More shoddy reefer madness reporting of cannabis risks

When you are in the midst of a fully fledged media cannabis panic, as we currently seem to be, you can be quite sure that any new research on the drug:

• will be pounced upon by lazy journalists
• will be trawled for any vaguely shocking sounding statistics (by non-scientists and non-statisticians)
  
• will have these statistics spun into sexy 'shock' headlines
  
• will have any negative findings, statistical ambiguity, commentary on confounding factors/ context / significance etc conveniently glossed over
• will see politicians responding to the media coverage of the research rather than the research itself *insert daft quote from David Davis*

This is what happened last week with the Lancet meta-study on cannabis and psychosis published last week. The main report headline, that cannabis smoking increases the risk of schizophrenia by 40%, achieved saturation media coverage for a science story, being covered by over 500 news outlets. Putting this headline figure in some sort of statistical context, along with anything that could reasonably be described as intelligent discussion the policy relevance of the paper (remember the endlessly tedious reclassification debate is still rumbling on) was almost completely lacking. (The Lancet, it has to be said, clearly courted this coverage. They played up the 40% figure in there press release at a key juncture on the policy debate (on which the paper does not comment), putting the cannabis story at the top of the issue's press release to maximise its exposure).

The conclusions of the paper, that cannabis use involves a small risk of mental health problems is not really news. This has been known for over a century, and it is acknowledged by everyone that all drugs present potential health dangers, and all drug use involves risk. Here, just for the record is what the Indian Hemp Commission concluded 113 years ago, back in 1894:

“Mental Effects

In respect to the alleged mental effects of the drugs, the Commission have come to the conclusion that the moderate use of hemp drugs produces no injurious effects on the mind. It may indeed be accepted that in the case of specially marked neurotic diathesis, even the moderate use may produce mental injury. For the slightest mental stimulation or excitement may have that effect in such cases. But putting aside these quite exceptional cases, the moderate use of these drugs produces no mental injury. It is otherwise with the excessive use. Excessive use indicates and intensifies mental instability (1:264).”

The Lancet paper tries to quantify the risk and suggests, not unreasonably, it is very real for a small proportion of heavy users, noting that there is a dose response in the phenomenon (the more you use the greater the risk - also hardly a surprise), suggesting that 800 cases of schizophrenia would not have occured if none of the UKs 6.2 million cannabis users had ever tried it. The estimate of a 0.00125% risk of schizophrenia for cannabis users (or you could equally well claim, 99.99875% likelihood of not getting schizophrenia) was mentioned, as far as I can tell, in none of the media coverage for whom the 40% increased risk proved far more panic inducing.

Whilst horribly out-gunned in terms of coverage, there has been some more responsible reporting of this paper:

Will One Joint Really Make You Schizoid? from Stats.org at George mason University, which notes that whilst cannabis use has leapt since the 50s, schizophrenia diagnosis have remained constant....

Blah cannabis blah blah blah blah Ben Goldacre's bad science column in the Guardian considers the poor media coverage of the lancet paper

Transform's press release on the Lancet paper titled 'Cannabis health risks should not lead to knee jerk policy making', got a bit of coverage, including the Sun (and an honourable mention to the Gallway Evening Echo). More importantly the quote we included from Martin Blakeborough landed him on the Today programme on radio 4 and all subsequent BBC coverage.

Now, just three days after the Lancet brouhaha, we have another almost identical one that has followed almost exactly the same media trajectory, but this time concerning another not terribly surprising and already well known fact that smoking stuff is bad for your lungs. This paper, which unlike the Lancet is based on original research, appears in the journal Thorax, and considers the relative impacts of cannabis and tobacco on a range of lung function measures. The Reuters press release (again some blame must go to the journal publisher) ran with a headline that 'one cannabis joint as bad as five cigarettes' (that has been picked up, again, by 100s of media outlets). With reefer madness alarm bells ringing I looked up the complete study and found the conclusions to be somewhat different. Rather than spell it all out myself, below is a brief comparative review of the paper and the Reuters coverage provided by Jamie Chen, a student at Columbia University in NYC, and an intern at CJPF (with thanks to Eric Stirling):




This is my cursory review of a study found in the journal Thorax, and my response to the Reuters story that smoking one joint is as damaging to your lungs as smoking 5 cigarettes.

The Reuters article appears to have come from the journal publisher

The study was by Sarah Aldington, Mathew Williams, Mike Nowitz, Mark Weatherall, Alison Pritchard, Amanda McNaughton, Geoffrey Robinson, and Richard Beasley. It is entitled The Effects of Cannabis on Pulmonary Structure, Function, and Symptoms. It is published in the July 2007 issue (note: you need an academic id to read it but i have a pdf if anyone is really keen)

Here are some direct quotes from the study, under the subtitle "Lung Function tests":

"Both cannabis and tobacco smoking were associated with a reduction in the FEV1/FVC ratio, but the effect of cannabis was only of marginal statistical significance." (FEV1 being forced expiratory volume in 1 second, FVC being forced vital capacity)

"Cannabis smoking had no effect on FEV1 but tobacco smoking reduced it."

"Cannabis had no statistically significant effect on MMEF and tobacco smoking reduced it." (MMEF is maximum mid-expiratory flow)

"Cannabis increased TLC with marginal statistical significance but tobacco had no effect on TLC." (TLC being total lung capacity)

"For TLCO/VA (adjusted), cannabis had no effect while tobacco smoking reduced this measurement." (TLCO/VA being carbon monoxid transfer factor)

The only test in which cannabis caused worse results than tobacco was sGaw (specific airways conductance).

"Cannabis and tobacco use reduced sGaw, although the effect was of marginal significance for tobacco."

Also, the study said that cannabis smoking had a negative effect on these tests if the subject was also a tobacco smoker.

A "novel finding" was that those who used cannabis regularly had an "increased percentage of low density lung tissue."

So, Reuters says one joint is as bad as 5 cigarettes on your lungs, when really, in every test but one, tobacco had negative effects while cannabis effects were statistically insignificant. Cannabis seems to negatively effect only one aspect of lung function, air flow. But when it comes to hyping the dangers, that single finding is sufficient to ignore the other findings and claim cannabis to be 5 times more damaging than tobacco. Notice that Reuters' headline says 5 times even though the study says 2.5 to 5.

Methodological issues:

Of 3500 randomly sampled adults, the researchers could only find 19 who smoked a joint a day for five years. They had to specifically advertise for people to come to them, which they admit may have attracted people concerned about their respiratory health (since the study focused on the health effects of smoking cannabis). Also, since joints are usually shared and packed at home, the amount of cannabis varies from joint to joint and the amount smoked by each person is different; numbers of joints smoked per person were based on the rough estimate of the individual himself - subjects were told to guess what percentage of a joint they smoked each time and then add up these numbers.

Other issues with the study:

They studied only those who smoked a joint a day for the past five years - these are long-term effects that would not pertain to the average marijuana user (especially if marijuana is not smoked but eaten or vaporised). And the reason there is no filter is because they are made at home, a problem easily remedied by use of a filter in the joint making process. Eliminating the risks of smoking on lungs through alternative methods of administration is not discussed as an obvious harm reduction policy implication, in the paper or any media coverage.

And the papers conclusion: marijuana smoking causes wheezing, coughing, mucus, and chest tightness. Tobacco smoking causes emphysema.

Another lovely example of biased media and badly communicated research.

Transform in the New Statesman

The following article, quoting Transform, appeared in this week's New Statesman (July 26th). It is a decent critique of prohibition, ironically enough by a former editor of the Independent on Sunday...




The drug strategies don't work

Peter Wilby

Prohibition has failed, just as it did with alcohol.

