Official Report: Minutes of Evidence

The Chairperson (Ms Kimmins): You are all welcome back. Apologies for the delay today. In attendance we have Canice Ward, head of the medicines regulatory group; Gary Maxwell, head of the health development policy branch; and Karen Simpson, head of the medicines legislation unit. We have just a few minutes for this section. After you make a few opening remarks, I will open it up for questions, if there are any. Thank you.

Ms Karen Simpson (Department of Health): Thank you for the opportunity to brief the Health Committee today on two statutory rules (SRs) relating to the control of a number of dangerous drugs under misuse of drugs legislation: the Misuse of Drugs (Amendment No. 2) Regulations (Northern Ireland) 2024 and the Misuse of Drugs (Designation) (Amendment No. 2) Order (Northern Ireland) 2024. The statutory rules were made and laid in the Assembly Business Office on 19 December 2024, with a coming-into-operation date of 15 January 2025. That was done to ensure parity with legislation that was introduced by the Home Office to amend the UK Misuse of Drugs Act (MDA) 1971 along with amendments to the equivalent GB regulations — the Misuse of Drugs Regulations 2001 and the Misuse of Drugs (Designation) (England, Wales and Scotland) Order 2015 — following advice from the Advisory Council on the Misuse of Drugs (ACMD) on the harms of those substances.

I apologise for the misunderstanding that led to the two statutory rules being laid before the Committee had considered the two SL1s that were originally submitted to the Clerk on 21 November 2024. I assure you that it was not the intention of officials to deliberately progress with the laying of the SRs without the Health Committee having prior opportunity to consider and scrutinise the policy intent in the respective SL1s. As we have now been made aware of the importance of ensuring that the Committee should, in future, have the opportunity to carry out informed policy scrutiny of all SRs prior to being made, we will ensure that that does not happen again.

The purpose of the subordinate legislation is to complement the Misuse of Drugs Act 1971 (Amendment) (No. 2) Order 2024, which applies UK-wide and seeks to control a number of new synthetic opioids that are a substantial current public health threat. They have similar effects to well-known opioids such as morphine and heroin, although some can be more potent. With a high potential for addiction and dependence, lower doses of those substances can lead to the same effects as other opioids. They have an increased risk of accidental overdose that can lead to life-threatening outcomes.

Under the Misuse of Drugs Act, a number of nitazenes, which are another type of synthetic opioid, are already controlled as class A drugs. However, more needs to be done to reduce the opportunity for criminals to circumvent existing controls by making minor alterations to the chemical structure of existing named nitazenes under control.

The amendments to the Act implement the ACMD proposal to introduce a generic definition of nitazenes. The intention is to future-proof the legislation by covering known and predicted variants that are likely to present a significant risk to health. The ACMD has published four updates to address newly structured related compounds under the definition.

Benzodiazepines are sedatives known for use in various treatments, including anxiety, insomnia and epilepsy. In recent years, there has been an increase in the non-medical use of novel benzodiazepines. They and related compounds have been associated with significant health harms. Since the ACMD's last report in 2020, further benzodiazepines and related compounds have been identified that are not controlled under the MDA. As such, the ACMD published new recommendations in March 2024. The ACMD recommended 15 compounds for control, none of which is licensed as a medicine in the UK. As such, in line with the ACMD advice, amendments to the Act seek to control 15 benzodiazepines and related compounds as class C drugs under the Act.

Xylazine is an non-opioid tranquiliser that has been approved for use in veterinary medicine. However, there has been an increase both internationally and in the UK in its illicit use. Xylazine can dangerously lower an individual's level of consciousness, especially if combined with other sedatives, so a further amendment to the Act seeks to control xylazine as a class C drug, as recommended by the ACMD.

