http://www.mapinc.org/drugnews/v09/n994/a06.html?102

UK: OPED: Penalties For Drug Use Must Reflect Harm

Pubdate: Mon, 02 Nov 2009
Source: Times, The (UK)
Copyright: 2009 Times Newspapers Ltd
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Website: http://www.timesonline.co.uk/tol/news/
Details: http://www.mapinc.org/media/454
Author: David Nutt
Note: Prof David Nutt was chairman of ACMD
Bookmark: http://www.mapinc.org/decrim.htm (Decrim/Legalization)
Bookmark: http://www.mapinc.org/hr.htm (Harm Reduction)

PENALTIES FOR DRUG USE MUST REFLECT HARM

How can true scientists advise this or any other government?

In July this year I gave a lecture on the assessment of drug harms and how these
relate to the legislation controlling drugs.  According to Alan Johnson, the Home
Secretary, some contents of this lecture meant I had crossed the line from science to
policy and so he sacked me.  I do not know which comments were beyond the line
or, indeed, where the line was, but the Government has lost its major expert on
drugs and drug harms and may indeed lose the rest of its scientific advisers in the
field.

All drugs are potentially harmful and many of the harms can be measured.  We can
use scientific methods to estimate these and produce a ranking, and compare our
scores with their location in the Misuse of Drugs Act.  Heroin and cocaine appear to
be in the correct place ( Class A ), whereas Ecstasy ( Class A ) and cannabis do not (
Class B ).

The reason for making drugs illegal is to let society reduce harms by punishing their
sale and use.  The purpose of having the ABC classes is to scale penalties according
to relative harms.  Possession of a class A drug for personal use can lead to seven
years in prison, for class B, it is five years and for class C, two years.

The classes are also important in educating the public about the relative harms of
drugs.  So it is imperative that the classification of drugs truly reflects their harms,
otherwise injustices may occur and the educational message be undermined.
Scientific inquiry into drug harms must also be honest and accurate so that the best
quality evidence is available to the experts and government.  Legal drugs such as
alcohol and tobacco are as harmful as many illegal drugs and currently score highly
on our ranking list.

What are appropriate penalties for drug use? This question has moral and practical
aspects, but the penalties must reflect the real and relative harms of drugs.

My sacking has cast a huge shadow over the relationship of science to policy.
Several of the science experts from the Advisory Council on the Misuse of Drugs (
ACMD ) have resigned in protest and it seems likely that many others will follow suit.
This means the Home Office no longer has a functioning advisory group, which is
very unfortunate given the ever-increasing problems of drugs and the emergence of
new ones.  Also it seems unlikely that any "true" scientist - one who can only speak
the truth - will be able to work for this, or future, Home Secretaries.

Others have suggested a way forward: create a truly independent advisory council.
This is the only realistic way out of the current mess.

