The unknown unknowns; what and why they are.

One of the few right wing American politicians of the past few decades worth quoting is Donald Rumsfeld who once famously came out with the following gem of wisdom:

There are known knowns; there are things we know we know.
We also know there are known unknowns; that is to say we know there are some things we do not know.
But there are also unknown unknowns – the ones we don’t know we don’t know.

Donald was talking about the planned invasion of Iraq, but it actually sums up the situation we have with cannabis quite well. So perhaps it’s time, as Douglas Adams of the Hitch hikers guide to galaxy may have put it, to demand rigidly defined areas of doubt and uncertainty because any scientific study in to the effects of cannabis should acknowledge the limitations of the study, which in the case of cannabis should include the uncertainties created purely by the prohibition regime.

First of all, a short recap of why we’re in the mess we are in. It starts with what may seem a  really really pedantic point at best, but it’s actually really important because it gets to the heart of why prohibition policy does what it isn’t supposed to do:

>> Drugs are not illegal, none of them are. <<

This is something the people at the Drug Equality Alliance have been going on about at some length for ages, as this blog noted a year ago. Strange as this claim seems it is actually quite  logical because “things” can not be subjected to  laws, only humans can be. What is actually illegal is termed “property rights”, what you’re allowed to do with cannabis is what the law attempts to control. Prohibition means you are not allowed to possess, produce or trade in cannabis, but the plant itself isn’t committing an offence.

This might all be considered pedantry but for the fact that it leads to a huge deception from politicians who term prohibited cannabis  a “controlled substance”. What they mean by that is  subjected to restrictions on property rights, not that it is actually controlled as such, because it isn’t.

This is really what’s at the heart of the problem we have with all so-called “illegal drugs” and in a massive way with cannabis because it is so popular: So called “drug control” doesn’t actually attempt to control drugs.

For cannabis this means how it’s produced and sold isn’t controlled. To do that you would have to control the trade through trading regulations as we do with alcohol and increasingly tobacco which aren’t called “controlled drugs”, but are.

In order to be a properly controlled drug the sort of regulations that could be applied to cannabis would include controlling the way it is grown, the strength, potency and purity, also imposing sales restrictions such as age limits, licensing the dealers and so on. Prohibition doesn’t try to do any of these things, instead it just states that officially as far as politicians are concerned the trade doesn’t happen, so when it does it’s entirely underground, unregulated, uncontrolled and pretty well unmeasurable.

Instead of controlling cannabis,  prohibition attempts to control people and what they do to themselves in private. Now this is always going to be a difficult thing to do at the best of times which is why prohibition is such a failure in practice. You may well persuade a proportion of the population to do what they’re told, but there will always be those who make a choice to ignore what they consider to be an unreasonable demand. Normally, of course, we call that exercising free will which religious people tell us is a God given thing and marks us out as different from animals. The long and short of it is that people will not do as they are told and prohibition will always be challenged. The uncontrolled trade will always exist because if people are not free to be open and honest about what they do, they will become devious and do it anyway.

In passing its worth noting that an added complication of course is that prohibition tries to work by by restricting supply, which makes no sense at all in a society fuelled by capitalism. Reducing the supply of something increases its value and hence motivates entrepreneurs to make the inflated profits by supplying the in-demand goods. Hence the stronger the enforcement, the more aggressive the supply side and the greater the problems of violence and everything else that goes with it, but that’s another story.

Away from the societal problems of increased levels of violence created by prohibition, because prohibited drugs are not controlled through a properly regulated trade they are of uncertain quality and strength. Indeed making the supply side as unreliable as possible is the goal of law enforcement. This, of course, ramps up the harms drugs can cause greatly which is why it’s termed (by me) “harm maximisation”. This is the cause of the “unknown unknowns” we face

Proper regulation of the supply side would mean that we would know everything about the drugs which were being sold, but prohibition not only prevents that happening, it also prevents us finding out what’s on offer by properly surveying the trade. Because the trade is underground  you can’t take proper samples of the products or the user group; there are standard ways to sample populations, but they all depend on being able to select a random and statistically valid  sample, which you can’t do with an illegal trade.

So the underlying cause of the problem is easy to identify, drugs policy is built on a huge deception as drugs are not illegal and therefore controlled drugs are not controlled. Hence we can apply Donald Rumfeld’s logic to the situation we have now with cannabis:

“There are known knowns; there are things we know we know”

Actually there should be  quite a lot of these, we do after all have nearly 5000 years of recorded historical use of the cannabis plant, this isn’t something that has just been invented. Normally, we would expect knowledge to increase with time, but that isn’t happening.

“We also know there are known unknowns; that is to say we know there are some things we do not know”

Because of prohibition the number of “known unknowns” is increasing by the day. For example:

* We no longer know where the cannabis is being grown – we used to, it had been grown in the producer countries for hundreds or thousands of years, now it’s grown in secret .

* There used to be a wealth of shared experience of cannabis use, passed down from parents to children which had established norms for its use, but far from learning from these cultures, we’re doing our best to eradicate the traditions.

* We know that we don’t know how strong or what strain of cannabis is being used.

* We know we don’t know much about the profile of the user group. Most cannabis users never come into contact with the police and thus never show up in the crime figures, which is all we have to assess the user group.

* We don’t know if doses have increased or decreased over the years.

* What evidence we do have for changes in the strengths – or is it potency which isn’t the same thing  (see here) –  is based on studies which barely deserve the title “scientific” – like the infamous Home Office study of 2008.

“But there are also unknown unknowns – the ones we don’t know we don’t know”

Now clearly it’s a bit difficult to be too specific about unknown unknowns but one whole new element of doubt and uncertainty has been created by  the new methods of growing and distribution. This essentially comes down to pollutants added to the cannabis crop, either to increase weight or to facilitate high turnover intensive grows.

Contamination added for weight is probably going to be more a problem for physical health, although quite what the effects of smoking powdered lead might be is anyone’s guess, while the glass beads found a lot around 2006 were probably too big to get into lungs, but really who knows and I doubt of the people who added them gave much thought to the issue?

Perhaps the biggest unknown unknown is connected with the way the plants are grown, and here we’re not talking about hobby growers but the large scale industrial concerns. A “grow op” will have rooms crowded with plants  in close proximity, grown quickly and rapidly followed by the next crop. This is certainly not organic gardening and will depend on the use of a lot of chemical fertilisers and – of very real concern – lots of insecticides to prevent infestation.

We have no idea what smoking organophosphate pesticide residue might do, we don’t even know how much there is in street cannabis. It is a real unknown unknown and it’s not the only one.

One other unknown unknown which is of special interest to the UK  might be how tobacco interacts with cannabis, especially in terms of the effect on mental health. Drugs used in combination often have different effects to drugs used separately and cannabis is frequently used in combination with tobacco.

Unknown unknowns are like that, they’re possibles rather than certainties and we won’t know they exist until we see their effects and then we won’t know what the cause was. But of course it’s the sort of thing that could be prevented by proper, meaningful, drug control.

There is no excuse for a policy that actually increases the amount of ignorance concerning the issue it claims to want to address, but that is what prohibition is designed to do. Any study which is carried out into the harms attributed to cannabis should acknowledge these sources of uncertainty, yet they are seldom of ever acknowledged. It’s as if it is the natural state of things, but of it isn’t.  Cannabis may have certain harms attached to its use, but under prohibition there are far more and far harder to quantify.

Prohibition is a hugely damaging and expensive folly on so many levels.