Showing posts with label David Nutt. Show all posts
Showing posts with label David Nutt. Show all posts

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





Thursday, 24 June 2010

Better safe not sorry?

The precautionary principle seems like good common sense. If in doubt play safe.  If we are not sure of the actual harms something may cause we should take action now rather than wait for firm evidence. In short better safe than sorry. However the reality can be rather different as David Nutt points out in an excellent blog entitled Precaution or perversion: eight harms of the precautionary principle.

Essential Nutt argues that in respect to drugs the precautionary principle leads to increased harm.  In particular he identifies these 8 harms:
  1. Increases personal harms
  2. Distorts markets to greater harm to society
  3. Impossibility to refute
  4. Disproportionate penalties
  5. Entrenchment of a flawed institutionalised moral position on drugs
  6. Encourages other drug use
  7. Blocks new drug discovery
  8. Denies innovation and medical progress
This counter-intuitive argument is an important one and one that I have used to argue that the harms of drug and alcohol policy are actually greater than the direct harms of the specific substances.


 

Wednesday, 13 January 2010

The Sun says sorry

Regular readers of this blog will be aware of all the fuss surrounding Home secretary Alan Johnson's decision to sack David Nutt as Chair of the Advisory Council on the Misuse of Drugs for telling the truth. In classic New Labour style a nasty attempt was made to get at Nutt through press stories about his children. [Interestingly the evening that Nutt made his speech I ended up chatting to his wife about how alcohol represents the most dangerous drug for young people - our kids are roughly the same ages.]

Stephen Nutt his son complained to the Press Council and their website revealed that the Sun has removed the story from its website and published a letter from Stephen. This was unsurprising not widely published. A google search shows no newspapers reporting on it.

Despite this silence well done Stephen - few take on the evil Sun and win.


Lest we forget


This picture relates to the call to boycott the Sun over its scummy reporting of the Hillsborough tradegy when 96 Liverpool fans were killed. For background read here

Sunday, 1 November 2009

The danger of a loose Nutt



Back in July I blogged about my trip to London to hear David Nutt deliver the Eve Saville Lecture at the excellent Centre for Crime and Justice Studies. Last week an edited version of his paper Estimating drug harms: a risky business was published.

David is a scientist not a politician and much of his work has been about identifying the harms associated with various drugs and other activities. His research shows that most illegal drugs are less harmful than legal drugs and other activities. The fact that horse riding is more dangerous than taking ecstasy and smoking cannabis is far less likely to kill you than wine or beer is an inconvenient truth for a government that whilst supporting the alcohol industry promotes the criminalisation of less harmful drugs on the basis of risk. The chart below produced by Nutt compares the harmfulness of legal and illegal drugs:


This shows clearly that the claim that drug classification is anything to with harm is nonsense.




Despite having demonstrated the nonsense of drug policy Nutt was appointed as Chair of the Advisory Committee on the Misuse of Drugs (ACMD) effectively making the Government's chief advisor on drug policy. Not surprisingly Nutt tried to advise the Government to move towards an evidence based policy and to sort out the mess of the classification system. This was too much for Home Secretary Alan Johnson who following the publication of the Eve Saville Lecture last week sacked Nutt.



Much though I respect David Nutt I thought he was wrong as the classification system needs abolishing not reforming. This case has been made powerfully by Steve Rolles in an article The ABC of UK drug classification - not fit for purpose (pages 7-9). Essentially classification links criminal sanctions to 'harmfulness'. This presumes that criminal justice is the most appropriate method for managing drugs potential harm. This approach has clearly failed with drug use increasing, availability widening, and price falling since it was introduced. It has also seen incentives on producers to produce stronger products and dealers to mix all sort of (often dangerous) rubbish with the product.

I suspect that although Nutt was an irritant to Government whilst he was an advisor, insisting on telling them truths they really didn't want to hear he will be a more substantial critic now he has been sacked. Freed from the ACMD and its role in the classification system he will now be able to look at wider drug policy and use his expertise to critique drug policy in far more detail. His sacking is likely to prove a massive mistake for government.

UPDATE
Two other members of the AMCD have resigned in protest at Nutt's sacking

FURTHER UPDATE
there is a petition which can be signed up to on the Prime Minister's web
site - you can sign it here

It says:

We the undersigned petition the Prime Minister to Re-instate Professor David Nutt On 30 October 2009 the Home Secretary sacked the Chair of the Advisory Council on the Misuse of Drugs. Professor Nutt has expressed politically unpopular opinions such as -

Alcohol ranks as the fifth most harmful drug after heroin, cocaine,
barbiturates and methadone. Tobacco is ranked ninth"

and

Cannabis, LSD and ecstasy, while harmful, are ranked lower at 11, 14
and 18 respectively."

Drug policy should be based on science not hysteria. Scientists
expressing their honestly held expert opinions should not find
themselves in fear of losing their jobs.

Professor Nutt should be re-instated immediate

Thursday, 16 July 2009

Safer Alcohol - A dangerous drug to be banned

I was up in London this week for the Centre for Crime and Justice Studies Annual Eve Saville Lecture given by Professor David Nutt. David who chairs the Home Office's Advisory Committee on the Misuse of Drugs (ACMD) spoke on Estimating drug harms: a risky business.



David has compared the dangers of (high risk) alcohol and (low risk) Ecstasy to highlighted the irrationality of the current system. Last year he got into trouble for pointing out the fact that horse ridding was more dangerous than taking Ecstasy. With colleagues he produced the chart below comparing the harms of both legal and illegal drugs.



What I found really interesting was an aside he made that he was sure he could create an alcohol substitute that had all the "positive" attributes of alcohol but had far less harmful effects. However such a 'drug' would be, he felt, banned under the Misuse of Drugs Act. I will follow up this madness and find out exactly why and the role of the Alcohol Industry in such decision making.