Almost anybody who takes a sustained, unprejudiced look at the current drugs laws eventually reaches the conclusion that they are hopelessly unfit for purpose. The Misuse of Drugs Act 1971 must be one of the least effective pieces of legislation ever enacted. At that time, there were perhaps 10,000 problematic drug users in the UK; now there are nearly 300,000.

The Downing Street Strategy Unit concluded that "government interventions against the drugs business are a cost of business rather than a substantive threat to the industry's viability". In April, an academic paper for the UK Drug Policy Commission warned that imprisoning drug offenders for long periods was not cost-effective. In March, a Royal Society of Arts commission - which included a recovering addict, a senior police officer, a drug treatment specialist and a Telegraph journalist - decided that "drugs policy should, like our policy on alcohol and tobacco, seek to regulate use and prevent harm rather than to prohibit use altogether". The authors would deny it, but the logic of these reports is that cannabis, cocaine, Ecstasy, heroin and the rest should be legalised.

The harm the various drugs do is irrelevant. Their prohibition has failed, just as prohibition of alcohol once failed in America. Calls for politicians to "get tough" are, as the RSA observes, "meretricious, vapid and out of date". Since 1995, the numbers imprisoned for drug offences have risen by 111 per cent and the average length of their sentences by 29 per cent. A different approach, based on regulation, offers a chance to reduce the harm done by drugs, and at lower cost. Yet politicians just fiddle with the classifications of substances, moving them up or down the rankings as though they were running a hotel guide. So Gordon Brown has asked the Home Secretary, Jacqui Smith, to look again at the classification of cannabis, which, scientists report, is probably more dangerous than generally thought when it was downgraded three years ago. The result is another parade of politicians coming forward to confess to youthful cannabis use which, oddly, none of them enjoyed at all.

Cannabis is an example of the nonsenses created by the 1971 act's simplistic classification system. Stronger types of cannabis are now on sale, we are told, and research shows a link with schizophrenia.

This is like saying Chablis should be banned because cognac is much stronger and because some people become alcoholics, with dire effects on themselves, their families and society. All drugs, legal and illegal (including gambling and pornography), vary in their effects according to how strong or pure they are, who takes them, and where, when and how they take them. The classification system cannot allow for this and is, in any case, full of anomalies. Coca leaves are in class A, alongside crack cocaine, even though the drug in its raw state is largely harmless. Ecstasy is also in class A, though it causes 25 deaths a year against 652 for heroin, which is taken far less widely.

Magic mushrooms, another class A drug, do nothing more than make eccentrics more eccentric. If we are trying to send "messages" to young people about the dangers of drugs, as press and politicians claim, we do it in a pretty confusing way. Many who try one class A drug without ill effects may well conclude they can all be taken freely.

The RSA commission proposed scrapping the 1971 act and putting all drugs, including alcohol and tobacco, within a single regulatory framework. Some drugs in some forms might remain illegal but their illegality would be placed in a coherent continuum, making some drugs available to certain groups in controlled circumstances, as most prescription drugs are, and others more freely available under licence, as alcohol and tobacco are.

But as the Transform Drug Policy Foundation (www.tdpf.org.uk) says, nobody should pretend that legalisation would solve "the drugs problem", however it is conceived. Many - perhaps most - users handle drugs without significant harm to themselves or others. Where drugs lead to crime, addiction and family breakdown, they are nearly always associated with wider social problems. The best way to wage war on drugs is to step up the war against poverty.

Spin tries to hide the £100 billion crime cost of the UK drug strategy

Transform News Release. 25 July 2007

Spin tries to hide the £100 billion crime cost of the UK drug strategy

Today (Wed 25 July) the Government has published its long awaited consultation paper on the future of its drug strategy. Transform, the UK’s leading centre of expertise on drug policy reform argue that it uses spin and rhetoric in an attempt to dress up failure as success, and fails victims by refusing to tackle the causes of drug crime.

Danny Kushlick, Transform Director said:

“Government drug policy has resulted in crime costs of over £100 billion in the last decade. Organised crime make billions every year from a totally unregulated and untaxed illegal drug trade. The government appears committed to continuing the nightmare for victims of crime who will continue to experience the chaos of violent unregulated street markets, and the thefts and robberies that result from the high cost of maintaining an illegal heroin or crack cocaine habit.

“The Government is spinning failure as success. The simple fact is that the UK drug strategy has failed to reduce drug use and failed to reduce drug supply. Class A drug use by young people, whilst stable, is at its highest ever level and is the highest in Europe. It is the use of heroin and cocaine, the drugs identified by the Government as causing the most harm, that have seen the most dramatic rise in use over the last 10 years. They have cherry picked and misrepresented statistics to try and demonstrate success when the general pattern has be rising use and rising harm, especially amongst the most vulnerable groups”.

“Cannabis reclassification is a red herring. On 6 June Gordon Brown was asked during Labour Party Leadership hustings if he would be reviewing cannabis classification. He answered, no. On 18 July he told Parliament that he would be referring cannabis back to the Advisory Council on the Misuse of Drugs. All that had happened in the intervening period was the publication of the Tory policy paper on drugs that had called for cannabis to be reclassified back to Class B. The announcement was all about politics and nothing to do with science.”

“Drugs are dangerous and do cause real harm. However, the Government appears committed to a drug policy that criminalises the poorest and most disadvantaged in our community, grants a multi-billion pound monopoly to organised crime and dramatically increases the harms suffered by our communities. Through spin Gordon Brown’s government has failed the hundreds of thousand of victims of drug related crime. Transform and other organisations will use the consultation period to highlight policy options to reduce drug harm. We hope the Government will listen. If not they will be responsible for the ‘violence, disruption, harassment and intimidation’ they admit blight many communities under the current drug policy.”

ENDS

Notes for editors:

A detailed critique of how Government spins its drugs figures


Transform press release on the recent cannabis classification announcement

Transform fact research guide with headline figures, links to key data sources official and Independent, and comment and analysis.

Transform on BBC Radio 4's 'Law in Action'

BBC Radio 4's Law In Action broadcast a special programme devoted to the drug laws on Tuesday 24 July.

Danny Kushlick, Transform Director, appeared on the studio panel. The Drugs Minister, Vernon Coaker, declined to take part. Is this perhaps because defending the status quo under close scrutiny would have been impossible?

Below is the BBC blurb to accompany the programme.

Drug Laws

It's an unpalatable fact that the UK has the highest level of dependent drug use, and among the highest level of recreational drug use in Europe.

Our drug problem worsened steadily during the 70's, 80's and 90's and yet the drug laws which are largely governed by The Misuse of Drugs Act, is now 36 years old.

When the Act came into force in 1971, there were a just few thousand heroin users in the UK. It's now estimated that there are more than 280,000 in England and 50,000 in Scotland.

Tomorrow, (July 25th), the Home Office publishes its long awaited consultation on its drug strategy, and on today's programme we examine whether our current laws and criminal justice system are working effectively?

Joining Clive to discuss that are:
Danny Kushlick is the Director of the Drugs Charity, Transform, a think tank committed to reform of the current laws and policy on drugs; Diane Mark is chair of the bench at Wimbledon Magistrates Court and Paul Hayes is head of the National Treatment Agency, a body created by the Government in 2001 to ensure that there is more, better and fairer treatment available to all who need it.

Other contributors to the programme:

Professor Colin Blakemore, Chief Executive of the Medical Research Council, "Paul," a former drug addict and offender, Greg Foxsmith, a criminal lawyer working in London, Deputy-Chief Constable of Nottinghamshire Police, Howard Roberts (and also representing the Association of Chief Police officers on drugs issues),

The Drugs Minister, Vernon Coaker, declined to take part.

