Neil McKeganey is the founding director of the Centre for Drug Misuse Research within the University of Glasgow and has directed the research programme of the Centre since 1994. For the last 15 years, Professor McKeganey has concentrated on research within the drug misuse field and has undertaken work on drug injectors and HIV, prostitution, and drugs and young people. He has acted as an advisor to the UK Home Office, the World Health Organisation and the United States Department of Justice.
One of the biggest news stories at the end of 2009 was the sacking of the government’s chief drugs advisor, David Nutt, by the Home Secretary, Alan Johnston. Within hours, the sacking was a headline national news story, and within days it had become a global news event. It is doubtful whether those involved could possibly have anticipated just how big an issue the sacking would become, leading in due course to serial resignations from the Advisory Council on the Misuse of Drugs, a ministerial statement from the Home Secretary, accusations from David Nutt that the Prime Minister and the Home Secretary had lost touch with reality in their attitudes and assessments of the harms of different drugs, and a deep rift between academia and government about the independence of scientists contributing to the policy process in the UK.
Beneath the heat and the fury of the public debate, there are important issues, a number of which are highlighted in David Nutt’s piece, ‘The role and the basis of the drug laws’. For David Nutt, it seems, our drug laws should be based principally on the scientific assessment of relative harm of different drugs. David Nutt makes much of the claim that certain drugs (most notably, cannabis and ecstasy) have been shown to be less harmful than either tobacco or alcohol. For David Nutt, this underlines a basic flaw in the UK drug laws which he suggests should be overhauled. David Nutt’s views are that if some of the illegal drugs are less harmful than tobacco and alcohol, then those drugs, too, should be legally available in a government regulated drug market in the same way as alcohol and tobacco are.
In supporting this argument, much has been made by David Nutt and others of the ranking of drug harm that appears to show that various of the currently illegal drugs are indeed less harmful than alcohol and tobacco. However, the rational ranking of drug harm that David Nutt has presented is itself no more than an assembly of the views of various addiction experts and psychiatrists about the harms of different drugs. Within the research that David Nutt originally undertook to create the rational ranking of drug harm, 77 consultant psychiatrists were asked to provide their assessment of the harms of 20 different drugs. Only 29 of those approached actually provided an assessment, a response rate of just 37.6% (Nutt et al., 2007).
The current division of illegal drugs into the now familiar three classes (ABC) of the Misuse of Drugs Act cannot be regarded as transparent. Whilst Professor Nutt and colleagues’ ranking may be more transparent than the existing three class classification within the Misuse of Drugs Act, it is questionable whether asking different people (whatever their expertise) to rank different drugs in terms of the relative harms is itself the right way to move forward. Surely what we need is not individual or collective assessments of harm but actual assembled evidence of relative harm.
There is another dimension of David Nutt’s piece that merits attention. For David Nutt, it seems, science should be the arbiter of drug policies. There is, though, no country on the planet that has given scientists such ultimate control over this important area of public policy. It is questionable whether an unelected group should have such power. David Nutt has criticised those in government for holding what he has characterised as a moral view of the drugs issue – and for allowing these moral views to influence policy. It is not clear whether the criticism here has to do with the fact that politicians hold such moral views, or their views having exerted a hidden influence on drug policy. My own view is that there is indeed a moral dimension to our drug laws and rightly so. Our capacity to make moral judgements about those behaviours that enhance the quality of life and those that, whilst meeting individual needs and desires, are socially harmful, is one of the characteristics that makes us human. Our drug laws express our sense of the society in which we wish to live. Whatever the logical flaws in the differentiation between different drugs, the division between those that are legal and those that are not does at least reflect out collective sense that we do not wish all drugs to be equally available within our society.
David Nutt has called for a more open and honest debate on our drug laws and there is no harm in that. Such debate would place an equal obligation upon scientists and politicians to be honest as to the drivers of their views. It is easy in that sense for some scientists to criticise politicians for holding hidden moral views on illegal drugs that influence their public statements while concealing their own politically motivated wish to see the repeal of our drug laws. Honesty, if we are to have it, must apply equally to scientists and politicians in their contribution to public debate.
- Nutt, D., King, L., Saulsbury, W. and Blakemore, C. 2007. ‘Development of a rational scale to assess the harms of drugs of potential misuse’. Lancet, 369: 1047–53. [Crossref], [PubMed], [Web of Science ®], [Google Scholar]
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