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?

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19 responses to “Drug Politicking “Wash up”

  1. Dave Parsons

    As I have said previously on your multiple confusing blogs
    make all drugs and chemical compounds illegal until tested and proved harmless.

  2. Aside from the recommedations (which should obviously have been discussed in more detail in light of the technical report) I actually think the report is a fine piece of work, in terms of a harm assessment, given the limited data, and I note it is careful to caveat all its content with details about data problems.

    Using google trends seems very smart to me given the shortage of other sources – and what it shows is that interest in the drug was fuelled by the media panic – hardly suprising that that particular factoid didn’t get any coverage.

    The clarification on drug death stats was also very useful – although barely reported.

    It wasn’t really the harm assessment that was at fault – i doubt it will be shown to be off beam – it is the idea that translating that into a hierachy of criminal penalties for young people via the MDA is a good idea, or is supported by an evidnce base to show it delivers good outcomes. Thats what the ACMD never consider and where they are seriously remiss.

  3. pineal gland band (herman)

    “”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””

    well thats a prohibition paradox

  4. Dave Parsons – what is deemed ‘harmful’? Alcohol – harmful, caffeine – harmful. In fact, pretty much everything we consume for ‘pleasure’ is harmful. Banning every single chemical compound would be a ridiculous thing to do – there are chemicals that are toxic to consume, but useful in other situations.

  5. Hi Eric , and again well done for getting the tone just right. The expedient approach of politicians and Home Office /Government is shown up here and in other (sex Education for instance) areas to be faulty and discriminatory in the extreme.
    £1.2 billion spent with no info about outcomes effectiveness/ change or process.
    That in itself should have the NTA resigning and the CJ lobbyists crashing in flames. But they just carry on imprisoning people with major mental health and social and educational exclusion issues, from the poorest communities where their home lives are terrorised by criminal drug dealers and their enforcers.
    If we say it long loud and hard eventually we will get somewhere.
    I take the libel reform group as my measure of how the pendulum can be swung back.

  6. What gets me is there only seems to ever be two options when it comes to drugs – allow an unrestricted trade or full blown prohibition. Why oh why is regulation and control never, ever considered?

    If the problem is kids buying a drug, then why not impose age limits for sales?

    Why, for example, should I as a 56 year old bloke be prohibited from taking this or any other drug on the grounds that kids are taking it?

    There are many options for regulation of the supply side, so why is it never considered? I seriously can’t understand why you never made points like this in your media interviews Eric, instead you seemed to defend prohibition as a regime.

    Prohibited drugs are not and should never be called “controlled drugs” frankly. Unless we properly control the trade in drugs vulnerable people like kids will always be in the firing line.

  7. No not ‘legal’ and ‘illegal drugs’ – this is why we have this all or nothing approach. They don’t exist – get this part right and rest will fall into place conceptually. Derek is being misleading in his last paragraph. Drugs are labelled controlled drugs in law, he is right that this problematic as well, it is a paradox of course, but this status does not have to equate to ‘prohibited’ drugs as he calls them. Controls should equate to the sort of differentials he describes (although there are probably are good reasons not to go on a 3 day fiending session at age 56 which don’t apply to younger types!).

  8. I am a young persons drug worker, and over this last year I have seen many problems ascociated with this drug. However many of the young people who have been using it are not criminals, they are very often experimenting or exploring the world they live in… And some of them are troubled YPs who seek any route to oblivion to block their pain or escape their reality. I fail to see how criminalizing these young people will benefit anybody. Surely we should be concentrating our efforts to protect our young people by much earlier prevention strategies, by encouraging YPs to be aware of coping methods, developing resilience and awareness of mental health, mood swings and stress.

  9. Jacques Cartier

    I’m starting to think that a new language is required. Clearly, English is not capable of expressing ideas in a non-emotive, formal manner. Any phrasing is seized on by people and twisted.

    We need a language that can express an exact concept, which cannot be misunderstood. It would be used by scientists to give advice to (say) politicians in a way that makes it impossible to interfere with the meaning.

