Tuesday, 7 December 2010

UK Government continues to ignore scientific advice on drugs

Downgrading the Importance of Scientific Advice

A new plan has been announced that will allow the UK government to make new policies on drugs without consulting expert doctors and scientists, effectively allowing them to change the law on controlled substances for reasons which are not supported by any evidence. The decision will come at the cost of a greatly reduced quality of scientific advice in government and a huge dent in the relationship between the government and scientists.
The changes are new amendments to the 1971 Misuse of Drugs Act, which requires the government to seek advice from the Advisory Council on the Misuse of Drugs (ACMD) when making decisions to ban drugs and potentially criminalise large numbers of people. The ACMD is required to have at least 20 members, among them representatives of the practices of medicine, dentistry, veterinary medicine and pharmacy, the pharmaceutical industry, and chemistry (other than pharmaceutical chemistry); and members who have a wide and relevant experience of social problems connected with the misuse of drugs. All are unpaid and have active careers in their area of expertise. The new plans are to remove the requirements for advisers from these professions.

The crime prevention minister James Brokenshire, on behalf of the government, said today:

"Removing the requirement on the home secretary to appoint to the Advisory Council on the Misuse of Drugs at least one person with experience in six specific areas will allow us greater flexibility in the expertise we are able to draw on."

I wonder though,  in what scenario wouldn't you want a medical doctor or pharmacist to give scientific advice on the misuse of drugs?

The Government do have a right not to take on board the advice from the ACMD, which they have exercised almost to its full potential over the last few years. On the Advice of the ACMD, Home Secretary David Blunkett downgraded cannabis from Class B to Class C in 2004. However, Home Secretary Jacqui Smith returned it to Class B in 2009. In February of the same year, the ACMD advised the government  to downgrade ecstasy from a Class A to a Class B drug. The ACMD's report on ecstasy, based on a 12 month study of 4,000 academic papers, concluded that it was nowhere near as dangerous as other Class A drugs such as heroin and crack cocaine. Once again, Jaqui Smith didn't listen to the advice.

Background: The Sacking of David Nutt

Senior Advisor to the ACMD, David Nutt, publicly condemned the UK government for ignoring scientific advice when making it's decisions. He believed that drugs should be classified according the the evidence of how harmful they are to the individual and to society. Nutt pointed out that alcohol and tobacco caused more harm than LSD, ecstasy and cannabis.

He also published a paper which showed that whilst there is one instance of acute harm for every 350 exposures to horse riding, there is only one instance of acute harm for every 10'000 exposures to ecstasy. His point was that the classification of drugs is obviously not based on how harmful they are but on an attitude fuelled by "scare stories" over the years. He backed up his claim for this distorted media attitude with a study of drug related news paper reports over a period of 10 years:

"the likelihood of a newspaper reporting a death from paracetamol was in per 250 deaths, for diazepam it was 1 in 50, whereas for amphetamine it was 1 in 3 and for ecstasy every associated death was reported."

Jaqui Smith received an enormous amount of criticism from the scientific community for bullying Professor Nutt into apologising for implying that horse riding was more dangerous than taking ecstasy, despite the fact he was doing his job as a scientist to set out the facts and that the paper was published outside of his ACMD role. Her successor, Alan Johnson, sacked David  Nutt, adding:

"It is important that the government's messages on drugs are clear and as an advisor you do nothing to undermine public understanding of them. I cannot have public confusion between scientific advice and policy and have therefore lost confidence in your ability to advise me as Chair of the ACMD."

However, he was never clear on how David Nutt had broken any guidelines or codes of practice.

David Nutt claimed that it was almost as if the ACMD was expected to find evidence to support the government's stance on drugs and that, in the end, they didn't like what real scientists were saying. His sacking delivered quite a blow to the relationship between scientists and the government and was followed by the resignation of many more scientific advisers on the ACMD. Many have also criticised the 'War on Drugs' for causing more harm than the drugs themselves.

"Science Opposing 'War on Drugs' is Overwhelming"

These are the words from  Dr. Evan Wood, the director of the urban health research initiative at the B.C. Centre for Excellence in HIV/AIDS. He is also the co-author of the Vienna Declaration, which calls on the world’s politicians to let scientific evidence guide their policies on illicit drugs.  Vienna was chosen as the site for the 2010 conference because it is home to the United Nations commission on narcotic drugs and a crossroads for Westerners to Eastern Europe and Central Asia, where HIV infections from dirty needles are skyrocketing.

He believes that the war on drugs, waged by many governments worldwide, continues to ignore the health and social harms cased by their antiquated policies and described it as a "global catastrophe. Up until now, the scientific community hasn’t really been outspoken about it,” he said.

Scientists have been attacked by groups seeking to maintain the status quo. I have been in a leadership position involved with the evaluation of the supervised injecting facility in Vancouver and have experienced first-hand how scientists promoting the notion that addiction is a public-health problem and a medical problem can be attacked for those views.” 

"One in 100 adults in Russia is already HIV-infected because of heroin use,” said Wood, chair of the committee that wrote the declaration. His main concern is the negative role the War on Drugs has played in the fight against AIDS, It’s an injection-drug-related epidemic. Needle exchange is illegal.” He pointed out that methadone, one of the best substitutes for heroin to combat addiction, is illegal there, even if prescribed.

Wood points out the declaration stresses gang violence in cities such as Vancouver is directly related to drug prohibition.“When these drugs are made illegal, organized crime groups are enriched by that,” he said. "They fight one another to maintain those profits.”

He also stated that the money spent on combating drug related crime could be better spent elsewhere. “In California, they spend more on incarceration than they do on post-secondary education. It’s estimated that one in nine African-American males between the ages of 25 and 35 are in prison on any given day in the U.S.

The World Health Organisation and Joint United Nations Program on HIV/AIDS have also strongly endorsed the call for drug-policy reforms.

Public Opinion

The reception to the evidence from the experts has been met with mixed feelings. This is largely due to the fact that many haven't heard about the evidence  and don't seem to understand that people like David Nutt and Dr. Wood aren't just spouting out their innermost thoughts based on biases concerning drugs, the media and government. They're doing their job, which is to represent the facts in the best way possible and tell us what those facts are. It seems that people don't like what they're now being told. Many people seem to be against drugs, not because the facts tell them to be but because of some moral obligation to oppose them.

The main problem is, it's hard to shake off what we've been told for so long about drugs. And that is probably the main reasons that the government is not willing to change the laws on drugs because they think it will send people the wrong message: that on the subject of drugs, they didn't know what they were talking about.

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