This entry concerns a paper by Kathy Glyngell entitled “Cannabis in the UK: Is a persistent culture of denial leaving treatment needs hidden and priming a public health time bomb?” published in The Journal on Global Drug Policy (read it here (PDF)).  First, however, it’s important to give a little background detail about the publishers and the author.

The Institute on Global drug Policy describes itself as

The Institiute (sic) on Global Drug Policy is an alliance of physicians, scientists, attorneys and drug specialists advocating public policies that curtail the use of illicit and misuse of licit drugs and alcohol.

Cathy Gyngell is a regular and high profile supporter of prohibition. She has had this particular bit between her teeth since 2006 or so when she was involved in two research projects for the Centre for Policy Studies, a right-wing “think tank” which has a fine sounding policy agenda:

The Centre for Policy Studies believes in freedom and responsibility. One of Britain’s best known and most respected think tanks, the Centre develops and promotes policies to limit the role of the state, to encourage enterprise and to enable the institutions of society – such as families and voluntary organizations – to flourish.

And

The Centre was founded by Sir Keith Joseph and Margaret Thatcher in 1974 to promote the principles of a free society and has since played a global role in the dissemination of free market economics. Its role in developing the policies of privatisation, low-tax government and support for the family, is recognised across the world.

It’s hard to understand how support for the sort of government infrastructure demanded by prohibition fits with the stated aims of promoting “freedom and responsibility”; whatever the harms associated with drug use may be, there can be no argument that it is a matter of personal responsibility to protect or endanger ones own health and there is a very good argument for demanding the freedom to do what you like with your own consciousness.

It’s even harder to understand how support for prohibition is compatible with understanding and promoting the workings of the free market economy; one of the biggest arguments used in defence of the free market is that it is the principle driving force behind human development. The trade in prohibited drugs is motivated by nothing less than the free market economics of supply and demand and because of the distorted effects caused by prohibition has grown to be in the top three of the worlds industries.

Strange then, that the two basic principles the CPS is founded on go out of the window when it comes to the war on drugs.

However, despite this obvious contradiction Kathy Gyngell is a regular contributor to the CPS blog, as well as a regular in the “Right minds” section of the Daily Mail. The Daily Mail of course, is a “newspaper” with an established track record of alarmist scaremongering about drugs.

This paper can therefore be seen in the context of a right-wing prohibition campaign, it is not a genuine, objective research paper.

An open-minded campaigner  for any cause would be expected to learn from the experience of being a campaigner; not so with people like Kathy Glyngell. Along with other “regulars” of the prohibition campaign such Mary Brett, she has only found ever more convincing evidence (in her eyes) to support her cause as time has gone on. She cherry picks data that supports her case and delivers this data with no context as to why it may be the case.

The latest outpouring from Ms Glyngell came last week and was promoted in an item in Addiction Today (see the previois blog)

Critique of the Paper:

Before we can begin to look at the claims made by Ms Gyngell, there is an important caveat to be made. Simply, many of the health risks she highlights are correct at least to some extent and some may well be correct or should be assumed to be a significant danger by the precautionary principle. So this blog will not attempt to dismiss many of the claims she makes. What is wrong with her analysis is the lack of context she provides and therefore by extension, the conclusions she draws.

The paper starts with a quote from the forward to a paper by the above mentioned Mary Brett

There are few substances which are surrounded by more controversy, and which have at the  same time such important and potentially far-reaching public health implications

Indeed. Which is why there is such a widespread debate about the prohibition of cannabis. To have the situation where such a large trade exists in a totally unregulated psychoactive product does indeed have the potential for public health implications. This is the context Ms Glyngell refuses to rationalise; we are (and have been for several decades) in the position where this trade and culture of cannabis use exists, it is not a theoretical possibility, it exists and it does so in a totally underground way. We are thus not in the position of being able to prevent it from happening, it has happened.