  10. Have a look at the latest John Fisher story under More Carpery

  11. see latest story on the ban the ballot website

  12. Dear Eric Carlin,

    For information and possible interest, here is an article which I wrote for the Scotsman, 13th April, 2010. It was prompted by your resignation from the Advisory Council on the [mis]Use of drugs:

    http://thescotsman.scotsman.com/opinion/Hugh-McLachlan-Mill–makes.6221095.jp

    Hugh McLachlan: Mill makes us mull more on mephedrone

    Published Date: 13 April 2010
    By Hugh McLachlan
    A SCIENTIFIC adviser, Eric Carlin, resigned recently from the highly controversial and troubled Advisory Council on the Misuse of Drugs in the wake of its recommendation to make the sale, possession and consumption of mephedrone illegal.
    He was deeply concerned about “the potential criminalisation of increasing numbers of young people”. This raises the general question of what the role of the criminal law should be. What is the justification for prohibiting particular actions and for punishing those who commit them?

    The proposed “harm principle” of John Stuart Mill, given in his stimulating essay On Liberty, is a useful starting point for considering this matter systematically. According to him: “…. the only purpose for which power can be rightfully exercised over any member of a civilised community, against his will, is to prevent harm to others.”

    He further specifies that: “His own good, either physical or moral, is not a sufficient warrant. He cannot rightfully be compelled to do or forbear because it will be better for him to do so, because it will make him happier, because, in the opinion of others, to do so would be wise, or even right.”

    We may remonstrate with people, according to Mill, and try to persuade them of the error of their ways. However, as long as they are rational adults who are acting voluntarily, we should allow them to make their own mistakes.

    Mill draws a distinction between those actions which concern other people and those which concern only the actor himself. With regard to the latter, according to Mill, the individual is not answerable to society and should be sovereign. However, this sort of distinction is controversial. Some people argue that it is not a meaningful one and that all of our actions can potentially affect other people one way or another. Hence, some people feel that it is justifiable to criminalise the taking of drugs even although drug-taking might appear to be an individualistic action.

    In response, it should be said that harm is a necessary but not a sufficient condition for restricting the liberty of the individual, according to any reasonable interpretation of Mill’s principle. Adult, rational human beings should be allowed to do what they choose to do if, but not only if, their actions do not harm other people. Even if their actions indirectly harm other people, their actions should still often be permitted.

    What counts as “harm”? What does it mean to say that an action “concerns” other people? These are awkward questions for a supporter of Mill’s position.

    The distinction Mill wants to make is not merely between those actions which affect other people and those actions which affect only the actor himself. He wants to distinguish between actions which breach the rights of other people and actions which do not breach their rights, whether or not they affect the other people adversely.

    He writes: “With regard to the merely contingent or… constructive injury which a person causes to society, by conduct which neither violates any specific duty to the public… or to any individual except himself, the inconvenience is one society can afford to bear for the sake of the greater good of human freedom.”

    This distinction, although difficult to make in practice, is of crucial importance. For instance, it could be the case that those who vote for candidates of one or other of the major political parties harm the rest of us if the government they help to elect makes a bigger hash of things than an alternative government would have made. However, it does not follow that such voting behaviour should be a crime. Our rights are not violated by such an action even if our interests are damaged.

    In an obvious sense, it concerns others if you live to a great age and enjoy for a long time a state pension and publicly funded healthcare. It concerns others if you do things that lead to using the resources of the NHS or any other public funds. It concerns others, harms them one might say, if people climb mountains or jog and get injured or take drugs and become ill and need expensive hospital treatment. However, it does not follow that taking drugs, climbing mountains or jogging should, on that account, be criminal offences.

    From what he says about alcohol, we can apply Mill’s view to the taking of drugs. He thinks that if people neglect their duties because they are drunk, they should be punished for neglecting their duties but not for the drunkenness as such, which is their own business. Similarly, it might be suggested that people should not be punished for or prohibited from taking drugs although they could be rightly punished for any harmful actions to others which are a consequence of their drug-taking.