Independent debunks itself on cannabis potency

In a strange turn of events Saturday's Independent ran a news piece by health correspondent Jeremy Lawrence, titled 'Debunked: politicians' excuse that cannabis has become stronger'

The piece is aimed at the politicians who have recently confessed to cannabis use but have been claiming, as some sort of excuse, that what they smoked 'back in the day' (you know, the harmless hippie stuff) is a world away from the super potent insane-abis which the feral street kids of Britain are being driven mad with today. The article is a fairly comprehensive debunk:

"The Advisory Council on the Misuse of Drugs, which examined the issue 18 months ago, will be asked to do so again. It concluded in its report in December 2005 that the strength of cannabis resin (hash) had changed little over 30 years and was about 5 per cent tetrahydrocannabinol (THC). Skunk, it found was 10 to 15 per cent THC - two to three times as strong, not 25 times.

Professor Leslie Iversen, a pharmacologist at Oxford University, said the widespread belief that skunk was 20 to 30 times as powerful was "simply not true".

The biggest change over recent decades has been in the strength of indoor-cultivated herbal cannabis, but even this has only doubled to 12 to 14 per cent THC. Although exceptionally strong skunk can be found on the market in Britain, it always has been available, according to reports from the UN Drug Control Programme."

The weird thing about this is that if anyone has been stoking the fire under the potency-panic furnace lately, it is the Independent on Sunday. Back in March the Independent on Sunday ran its now famous cannabis apology front page, claiming that skunk 'is 25 times stronger than the resin sold a decade ago'. Much more of the same followed over the next 5 weeks with no less than 15 cannabis health-panic news items or comment pieces used to justify their new 'cannabis is bad for you therefore we advocate mass criminalisation' editorial line/ratings booster.

Much of this was diligently and patiently critiqued here on the Transform blog:

• How the Independent on Sunday got it horribly wrong on Cannabis
  
  
• The Independent's born-again drug war: Round Two
  
  
• The Independent and cannabis: on it goes
  
  
• Cannabis potency update: IOS digs in, ONDCP ‘fess up

There was also a good deal of intelligent critique from elsewhere in the media and blogosphere:

• Bad science column in the Guardian: 'Reefer Badness'
  
  
• Cannabis - sorry about the apology by former prime-ministerial advisor, and former director of anti-smoking charity Ash, Clive Bates
  
  
• Do 'Skunk' stats stink? from the George Mason University (Washington DC) statistical assessment service.

So, whilst we might expect a critical view from an opinion writer (Deborah Orr has a piece in the paper aswell for example calling for legalisation and regulation, and Indeed Johann Hari has been writing about all this at length in the daily Independent for ages) , it does seem odd that they would now run a news item that utterly and completely undermines their own position, which they so prominently paraded on the front pages and in leader columns just a few months back.

What exactly is the relationship between the Independent and the Independent on Sunday? Do they share more than a name, logo and website? Has Jeremy Lawrence ever met Jonathan Owen (chief cheerleader of the IOS's canna-panic)? Was Lawrence secretly fuming at all the shoddy reporting being trotted out by his sister paper and lying in wait for his moment to strike back?

Who knows, or to be honest, cares. Its just good to see that poor reporting and populist silliness based on bad science can, apparently, be challenged in house. And fortunately we have seen more of this elsewhere in the past two weeks as the Guardian's withering critique of a populist MMR shock-piece in the Observer demonstrates. Perhaps there is some glimmer of hope yet for improved critical coverage of science stories in the media.

note: non-cannabis blog coverage will hopefully be resuming shortly

thanks to Science punk

Bad Science: Testing social policy

Testing Social Policy

July 21st, 2007 by Ben Goldacre in the Guardian

There is no sense in which I am a hardliner on trials, and I’m totally down with the idea that there can be many different kinds of evidence, but one thing has always puzzled me: in these days of “evidence based thinking” in Whitehall, why don’t we do randomised controlled trials on social policy? One statistician, Professor Sheila Bird, will hear this week if a grant has come through to do just that, and if the money appears it will be a first for the UK. How deep is the problem?

A while ago we introduced Drug Treatment and Testing Orders, under which offenders attend a clinic for rehabilitation instead of serving a custodial sentence. In 2003, just moments after they were launched, 21,000 convicted offenders had been given DTTOs. But because there was no randomised trial to see if they faired better than those sent to prison nobody really knows whether DTTOs work or not, for reducing re-offending, or drug taking, or anything.

Like all the best problems, the barriers are institutional and historical: and the objections raised against trials in social policy are exactly the same as those raised in medicine 40 years ago.

Judges will say, as doctors once did: we have expertise, we know what works for an individual. Interestingly, there is a way to test this, too, in a trial. You divide prisoners awaiting sentence into two groups: one is randomised to either DTTO or custodial, the other fielded into DTTO or a custodial sentence at the judge’s discretion. Then measure whatever outcomes you think are important between the “judge decision” group and the “randomised” group, and there’s your answer on judges’ discretion.

But even with discussions about sentencing, judges may be in denial about the extent of disagreement within their profession. Iain Chalmers, founder of the Cochrane Collaboration and champion of evidence-based medicine, once described putting several obstetricians in a room - all absolutely certain they knew best for individual patients, and who objected to trials - simply so they could witness the disagreement and certainty of their colleagues.

There is also wider professional resistance: social policies feel good, like alternative therapies; but, like alternative therapies, most policies don’t work. In the field of recidivism, even from uncontrolled studies there aren’t many successful interventions.

When you know, deep down, that your intervention doesn’t work, then you’re not going to subject yourself to public exposure through a randomised trial. And if you really believe your policies are effective, then when the results come back negative you’re simply going to argue that trials aren’t the right way to test a policy. For some cod-philosophical reason or another. Just like the quacks. Medicine, perhaps through the ubiquity of death, has learnt to accept failure better. Most of the drugs developed don’t work either, but we don’t say “let’s stop bothering”; we say, “great, we’ve stopped wasting money and side effects on ineffective treatments”.

But lastly, people will object, because even when you’re subjecting citizens to an experimental new policy, flagging the uncertainty with a trial reinforces the uncertainty. This was a key issue with early trials in medicine, and we overcame our irksomeness decades ago, right up at the front of the game. The crucial early trials on surgical options for breast cancer were highly emotionally charged, but necessary, simply because the options were equipoised.

If we can do RCT’s on something as horrifying as whether women have their breasts removed then we can do RCT’s on social policy. Best of luck Prof Bird.


thanks to Ben Goldacre and the Bad Science blog

-------------------------------------------------------------------

.....and interestingly, just for the record:

“In the face of all the evidence, thorough research into the possibility of legalisation is the only intelligent thing to do.”

Professor Sheila Bird, Principal Statistician at the Medical Research Council Biostatistics Unit.

Cambridge Evening News March 2006

from the Transform quote archive

'Smoke and Mirrors'. Sue Blackmore in the Guardian

The article below by Transform patron Sue Blackmore appeared in today's Guardian (Transform is linked twice). There is some interesting discussion following the online 'comment is free' version.

Smoke and mirrors

Here we go again, another politician forced by our stupid laws to say that drugs are wrong and unpleasant.

July 20, 2007 7:00 AM

Oh no, not again. Another poor politician (and I don't very often feel sorry for them) has been forced by our stupid laws to say: It was wrong; I have learnt my lesson; drugs are wrong; and I did not particularly enjoy smoking cannabis. Really? Is Jacqui Smith lying?

I expect so. And who can blame her. What if the home secretary were to say, "I smoked cannabis sometimes like most of my Oxford friends. I enjoyed it a lot. I had fun, explored my mind, and learned things, but then grew out of it"? Or even if she said that taking drugs was not intrinsically wrong if it hurts no one else? Well, if that were what she really thought, and she said it, then she would almost certainly lose her job.

A law that makes millions of ordinary people into criminals and risks even driving our own politicians to lie has to be a bad law. It should be changed.

