Get the drugs debate rolling

If there's one thing that most politicians can be relied to do, it's to come over all authoritarian as soon as the word "drugs" is mentioned. Professor David Nutt found that out to his cost when he published the text of a lecture, given by him in July to an audience that included Home Office representatives, concluding that cannabis is mildly harmful but not nearly as harmful as alcohol or tobacco. Nutt's evidence is clearly set out in his paper and, frankly, his conclusion is unsurprising. Home Secretary Alan Johnson, on the other hand, didn't rely on any evidence. He just sacked Professor Nutt from his position as chairman of the Advisory Council on the Misuse of Drugs having "lost confidence" in him. When Johnson argues: "There are not many kids in my constituency in danger of falling off a horse - there are thousands at risk of being sucked into a world of hopeless despair through drug addiction," he engages in classic politicians' scare-mongering. The phrase "hopeless despair through drug addiction" is worth analysing. It's unfortunate that Nutt chose horse-riding for his comparator with ectasy, as it permits Johnson to portray Nutt as out of touch with most people. But Nutt's overall point is entirely sensible. There are some legal activities which society acknowledges there is a risk of injury to the user and to others but prefers to take the risk after having decreased it by regulation and supervision - not only horse-riding but cycling, driving or travelling in a car, eating certain foods, sports and all sorts of other everyday activities come to mind.

If legal activities are, in fact, more risky than the risks associated with some illegal drugs - cannabis and ectasy - why do we ban those drugs? It's the fact that cannabis and ectasy are illegal that allows Johnson his sleight of hand. Johnson implies that once a young person has succumbed to a joint, addiction to smack and crack cocaine will inevitably follow. That's nonsense, of course. What cannabis, ecstasy, heroin and crack cocaine have in common is that they are illegal, not that they all have the same level of risk of harm. But unlike Johnson, Nutt has examined the evidence. He says that cannabis can be harmful to some people - there is a probable but weak causal link between psychotic illness and cannabis use, meaning some people are at a greater risk of having psychotic experiences if they indulge in cannabis. His research does not show a link between cannabis and schizophrenia despite popular belief that there is that link. Cannabis doesn't kill people, but alcohol does, as it fuels propensities for violence. Tobacco kills both smokers and non-smokers.
It is perfectly rational and in accordance with the evidence to recognise that cannabis is less harmful that alcohol or tobacco; I have been smoking cannabis on occasion as a recreational habit since I was thirteen And it leads to the absurd situation that high-risk and low-risk drugs - heroin and crack cocaine, and cannabis and ecstasy - are banned, while medium-risk drugs such as alcohol and tobacco are not. So what's the most sensible way forward?

Nutt recommends returning cannabis to class C from the present class B classification. The problem with this approach is that cannabis remains illegal but the police are less likely to prosecute someone for possession. However, the police retain the discretion to prosecute and this means that they can use that discretion to harass certain groups such as black people and young people. My view is that government policy on drugs should go much further than Nutt recommends. It seems to me obvious that all drugs, from the less risky to the most dangerous, should be decriminalised. Not because I don't think that heroin and crack cocaine are dangerous - as they obviously are - but because I don't see how criminalising an addiction can help. The principal argument against the decriminalisation of all drugs is that keeping class A drugs unlawful deters and prevents people from using them. That seems to ignore reality. Anyone who wants to find heroin or crack cocaine can, with a certain amount of effort. So what about the other arguments for illegality? Johnson's "risk of being sucked into a world of hopeless despair" is principally because drugs are illegal. Once illegality is out of the picture, the suggestion that cannabis use might lead to heroin addiction is no more valid than suggesting a drinker of camomile tea will get sucked into a heavy coffee addiction.

Decriminalisation would end the huge discretion currently enjoyed by the police to harass and criminalise someone who might have a joint or pill in his or her pocket. It would allow addicts who want help and treatment to seek that help openly without any fear that they will be treated as criminals. The legal supply of drugs would, quite simply, break the link with organised crime. And it would probably keep prices down so that addicts felt less compulsion to commit crimes to pay for their habits. Indeed, open legal suppliers would be businesses paying taxes, responsible for paying and treating their employees properly and resolving differences through the courts like everyone else. Legalising the supply of drugs allows for regulation. There can be restrictions on where drugs can be sold, to whom, in what form and quantity, and plenty of advice available about the risks involved. Society would accept that the consumption of harmful drugs is risky but would prefer that risk to be out in the open rather than part of a criminal underworld. The 19th century temperance movement was absolutely convinced that because alcohol is dangerous for drinkers and harms others it should be prohibited. Between 1920 and 1933 during the prohibition-era in the United States gangsters flourished and alcohol consumption first decreased but then rose over the period. The risks associated with drinking alcohol increased because its illegality prevented regulation and it was often diluted with even more dangerous substances. Public resources were spent on closing down speakeasies rather than treating alcoholics. Nowadays we know far more about the risks of alcohol. But we prefer to publicise those risks and treat the consequences, rather than drive alcohol underground again. Shouldn't we start to take the same approach to other drugs?

Drugged up Britain?