    We might, as the saying goes, be tough on the crimes, but the causes of the crimes are not always our business to regulate or punish.

    There is a strong case for saying that things should always be legally available for sale to the public under, but only under, certain conditions. It is debatable whether or not these conditions could prevail in the case of some particular drugs. Whether the possession and consumption of drugs should be criminal offences is another matter. For instance, to say that it should be a crime to sell cigarettes to a minor is not to say that it should be a crime for a minor to smoke or be in possession of a cigarette.

    Actions should be legally permitted unless there is a justification for prohibiting them and for punishing those who perform the actions. Prohibition and punishment often is justifiable. However, the point is that it requires to be justified or it stands condemned. The onus is always on the banners to justify the bans. When is prohibition and punishment justifiable? If we reject Mill’s harm principle, we have the problem of suggesting what to put in its place.

    Mill raises a very challenging issue. To punish people for taking drugs because drugs are harmful to the drug-takers is perverse. To punish people for taking drugs in order to deter other people from taking drugs is unfair and unjust. The only acceptable justification for punishment is that the people who are punished deserve the punishment. It is not easy to see how we can justify punishing people who have not harmed others in such a way that their rights are infringed. Why else would they deserve punishment? Why else would we be justified in meting it out?

    • Hugh V McLachlan is professor of applied philosophy at the School of Law and Social Sciences at Glasgow Caledonian University

  13. The Lancet expresses concern and calls for a review of the Misuse of Drugs Act:

    http://download.thelancet.com/pdfs/journals/lancet/PIIS0140673610605569.pdf

  14. I’m just wondering. As the UK brought the cathinone analogues into the B class of illegal drugs, what will the people, who didn’t use illegal drugs but did use mephedrone/methylone, think of the dangers of other B class drugs?

    Maybe is’t a good research starting point?

    • Research about behaviour seems to be low priority but it’s a point well made. Does anyone honestly think that in deciding to use illegal drugs people consider what class they are? Would young people really be aware of the legal risks they are taking in using Ecstasy as a Class A drug? Yesterday on Jeremy Vine’s Radio 2 show there was a manufacturer of mephedrone who made it clear he was now working on producing a whole new range of legal drugs…so we’ll ban these and then the next…I interviewed a young man 3 weeks ago who, in response to my question about what made him feel good about himself, in control and hopeful. He said, honestly, “Smoking weed”.

  15. True enough…

    Does anyone honestly think that in deciding to use illegal drugs people consider what class they are?

    If the classification would be sound, then I hope they would. But people see the discrepancy between what they see and what the classification says – alcohol included. I don’t know how it is in the UK, but here we see more drunks then drug addicts.

    The states have a analogue act that covers most of the things you are banning now, but they still have a big drug problem. If you make synthetics illegal and harder to get, people will turn to products that are readily available and well established (cocaine, heroin). What I have observed is since MDMA has been “missing” for the past two years in my country there has been a massive increase in cocaine consumption in the population that was using MDMA. (and I know, correlation doesn’t mean causation)

    • Yes, of course alcohol is a far bigger social and health problem than the illegal drugs and in the UK the ACMD has recommended that it or another equivalent body should advise on appropriate measures to prevent and reduce harm. To no avail. Re-MDMA (Ecstasy): against the ACMD’s recommendations this is crazily categorised as Class A, alongside heroin and cocaine. The UK Home Office has trumpeted the fact that Ecstasy use has reduced; however, this has been at the same time that Cocaine use has increased. For me, that’s not a success.

  16. As if all the above were not astonishing enough, now we hear that they are closing the Wellcome Institute for the History of Medicine. Those who do not study history are bound to repeat it, as the present case so well illustrates. I weep for biomedical science in the UK!

  17. yeah i know what you mean, i actually used hxxp://www.energyplantfood[com]

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