Scientific advice and policy confusion
As I’ve pointed out in the past, the drug policies of most governments are profoundly irrational. They are based upon ideology, spurious reasoning and outright falsehoods. Furthermore there is no evidence whatsoever that they achieve their stated aim. In fact, the circumstantial evidence available seems to suggest they have precisely the opposite effect to that which is desired by policy makers. Prohibition appears to increase drug use, as well as increasing the social problems associated with that drug use.
Never has this bizarre irrationality been thrown into more stark relief than with the British decision to sack Professor David Nutt. Professor Nutt was the UK’s chief scientific advisor on drug policy and chaired the Advisory Council on the Misuse of Drugs (ACMD). In response to his dismissal two more members of the council have resigned and there are rumblings that the entire ACMD is about to dissolve in disarray with Professor Nutt claiming that there is “no future for the council in its present form”.
Nutt is a psychiatrist and pharmacologist. He heads the Psychopharmacology Unit in the Faculty of Medicine and Dentistry at the University of Bristol, is a Consultant Psychiatrist to Avon and Wiltshire Partnership NHS Trust and is Head of the Department of Neuropsychopharmacology and Molecular Imaging at Imperial College London. He was appointed Chairman of the ACMD because he probably knows more about the science of drug use than anyone else in the UK.
Professor Nutt was fired by the British Home Secretary, Mr. Alan Johnson. Johnson left school when he was 15 to stack shelves at Tesco. He then worked as a postman for a while before becoming a career politician.
Science Vs Policy
In a letter to Professor Nutt, Alan Johnson informed him he was being dismissed because “I cannot have public confusion between scientific advice and policy”.
This is a remarkable admission, by the man in charge of UK drug policy, that the policy is not based upon scientific advice. It’s reminiscent of the Bush Administration’s contempt for what they described as “the reality-based community”.
We’ve known for years, of course, that the British government (along with almost every other) do not base drug policy on the scientific advice of those actually qualified to provide it. Professor Nutt’s statements about the relative dangers of various drugs (the statements that got him into all this trouble) are very similar to the conclusions reached by the Wootton Report forty years ago. According to that report (published in January 1969), “Cannabis is less dangerous than the opiates, amphetamines and barbiturates, and also less dangerous than alcohol.”
In Nutt’s case, his indiscretion was to provide a list of commonly consumed drugs in order of the harm they cause based upon the scientific evidence available. Cannabis is listed in 11th position while alcohol is 5th and tobacco 9th.
It’s worth pointing out that this list was published two years ago. In the intervening period, Nutt has essentially watched as every piece of scientific advice provided by the ACMD has been ignored, while at the same time parliament’s Home Affairs Select Committee sought the advice of Amy Winehouse’s dad (a cab driver)* on drug policy. One imagines that Professor Nutt’s frustration began to increase when he noted that his advice was not merely being ignored, but that policies were being pursued (the reclassification of cannabis as a Class B substance) which actively contradicted his advice.
I would argue, despite Alan Johnson’s claims, that Professor Nutt was not merely right to inform the public that his advice was being ignored, but actually had an obligation to do so. The public, after all, should know the basis upon which policy is being decided. Particularly if that policy involves the potential criminalisation of between 2 and 5 million people (“In the UK, around 15 million people would now admit having tried cannabis, with between 2 and 5 million regular users.” — Cannabis Use in Britain, PDF).
Professor Nutt, and it’s worth making this clear, never made any specific policy recommendations. He didn’t call for legalisation or decriminalisation and never suggested that cannabis or ecstasy were harmless. He merely made the following observations:
- most of the drugs for which we currently incarcerate people for using are less harmful than drugs we sell in corner shops and derive tax from.
- some of the drugs for which we currently incarcerate people for using are less harmful than common recreational activities such as horse-riding.
- there is absolutely no evidence whatsoever that the current drug classification system results in a reduction of drug use.
- the current drug classification system may actually result in significant social harm.
- numerous statements made about drugs by politicians are demonstrably false (including Gordon Brown’s bewildering comment about “lethal cannabis”).
I am forced to wonder, now that Alan Johnson has admitted that drug policy isn’t actually evidence-based (not in those words of course, but it’s the inescapable interpretation), just what he believes it is based upon. Whatever it is, the tories are clearly in on the secret as David Cameron is — unsurprisingly — supporting Alan Johnson on this issue and suggesting that Professor Nutt’s comments about ecstasy were not “a particularly good way of putting it” (it seems Nutt failed to spin the truth sufficiently to make it palatable to Cameron’s irrational hardline stance).
Of the mainstream politicians, only the Liberal Democrats seem to have worked out exactly what’s going on, with Chris Huhne insisting that “any minister who hides away from scientific advisers who are saying clearly what the scientific evidence shows is frankly going to end up with policy which is a complete mess.” He also suggested that the government may as well set up “a committee of tabloid newspaper editors to advise on drugs policy”.