Messing about with the classification of drugs is never going to provide a real solution to the problems we face (street crime, over-filled prisons, lack of treatment, lack of proper drugs education). I welcome Colin Blakemore's scientific examination of the harm drugs do and the subsequent attempt to make drug classification reflect more accurately the harm each drug does. But Jacqui Smith wants to bring down crime, and for that there is only one real solution: to take drugs out of the hands of criminals and make them legal.

Just imagine this brave new world. Anyone over a certain age can go to a drugs shop and buy sensibly priced, properly taxed, clean drugs. Drugs cartels have to give up and half the street crime is gone. Tax revenue pours in, prisons have plenty of space and ... what about the politicians?

Perhaps we might hear on the news that a new home secretary has said: "I smoked cannabis at university and I loved it. It was fun and interesting, and wonderful for listening to music, but it's no good for studying, and now I'm more interested in my career and how to do my job well."

And wouldn't this set a better example?

Youth cannabis consumption plummets following ministerial revelations

In a remarkable development following the recent admissions of youthful indescretions by 6 cabinet ministers, it appears that cannabis use amongst young people has plummeted.*

In a snap poll undertaken by Transform in the wake of the cabinet mass confessional, it appears the possibility of cannabis turning you into a cabinet minister has deterred thousands of young people away from the psychosis and schizophrenia inducing drug.

Interviews with some of the youngsters who answered the questionnaire included the following comments:

"After Cameron came out as former user I cut my use right back. After this Ive quit altogether. The risk is just too serious"

"Ive read the Da-vinci code, so i know what Ruth Kelly and that opus-dei lot are like. I know cannabis is bad for you, but theres no way I'm going to risk becoming a murdering psycho-monk"

"years of school drug prevention meassages just washed over me but this news has really hit me hard. Its shocking to see what a supposedly 'safe' drug can drive people to. They seem to talk rubbish all the time - which must be something to do with the way cannabis is stored in your fat cells for 50 years"

"they were all smoking like mad when they were students and look what happened. I want a proper job, and I dont want to turn into a boring minger like that lot"

A leading academic commented:

"Weve seen this effect before when sales of converse trainers plummeted after Cameron wore them, and similarly with Levi 501s when Tony Blair stepped out in them. The hope is now that even more un-charismatic Westminster bores will reveal their past drug use so we can build on the successes of the last few days."

"With drug free role models like Posh and Becks its good to know young people have some real intelluectual heavy weights to aspire to, ones whose brains havent been befuddled by use of illegal drugs."

* entire story completely made up

US drug tsar faces investigation for politicising drug programmes

John Walters, the US drug tsar, has run into a spot of bother, and could be facing the congressional hot seat for allegedly injecting political considerations into the spending of Government drug programs.

Drug policy and party politics getting all mixed up. Who would have thought it?

coverage and discussion at:

Dare Generation Diary

Drug War Rant

The Raw Story

Media obsess over cannabis reclassification. Again

So the cannabis classification review has made a big splash in the media, fuelled now by the rather dull news that the new home secretary has admitted using cannabis when she was a student, although with the predictable caveat that "I did break the law…I was wrong…drugs are wrong."

Jaqui Smith in her c-rayzee student days

Its all a terribly tedious rehashing of the last time the reclassification debate hogged the news, and the last time a politician admitted a student indiscretion (and the public revealed themselves again to be remarkably unbothered by the revelations). But still, here we are again.

The ACMD will again review the evidence and no doubt say exactly the same as the have been saying for years (in fact decades) that cannabis has serious risks for a subset of vulnerable users, but for the majority of occasional moderate users the risks are relatively low, before re-affirming there view that C is the appropriate classification. Two ACMD members I have spoken too are very annoyed that they are going to have to go over this issue for the third time in 5 years. Seriously, there are far more important issues for them to be directing their limited resources at.

The 'public consultation' on classification (which would have been part of next weeks consultation on the drug strategy anyway - so really is non-news) will provoke a spectrum of predictable views ranging from the ferocious anti-cannabis extremists who think pot turns you into an crazed axe-wielding lizard and should be class A, through to the equally blinkered cannabis evangelists who think its completely safe and use should be not only legal, but mandatory.

Most people take a more pragmatic view that consenting adult use should not be a criminal offence, that the market should be appropriately regulated and taxed by the state, and that resources should be put into education, prevention and treatment, rather than a demonstrably failed punitive approach involving mass criminalisation.

I do find it especially strange that those who like to tell heart-rending stories about tragic wasted teenage lives destroyed by mental illness, then see criminalisation of these vulnerable and damaged youths as the front line solution.

It's an emotional knee-jerk response to a problem that is not based on any evidence that such an approach will effectively reduce harms. Indeed, we have over 30 years of experience showing it is actively counterproductive. The debate over whether cannabis should it be one alphabetic increment this way or that is of course a massive distraction form the fact that the classification system and its hierarchy of criminal penalties simply does not work and is demonstrably both unjust and ineffective.

Brown, I suspect, knows full well that the ACMD will not call for a move back to B, and it is highly unlikely that the Government would over rule them. On the face of it, it appears to be a political decision primarily to remove the sting from the Tories accusations that the Government is 'sending out the wrong message', 'soft on drugs' and so on. Exactly the same thing happened in the run up to the last election when the Tories were similarly going on about a move to class B and the then home secretary announced yet another review. I had hoped Brown would draw a line under past failing by doing something a bit more sensible on drug policy. Oh well.

• Transform briefing on re-classification 2004
  
  
• Transform briefing for when the ACMD had to tediously go through it all again in 2005

Anyway. Transform put out a press release yesterday, which was quite widely picked up including:

The Telegraph

Jacqui Smith admits to smoking cannabis

Supporters of a more liberal regime accused Mr Brown of political posturing. A spokesman for the Transform pressure group said: "The potency issue and the mental health issues associated with cannabis are well understood and have not changed significantly since they were last reviewed in 2005."

The Independent

Brown plans to abandon softer laws on cannabis

But Martin Barnes, the chief executive of DrugScope, said the "fairly hysterical coverage in some sections of the media" was a factor in yesterday's announcement. He said: "Repeated movements on classification will only serve to further confuse young people, and increase the political point-scoring, at a time when cannabis use is falling among young people and adults alike." A spokesman for Transform Drug Policy Foundation said: "This announcement is all about political posturing and has nothing to do with science.

"It follows in the wake of a series of all-too-familiar cannabis health panics, which have been hyped up by certain newspapers, and more recently by the Tory party."

The Express

PM REVIEWS CANNABIS CLASSIFICATION

Spokesman [Rethink] Paul Corry said: "Although there has been renewed interest in yet again reclassifying cannabis, the experiences of our members tell us that re-introducing tougher criminal penalties for possession and use would do nothing to reduce use."

Former home secretary Charles Clarke commissioned the ACMD's first review of the evidence on cannabis, but in January 2005 announced that it would remain class C.

Mr Hellawell, who resigned over the re-classification of cannabis, told BBC Radio 4's The World At One: "There was never any justification for re-classifying it in the first place. It was at the whim of David Blunkett. It was against the will and wishes of the Cabinet at that time. I don't know how he got it through. It was a perverse decision then. It was a decision which, in my view, put back drugs policy in this country more than a decade and something clearly the Government are embarrassed by and are trying to resolve."

A spokesman for Transform Drug Policy Foundation claimed Mr Brown's announcement was "all about political posturing and nothing to do with science"

The Daily Mail

PM reviews cannabis reclassification

Same quote as the express, above - i assume this one was from an agency because the same quote is used all over the place.

The Scotsman

Brown announces review of cannabis classification

The Transform Drug Policy Foundation said Mr Brown's announcement was "political posturing and nothing to do with science".

The same quote also appeared in various other places and news sites including The Belfast Telegraph.

I also appeared on BBC news 24 last night and did an interview today with a broadsheet based in Montreal Canada, and Danny had a quote in the guardian online coverage. So some pleasing media exposure in some ways, just a shame it had to be around such a boring and ultimately pointless story.

