Foxes, henhouses and cans of worms.

The debate surrounding the sacking of professor Nutt has opened up a whole can of nice big juicy worms. Issues which have never been allowed into the debate – such as the whole concept of “relative harms” – are now out there and people are talking about them which is all to the good, but perhaps the debate is wider than even that.

What might be coming out of it all is we’ve got it wrong, all of it, totally wrong.

Pulling the first worm out of the can we see that one thing has so far never been questioned and it’s the one issue which really is central to the whole debate about drugs: What is it we actually want drugs policy to achieve? Now that might seem a daft question but actually like so many other blindingly obvious questions, it’s not.

Worse, as more worms wiggle out the question “what do we want to achieve” also has a large side-order attached which is to ask “what is the true nature of the problem?”

First worm first, what do we want from drugs policy? Put another way, what do we want drugs policy to achieve?

The usual answer you’ll get is to reduce drug use to a minimum because that’s how you reduce the harm. Well, is it? In all honestly it’s pretty obvious that aim is over simplistic in the extreme, indeed it’s dangerously simplistic to the point of being utterly wrong. It isn’t the absolute number of drug users we should worry about, but rather the nature of that drug use – where, how, for what reason and who is doing it.

By way of example, an analogy which has been mentioned here before but is worth repeating. Take as an example two groups of alcohol users: 1000 blokes supping beer in a pub and 10 kids swigging vodka from a bottle somewhere out of the way, like in a derelict building. Now it’s a safe bet that most people would reasonably regard the 1000 blokes supping beer in a pub to be less damaging – indeed even socially desirable – than the 10 kids knocking back the vodka and would generally expect the law to work in such a way as to prevent such things happening as far as possible.

The way we deal with illegal drugs though – to continue the analogy – is to prohibit the use of them, which closes the pub down and stops the social beer drinking. The goal of the policy is thus achieved and the use of alcohol would be reduced greatly. But what it hasn’t tackled is the kids hitting the vodka in the trashed office block.

Actually what it does is to swap the vodka for contaminated moonshine supplied by armed organised criminals which makes it all a lot worse but that’s just another complication. What the above example is designed to show how the aim of reducing drug use is, in and of itself, a false goal. Better surely to seek to prevent the under-age and dangerous use of such drugs, or indeed to support and help people who are using drugs as a means of escape or unwisely as an attempt to self medicate and so on. For everyone else, the moderate users, the non-problematic social user, encourage the safest methods of use, allow them to make informed choices and protect them from exploitation (more about that later) but otherwise leave them alone.

So the first answer to the question of what we are trying to achieve should not be reducing drug use to a minimum. That, of course, holes the present drug policy way below the waterline because doing precisely that is it’s sole aim.

The second worm asked what actually is the problem we have with drugs? The answer to that one is partly the uncomfortable “not the one the law was designed to prevent” and partly to do with foxes and henhouses.

Firstly kids; supporters of prohibition have one mantra these days, that of child protection. The problem, we are told, is adolescent drug use and that is the reason given for enforcing prohibition with an iron hand.

But the law against drugs was never intended as a form of child protection. It was always a measure aimed at adults, indeed back in the 1960’s and 70’s when all this madness started there wasn’t a child protection issue to be considered, children didn’t use drugs at all.

One person often quoted by prohibition supporters (and we can expect to hear more from him in the next week or so) is Professor Robin Murray, Professor of Psychiatric Research, Institute of Psychiatry at the Maudsley, Kings College, University of London. He was perhaps unwise in becoming associated with the prohibition campaign back in 2002, but to be fair to him Prof Murray has always correctly identified the problem with cannabis as being the use by young people – kids – and in particular the heavy use by kids. Writing in the Guardian recently he said

Personally, I care little whether cannabis is classified as a class B or class C drug. Fourteen year olds starting daily cannabis use do not agonise over its exact classification; many do not even think it is a drug and few have any knowledge of its hazards. By comparison, most adults in the UK drink alcohol in moderation, but do so in the knowledge that drinking a bottle of vodka a day is likely to be injurious to health, and few are in favour of daily drinking from age 14 years.