Personally I suspect they already have.
Tune in next week when Gordon Brown appoints a window-cleaner from Stoke to design the next generation of nuclear power stations.
Hold on a minute Jim. I agree that the sacking of Nutt is unacceptable, and I’d support a re-design of British drug policy along the Portugese line, but I’m strongly resistant to the idea that policy should flow directly from scientific advice, no matter how good the advice.
Making drugs policy should involve scientific advice on the real impact of drugs, yes, but should also incorporate values and social norms which are not a matter on which we can ever take expert advice. And I think a postman or a cabbie are just as well qualified to comment about the moral issues around drugs – just not the scientific ones.
November 2nd, 2009 | 4:50pm
by Stephen Whitehead
Well, I’m afraid we disagree profoundly on this then, Stephen. I don’t dispute that a postman or a cabbie are “just as well qualified to comment about the moral issues around drugs” as anyone else. I just don’t think that the moral issues around drugs should play any part in policy formation.
As it happens, I personally believe that drug prohibition is morally repugnant (I insist that my body is my own property and that drug prohibition asserts a government’s right to stipulate what I may or may not do with it, up to and including imprisoning me if I disagree).
So bringing morality into such an important policy area is extremely problematic and essentially boils down to “well, my parents told me it was wrong, so you’re going to prison” (morality is the internalisation of parental beliefs, and only insofar as parental beliefs reflect social norms, it is the internalisation of those norms).
If anything we should tie social policy (in this area and perhaps all others) to some objective evaluation of social harm. I would argue that the evidence available demonstrates that current policy does more harm than good.
Your position is basically an argument in favour of Sharia law in Afghanistan or Somalia.
November 2nd, 2009 | 5:14pm
by Jim Bliss
I’d like to think of it as a qualified argument in favour of democracy, but let’s not quibble.
I don’t want to get drawn into defending current drug policy (that’s really not a position that comes naturally to me) but I do want to question the idea that evidence alone can be a sufficient guide to any policy decsions.
Drug policy, like any other complex area of public policy, involves multiple competing goals – improve public health, reduce crime, reduce institutional corruption, reduce nuisance behaviour of various kinds. Scientific or and social-scientific evidence can tell us a lot about how different policies perform against these different criteria (and I think that we can agree that prohibition is a big fat wash-out on most of them) but it can’t tell us which is the most important or how we choose between policies that perform better on different criteria.
If we accept that policy should be made solely by technocrats then we are abandoning the real ideological conflicts that sit behind many areas of policy making. It might get us to the right place on drug policy, but we abandon any kind of visionary or transformative politics in favour of wonkish fiddling to meet an unquestionable set of goals that, likely, entrench many of our existing problems.
Campaigners for a change in drug policy (which includes myself) need to accept that the major stumbling block is public opinion, and attempt to change that by combatting the misinformation pumped out by mad Mel and her ilk. Nutt had exactly the right approach, and he suffered for it, but I don’t think that the solution is to put him in charge.
November 2nd, 2009 | 5:35pm
by Stephen Whitehead
Hey Stephen. I’m not sure how familiar you are with this blog and the opinions I express on it, but I should probably point out that I’m not a great believer in democracy. My research in the field of group psychodynamics has left me with very little faith in the decision-making ability of crowds. I believe that a centralised representative democracy is a dreadful way of running human affairs.
Which is not to say that democracy has no place within our decision-making process, merely that limitations should be placed upon it.
Whether it’s drug policy or — my current area of interest — sustainability, I do not believe that an elected government should be permitted to implement policies which can be clearly demonstrated to cause more damage than they prevent. Large groups of people can be manipulated into acting in extraordinarily destructive (and self-destructive) ways with worrying ease.
Now, we can all sit around a table and thrash out the definition of “damage” (though I’d suggest in the case of drug policy, it’s pretty self-evident that more social and individual harm is created by prohibition than is prevented by it). And in those cases where there is no clear evidence, or the evidence is in reasonable doubt, then the arbitrary preferences of the majority should probably be pursued.
I don’t accept that “morality” (more often than not, an inherited and unexamined value-system) should play a major part in the creation of social policy except in the sense that “social policy should not do more damage than it prevents” is itself a moral statement. However, it’s a moral statement based upon a demonstrable truth, i.e. that which harms our environment / society harms ourselves.
It is not unreasonable to suggest that such harm should be avoided and that those who attempt to inflict it upon themselves and others should not be permitted to do so. The use of drugs can — and often does — result in harm for the user and occasionally those around them. The criminalisation of drugs results in significantly more harm. Therefore, the criminalisation of drugs should not be a democratic decision.
November 2nd, 2009 | 9:42pm
by Jim Bliss
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November 4th, 2009 | 3:48pm
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