Prof David Nutt was chairman of ACMD
~~~~~~~~~~~~~~~~~~~~~~~~~~

http://www.mapinc.org/drugnews/v09/n994/a01.html?1042

UK: Johnson Under Fire As More Advisers Threaten to Resign

Pubdate: Tue, 3 Nov 2009
Source: Independent (UK)
Copyright: 2009 Independent Newspapers (UK) Ltd.
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Website: http://www.independent.co.uk/
Details: http://www.mapinc.org/media/209
Author: Jeremy Laurance, Health Editor
Bookmark:
http://www.mapinc.org/topic/Advisory+Council+on+the+Misuse+of+Drugs
Bookmark: http://www.mapinc.org/people/David+Nutt
Bookmark: http://www.mapinc.org/find?207 (Cannabis - United Kingdom)

JOHNSON UNDER FIRE AS MORE ADVISERS THREATEN TO RESIGN

Decision to Sack Top Drugs Scientist Threatens to Tear Apart Council Established in
1971

The future of the Government's scientific advisory council on illegal drugs hung in the
balance last night as further resignations were threatened.

After four days of increasingly acrimonious exchanges between the Home Secretary,
Alan Johnson, and the scientific establishment following the sacking of Professor
David Nutt, the Advisory Council on the Misuse of Drugs which Professor Nutt chaired
until Friday, broke its collective silence for the first time.

In a letter to Mr Johnson yesterday, the council said that while it had not been
possible to contact all 28 remaining members - two resigned at the weekend - "it is
clear that a majority of the council have serious concerns" about Professor Nutt's
dismissal and the future of the council.

The letter said the case had "brought to the fore wider and pre-existing concerns
among members about the role and treatment of the council".  It added: "For some
members these matters are of such seriousness as to raise the question whether they
can, in good conscience, continue on the council.  In this situation members wish for
clarity and assurances about how the ministers view the council's advice and will view
the council's advice in the future."

Mr Johnson proffered an olive branch in the shape of a promise to meet them
"shortly" - possibly at their scheduled meeting next Monday - - and praise for their
work.  In a statement to the Commons he said the advisory council, set up in 1971,
had been "invaluable to the successive governments it has served".  But he told MPs
that he had "lost confidence in the professor's ability to be my principle adviser on
drugs" because he had "acted in a way that undermined the Government rather
than supporting its work".

The row erupted last week after Professor Nutt said the dangers of alcohol and
tobacco were more serious than those posed by ecstasy and LSD and criticised the
decision to move cannabis to Class B.  It emerged yesterday that a review of the
council's functions, planned before the present row erupted, is under way.  But Mr
Johnson said it was part of a routine Cabinet Office value-for-money review of non-
departmental public bodies and not linked to Professor Nutt's departure.

Bitter criticism from scientists of the Government's role continued to flood in yesterday
as the row escalated.  Sir John Krebs, former head of the Food Standards Agency,
said the Government operated a "pick and mix" approach to scientific advice.  "When
it suits the Government ( for instance, on BSE in meat, badgers and bovine
tuberculosis ) ministers say they 'cannot make policy without the scientists - we have
to go with what the scientists tell us'.  If ministers reject science advice they should
be completely open about why, and the advice itself should be totally public.  There
should be no gagging of scientific advisers.

"I cannot imagine any reputable scientist wanting to take on David Nutt's job with
Alan Johnson as Secretary of State.  All academics will think hard about offering their
advice in such a regime.  Without science advice the Government is compromised."

Opposition politicians were more muted in their criticism, refusing to attack Mr
Johnson over the sacking of Professor Nutt, who is seen as a loose cannon because
of his comparison of the dangers of ecstasy with riding a horse and similar remarks.
The Tory leader David Cameron branded the row "very unseemly", and said there
had been a "breakdown of confidence" between the Government and its advisers.
But he said everyone who takes part in public life "has to think about what they are
saying and the way they are saying it".

Mr Johnson was backed by Gordon Brown yesterday.  But the Prime Minister came
under fire from the former home secretary Charles Clarke, who said it had been
wrong for the Prime Minister to say at the beginning of his premiership that he was
going to change the classification of cannabis - from Class C to Class B - before the
advisory committee had considered its position.  "I think that was an error," said Mr
Clarke.
~~~~~~~~~~~~~~~~~~~~~

http://www.mapinc.org/drugnews/v09/n994/a08.html?102

UK: Column: Removal Risks Discouraging Experts From Giving

Pubdate: Mon, 02 Nov 2009
Source: Times, The (UK)
Copyright: 2009 Times Newspapers Ltd
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Website: http://www.timesonline.co.uk/tol/news/
Details: http://www.mapinc.org/media/454
Author: Sam Lister

REMOVAL RISKS DISCOURAGING EXPERTS FROM GIVING OPINION

David Nutt may be outspoken - increasingly so in recent years - but his appointment
as chair of the Advisory Council on the Misuse of Drugs was based on his standing as
a psychiatrist and pharmacologist.

He was appointed to the independent body given the task of providing scientific
ballast to the formation of government policy.  He has written on the relative harms
of alcohol, Ecstasy and other drugs, based on a 30-year research career.

That his views were at odds with the Government was clear, but that did not stop
them being credible and valuable.  Did ministers really expect Professor Nutt to stop
speaking about drugs and risks, even in a personal capacity, or to stop publishing
peer-reviewed papers? They can't have believed so.

The timing of his comments, and their vociferousness, may have been born of
exasperation.  He was not simply ignored by Government but publicly admonished.

When he wrote controversially about the relative dangers of horse-riding and Ecstasy
this year he could have expected criticism.  But to be told by Jacqui Smith, then
Home Secretary, to make a public apology for an editorial published in the Journal of
Psychopharmacology was beyond the pale.

