Thursday, 28 October 2010

Drug Policy Harm Part Two: Misrepresenting Harms

Continued from Drug Policy Harm Part One: Social Harm Theory -v- Criminology

The Myth of the Misuse of Drugs Act and Harm

The prohibition of certain classes of drugs is a policy decision which has cross-party consensus with both the last Labour and the current Conservative/Liberal Democratic Governments supporting this arrangement and indeed keen to include any new drugs that emerge on the market.  The core piece of legislation underpinning this policy is the Misuse of Drugs Act 1971 (MDA) which seeks to control specific drugs through criminal justice interventions based on the scientific classification of their harms. (Jason-Lloyd 2007) Although harm appears to be an established component of this regime this is an illusion than needs exposing. To do this I want to highlight the work of David Nutt, an eminent scientist and former chair of the scientific committee, established by the MDA, to advise the Home Secretary on drug policy.

Nutt (2009:4) raises ‘the critical question of why society tolerates –indeed encourages – certain forms of potentially harmful behaviour but not others’, highlighting the comparative risks of ecstasy and alcohol, ecstasy and horse riding and the relative harms of legal and illegal drugs. (Nutt 2006, 2009 & Nutt et al 2007) In figure 1 below Nutt (2006:316) compares the relative harms of the two E drugs, ethanol, better known as alcohol, and ecstasy and his figures make clear that the harms caused by alcohol are dramatically greater than ecstasy. 
Figure 1 (Source: Nutt 2006:316)
In fact what is clear from this is how much harm alcohol causes; twenty two thousand premature deaths, one thousand five hundred road traffic deaths and over 10,000 cases of interpersonal violence per annum, and how little harm is caused by ecstasy. Yet earlier in 2009 the government choose to retain ecstasy’s classification as a class A drug under the MDA. (Home Office 2009, ACMD 2009)

In an interesting analysis Nutt et al (2007) attempted to incorporate both legal and illegal drugs in a single hierarchy of harm. The results, published in the Lancet and shown in figure 2 below, clearly demonstrate the lack of any clear correlation between a drug’s harm and it’s classification under the MDA. Methodologically this study is not unproblematic and remains trapped in the paradigm of prohibition. For example, considering the most harmful drug, heroin, it fails to separate those harms intrinsic to it as a chemical substance and those harms that are generated by its legal status. (TDPF 2009:12-13) Hopefully this exercise will be repeated with the harms directly attributable to prohibition disaggregated. Would illegal street heroin have exactly the same level of risk of harm as prescribed heroin?

Figure 2 (Source Nutt et al 2007:1050)
 In an editorial in the Journal of Psychopharmacology, Nutt returned to comparisons of the relative harm of two ‘e’s, this time Ecstasy and Equasy (Equine Addiction Syndrome). Figure 3 below summarises his results. The legitimacy of his comparison of their respective harms generated a strong backlash with, the Home Secretary, Jacqui Smith, declaring that she was  ‘sure most people would simply not accept the link that he makes up in his article between horse riding and illegal drug taking.’ (BBC 2009) 
Figure 3 (Source: Nutt  2009:4)

Melanie Phillips (2009) commenting on Nutt’s paper declared ‘The only reason there are not many more deaths from ecstasy is that unlike horse riding, it is illegal.’ In fact the relationship between ecstasy’s illegality and fatalities associated with use are more complex. Its illegality removes the opportunity for any quality controls, it has led to moral panics, misinformation and has potentially impacted on levels of consumption. Lack of quality control means the consumer has no reliable information about ingredients and this lack of regulation leaves the control of the exact composition of the product retailed, and the health and welfare of consumers in the hands of organised crime. Moral panics over ecstasy have undoubtedly created harm; Leah Betts, the iconic ecstasy victim, died from water intoxication, consumed on the misunderstanding promoted by the press that vast quantities of water were the antidote to ecstasy. (Joseph 2000:91) Illegality therefore certainly increases the risk of death but does it deter use, thereby reducing the risk as well?

The Home Office claims that ‘(d)rugs are controlled because they are harmful. The law provides an important deterrent to drug use and legalisation would risk a huge increase in consumption’; though they provide no evidence to support their assertion. (Easton 2009) The Number Ten Strategy Unit, whose confidential report on drug policy to the cabinet in 2003 was leaked to the Guardian, concluded that ‘attempts to intervene have not resulted in sustainable disruption to the market at any level.’ (SU Drugs Project 2003:104) This conclusion was backed up by the UK Drug Policy Commission whose research concluded that ‘seizures and enforcement efforts have had little adverse effect on the availability, purity and price of illicit drugs in the UK ‘ and that ‘(s)ince 2000, average street prices in the UK have fallen consistently for heroin, cocaine, ecstasy and cannabis.’ (Mc Sweeny et al 2008:48 & 40)

Figure 4 below is reproduced directly from the Number 10 Strategy Unit’s report to the Cabinet. It demonstrates how effectively use of Heroin has been controlled since the introduction of the MDA. Illegal drugs are today widely available, at historically low prices, suggesting that prohibition has neither reduced supply nor demand, both of which have actually grown dramatically over the last forty years. Whatever their ambitions it is clear that the MDA and the prohibitionist paradigm in which it operates have not reduced harms.

Figure 4 (Source: SU Drugs Project 2003:38)
The lighter columns are addicts notified to the Home Office, and the darker columns from 1997 when the HO notification system was shelved, are numbers in treatment.

Continued ... Drug Policy Harm Part Three: The Failure to Regulate

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