted and indicted under this category there is a fine of £1,000 or five years in prison or both for simply possessing those drugs. That requires further investigation. If the Minister says he will get some clarification on this I will be very interested in this Bill.

The purpose of the Bill is to provide a more enlightened approach to the problem of drug abuse but there are still serious defects in it, such as the Garda having unnecessarily wide powers. I want to show where those powers can be used and abused. I want an absolute guarantee for the freedom and the protection of the individual. Every Deputy should seek that. The Minister might seriously consider putting the cannabis drug in a section of its own. We would then be seen as one of the most enlightened countries in the world in this respect.

I would like to know how the powers of inspection, the production of books or documents or the taking of samples will be implemented. Does it provide for doctors having special books in which they enter details of when they used this particular drug? Doctors do not have books at the moment. The doctor is included in the section where those powers are given to the Garda. There is a very grave risk involved here. Should the doctor open up all his patients' records for the Garda? Should he provide confidential information? That is the only way the Garda can get information on the use or misuse of a drug. Has a garda the right to examine the records of patients? Will we provide special books for doctors to enter details of when they use particular drugs? I would like an answer to those questions.

The only way I would know if I used a particular drug is that I would mark it on a patient's chart when he was given a shot of the morphine type. Do I display all the charts for the inspection of the Garda? Am I right in doing this? Do I risk imprisonment if I refuse to co-operate? Those are very wide powers for the Garda to have and I would like to know how this inspection will be implemented. What must the doctor provide for the information of the Garda who may wish to inspect the use of the drug in question? There should be some means of providing that confidentiality in respect of a patient's condition is preserved and that such information is not made available to the Garda.

Debate adjourned.

The Dáil adjourned at 5 p.m. until 3 p.m. on Tuesday, 25th February, 1975.