My Lords, in speaking for these Benches I would ordinarily speak from a health perspective. From our point of view, a lot of the drug abuse issues fall within that category. We are obviously dealing with a Home Office statutory instrument today, but I hope that the Minister will indulge me if I put some questions that come from that angle of considering the impact on individuals of the drugs we are due to control.
The first is around how we will monitor, in particular, the prevalence of the synthetic opioids that are to be classified by the instrument we are considering. I think we have all looked in horror at the situation in the United States, where the firewall that exists between heroin and other forms of drugs has broken down, in a sense, through the distribution of synthetic opioids to a much broader demographic who, it seems, feels more comfortable taking them than would feel comfortable taking heroin. But the medical harm is just as severe—in some cases, more severe—so I will be interested to hear from the Minister how the Government intend to monitor the prevalence and usage, particularly across different demographics, of these synthetic opioids, as well as prohibiting them, which is right. It is correct that we are following the advice of the advisory council here, but also really important that we understand the way in which these synthetic opioids are being consumed within the community.
The second issue I want to raise follows on from that, which is to consider how treatment services will deal with people who present because they have an
addiction to the drugs we are considering. The numbers are quite stark: in 2021-22, just over 289,000 people presented for treatment services. Nearly half of them presented for opiate addictions and over 70% had mental health problems. It is critical to understand, as we broaden the net on the drugs that we bring into scope, how we will be able to respond to the people who come to the attention of the authorities because they are using these opiates—and get them off those. Just as important as any attempt to ensure that they are prosecuted is to get them out of that drug dependency and back into a normal state. Again, I want to understand what consideration has been given to how treatment services will need to be adapted to cover this broader range of synthetic opiates that we are bringing into scope.
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The third issue is very specific—I will also mangle the pronunciation—to remimazolam, the one drug to be proscribed that is licensed for medicinal purposes, and is to raise a point that has come up in other contexts. Where a drug is both licensed and controlled in this manner it presents issues for prescribers, particularly one category of them: paramedics. Paramedics may often have prescribing powers but those powers may not extend to prescribing controlled substances, even where these have a significant beneficial effect for the person who they are treating, absent regulation. There have been some issues about the speed with which a regulation is adapted within the Home Office to keep up with the requirement for prescribers—in particular, paramedic prescribers—to continue prescribing those drugs once they have become controlled.
That is a very specific point. I have to confess that the ins and outs of the sequencing of the bits of secondary regulation are more complex than my brain will cope with. However, I hope that the Minister, with advice from his officials, will be able to confirm that, as we move a new medicinal drug on to the control list, steps will also take place in the background to ensure that prescribers—specifically paramedic prescribers—do not find themselves unable to prescribe that particular medicine, absent some other piece of regulation for which there will have to be a long wait.
Those are the three points that I hope the Minister can cover in his response: monitoring the prevalence of the synthetic opioids in the instrument; how treatment services will be adapted to cope with people presenting as users of these new controlled substances; and the very specific point around prescribing and, in particular, paramedic prescribing of controlled substances.