Such a relationship was going to end only one way.  Professor Nutt jabbed his points
home to the embarrassment of ministers devising policies that did not fit with
expertise they received.But his sacking risks discouraging more experts from
venturing near a domain where they might have to tailor a lifetime's work
accordingly.
~~~~~~~~~~~~~~~~~~~~~~

http://www.mapinc.org/drugnews/v09/n994/a11.html?102

Pubdate: Mon, 02 Nov 2009
Source: Times, The (UK)
Copyright: 2009 Times Newspapers Ltd
Contact: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Website: http://www.timesonline.co.uk/tol/news/
Details: http://www.mapinc.org/media/454
Author: Mark Henderson
Bookmark: http://www.mapinc.org/find?207 (Cannabis - United Kingdom)

THERE'S NO POINT IN ADVISERS IF THEY CAN SAY ONLY WHAT MINISTERS WANT

This Government is fond of promoting its decisions as "evidence-based policy",
grounded in the findings of research.  Civil servants and scientists, however, like to
joke that what it really values is something rather different: policy-based evidence
that justifies a course of action that has been decided on for political reasons.

Ministers, of course, are perfectly entitled to do this.  They are democratically
elected; expert advisers are not.  While scientists might prefer politicians to do as
they are told, their view is often just one of many factors to consider.

Few scientists who advise the Government are naive enough to expect that their
opinions will never be overruled, but if this is to happen they rightly expect certain
behaviour in return.  They should be consulted in good faith before a decision has
been made.  Their advice should be clearly communicated to the public, along with
an explanation of why it has not been taken.  And they should not be admonished or
silenced if their views are not politically convenient.

In the David Nutt affair, the Government has failed on all counts.  The Advisory
Council on the Misuse of Drugs was asked to review cannabis after the Prime Minister
had made his intention to toughen its classification clear.  Its findings were then
released through the Home Office press office, which briefed journalists negatively.
Professor Nutt's dismissal has now provided the final insult.

This saga could certainly deter experts from advising the Government, not only in
science but in other areas of public policy.  We are not talking about ministers that
are bound by collective responsibility, or Civil Service employees, but independent
academics with a day job who often give their time and knowledge for free.  They
have a right to speak plainly, without being spun against or sacked.  There is no
point in having expert advisers if they can say only what the Government wants to
hear.

In highlighting so clearly how ministers ought not to behave, Alan Johnson may yet
have performed a service to colleagues who value scientific advice more highly than
he does.  His spectacular own goal with the scientific community presents an
opportunity to strengthen its voice in Whitehall.

Lord Drayson, the Science Minister, would do well to use it to press for two sensible
proposals made recently by the Commons Science and Technology Select Committee
that would help to prevent a repeat of this fiasco.

An independent media office serving all of the Government's advisory panels would
remedy the ridiculous situation where the Home Office was tasked with
communicating scientific advice it was keen to undermine.

Departmental chief scientists, too, should be required to report and explain all
instances where expert advice has been sought but not followed.  Both measures
would make ministers think twice before commissioning opinions they have no
intention of heeding and then shooting the messenger.
~~~~~~~~~~~~~~~~~~~~~~~~~~

http://www.mapinc.org/drugnews/v09/n994/a07.html?102

Pubdate: Tue, 03 Nov 2009
Source: Times, The (UK)
Copyright: 2009 Times Newspapers Ltd
Contact: This e-mail address is being protected from spambots. You need JavaScript enabled to view it
Website: http://www.timesonline.co.uk/tol/news/
Details: http://www.mapinc.org/media/454
Author: Robin Murray
Note: Robin Murray is Professor of Psychiatric Research at the Institute of
Psychiatry, King's College London
Bookmark: http://www.mapinc.org/find?207 (Cannabis - United Kingdom)

CANNABIS RISKS MUST NOT BE UNDERPLAYED

Professor David Nutt Is Wrong.  We Cannot Compare Smoking The Drug With Using
Cigarettes Or Alcohol

The ill-tempered argument over cannabis use is an ideological dispute between those
who regard it as an entirely safe herb and those who regard it as a devilish drug
likely to drive one mad after a few puffs.  Sadly, there is rarely an honest and open
discussion on why people enjoy it, what level of consumption is safe, if adolescents
are especially at risk and whether certain types of cannabis pose greater dangers.

