Going Nutts on drugs

Sun 01 Nov, 2009

British government drug policy preaches harm reduction but actually the agenda is moral and political, says Dr. Stephen Ginn

Having been sacked from his position as the chief UK government drugs advisor, professor David Nutt may today be reflecting on the precarious position of anyone who seeks to advise politicians on controversial matters.

For it seems that whilst such an advisory position would appear to call for candour as a job requirement, in reality an expert who expresses an opinion out of step with the thinking of his or her political masters will find this leads to chastisement and the possibility of dismissal. Nutt irked British home secretary Alan Johnson by penning an article which criticised the UK’s drug classification system and in particular the way in which the previous Home Secretary Jacqui Smith ignored learned advice against reclassifying cannabis from class C to B. (1) He also suggested that if the argument against the use of drugs by UK subjects is driven by the drug’s perceived harms, then it would be appropriate to compare these harms to the risks run by users of currently legal drugs as well as other harmful activities.

As far as the Alan Johnson is concerned, this is so say the unsayable. In his letter requesting Professor Nutt’s resignation Johnson wrote: “It is important that I can be confident that advice I receive from the AMCD (Advisory Council for the Misuse of Drugs) will be about matters of evidence. Your recent comments have gone beyond such evidence and have been lobbying for a change in government policy”. (2)

When it comes to drugs, Mr Johnson is not the only person who has admired scientific advice only insofar as it agrees with current policy. As well as ignoring the AMCD’s advice regarding cannabis, Jacqui Smith also vetoed their recommendation that ecstasy be downgraded from a class A drug, a conclusion that involved the AMCD reviewing four thousand scientific papers over a twelve months period. Internationally the situation is hardly better. In 1995 the World Health Organisation conducted a thorough survey on global cocaine use. Although eventually leaked, the full report was never officially published as the US representative to the WHO threatened to withdraw funding unless the organisation dissociated itself from the conclusions of the study and cancelled its publication. (4) The report had suggested that use of cocaine did not necessarily lead inexorably toward either individual or societal collapse.

The debate on drug legalisation appears, as professor Nutt has found, to be almost uniquely charged.

The reasons for this are complex but seem to be rooted in drug use’s consequences being easy fodder for any right wing commentator: people enjoying themselves, youth running amok and slothful hippies. Successive governments have run scared from sections of the popular press that purport to represent the attitudes of the public. It is reasonable to be very wary of drugs as some – but not all – of them have the potential to do great harm, but the current debate is distorted and muddled and the focus on illegal drugs in isolation blinds to the damage currently visited by the excess use of alcohol.

Despite the positioning of politicians, Dr Nutt’s resignation shows us that UK drug policy is clearly driven not by sober reflection of evidence and what this tells us about harm, but rather lip service is shown to scientific opinion which then partially conceals an unacknowledged moral and political agenda.

Stephen Ginn is a medical doctor based in London. He blogs at Frontier Psychiatrist

(1) Estimating drug harms: a risky business?, David Nutt, Crime and Justice Briefing 10, October 2009
(2) Nutt gets the sack, Mark Easton, BBC News, October 30, 2009
(3) See: Advisory Council for the Misuse of Drugs
(4) Copy of leaked report at Transform