Both Professor Nutt and I agree that what we need is a major educational campaign to inform the public about the risks associated with heavy use of cannabis particularly in early adolescence.

It should really be obvious that if, as I suspect is the case, Prof Murray is right in his analysis the policy of prohibition aimed at preventing the moderate use of cannabis by adults is the wrong policy trying to achieve the wrong thing.

The other point is about exploitation, foxes and hens and it was provided by an unlikely source by even less likely contributors. Kathy Gyngell weighed into the Nutt debate with another one of her prohibition supporting blogs (which yet again quoted Mary Brett as some kind of expert) . Kathy’s selective cherry picking of the scientific debate isn’t of interest here, but rather the view expressed by a couple of her supporters who posted comments.

Kenneth Eckersley observed

From its very inception the ACMD has always been a tool of the pharmaceutical industry staffed by their cohorts and intended to protect their business from the condemnation it deserves for the seamy side of its activities.
<snip>
Of course cannabis is harmful. So is alcohol, and so are benzos, but we are not going to get sensible workable policies in any of these fields whilst the foxes are in charge of the hen house. i.e. when vested interest profit motives have a greater political importance than the population’s health, wellbeing and productivity.

While Rosemary Burns wrote:

One possible explanation for this dichotomy might be if some of the ACMD’s scientists were to have links to pharmaceutical companies whose interests could lie in perpetuating the misery of drug addiction in order to supply quantities of anti-psychotic drugs, Methadone, benzodiazepines, etc., to sufferers. Or is this too cynical a view?

Perhaps it’s less a can of worms, more a skulk of foxes. Now what what other examples of foxes being in charge of the drug policy henhouse we can find if we look? UKCIA received an interesting bit of feedback during the week from a reader of this blog:

Just thought you may enjoy this story

Now that alcohol (beer) is 10 times stronger than 40 years ago does it not require a radical re-think regarding its dangers (just like has been done with cannabis !)

“This story” concerns a new beer called “Tactical Nuclear Penguin” which has a strength of 32% ABV. To put it in context that’s over three times the ABV of Special Brew.  The “fox” of course is the Portman Group, the brewers association which is given the role of overseeing the conduct of the alcohol trade. The point the contributor was making of course is that there has been a lot of fuss made about the “new” “super strength” “skunk” cannabis “flooding the playgrounds”, yet there seems very little concern about the increase in alcohol strengths over the same period.

Twenty years ago, when your parents were drinking beer in parties at university it was around 3%, it’s normally around 5% these days, as with cannabis the strength has on the whole nearly doubled.

Now it’s true that groups such as Alcohol Concern try to draw attention to all this, but for some reason the argument doesn’t seem to excite the tabloid press or the drug campaigners in quite the same way as the “skunk” issue. Odd that, isn’t it?

Actually, having mentioned Alcohol Concern it’s interesting to note they have a fact sheet available (to buy) with a summary online for free entitled “Alcohol & Mental Health”.Did you know that

Heavy drinking is closely linked with mental illness (psychiatric morbidity).

Or that

65% of suicides are linked to excessive drinking

Or

Alcohol misuse is particularly associated with mental health problems in vulnerable groups such as offenders, young people and the homeless.

Isn’t it odd we never hear about this? Could it be that vested interests really are at work here? Is it really the fox in charge of hen house policy? Ever been had?

So back to our first juicy worm, what are the aims of drug policy? It may have seemed a daft question, but perhaps it’s not when such clear concerns can be so easily identified. The policy should perhaps be to prevent those who stand to gain the most financially – the brewers, the drug dealers or the pharmaceutical companies, leading and overseeing the policy.

This all brings us back to what we want to see happen to cannabis. The law reform argument is really obvious in that illegal cannabis is not a controlled cannabis, but that does beg the questions of not only what do we mean by control, but who should be doing the controlling and for what purpose?

One thing seems obvious, policy should seek to limit commercial exploitation of the drugs market. Now there’s an interesting idea that’s not going to be popular with the fox.