Estimating drug harms

In the 2009 Eve Saville lecture delivered this past July, Professor David Nutt of Imperial College London, also the chairman of the UK government’s Advisory Committee on the Misuse of Drugs, made some claims that few of us would contentious:

* He argues strongly in favour of an evidence-based approach to drugs classification policy
* Estimating drug harms David Nutt UK drugs Centre for Crime and Justice StudiesHe argues that by erring on the side of caution when it comes to drug information, politicians ‘distort’ and ‘devalue’ research evidence. “This leads us to a position where people really don’t know what the evidence is’, he says.
* He argues that the relative harms of legal drugs such as alcohol and tobacco are greater than those of a number of illegal drugs, including cannabis, LSD and ecstasy.
* As such, he proposes a ‘drug harm ranking’, which would compare the harms caused by legal as well as illegal drugs, making no distinction between them. Alcohol ranks as the fifth most harmful drug after heroin, cocaine, barbiturates and methadone. Tobacco is ranked ninth. Cannabis, LSD and ecstasy, while harmful, are ranked lower at 11, 14 and 18 respectively.
* He argues that stopping the ‘artificial separation of alcohol and tobacco as non-drugs’ is the only way to assess the real harms of all drugs.
* Professor Nutt concluded by saying, “We need a full and open discussion of the evidence and a mature debate about what the drug laws are for – and whether they’re doing their job.”

You can read an edited transcript of Professor David Nutt’s 2009 Eve Saville lecture here.

In reaction to Nutt’s call for full and open discussion and mature, evidence-based debate, UK home secretary Alan Johnson wrote to Nutt to say he no longer had confidence in him as chairman of the Advisory Committee on the Misuse of Drugs. And then Johnson fired him.

A Home Office spokesman said: “The home secretary expressed surprise and disappointment over Professor Nutt’s comments which damage efforts to give the public clear messages about the dangers of drugs.”

In his reply, Nutt said: “If scientists are not allowed to engage in the debate then you devalue their contribution to policymaking.”

Phil Willis, a Liberal Democrat MP who chairs the Commons science and technology committee, said independent advice to the government was essential and the sacking of Nutt was “disturbing if an independent scientist should be removed for reporting sound scientific advice”.

Harry Shapiro, director of communications for DrugScope, said: “The home secretary’s decision to force the resignation of the chair of an independent advisory body is an extremely serious and concerning development and raises serious questions about the means by which drug policy is informed and kept under review.”

UK drug policy is based on the Misuse of Drugs Act, which divides drugs into three classification groups, supposedly according to the danger they pose. Class A are considered the most dangerous and net offenders the harshest punishments. Politicians can move drugs from one class to another as long as they have commissioned a report on the proposed change from the Advisory Council on the Misuse of Drugs, of which David Nutt was chairman. The government is not bound by the Council’s advice, however; it simply has to seek it out before reclassifying a drug.

Anyone who follows the scheme knows that some drugs have changed classes with a comedic absence of rational decision-making. For example, last year Home Secretary Jacqui Smith rejected the Council’s advice to maintain marijuana as a class C drug and reclassified it as class B anyway, claiming that stronger strains of pot are linked to mental illness. Nutt has argued that smoking pot poses only a “relatively small risk” of psychotic illness.
In February of this year, Jacqui Smith vetoed the Council’s advice that ecstasy be downgraded from class A to class B based on a review of over 4,000 scientific papers on the drug’s potential harms. Professor Nutt argues that LSD, marijuana, alcohol, tobacco and 13 other drugs all pose more potential harm than ecstasy.

With a UK election just around the corner, it’s worth UK voters considering whether or not the candidate they vote for believes public policy, including drug laws, should be based on scientific evidence or something scary we read about in HELLO! magazine. Because there are far too many people – poor people, black people, everyday people who just like to party – sitting in publicly-funded jails all because they prefer to sell pot and ecstasy instead of the more harmful cigarettes and alcohol that governments profit from.

Why do we let our politicians get away with it?


[via The Guardian]

This post first appeared at Ickaprick & Ironpussy and was cross-posted here by the original author.

Nico Little

Nico Little is an Anglo-Albertan who decamped to Montreal sometime in the late nineties “to learn French and be gay.” He then moved to Ottawa, Ontario, where he worked as an HIV outreach...