She then makes the first of her illogical statements:

However, it [cannabis] continues to be exempt from the hazardous reputation held by other illicit drugs, drugs which are recognized by government as posing a serious public health risk.

Again, context is important here, cannabis use is widespread and at least an order of magnitude greater than other prohibited drugs, thus a lot of people have direct experience of what it does. The reputation cannabis has for being relatively safe – certainly much less dangerous than most other prohibited drugs, is well understood because, quite simply, it is. Cannabis doesn’t produce anything like the harms associated with heroin or crack cocaine for example. It doesn’t have the hazardous reputation of those drugs because it doesn’t deserve to have it.

The above paragraph however, does not imply cannabis is totally and utterly benign, it implies an understanding of relative harm.

Right from the start she warns of the claimed danger from high potency (low CBD) cannabis – so-called “skunk”. Although UKCIA is quick to draw attention to the near cod science of the evidence to support this move to high potency cannabis (here) – which demonstrates the stifling effect of prohibition on the science surrounding drug use, there is no doubt a big change in the cannabis supply took place during the 1990’s. The supply of imported hash – high in CBD – was  choked off by the prohibition campaign and the resulting demand created the “home-grown” industry we have today. The resulting product is certainly different. However, this change did not come about by itself, it was a change created by the policy of prohibition. Worse, it went unnoticed by the authorities supposedly “in control” for the better part of 10 years.

So when Ms Glyngell warns of the dangers posed by high potency cannabis, it should be put into context; it happened on her watch, under and caused by the policy of prohibition she promotes.

Again, however, there is a reason to accept the possibility of harm from high potency cannabis, we do not deny that. We simply point out that it was caused by prohibition and need not be happening. Cannabis as a prohibited drug is not a controlled drug.

She makes the point that starting young is likely to raise the risk of psychiatric problems. Yes, it is. This is one of those issues where we don’t need proof, the precautionary principle should be enough to understand that children should not be using drugs of any kind, including cannabis. That they are is an indication that something is wrong.

She writes

It is a drug around which, despite this ever growing corpus of scientific evidence, a culture of  denial still persists. Of the mind altering drugs, it is the one with which demands for decriminalization or legalization are most associated.

It is an understanding of what the risks are – who those who need the protection of the law actually are for example – is behind the present drive for law reform, it is not denial. We have terribly high rates of child drug use in this country, that is where the efforts of prevention should be directed. It is simply because cannabis use is so widespread and that adults have a clear established culture around its use that drives this law reform effort.

Prof David Nutt – sacked from the ACMD because he refused to toe the line on drugs policy by the previous government – is slagged off by the comment

He could be accused of burying his head in the sand.

for claiming that legalised cannabis would cause a drop in alcohol consumption through the process of drug substitution, and that this would be a good thing.

She also comments on his published paper “Development of a rational scale to assess the harm of drugs of potential misuse” (here)

 a new classification of harms in which legal ‘drugs’, alcohol and tobacco, emerged more harmful than cannabis and  ecstasy

Why would she have written ‘drugs’ in inverted commas unless she doesn’t accept that they are really drugs? Denial, it seems, isn’t only a criticism of the law reform campaign.

Again, she plays on the fact that age of initiation in the UK is low

Early  initiation into cannabis use turns out to be almost uniquely British. The typical starting age is  much younger than in other European countries – a startling 9 per cent of British school children start using it by the age of 13. In Holland and Germany the number is 6% and  in Sweden just 2%.

Which shows there is something very wrong with the drug laws, although perhaps the blame for which is the head in the sand approach not of drug law reform campaigners, but of the drug laws themselves which seek to deny the reality of British culture.

Young adults are the most dependent on this drug too. As many as 13.3 per cent of users between the ages of 16 and 24 and 9.0 per cent between the ages 25 and34 are judged to be dependent.