Government attempts to persuade thousands of young people to stay away from drugs have failed and done nothing to curb the soaring popularity of illegal substances, a devastating report has warned. The number of young people using cocaine and cannabis has increased rapidly over the past 20 years despite high-profile campaigns, such as the £9m 'Frank' initiative aimed at 11 to 15-year-olds, according to an in-depth examination of official efforts to tackle Britain's chronic drug problem. It is also expected to claim that Britain's 'unusually severe drug problem compared with that of our European neighbours' is linked to social and economic deprivation, that punitive laws have had little effect and that police efforts to disrupt the drugs trade have also failed. The study, 'An Analysis of UK Drugs Policy', has been written by two internationally respected experts, Professor Peter Reuter of Maryland University in the US and Alex Stevens, senior researcher at the European Institute of Social Services at Kent University. The report cites an array of official statistics charting the steady growth in Britain's drugs culture. For example, according to the 2005 British Crime Survey, 40.4 per cent of 16 to 19-year-olds have used drugs at some point in their lifetime, as have 49 per cent of 20 to 24-year-olds, 51.6 per cent of 25 to 29-year-olds and 45.8 per cent of 30 to 34-year-olds. While cannabis use by young people has fallen recently, it remains around 50 per cent and consumption of cocaine has increased. The Home Office rejected the new body's findings. A spokesman said research showed that giving young people information about drugs, rather than adopting a 'just say no' approach, was a more effective way of warning them about the dangers.

Young people in Britain are reported to be taking up to five times more illegal drugs than their European counterparts. Britain topped the western European league on ecstasy and amphetamines and came second for cocaine and cannabis. Nine per cent of young people in the UK said they had tried ecstasy, compared with only 2.8% of Germans, 3.1% of French and 1% of Belgians and Swedes. And as many as 16% of British young people said they had tried amphetamines, compared with 1.6% of French people and 4% of Germans. Spain topped the league, but French, Swedish and Belgian young people were half as likely as the British to try the drug. Around 36% of Britons admitted to taking cannabis - the most common illegal drug in Europe, compared with 25.7% of French people, 21% of Germans and 22% of Spanish people. A smaller Danish survey showed cannabis use running at 43% among teenagers and people in their 20s, 30s and 40s. Heroin use was low across Europe. In most countries, less than 1% of people had tried the drug. However, it accounted for the most health problems; the report says there are up to one million heroin addicts in Europe. Some countries have noted a small rise in its use. Drug abuse in Britain is worse than anywhere else in Europe - Young people in the UK are more likely to take cocaine, Ecstasy and amphetamine than those in any other country on the Continent, but they are also using cocaine in quantities and with a frequency unmatched anywhere else in the world apart from the U.S.

It's pleasing to see, in the storm of commentary over Professor David Nutt's sacking as the government's chief drugs adviser, that everyone outside politics now recognises the importance of scientific evidence in devising laws. But a strange reasoning twitch has appeared, in the arguments of politicians and rightwing commentators. Science can tell us about the molecules, they say, about their effect on the body and the risks. But policy is separate: a matter for judgment calls on social and ethical issues. Only politicians, they say, can determine the correct way to send out a clear message to the public. It is not a matter for science. This is wrong. Alongside research into the risks of drugs, lots of work has also been done on the deterrent impact of different laws, classifications and levels of enforcement. As every piece of research has its own imperfections (and nobody has yet conducted a randomised controlled trial on drugs policy) you can make your own mind up about whether you find the results compelling.

One strategy is to compare different countries. A World Health Organisation study from 2008, published in the academic journal PLOS Medicine, compared drug use and enforcement regimes around the world. It was clear: "Globally, drug use is not distributed evenly and is not simply related to drug policy, since countries with stringent user-level illegal drug policies did not have lower levels of use than countries with liberal ones." Alternatively, you can compare drug use between states within one country, if they have very different enforcement regimes, as when parts of the US liberalised their laws a few decades ago. Another line of evidence comes from "before and after" studies, when laws are changed. Cannabis use in the UK dropped after cannabis was moved from class B to class C. Prohibition of alcohol in the US from 1920 to 1933 is the most famous example: alcohol use fell dramatically when prohibition began, and the price of alcohol rose to 318% of its previous level. By 1929 this initial impact had begun to wear off and rapidly: alcohol consumption had risen to 70% of pre-prohibition levels, and was still rising when prohibition was repealed, and the price had fallen to 171% of pre-prohibition levels. This reversion to old patterns of use occurred despite escalating spending on enforcement, up 600% over the same period. There are many more examples.

This is not an unresearchable question. There are other factors at play in all of these studies, and if they are not sufficiently rigorous for the government, or a brief informal dip into the literature is not enough, (it shouldn't be) then they should commission more research: because it is a tenet of evidence-based policy that if you discover a gap, you commission work to fill it. This work is important for one simple reason. If you wish to justify a policy that will plainly increase the harms associated with each individual act of drug use, by creating violent criminal gangs as distributors, driving the sale of contaminated black market drugs, blighting the careers of users caught by the police, criminalising three million people, and so on, then people will reasonably expect, as a trade-off, that you will also provide good quality evidence showing that your policy achieves its stated aim of reducing the overall numbers of people using drugs.