UK Liberty

Government on drugs!

Posted in law and order, politicians on liberty, relates to ordinary people, stupid by ukliberty on October 31, 2009

Sort-of-independent body

What is the ACMD?

The Advisory Council on the Misuse of Drugs (ACMD) is an independent expert body that advises government on drug related issues in the UK.

It was established under the Misuse of Drugs Act 1971 and its current Chair is Professor David Nutt.
He isn’t the Chair any more. You see, Professor Nutt was a bit silly. Last week he gave a lecture (well worth reading, by the way) at the Centre for Crime and Justice Studies in which he dared to constructively criticise the Government’s policies on drugs and how policy is developed. Imagine!
Home Secretary Alan Johnson wasn’t happy about that and asked Nutt to step down as Chair.

Wot he said

In his lecture, Nutt discussed, among other things, relative risks – the risk of doing one thing, e.g. horse-riding, compared to doing another thing, e.g. taking ecstasy. Nutt wrote about this earlier in this year and then-Home Secretary Jacqui Smith slapped him down:

He wrote that the risks of horse riding [10 deaths and more than 100 road traffic accidents a year] showed that society “does not adequately balance the relative risks of drugs against their harms”.He said: “Making riding illegal would completely prevent all these harms and would be, in practice, very easy to do.”This attitude raises the critical question of why society tolerates – indeed encourages – certain forms of potentially harmful behaviour but not others, such as drug use.”

There were plenty of other “risky activities such as base jumping, climbing, bungee jumping, hang-gliding, motorcycling” which were worse than which “many illicit drugs”.

We don’t as a society have a good grasp of relative risks – the point being that if you think taking ecstasy is too risky and therefore want to stop people doing it, and it so happens that horse-riding is equally risky, you should think horse-riding should be stopped too. If you are consistent, that is, and genuinely want to base a harm prevention policy on evidence in a careful and considered reasonable way.
Here is a chart he included on drug harm ranking:
drugharmranking
Drugs in the media

In the recent lecture Nutt spoke about the reporting by the media of drugs in drug-related deaths:
Over the decade, there were 2,255 drug deaths, of which the Scottish newspapers reported 546. For aspirin, only one in every 265 deaths were reported – clearly aspirin was of no interest. For paracetamol, there was one newspaper report per 50 deaths, and for benzodiazepines (diazepam and temazepam) one in 15 to one in 50. For morphine, one in 72 deaths were reported, indicating that editors were not interested in this opiate. They were more interested in heroin, where one in five deaths were reported, and methadone where one in 16 deaths were reported. They were also more interested in stimulants. With amphetamines, deaths are relatively rare at 36, but one in three were reported; for cocaine it was one in eight. Amazingly, almost every single ecstasy death – that is, 26 out of 28 of those where ecstasy was named as a possible contributory factor – was reported. So there’s a peculiar imbalance in terms of reporting that is clearly inappropriate in relation to the relative harms of ecstasy compared with other drugs (Nutt et al., 2009). The reporting gives the impression that ecstasy is a much more dangerous drug than it is.
So we get very excited about ecstasy.  That is not to downplay deaths from taking ecstasy, but there are lots of deaths caused by taking aspirin, paracetamol, diazepam, temazepam, morphine, and horse riding.  Why don’t we get as excited about those deaths?  Because we read much, much more about how harmful ecstasy is.   It makes for a better story. Who cares about horse-riding?
The importance of advice to the Government

Nutt also mentioned what happened in 2008 when the ACMD submitted their recommendations on the proposed re-classification of cannabis.  Then Home Secretary Jacqui Smith said,
I have given the council’s report careful consideration. Of its 21 recommendations, I accept all bar those relating to classification. I have decided to reclassify cannabis, subject to parliamentary approval, as a class B drug. My decision takes into account issues such as public perception and the needs and consequences for policing priorities. There is a compelling case for us to act now rather than risk the future health of young people. Where there is a clear and serious problem, but doubt about the potential harm that will be caused, we must err on the side of caution and protect the public. I make no apology for that. I am not prepared to wait and see.
Nutt said of this,
… the precautionary principle misleads. It starts to distort the value of evidence and therefore I think it could, and probably does, devalue evidence. This leads us to a position where people really don’t know what the evidence is. They see the classification, they hear about evidence and they get mixed messages. There’s quite a lot of anecdotal evidence that public confidence in the scientific probity of government has been undermined in this kind of way.
As he said, the extraordinary and terrible fear of MMR has led to great harm, so erring on the side of caution might not be a good idea.
Public perception vs. evidence-based policy making

It’s obvious why politicians’ beliefs about what the public thinks is important.  After all, there could be more votes in banning something than in legalising and regulating it.  But Nutt & co. have looked at what the public thinks about drugs and it is rather more complicated, as you might expect, than people simply thinking that drugs should be illegal and users should be banged up for decades.
Incompetent and unaware of it

Nutt also discussed the paper he and others wrote about the relative risks of illegal drugs and legal drugs – comparing for example alcohol and tobacco against illegal drugs.
I believe that using analogies with other harmful activities helps us engage in appropriate debate about relative harms of drugs. One problem is that sometimes you get into what I think of as an illegality–logic loop. This is an example of a conversation that I’ve had many times with many people, some of them politicians:
MP: ‘You can’t compare harms from a legal activity with an illegal one.’
Professor Nutt: ‘Why not?’
MP: ‘Because one’s illegal.’
Professor Nutt: ‘Why is it illegal?’
MP: ‘Because it’s harmful.’
Professor Nutt: ‘Don’t we need to compare harms to determine if it should be illegal?’
MP: ‘You can’t compare harms from a legal activity with an illegal one.’
repeats …
I have been surprised how difficult this concept is to get across to some people, whether they are politicians, fellow scientists or members of the general public. The supposition that if something is illegal its harms can’t be assessed in the same way as if it were legal is one that is quite difficult to break.
Isn’t that extraordinary?  Just because something happens to be legal, it cannot be assessed in terms of harm in the same way as something illegal.
Well said

Do read Nutt’s lecture, it’s well worth your time if you are interested in this subject.
The last paragraph:
Another key question we have to address as a society is whether our attitude to drugs is driven because of their harms or are we engaging in a moral debate? One thing this government has done extremely well in the last ten years is to cut away much of the moral argument about drug treatments. They have moved in the direction of improving access to harm reduction treatments, an approach that, I think, is wholly endorsed by the scientific community and by the medical profession. For reasons that are not clear, the same evidence-based change has not happened in relation to the classification of drugs of misuse. I think it should happen because, while I’m not a moral philosopher, it seems to me difficult to defend a moral argument in relation to drugs if you don’t apply it to other equally harmful activities.
Very reasonable point, I think.
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