Still, at least we dont have things as bad as they do in States:

Playing politics with cannabis classification. Again.

News Release

Playing politics with cannabis classification. Again.

Gordon Brown has announced yet another review of the classification of cannabis. This follows a resurgence in media scare stories on the drug and recent calls from the Tories high profile calls for the drug to be reclassified back to B.

The review will be part of long awaited consultation on the new drug strategy (as the 1998 10-year strategy nears its end), although the Home Office have also announced that the issue will be returned the the Advisory Council on the Misuse of Drugs, for the third time in 5 years.

A Transform spokesperson said;

'This announcement is all about political posturing, and has nothing to do with science. It follows in the wake of a series of all-to-familiar cannabis health panics, which have been hyped up by certain newspapers and more recently the Tory party who have been vocally calling for reclassification back to B.

'In reality the potency issue and the mental health issues associated with cannabis are well understood and have not changed significantly since they were last reviewed by the ACMD in 2005. The ACMD will not be happy to have to rake over the coals yet again: there is no evidence to warrant another time consuming review, and even if there were, there is also no evidence to suggest another reclassification would reduce harm.

'Classification appears to be entirely irrelevant to levels of use, or associated harms; Since the move from B to C in 2004, cannabis use has continued its slow decline, according to data from the British Crime Survey.

'It is the criminalisation of cannabis, and the unregulated illegal markets this creates, that is responsible for increasing the harms associated with its supply and use. If the Government is serious about reducing harm they should legally regulate the trade and use their limited resources to educate young people about the risks.

ENDS

Background info from Transform:

Cannabis reclassification revisted
the Advisory council looked again at cannabis reclassification, at the request of the Home Secretary. TDPF has made its consultation briefing available here.

Cannabis reclassification
Examines the political and policing issues around the decision to reclassify cannabis as a Class C drug at the end of January 2004.

How the Independent got it horribly wrong on cannabis:
debunking the various strands of the latest cannabis panic

Drug Discrimination and the case against Casey Hardison

The following article was sent to the Transform blog for publication on behalf of the the freecasey.org campaign, which we have reproduced un-edited. It raises a series of important issues about the interface between personal freedoms and heavy handed enforcement of the prohibition of some drugs, specifically the inconsistent and hypocritical ways in which government and law deal with the difficult questions this debate throws up. For certain individuals such as Casey Hardison, the failure of law makers to grapple with these issues has tragic consequences. Murderers and rapists are often getting sentences of under ten years, yet, in the shadow of an unprecedented overcrowding crisis Casey now faces his entire adult life behind bars at taxpayers expense.

Drug Discrimination: An End to the War on Drugs?

The Government will shortly commence the consultation for its post 2008 'New Drug Strategy', so it is perhaps timely to consider those who are suffering from the effects of the last 10-year strategy. British prisons are full of non-violent drug offenders – some of whom describe themselves as POWd's (Prisoners of the War on Drugs). The British Government now refrains from openly using the term 'war on drugs', but this lack of political rhetoric does not mask the very real casualties that continue to mount in this battle for the moral majority.

On April 22nd 2005, a British court sentenced Casey Hardison to imprisonment for making MDMA and LSD. A forensic chemist from the Forensic Science Service described Hardison's DIY lab 'as the most complex he had ever encountered'. Hardison however has consistently argued that he is the victim of one of the biggest injustices of the 21 st century – despite openly admitting he made numerous illegal psychotropic drugs.

The same week as Hardison received his 20-year sentence, Islamic extremist Kamel Bourgass, previously convicted of murdering a policeman, was sentenced to just 17 years for attempting to make deadly poisons to carry out terror attacks in the UK.

Making a Hash of It

In the light of these contrasting punishments, the Government may be wise during its consultation to consider the string of recent reports by Select Committees and respected independent think tanks on UK drug policy. Many of these reports heavily criticise the UK's 'ABC' drug classification system. According to the Government, a drug is labelled Class A, B or C to reflect it's harmfulness. Each Class of drug has corresponding levels of punishment associated with its possession or supply – up to life in prison for supplying Class A drugs.

Experts however say the Government has failed to produce any evidence to justify why particular drugs are in a particular Class, asking for example; why did this Government classify magic mushrooms as a Class A drug alongside crack cocaine and heroin? Something that until July 2005 was available to buy legally in Covent Garden could suddenly earn the seller a lifetime behind bars. Those who have tried magic mushrooms find it hard to understand why such draconian measures were needed, except perhaps for the most Machiavellian of political reasons.

Casey Hardison appealed against his 20-year sentence, defending himself on human rights grounds. He argued, among other things, that prohibiting certain drugs violated his right to equal treatment before the law. Why is it, he asked, that those who produce alcohol and tobacco get the Queen's Award for Enterprise, while those caught producing ecstasy and LSD are punished so harshly? Indeed respected academics recently published research in the Lancet, ranking each drug by harmfulness according to the evidence. The research shows that the drugs produced by Hardison rank far below both alcohol and tobacco. But the law is blind so they say.

The Government itself, in it's response to a recent Select Committee report on drugs, admits that the harmfulness of a drug, to either individuals or society, is not the only factor in determining the criminal penalties linked to it. The Government also relies on 'historical and cultural precedents' (civil servant speak for 'good old fashioned majoritarian, media-driven prejudice') to decide how to treat those associated with a particular drug.

To people like Hardison and others, who consider their drugs of choice to have been unfairly singled out, such distinctions matter. If those who use and supply certain drugs are treated differently on the basis of prejudice, as opposed to objective factual evidence, they are the victims of heinous discrimination.

Hardison and his supporters believe that such 'drug discrimination' should be treated in much the same way as sexual or racial discrimination is today. They hope that the minority who currently use low-risk illegal drugs will one day have a legal right to be treated equally alongside the majority's comparatively more risky consumption of alcohol and tobacco.

Food For Thought

Hardison's use of a rights-based defence against a drug conviction is not as far fetched as it may first appear. Since 1993, Native Americans have been permitted by US legislation to ingest the powerfully hallucinogenic peyote cactus in their religious ceremonies. Similarly, last year the US Supreme Court granted the União do Vegetal, a New Mexico based religious group, the right to use certain illegal hallucinogenic drugs. The Court held that banning the use of the hallucinogenic tea, drunk by the group during worship to alter consciousness, would excessively infringe on their religious freedom.

Protecting human rights and preventing the use and traffic of controlled drugs are both long-standing international policy goals. The global drug prohibition regime is built upon three international United Nations conventions to which almost all states have agreed. International human rights law is based on three even older UN treaties, signed up to by an almost equal number of nations. Could it be that these two giant cornerstones of international law have conflicting interests - one intent on protecting personal freedom and equality and the other on restricting it?

Global drug prohibition is a fixed ideology based on the premise that all controlled drugs are an 'evil' for both the individual and society; therefore they must be prohibited - even at great cost. The number of lives lost and billions spent fighting drug wars that rage around the world, from Columbia to Afghanistan, are testimony to this cost and to the value that many politicians place on fighting this war.

Perpetual War

As George Orwell once wrote in '1984', his prophetic novel on social control, 'since no decisive victory is possible, it does not matter whether the war is going well or badly. All that is needed is that a state of war should exist…' Often, the so-called 'war on drugs' is a war waged against our friends, families and neighbours; as individual freedoms are sacrificed to ever-growing surveillance and ever-tougher laws. Still the war on drugs goes on, seemingly without end, as illegal drug production and use rises year after year.

Why fight this war to begin with? Since the early 20th Century, misguided moral panics around drugs have been the driving force behind the creation of drug laws; spurred on by racial prejudice, ambitious bureaucrats involved in the prohibition enforcement regime, and films such as 'Reefer Madness'.