That’s probably about right. it is variously estimated that around 10% of cannabis consumers will develop a “dependency” – mostly in the form of a psychological rather than a physical condition. The British Lung Foundation’s recent much criticised paper “The Impact of Cannabis on Your Lungs” (here) gave this summary:

It is estimated that 9 per cent of cannabis users will become dependent over their lifetime. This rises to one in six for people who start using cannabis in adolescence

1 in 6 is 16%

Compared to

The equivalent risks are 32 per cent for nicotine, 23 per cent for heroin, 17 per cent for cocaine, 15 per cent for alcohol and 11 per cent for stimulants

All of which of course will be higher for people who start using in adolescence, but the point is, again, one of context. Cannabis is much less dependence forming than other substances including alcohol (and by a long way) tobacco. An important rider to this of course is that cannabis is unregulated and therefore any harms it may posses will be magnified by the workings of prohibition (uncertain strengths/potency etc). Unregulated alcohol in the form of moonshine would not likely be less problematic than the legal regulated stuff.

In passing it’s worth noting that she doesn’t warn of the most serious health problem surrounding cannabis use; the connection with tobacco. Would she support tokepure?

She then spends the next few pages labouring the point about adolescent use potentially leading to psychiatric problems later in life. To run the risk of sounding like a stuck record, children should not be using drugs and we should do all we can to prevent that happening. Where we differ is how to go about it.

Rather pleasingly CLEAR gets a mention:

Cannabis legalization lobbies continue to ferociously rebut media comment on, or reportage of, any such studies or any reference to cannabis use doubling the chances of developing schizophrenia or that it can induce an irreversible illness. In face of the mounting evidence, they continue to orchestrate rebuttals across government and medical websites and win newspaper retractions through complaints to the Press Complaints Commission.

She justifies that statement with a link to CLEAR’s PCC campaign which I am pleased to have had some involvement with

Over 70 entries in the PCC Category on the CLEAR website indicate that a vigorous campaign is being pursued

Good, she noticed (insert smiley face here). Most of those complaints were against the Daily Mail of course, which is well-known for its comic book approach to news about cannabis. I note she accepts that some of these complaints have been won, so her point is what exactly? Neither CLEAR nor UKCIA has ever “denied” any mental health implications of cannabis use; what we’ve complained about were inaccuracies, falsehoods and general lies.

She writes

Cannabis use has nothing to recommend it.

Which is demonstrably untrue because millions of people decide to use it.

She then quotes from the British Lung Foundation study linked to above that

Young people in particular are smoking cannabis unaware that each cannabis cigarette they smoke increases their chances of developing lung cancer by as much as an entire packet of 20  tobacco cigarettes

A claim which flies in the face of much science. UKCIA carried a review of that paper here

The level of public understanding about cannabis risks is still inadequate. A culture of denial is fed by Professor’s Nutt’s continued public minimization (sic) of cannabis harms and risks. This has impacted on awareness of and need for treatment. Treatment needs remain hidden and unmet, as the many desperate and tragic cases brought to the attention of Charities, such as Cannabis Skunk Sense, and self help groups like Clearhead reveal

Cannabisskunksense is Mary Brett’s site. Clearhead is one we haven’t heard from for a while, but it and the “No need for weed” book was reviewed here

Then we finally get the agenda Ms Glyngell is pursuing

The Government in the UK has neither fulfilled its pledge to run a major public health education campaign, nor has it used the criminal justice system to encourage adolescents and young adults into robust cessation treatment.

The term “robust cessation treatment” is perhaps typical of the language used by prohibitionists; she means strict prohibition enforcement to force people to not use cannabis.

She then discusses the fact that cannabis use is common among people with mental illness. Again, this is not in dispute, what is in dispute is what to do about it.

In conclusion this paper is just the latest in a series of quasi-scientific papers put out by the prohibition lobby in an attempt to undermine the growing calls for cannabis law reform. The message is always the same; prohibition hasn’t worked because we haven’t been doing enough of it.