A legitimate argument?

 
Lyrica Lyrica tablets, used by the NHS to treat epilepsy, contain "legal highs"

Would UK ministers and officials really claim that a range of NHS-approved drugs have no "legitimate use" in order to justify an EU opt-out?

NHS England alone spends more than £200m a year on the drugs - used to treat Parkinson's disease, epilepsy, depression and insomnia - but Home Office minister Norman Baker has told parliament that "very little" legal trade in the medicines takes place.

The apparently preposterous British position comes about because, to admit these substances are marketed legitimately, would fundamentally undermine the UK's argument this week for claiming an opt-out from proposed European regulation of "legal highs".

A Home Office official has told me the UK government does not believe medicines should be included as a "legitimate use" for substances identified as legal highs.

This week the crime prevention minister Norman Baker announced that the government had decided to opt out of proposals for a directive on new psychoactive substances (NPS), fearing that they would "fetter the UK's discretion" to control legal highs.

Norman Baker Norman Baker, the crime prevention minister

The prospect of press stories about "Eurocrats" telling the Home Office how tough they could be on legal highs is a nightmare for the UK government. "Member states should not be prohibited from unilaterally introducing more stringent controls for NPS," Mr Baker argues.

In a ministerial statement this week he explains how the coalition government "strongly dispute the evidence base stated in the EU Commission's impact assessment which estimates that 20% of new psychoactive substances have a legitimate use".

This is a key part of the government's legal justification for opting out. Without a significant legitimate trade in NPS, questions over the single market disappear.

The Commission has argued for a Europe-wide directive on legal highs because it says different approaches across the EU "can impede their legitimate use… and fragment the internal market".

The Brits refuse to accept there is much "legitimate use" for substances notified to European authorities as NPS.

"Our evidence suggests the trade is overwhelmingly illicit," Mr Baker told a Lords Committee last year, "and therefore it is difficult to argue that this is a trade measure, when there is very little legal trade taking place on this basis."

Start Quote

There are dozens of substances currently being monitored as potential legal highs which have medicinal uses or properties”

End Quote

However, the EC has produced a long list of all the uses and potential uses of substances flagged up to EU drug monitors as worrying legal highs.

Among them is Pregabalin, notified as a legal high in 2009. In 2012, NHS England alone spent more than £181m on the drug as a treatment for epilepsy, sometimes under the trade name Lyrica. The European market is worth considerably more.

Another substance notified to the European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) as a potential legal high is Aminoindan, from which a drug used in the treatment of Parkinson's disease, Azilect, is derived. The health service spends around £9m a year on the treatment.

Again, ministers argue there is no significant legitimate trade in Aminoindan.

Another substance identified as a legal high, ODT, is a metabolite of the pain relief tablet Tramadol. NHS England spent £33m on such pills in 2012.

The Home Office itself notified the European authorities that Zopicline was being sold as a legal high. The NHS in England spends around £4m on Zopiclone as a treatment for insomnia each year and it is sold across the EU.

NHS England also spends around £250,000 on Nefazodone and Trazodone - drugs used for treating depression which include notified legal highs among their ingredients. Again, UK ministers appear to be claiming the substances should not be regarded as having "legitimate use".

It is hardly surprising that prescription medicines and potential treatments should also be turning up as legal highs. To recognise their medical use does not prevent UK ministers from introducing tough penalties for their illegal sale and possession. After all, diamorphine (heroin) is widely used within the NHS and is also a class A illicit drug.

Tramadol NHS England spent £33m on Tramadol in 2012

It does, though, make it much harder to claim the legitimate market is "minimal at best".

The Swedes in 2011 alerted the authorities that Ostarine was being sold as a legal high. The NHS has suggested the drug has the potential to be an exciting new first-line therapy in the treatment of patients with lung cancer. Home Office ministers, though, dare not accept that the substance has a potential market across the EU.

Etizolam was identified as a legal high by the UK in 2011, a substance sold in chemists across many countries as a treatment for insomnia and anxiety. The Home Office also notified European drug monitors about Glaucine, a drug used in parts of Europe as an ingredient of cough medicine.

According to the European Commission, there are dozens more examples of substances currently being monitored as potential legal highs which have medicinal uses or properties.

And yet a Home Office official, David Greaves, told a House of Lords committee that, apart from two industrial cleaners and a "small number" of substances used to make medicines, "none of the other approximately 300 new psychoactive substances that have been reported to the EMCDDA have commercial or industrial uses".

There is a clear difference between the UK argument that legitimate uses for legal highs are "few and far between" and the EC argument that "the size of this market is considerable".

According to the Commission, almost a fifth of all new legal highs notified since 1997 have other uses, adding that, since data on legitimate use is not systematically collected, this may well be an underestimate.

I contacted the Home Office to ask how they could come up with such a different conclusion from the European Commission. A press officer tells me: "We disagree with how the Commission has defined legitimate use. They have included medicines and potential medicines. We don't think medicines should be included."

Why?

I am still awaiting a response to that question. But I think I know the answer. It is not because Norman Baker truly believes there is no legitimate use for a cancer drug or a market for an insomnia treatment. That is a ridiculous claim.

It is because, as Mr Baker said, "the proposed NPS regulation… is a harmonisation measure". And if avoiding that horror requires UK officials and ministers to claim NHS-prescribed medicines for epilepsy and Parkinson's disease have no legitimate use, then that is just what they will say.

 
Mark Easton Article written by Mark Easton Mark Easton Home editor

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  • rate this
    0

    Comment number 102.

    andyd @ 84 said:
    "Another case of ministers dismissing expert advice just because their decades of research don't fit in .. snip .. I am now at the stage where I wonder if there is a single politician left who makes decisions based on evidence and not on who's 'supporting' them."

