Nov 2009

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:

  1. 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.
  2. some of the drugs for which we currently incarcerate people for using are less harmful than common recreational activities such as horse-riding.
  3. there is absolutely no evidence whatsoever that the current drug classification system results in a reduction of drug use.
  4. the current drug classification system may actually result in significant social harm.
  5. 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.

* I’m not suggesting that Mr. Winehouse’s observations about the lack of rehab facilities for heroin addicts aren’t valid, merely that Professor Nutt is bound to wonder why the government bothers soliciting scientific evidence and advice in the first place, if policy is ultimately going to be made by a postman who consults a cabbie.

Posted in: Opinion