The Misuse of Drugs Act 1971 (Amendment) (No. 2) Order 2024 also amends the entry for methoxyphenidine to add an additional common name and its full international standardised name. That does not affect the existing control of the substance as a class B drug, but it adds clarity on exactly which drug is controlled, given that there are multiple common names. To complement the amendments to the 1971 Act, which applies UK-wide, amendments are required to both the separate GB and Northern Ireland's respective misuse of drugs regulations and designation orders to schedule and designate the newly controlled drugs as appropriate. That follows the ACMD advice and will ensure they will be available only for research or other special purposes under licence. Therefore, in both the statutory rules in front of the Committee, the 21 substances controlled by the 2024 No. 2 order, along with the nitazenes that fall under the generic definition, have been added to schedule 1 to the Misuse of Drugs Regulations (NI) 2002 and Part 1 of schedule 1 to the Misuse of Drugs (Designation) Order (Northern Ireland) 2001, owing to their lack of recognised medicinal value in the UK. Consequently, it will be possible to lawfully import, export, produce, possess, supply and administer those substances only under a licence.

As xylazine has legitimate use as a veterinary medicine, it will be placed in Schedule 4, Part 1 of the Misuse of Drugs Regulations (Northern Ireland) 2002, to enable its continued legitimate use. Both sets of statutory rules also amend the entry for methoxyphenidine to add an additional common name and its full international standardised name. That does not affect the existing placement or designation of the substance but adds clarity on exactly which drug is referred to, given their multiple common names.

The amendments to both the Act and the regulations came into force yesterday, 15 January 2025, across the UK to protect the public from dangerous substances and to ensure appropriate controls are in place.

Thank you for listening. My Colleagues and I will be happy to answer questions.

The Chairperson (Ms Kimmins): Thank you, Karen. That was a difficult piece to get through, given all the complex names. Fair play to you for doing that. I have no questions. Danny wants to come in.

Mr Donnelly: Thank you for that. I appreciate that there were a lot of drug names in the presentation. We are familiar with some of them, and nitazenes are seen as highly dangerous, particularly on the streets. Synthetic opioids are very worrying for a lot of drug workers, who find them harder to deal with. Naloxone does not work as well with synthetic opioids as it does with more traditional drugs, such as heroin.

We keep referring to the Misuse of Drugs Act 1971. It appears to me that it is extremely outdated. It is more than 50 years since 1971, and a lot has changed in the world of drugs, and we have seen a lot of changes in drug use. Certainly, across the decades, it has changed unrecognisably. It would appear that the 1971 Act is now very outdated.

I know that it is a reserved matter, and it is not something we can look at here, but large amounts of drugs are, sadly, available in our communities, and we have seen it ourselves. There have been documentaries showing people buying drugs on their phones and having them delivered to their houses. Our streets are awash with drugs. The 1971 Act does not seem to be working. The way in which we are fighting the war on drugs does not seem to be working. Drugs are very much available, sadly, and people are paying a heavy price. Criminals are making huge amounts of money out of drugs, and people's lives are being ruined.

We have talked to families whose lives have been ruined by losing loved ones to drugs. The figures show that there have been 154 deaths in 2022, and we do not have more recent figures. There clearly is a big issue with having those drugs added to the Misuse of Drugs Act, because it is not working. We clearly have to look at something else. I appreciate that there are dangerous substances, and, as you have said, it is about protecting the public from dangerous substances, but it is not working.

I appreciate that the Committee has a process to do. We have substances that are dangerous, and we are putting them onto a system, which is what we are doing today. However, it appears to me that the system is not working, and people are being harmed at an alarming and increasing rate. We certainly need to look at how we are dealing with that. Thank you very much for the presentation.

Mr Gary Maxwell (Department of Health): Thank you, that was helpful. As you have said, the Misuse of Drugs Act is a reserved matter. We have an action in the strategy to work with the Home Office and colleagues to make sure the Act takes account and reflects Northern Ireland's circumstances. We are working with the ACMD and others, who now come to Northern Ireland and hold a meeting once every couple of years to hear the local situation, and that is helpful. A couple of four-nation ministerial meetings on drugs are coming up over the next few months, and they will present an opportunity to reflect the fact that Scotland, Wales, England and Northern Ireland's situations need to be reflected in whatever legislation comes forward. We need to make sure that our case is included in that. I just wanted to let you know that we are doing that work at the UK-level as well as the work that we do locally.