    Like the BBC's refusal to show this:

    http://rt.com/news/study-challenges-syria-chemical-attack-681/

  • rate this
    0

    Comment number 101.

    fascinating. Once again thank you Mark for exposing this data and analysis

  • rate this
    0

    Comment number 100.

    Stop the drug war , we have lost enough lives and money.

  • rate this
    +1

    Comment number 99.

    Legalising ALL drugs is the only sensiblie thing to do. The tax that would be generated would massive and the police could then start to nick "real criminals".
    Like Bankers and crooked MP`s

  • rate this
    -2

    Comment number 98.

    The elephant in the room is the EU as always - if they weren't trying to bring in such draconian measures on every area of our lives then the government wouldn't have to pull stupid stunts like this to get out of them.

    Forget politicing for a moment - why do we, a supposed sovereign state - owe the EU an explanation for anything?

  • rate this
    +3

    Comment number 97.

    I was refused a medication that used to be commonly prescribed for side effects of phenothiazine meds because I was told people abuse it. I certainly had no intention of doing so, but was left to suffer out the consequences of being prescribed a strong medication with nasty side effects. I wonder as to the extent of the truth of such ideas.

  • rate this
    -1

    Comment number 96.

    This brings us round to today's big health story: gout. It isn't high blood pressure that causes gout it is its treatment, this generally includes a diuretic. That's what causes gout these days, although the medical profession are keeping quiet about it. Treatment, and not eating purines is only part of it, fructose is much more important, together with yeast extract so honey and Marmite are out.

  • rate this
    0

    Comment number 95.

    The only people competent to determine if a substance has a legitmate medical use are members of the medical professions. Politicians have no role in this determination.

  • rate this
    +1

    Comment number 94.

    It's clear that medical users who need a drug should have access. If the illegality of such medicines is prohibiting such access then we have yet another reason as to why shouldn't continue with these prohibitions. Presumably medical research is also limited.

  • rate this
    0

    Comment number 93.

    85.JehovahBean
    Can we just stop being so dilatory and agree that any drug use, legal or not (unless prescribed),
    87.JehovahBean
    Any drug use (prescribed or not) should be banned,
    -
    You've gone from a stupid comment to dangerous and irresponsible fundamentalism in 12 minutes. An awful lot of people would die if there are no drugs available at all. I suppose you would regard this as your god's will

  • rate this
    -2

    Comment number 92.

    Health & Safety measures are stifling natural selection. All powerful (useful) medicines have powerful side effects. They should be used in minimal doses for the minimal therapeutic time and then stopped. If someone then is so stupid to use them routinely or without medical supervision, then let them but do not waste A&E resources on them for bad effects & overdose. Self 'medication' is stupid.

  • rate this
    0

    Comment number 91.

    @87. JehovahBean
    If we are going by the bible then we should kill everyone who has ever sworn at their parents:
    " All who curse their father or mother must be put to death. They are guilty of a capital offense. (Leviticus 20:9)

  • rate this
    0

    Comment number 90.

    @87 Jehovah Bean..

    ... Is your real name Peter Hitchens?
    ... Do you read the daily mail?

    I suspect at least one of the above is correct. Why not try thinking outside the cramped box you seem to be living in.

  • rate this
    0

    Comment number 89.

    @82 John Knee.
    That is very true, I know personally people who abuse the system to get hold of drugs such as valium. But you imagine that the NHS carriers out risk assessments on if the drug is of sufficient beneficial medicinal benefit to outweigh the risk of it being misused. My comment was not denying that, it was just stating that Norman Baker is just plain wrong.

  • rate this
    +1

    Comment number 88.

    87.JehovahBean
    Any drug use (prescribed or not) should be banned, and users should be arrested with 5-10 years in jail.
    ------
    What a monumentally stupid suggestion. For a start who is going to pay for this?

    Selective quotes from the bible don't cut much ice either do they, you can find a quote to support practically anything can't you.

    Whatever happened to Christian compassion and forgiveness

  • rate this
    -5

    Comment number 87.

    Any drug use (prescribed or not) should be banned, and users should be arrested with 5-10 years in jail. As it says in the bible,

    Romans 14:21 - [It is] good neither to eat flesh, nor to drink wine, nor [any thing] whereby thy brother stumbleth, or is offended, or is made weak.

    Please, listen to Jesus' holy words and put aside your highs. We need to function properly in society, not in a stupor

  • Comment number 86.

    This comment was removed because the moderators found it broke the house rules. Explain.

  • rate this
    -6

    Comment number 85.

    Can we just stop being so dilatory and agree that any drug use, legal or not (unless prescribed), should be punished with ~5-10 years in prison, or life if class A. Seriously, this whole thing is getting ridiculous. Anybody trying to get 'high' is just a parasite to an otherwise fully functional society, why are we allowing this?

  • rate this
    +1

    Comment number 84.

    Yet another case of ministers dismissing expert advice (and often the expert too), just because their decades of research don't fit in with the narrow views held by politicians who have zero experience of the 'real world'.

    I am now at the stage where I wonder if there is a single politician left who makes decisions based on evidence and not on who's 'supporting' them.

  • rate this
    0

    Comment number 83.

    What dos EU opt-out have to do with drugs?
    If you want to justify drugs, go directly to Big Pharma, ask for the research, testing (double-blind), size of studies, etc. This Big Phama battle, by the way, increases the drug costs in ALL countries while Big Phaarma gets richer; people get sicker & co-operative doctors line their pockets.
    This is a fight worth fighting, but not re opt-out EU.

 

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