Daily Archives: April 7, 2010

Drug Politicking “Wash up”

Now we’re into the election period, there is horse-trading going on between the parties as part of what is known as the “wash-up” to push through outstanding legislation on which all agree. No doubt, as part of finishing of Parliamentary business, the classification of Mephedrone and the other Cathinones will also be concluded.

I was surprised at how much media attention my resignation from the ACMD provoked last week; also alarmed at the huge gap between the politicians and the overwhelming numbers of people who contacted me to express support for my arguments for a more evidence-based, Public Health-focussed approach to determining drug policy. Unfortunately, this seems a long way off. Not missing an opportunity to kick the Home Secretary, the Tory Shadow Chris Grayling said the relationship between the government and the ACMD had become “utterly shambolic”. However, just to make sure that we know that he’s ‘tough on drugs’ and, in line with Alan Johnson’s lack of interest in evidence, he added “The decision on Mephedrone was the right one.”

For those who haven’t read the ACMD’s report on the Cathinones (including Mephedrone), which I received after my resignation and which was still in draft form at the time the Home Secretary was appearing on television, announcing the ban “as a result of the council’s swift advice”, it includes the following:

  • Data on Google and FRANK searches – I’m not clear what that’s supposed to tell us other than that people have been curious and/or concerned. This could of course have been due to the media hysteria.
  • Re- acute toxicity: “there are very few clinical data available”.
  • Data that when users consumed massive amounts over 3-day binges they “described vivid hallucinations…However, the quantities consumed are not likely to mirror those of most users.”
  • “anecdotal reports from members of the public that when taken in conjunction with other drugs e.g. amphetamines the effects can be quite marked and lead to personality changes, paranoia and sometimes violent episodes.”
  • Re-deaths: In England Mephedrone has been present at 7 post mortems but inquests have still not taken place. To date, in 1 case, the death was judged to be ‘natural’.
  • In Scotland 1 death has been reported as the result of “adverse effects of Methadone and Mephedrone”.
  • 1 person has been reported as dependent in Glasgow.
  • “Media reports” have indicated that children have been missing classes because of Mephedrone. However, the report later states “Although recent media profile has presented much apparent public health information it is not always credible or consistent.”
  • “At present there remains only limited evidence of a relationship between Mephedrone and anti-social behaviour”…this is judged to be due to the drug being openly dealt and consumed. Would that we could say the same about alcohol!

For those who have accidentally or deliberately misunderstood my position, I am not saying that this drug is safe. I really do empathise with parents who are worried and I believe they and their children need clear, accurate information and advice. Moreover, they need to have adequate support to provide help if they are getting into difficulties with this or any other legal or illegal drug. Rather, I have argued that:

  • Last week ACMD did not have sufficient evidence other than pharmacological evidence presented to us to help us judge harms.
  • We were unduly pressured by media and politicians to make a quick, tough decision to classify.
  • We did this without adequate consideration of how and why young people use this drug and how to develop effective prevention and early intervention strategies.
  • We made a recommendation to the Home Secretary on a partially considered and inadequate report. For political reasons, he heard the bit he was most interested in – Class B! – and accepted a report which hadn’t even been completed.
  • We failed to consider in any detail what the impact of our recommendation to potentially criminalise young users of Mephedrone and to drive its use underground might be.

The House of Commons Public Accounts Committee has just published a report, “Tackling problem drug use”. The report is severely critical of the Home Office’s failure to evaluate the impact of its drugs strategy:

“Given the public money spent on the strategy [£1.2 billion per year] and the cost to society, we find it unacceptable that the Department has not carried out sufficient evaluation of the programme of measures in the strategy and does not know if the strategy is directly reducing the overall cost of drug-related crimes.”

The report also states that the Home Office “does not know how to most effectively tackle problem drug use.” It goes on,

“We consider that measures to reduce problem drug use by young people have had limited impact. Preventing young people from becoming problem drug users is important in bringing down the future number of problem drug users and the associated costs to society.”

Hear! Hear!

In a paper presented to the Commission on Narcotic Drugs in March 2010, Antonio Costa, the Executive Director of the United Nations Office on Drugs and Crime, stated

“Placing human rights at the centre of drug control, crime prevention and criminal justice provides an organizing set of principles that dissolves boundaries between the fields and promotes a single coherent response.”

It should be a human right for young people with problems, rather than simply being criminalised, to be helped to overcome their problems, to have aspirations and support to achieve these. Strategies to prevent and reduce drug harms need to be based on evidence of effectiveness. I hope that in the electoral debates over the next few weeks we might hear some commitment to a root and branch review of drug policy. Which of the leaders is prepared to commit to this and to address drugs as a Public Health issue, shifting responsibility for the drugs strategy to the Department of Health or perhaps to the Department of Communities and Local Government?