Politicians knew they were onto a winner; as a political smokescreen, the 'war on drugs' is perhaps only surpassed by the 'war on terror'. Drugs, the insidious enemy within, can be conveniently blamed for a wide range of incurable social ills at home; from the break up of the family to rising crime rates. In an age of moral pluralism, those in power may be running short of moral values they can be seen to support, but tough anti-drug statements by politicians are as popular as ever.

Rights Evolution

Modern democracies however, are not simply a dictatorship of the majority, leaving minorities to be sacrificed at the whim of every moral panic and media scare. In a modern democracy, laws made by our elected representatives are constrained by either a constitution or legislation such as the British Human Rights Act. Such human rights protection, inspired by centuries of struggle and the murder of millions during World War II, ensures that the few are not sacrificed for the 'good' of the many. Today, it is generally accepted that even murderous would-be terrorists like Kamel Bourgass are entitled to have their rights respected and to receive a fair trial.

Unlike the rigid laws governing drug prohibition, human rights law evolves over time with new case law. Homosexuality, to give an example, was considered highly immoral and criminalized in many European countries at the time the European Convention on Human Rights was drafted. Half a century later, morality has changed enough to permit the Convention to be used to prevent discrimination against homosexuals and a range of other 'deviant' minorities. In much the same way, it is possible that human rights law could continue to evolve to eventually protect certain types of non-medical drug use currently deemed illegal.

A number of legal cases have arisen in various countries questioning whether laws prohibiting non-medical drug use violate certain constitutional or human rights. In South Africa, for example, a Rastafarian law graduate was barred from continuing his legal career because of his religious use of cannabis ( Prince v President of the Law Society). The South African Supreme Court agreed with the argument that cannabis is genuinely used by Rastafarians in a religious context, but failed to grant the man the rights-based protection he sought. The court argued that allowing cannabis use for Rastafarians would be impractical when trying to enforce a complete ban on cannabis use for the rest of the country.

In the UK, a similar case involving a Rastafarian (Taylor, R. v [2001] EWCA Crim 2263 ) was struck down because, amongst other reasons, Britain has international treaty obligations to make cannabis illegal for all those within its jurisdiction. Such arguments were not however strong enough to defeat the religious group in the União do Vegetal case, recently decided in the US Supreme Court.

Cognitive Liberty

Generally, governments must show that they have a very good reason, or 'compelling state interest', for violating a fundamental right such as freedom of religion or the right to equality before the law. In the União do Vegetal case, the Government was unable to prove that allowing the group to drink their hallucinogenic tea would result in any significant harm. Conversely, the group was able to prove that banning their consciousness-altering tea parties was a severe restriction of their religious freedom. The Federal Court Judge in the case rightly concluded that if there is 'a proven interest of high order on one side, and mere uncertainty, or 'equipoise', on the other, the balance of equities is plainly in the plaintiff's favour.' The Government therefore had no legal justification to prevent the groups' drug use.

The Bush administration was concerned by the outcome of the União do Vegetal case; for if this logic can be applied to one drug in one circumstance, it may also be applied to others. To those hard-line opponents of non-medical drug use, this could be viewed as a slippery slope towards liberalization of the drug laws. To those who are in favour of drug policy reform, it is a welcome step towards evidence-based policy making and the protection of individual liberty.

Moral Dilemma

Why is it important to base drug policy reform on the moral values enshrined in human rights law, as opposed to merely presenting factual information about the ineffectiveness of drug prohibition? The answer is that to many people, drug prohibition itself enshrines a set of moral values, such as the ideal that 'all drugs are bad' and 'sobriety is good'. To usurp international drug control conventions, that have been in place for almost a century and are tinged with moral assumptions about good and evil, takes more than an academic study or two.

In other words, presenting an evidence base that seeks to undermine the assumed foundations of international drug prohibition will not, on its own, be enough to effect a profound change in drug policy. Moral, or 'normative' claims can only be effectively challenged by other moral claims. In this case, moral arguments based on international human rights law, supported by the growing evidence base against the effectiveness of global drug prohibition, are best suited to challenging the current orthodoxy.

The media, the courts, politicians and non-governmental organisations can all play a role in shaping the protection human rights law can offer to individuals. Giving new meanings to established rights has never been an easy task, but rights discourse can act as a lens, focusing small shifts in public morality to burn through the most obstinate policy roadblocks.

On May 25th 2006, Casey Hardison lost his final appeal. He now faces 20 years without freedom as a result of basing his defence on arguments he believed would allow greater freedom for everyone. Three years after Kamel Bourgass has been set free, Casey Hardison may still be in prison wondering what the right to freedom from discrimination actually means and why we as a society consider his crime so heinous.

Number 10 website petition to end drug prohibition: the Government responds

The text below was emailed to those who signed the petition, providing a concise summary of the Government's miserably weak intellectual arguments for maintaining prohibition. I have added some commentry (in blue italics to avoid any confusion).

Drug policy petitions on the Number 10 site are considered in some detail in a previous blog here (the blog is titled 'Number 10 drug policy petitions: a total waste of time?' . Read on to discover the all too predictable answer). For the record this particular petition was set up by the Transform Blog's very own founder, Ali G, for a blog post last year.

16 July 2007

We received a petition asking:

"We the undersigned petition the Prime Minister to End The Prohibition of Drugs And To Regulate A Safer Marketplace For All Currently Illegal Drugs."

Details of Petition:

"To reduce the criminal and social harms associated with the prohibition of drugs, we the undersigned, petition the Prime Minister to end prohibition and to regulate strictly the sale and marketing of potentially dangerous and currently illegal substances perhaps via licensed pharmacists. The costs of prohibition far outweigh any benefits."

• Read the petition
• Petitions home page

Read the Government's response

Thank you for your petition seeking the legalisation and regulation of all currently illegal drugs.

The Government has no intention of legalising the recreational use of any currently illegal drug. In response to the Home Affairs Committee report on The Government's Drugs Policy: Is It Working? in 2002, we stated that "We do not accept that legalisation and regulation is now, or will be in the future, an acceptable response to the presence of drugs".

You can read this response here, the last time I can remember an official written statement on this issue. Notably the original response to the Committee was a derisory cut and paste job of Government policy, totally failing to answer the questions asked on decriminalisation / legalisation. The rather affronted committee had to then demand answers to the questions asked. There is some discussion of this response in a previous blog titled: 'Classification and Deterrence: where the evidence?'

An end to the prohibition of all currently illegal drugs and their regulation in a managed way, as you would wish, inevitably draws attention to the international dimension of the problem of drug misuse and its legislative control. It is a huge global problem which poses an ongoing threat to people in many countries worldwide, including the United Kingdom.

Completely true. Bravo.

The international community has - since the early 1960s - taken the view that, for protecting public health and welfare, effective measures to restrict the availability of drugs of misuse would require co-ordinated and universal action. The course taken has been that of prohibition, as set out in the three United Nations Conventions on drugs (1961, 1971 and 1988).

It is also true that this has been the view of the international community (or at least its view as translated through the UN drug conventions under the bullying hegemonic dominance of those entities by the overlords of Global Prohibition: the US). The fact that the enforcement of the conventions (and their translation into domestic legislation) has failed in quite spectacular to 'restrict the availability of drugs' (which have incontestably become more available with every passing year) or to protect 'public health and welfare' (which have similarly deteriorated under the drug laws in question) is conveniently overlooked. Effective measures indeed.

Any possible reversal of this position would be likely to require a similar, concerted UN-agreed initiative. As a signatory to the Conventions, the UK will not alter its stance on legalisation without international agreement based on sound reasons for doing so.