Professor David Nutt, who was sacked as the Government's drugs adviser, claims that
cannabis is no more dangerous than alcohol or cigarettes.  But is it sensible to equate
even these two? There are no health benefits in smoking cigarettes, which is simply a
manifestation of nicotine addiction.  Most adults in Britain, however, drink alcohol in
moderation, and suffer few adverse consequences.  Yet most know that drinking a
bottle of vodka a day is likely to harm their health, and few favour daily drinking from
the age of 14.

There is a lot of evidence that smoking several joints a day impairs memory.  Using
brain imaging, cannabis can be seen to impair the function of the hippocampus, a
structure essential to memory.  If we drink heavily for an evening, we may remember
little the next day.  But alcohol is washed out of the system in 24 hours; cannabis can
be detected a month later.  No wonder the academic performance of school children
who smoke it daily deteriorates; they have a chronic low-grade intoxication.

It remains disputed whether memory returns totally to normal after consumption
ceases.  In those who have smoked only for a few months or years, there is every
hope of a return to normality in months.  But whether a "stoner" addled by decades
of consumption can regain all his faculties remains uncertain.

People with schizophrenia use more cannabis than the general population; that is
undisputed.  The critical question is whether cannabis use has helped to cause it.
Evidence has been mounting steadily over the past six years that initially healthy
people who use cannabis daily are more likely to develop paranoia and psychosis.
Those with a family history of mental illness, with a suspicious or psychosis-prone
personality and those who start cannabis use in early adolescence appear at greater
risk.

It is not surprising that the link between cannabis and schizophrenia remains
controversial.  It took several decades for society to accept that smoking tobacco
increases the risk for lung cancer.  Now it is generally accepted.  In his lecture last
week Professor Nutt contrasted a 2.6-fold increase in the risk of psychosis from using
cannabis with a twentyfold increase in the risk of lung cancer if one smokes
cigarettes.  Unfortunately he was not comparing like with like here.  The twentyfold
increased risk does not come just by being a smoker but by being a long-term heavy
smoker.  For cannabis, the risk of schizophrenia rises about sixfold if one is a long-
term heavy user.

Nevertheless, 90 per cent of daily users will not develop schizophrenia, just as most
daily smokers will not die of lung cancer.  But even among those who never come
near a psychiatrist, daily cannabis users are more likely to be unsuccessful in their
careers, to have broken marriages and to suffer minor psychological problems such
as anxiety and depression.  For teenagers and their families the consequences of
cannabis smoking may never register in medical statistics, yet be devastating in their
impact on family life.

In 2007 the Advisory Council on Misuse of Drugs concluded that street cannabis was
getting more potent, a view confirmed by two large surveys.  These showed that the
concentration of THC, its main active ingredient, had increased from about 4 per cent
in 1970s resin to 14-18 per cent in present day skunk.

Giving THC to normal volunteers in a laboratory setting induces psychotic symptoms
to a varying extent, depending on the dose.  Cannabis is a complex substance and
THC is not the only constituent.

Another is cannabidiol ( CBD ), which does not induce psychosis in studies; if
anything it relieves anxiety, and may even have antipsychotic effects.  Traditional
cannabis resin contains equal amounts of THC and CBD, so some pro-psychotic
effects of THC may be counterbalanced by the CBD.  In skunk, not only has the
concentration of THC greatly increased but the CBD has virtually disappeared, so it
may carry a double whammy.  Skunk's ever-larger share of the street market is
worrying.

There is little evidence that altering the legal classification of cannabis affects
consumption.  When the law was liberalised in 2004 cannabis consumption was
falling in most of Western Europe, and the UK has followed the general trend.

Two Western European countries with markedly different policies have less of a
problem than the UK.  The Swedes adopt a prohibitionist line and only about 8 per
cent of adolescents have smoked cannabis.  The Dutch have a very liberal policy and
28 per cent of adolescents use cannabis.  Both have lower consumption than the UK
where 38 per cent of 16-year-olds have used it.  Teenagers starting to use cannabis
do not debate its exact classification; many do not even think it is a drug and few
have any knowledge of its hazards.  What does appear to have an effect is
knowledge about the risks of heavy consumption.

Rather than arguing whether cannabis should be a Class B or C drug, politicians
would be better to support a big educational campaign on the properties and
constituents of different types of cannabis and the risks associated with heavy use.

Robin Murray is Professor of Psychiatric Research at the Institute of Psychiatry, King's
College London