Ms Flynn: Thanks very much. On the back of what Danny said, this process must be followed when there are dangerous substances on the street. It is right that the amendments have come into place through the regulations.

I completely agree that the more important aspect is what we are doing to prevent people from dying from using these drugs. Changing a regulation does not have any impact on the ground for the people who overdose. As you stated, there has already been a massive increase in accidental overdoses from people taking synthetic opioids.

It is good to know that meetings are taking place about things that might be working in England, Scotland and Wales. I know that a proposal was submitted a number of months ago. We have spoken about the rapid drug testing. I spoke to the Minister, Mike, about it, although I think that I only communicated with him in writing. I am not sure where that is sitting. I know that you are introducing initiatives such as the urine samples, so work is being done, but the rapid drug testing would be a game changer when it comes to these drugs, because, as we know, when those are on the streets, whatever they are made up of, if they can be tested and the turnaround time is there and the alert system can be put in place, it saves lives. That rapid testing is used in different parts of Britain and in Dublin, and, while there is a cost associated with it, it is not massive. I just wanted to put that on the public record.

I hope to tic-tac on that, probably with yourselves. I will send Mike a letter to see whether we can get a meeting to see where that is at. I know that you are trying your best and bringing in different initiatives, but that rapid drug testing will make a difference to what we talked about today in relation to benzos.

Mr Maxwell: Conversations are ongoing about that proposal. There are legal issues about how that operates as well as financial issues with meeting it, but conversations are ongoing.

I want to highlight a couple of things. As part of needle exchange, we give out testing strips for nitazenes so that users can test themselves. Those are not perfect for identifying the substance – there are risks with them – but they are, at least, an early warning system that those individuals can use to test their substances and see where they sit. Those testing strips go out to everybody who uses needle exchanges at the moment to try to identify where nitazenes are working. We have worked with forensics, and it seems that they have picked up instances of nitazenes.

At the moment, where we have concerns about a substance, we can get it tested through the PSNI and Forensic Science Northern Ireland. We have access to testing when we have specific concerns about those drugs. Those tend to be drugs that were handed in or seized. It is exactly as you said, Órlaithí: there is a question around the wider process of how we test over time, and we are continuing conversations on that. It is a difficult conversation given the current financial situation, but there are legal implications around how the service would operate, how it would get the drugs and how to dispose of the drugs. All those things that need to be managed.

Ms Flynn: I fully appreciate that, Gary. As I said, we will take that conversation out of today's meeting with anyone else in the Health Committee who wants to take part in it. I get that the testing system is in place at present. Is it Wales that the drugs get sent to?

Mr Maxwell: We can send them to the Welsh Emerging Drugs and Identification of Novel Substances (WEDINOS) service in Wales. However, if we identify a drug of concern in Northern Ireland, we can get that to the police, who will get it to forensics for rapid testing, and we can put out alerts on the back of that. That is done on the basis of there being a concern rather than ongoing prevalence testing. It is more a case of, "This drug seems to have appeared at a couple of incidents. Is there a specific issue with this substance?". We can then get it tested and get information out on it.

Ms Flynn: We will, hopefully, pick up on that, then.

Mr Maxwell: Yes, I will be happy to do that.

Ms Flynn: I will write to the Department on that, but thanks very much for giving evidence today.

The Chairperson (Ms Kimmins): No other members else have indicated that they want to ask a question. Thank you for giving your time; we appreciate it, and it is good to get that information.

I remind members that both rules are subject to the negative resolution procedure and that the Examiner of Statutory Rules has raised no issues with respect to the SRs.

Are members agreed that the Committee for Health has considered SR 2024/222 the Misuse of Drugs (Amendment No. 2) Regulations (Northern Ireland) 2024 and has no objections to the rule?

The Chairperson (Ms Kimmins): Are members agreed that the Committee for Health has considered SR 2024/223 the Misuse of Drugs (Designation) (Amendment No. 2) Order (Northern Ireland) 2024 and has no objection to the rule?

The Chairperson (Ms Kimmins): Thank you, members.