Breathtaking abdication of responsibility. If a law or legal framework is demonstrably unjust, ineffective and counterproductive, as is the case with global prohibition ('sound reasons' for changing it), then you fight to change it, if needs be through a 'concerted UN-agreed' initiative. UN conventions can and have been revised, updated, and reformed. Its not easy or quick, but that is not a reason to ignore failed legislation and it is certainly not an argument against the policy in principle. There is a section on precisely this question in Transforms new report After the War on Drugs, Tools for the Debate which will be available online later this month.

The Government's view is that the drugs subject to our misuse of drugs legislation are controlled for good reasons.

But they are N O T C O N T R O L L E D, are they. Control of the £300 billion a year market in dangerous drugs was abdicated to violent gangsters and uncontrolled criminal dealers when we bought into global prohibition back in 1961. (see above). And what are the 'good reasons'?

Many - like heroin and crack cocaine - are clearly addictive and harmful to health.

The fact drugs are harmful is the reason why they need to be properly controlled and regulated within the law, as alluded to in the petition. There are of course a number of legal drugs that are also 'clearly addictive and harmful to health'. The Government's response entirely fails to tackle the screaming contradiction and hypocrisy that exists within it's own policy on 'addictive and harmful drugs'.

Legalisation of currently illegal drugs would run counter to the Government's health and education messages.

In what other area of public health policy is heavy handed enforcement of criminal law used as the primary tool to send out public health messages? Surely the stunning failure of this approach in drug policy (which has witnessed consistent rise in overall drug use, especially of the most dangerous drugs, for two generations) should prompt a pause for thought. Maybe there is a better way to educate the public about the dangers of drugs and encouraging responsible lifestyle choices, through, for example, established public health education channels.

Our educational message - to young people in particular - is that all illegal drugs are harmful and that no one should take them.

Only illegal drugs?

To legalise their supply for personal consumption would send the wrong message to the majority of young people who do not take drugs on a regular basis, if at all, with the potential risk of increased drug use and abuse.

You send whatever message you deem appropriate (e.g. don't do drugs, they are bad for you) using public health education, media campaigns, school education and so on. There all manner of risky consenting adult behaviours that are not subject to legal sanction as a way of discouraging them. Why are (some) drugs different. Can you provide any evidence to show that this unique approach to reducing the harms associated with one specific consenting adult choice is in any way effective? No?

The Government's objective is to reduce the harms caused by use of all illegal drugs substantially, not to encourage increased consumption due to more ready access to increased supply.

Where in the petition does it mention 'encouraging increased consumption' (something, I note, that prohibition seems to have achieved with great success), or indeed 'more ready access to increased supply' (something, I further note, that prohibition seems to have achieved with great success)? If I read the petition correctly it called for the Government to 'regulate a safer market place' (one where the government controlled availability and supply, not the mafia), specifically 'to regulate strictly the sale and marketing of potentially dangerous and currently illegal substances perhaps via licensed pharmacists'. So, just to reiterate, that's strict regulation of dangerous substances, as opposed to violent unregulated street markets and criminal anarchy.

Our existing 10-year Drug Strategy is delivering tangible improvements in communities and reducing the harms caused by illegal drugs. Overall drug use amongst 16-59 year olds has fallen by 16% between 1998 and 2005/06. The Young People and Drugs Programme has been introduced to ensure that a comprehensive range of support is in place for young people. The use of any drug amongst 16-24s has fallen by 21% between 1998 and 2005/06, whilst Class A drug use remains stable.

This statistical tricksyness is dealt with in some detail on the blog here: How to spin prevalence data: a beginners guide

The Government has also achieved huge success in delivering treatment services and a national target of 170,000 people receiving treatment has been exceeded two years earlier than anticipated. More people are also successfully completing treatment programmes or being retained in treatment - 78% of those treated in year in 2005/06.

Throw money at the problem then trumpet lots of impressive sounding process measures. Sadly no mention of treatment outcomes (because they are all rubbish).

Drug-related crime is falling - recorded acquisitive crime (to which drug-related crime makes a significant contribution) has fallen by 20% since the introduction of the innovative Drug Interventions Programme (DIP) in April 2003.

There is absolutely no evidence that the DIPs are responsible for this drop in crime. The Government does not measure what crime is 'drug related' so any conclusions presented is speculation and inference based on secondary data sources. The drop in crime could equally well be related to the failure of supply side interventions that have led to increasing drug availability and significantly: falling price. When dependent drug users can get there drugs cheaper they don't have to nick as much to raise the money to buy them. So failure in one area of UK drug policy is potentially being dressed up as success in another. Needless to say if the drugs in question are made available on prescription, as is the case with heroin to a very limited degree, the need to raise money to buy those drugs disappears entirely. That would be the 'licensed pharmacists' then.

Around 3,500 drug misusing offenders are currently entering treatment each month through DIP. We are on track to achieve an overall target of 1,000 offenders a week into treatment by March 2008.

Process and throughput indicators again. No mention of outcomes (because...etc)

We have also developed better enforcement through an intelligence driven approach to tackling street level dealers and organised trafficking groups at all levels in the supply chain.

No mention of that pesky 'fact' that drugs are cheaper and more available than ever before. Grrr

The Government nevertheless accepts that more needs to be done.

meaningless platitude

In particular, this includes a stronger emphasis on dealing with problematic drug users and the problems they pose, and on reducing the harm from drug misuse to their own well-being and that of others.

....a large part of which is either exacerbated by or a direct result of prohibition and its enforcement.

The existing Drug Strategy ends in March 2008 and we need to build on our achievements so far. Our intention is to commence a consultation on the new strategy over the Summer and consult widely.

...then ignore anyone who suggests we do anything differently, announce a new strategy exactly the same as the last one dressed up with a few headline grabbing spin-itiatives, and launch it in a torrent of tough talking soundbites (with a bit of faux-compassion chucked in for the Guardian readers).

Critiquing the failings of current policy

Extract 8 from Transform's upcoming publication: After the War on Drugs, Tools for the Debate.

Critiquing the failings of current policy

Once some common ground has been established on the aims and principles underlying drug policy, the next logical step is to critique prohibition based on these agreed aims and principles. Generally speaking, this is not especially difficult , as prohibition has failed on almost every indicator imaginable. The key here, given that you are being listened to in the first place, is simply to make sure you have the basic facts and analysis at your finger tips.

Bear in mind, however, that no policy which has been such a spectacular and consistent failure could have been sustained for so long without a monumental propaganda effort to prop it up. As you critique prohibition you will need to be aware of the forest of misinformation , myth, and statistical chicanery that defends it, so that you can cut through it when necessary.

Challenging prohibitionist myths and misinformation

There are numerous myths perpetuated by the defenders of current drug policy, most of them aimed at supporting the case that prohibition is effective. Quite simply, it isn’t, as even a cursory examination of the facts reveals. Prohibition was intended to eliminate drugs from the world and has achieved the exact opposite. On a consistent basis, over more than two generations, drug production has risen, drug consumption has risen, drug availability has risen (whilst prices have fallen), and drug related health problems have risen. Crucially, in addition, prohibition has directly created a raft of new problems associated with criminal markets locally and narco-states globally. Once an illegal market has become established, prohibition has not worked anywhere, ever. Moreover it has been universally and quite spectacularly counterproductive on all meaningful indicators.

The myth of prohibition’s effectiveness is constructed from a series of assertions that can very easily be demolished:

1. Prohibition reduces availability

This is perhaps the most easily-refuted claim made for prohibition – so much so that you rarely hear it anymore. Nevertheless, the goal of reducing the availability of drugs remains a key pillar of the UK national drug strategy, and indeed of the entire UN international drug control apparatus. Reducing availability remains the sole aim of supply side enforcement at the international, domestic and local levels, absorbing billions of government spending each year.

The simplistic rationale for this strategy is that if drug supply can be stopped then no one will take drugs and the drug problem will disappear. However, drug markets are demand-driven, and supplying them is a staggeringly lucrative business. Consistently, over several generations, and in countries across the world, there has been a clear trend of drug supply and use steadily increasing. Drugs are cheaper and more available today than at any time previously, something that even official analysis from the Home Office, the ACMD, and even Tony Blair’s own confidential report produced for him by his Number 10 Strategy Unit does not dispute.

Never let anyone claim that supply side enforcement is effective without a very robust challenge – the evidence against this assertion is clear, overwhelming and acknowledged by all credible sources, official and independent.

2. Prohibition reduces use / is an effective deterrent

This myth is entwined within the previous one, that prohibition reduces drug availability; but it also depends on the concept of using enforcement to ‘send out the right message’ on drugs, namely that they are harmful to health and you shouldn’t take them. The concept of criminal law as a deterrent to drug use is absolutely central to the entire prohibitionist paradigm, and yet the assumption has little or no evidential foundation. This is a point that you can raise with great confidence whenever the deterrent issue arises:

• Drug use has risen faster under prohibition than at any time in human history.
  
  
• International comparisons show no correlation between the harshness of enforcement and prevalence of use. The UK, for example, has one of the harshest regimes and the highest level of drug use in Europe.
  
  
• Different states within the US and Australia have very different enforcement regimes for Cannabis possession – from very punitive to de-facto decriminalisation. Comparing the different states shows there is no correlation between enforcement and prevalence.
  
  
• In the UK it is mostly Class A drugs, with the harshest penalties, which have seen the most dramatic rises in use. Heroin use in the UK has risen by at least 1000% since 1971, cocaine use has doubled in the last ten years. Similarly ecstasy use went from zero to several million pills a week being consumed in a matter of years in the late 1980s.
  
  
• The Home Office has never undertaken any research to establish the extent of enforcement related deterrence, despite it being at the heart of the Misuse of Drugs Act and all subsequent policy thinking. The research that does exist suggests enforcement related deterrence is, at best, a marginal factor in influencing decisions to take drugs.
  
  
• In his oral evidence to the recent Science and Technology committee, Professor David Nutt, Chairman of the ACMD Technical Committee stated: “I think the evidence base for classification producing a deterrent is not strong”.
  
  
• The Commons Science and Technology Committee reported in 2006 that: “We have found no solid evidence to support the existence of a deterrent effect, despite the fact that it appears to underpin the Government’s policy on classification”.

part 1
part 2
part 3
part 4
part 5
part 6
part 7




Online July 2007...
print copies in the office

Finding Common Ground: the aims of drug policy

Extract 7 from Transform's upcoming publication: After the war on Drugs, Tools for the Debate, this description of the aims of drug policy follows from the discussion of the principles of drug policy covered in extract 6

The Aims of Drug Policy

As developed by Transform, the core aims of drug policy, which can only be properly addressed once the current prohibition of drugs is dismantled, are:

• To minimise the prevalence of problematic drug use and related health harms, including drug related death.

Although this sounds uncontroversial, it actually challenges a central tenet of current drug policy: that any illicit drug use is unacceptable / illegal, and / or that non- problematic drug use does not exist. However, this assertion ignores the reality that problematic drug users, defined by the need for social or criminal justice intervention, are in reality only a small fraction of the drug using population. Transform argues that non problematic use should not be the primary concern of Government, beyond efforts to prevent progression into problematic use, which can be supported on public health grounds if there is evidence that they are effective.

• To minimise disorder, violence and social nuisance related to drug use
  
  
• To minimise criminal activity associated with the production and supply of drugs

These two aims are linked; however, there is a clear distinction between public order problems caused by intoxication (overwhelmingly by alcohol) and the far more significant problems caused by illegal markets.

• To minimise drug-related harm to vulnerable groups, young people and families

Whilst the ethics of dictating personal behaviour to adults is a tricky area, for non-adults there are clear arguments for programmes to prevent early drug use as a public health initiative and as part of a wider harm reduction approach.

• To ensure adequate provision of support and drug treatment for people seeking help

Some may argue that drug users don’t deserve care or should not be allowed to receive the benefit of non-drug-using taxpayers’ money. It’s a potentially thorny area (as recent debates on restricting certain treatments/procedures to alcoholics/smokers have shown). It can be avoided by highlighting the positive cost-benefit analysis of treatment versus continuation of chaotic drug use.

part 1
part 2
part 3
part 4
part 5
part 6




Online July 2007...
print copies in the office on Monday!

More critiques of the Tory Social Justice Policy Group on Addiction report

I went to the launch event for the Tory Social Justice Policy Group on Addictions report (full report, exec summary) yesterday and discussed some of its contents with the working group and its authors. Interesting stuff indeed, and I have been diligently poring over the detail of the report. There is a lot to talk about; it covers an awful lot of ground at 428 pages and it is certainly a heavyweight document, literally, if not always intellectually. I hope to discuss some of its recurring themes over the coming weeks on the blog as I feel it will be a useful exercise to highlight many of the problems and confusions within contemporary drug policy thinking and debate.

In the mean time here are a three of the critical responses that emerged for yesterdays official launch:

Firstly from the International Harm Reduction Association:

Evidence, not ideology, must drive public policy on drug use

Commenting on the launch of the Conservative Party’s new drug policy proposals, the International Harm Reduction Association (IHRA) has called for UK drug and public health policy to be based upon evidence, not politics.

IHRA is the leading organisation in promoting evidence-based harm reduction policies and practices on a global basis for all psychoactive substances, including illicit drugs, tobacco and alcohol.

“Iain Duncan Smith say he wants a ‘clean break’ from harm reduction programmes such as needle exchanges,” said Prof Gerry Stimson, IHRA Executive Director. “These programmes were in fact introduced by the Conservative Government in 1987, and they have helped keep HIV infection among injecting drug users extremely low by international standards. The Tories also expanded our methadone programmes.”

“The Conservative’s new drug policy suggests there is insufficient research to support harm reduction interventions. In fact nothing could be further from the truth, as the controversial nature of these programmes means they are among the most rigorously monitored and evaluated of all drug programmes. The scientific research from around the world shows clearly that needle exchange and methadone save lives, and for this reason these interventions are supported by the World Health Organization and the United Nations, among many others.”

“Interestingly, the detailed research on harm reduction produced by the WHO and the UN is conspicuously absent from the new Tory policy, suggesting that the authors have cherry-picked their ‘evidence’ to fit pre-determined, ideologically driven outcomes,” said Prof Stimson.

“Of course we need more and better treatment programmes to rehabilitate people who use drugs. But let’s not fool ourselves, you can’t rehabilitate someone who has died from HIV/AIDS.”

end

Appended to the above press release is the document:

Misrepresentation of the Effectiveness of Harm Reduction: Evidence Ignored in Conservative Party Policy Recommendations

"We certainly know from our experience in the UK that clean needles can dramatically improve the position as far as drug users are concerned. To those who say that free needle exchange is too radical, too liberal a step, I reply that it was introduced here not by some way out administration of the left but by the government of Margaret Thatcher."

Lord Fowler
House of Lords
19th May 2004

World Health Organization Effectiveness of sterile needle and syringe programming in reducing HIV/AIDS among injecting drug users – Evidence for action technical papers (2004) online here

This is the most comprehensive report ever produced reviewing the evidence base for needle/syringe programmes (NSPs), and is based on a review of over 200 scientific studies:

“The studies reviewed in this report present a compelling case that NSPs substantially and cost effectively reduce the spread of HIV among IDUs and do so without evidence of exacerbating injecting drug use at either the individual or societal level.” (p. 30)

World Health Organization, United Nations Office on Drugs and Crime and UNAIDS position paper: Substitution maintenance therapy in the management of opioid dependence and HIV/AIDS prevention (2004)
online here (pdf)

“Substitution maintenance therapy is one of the most effective treatment options for opioid dependence. It can decrease the high cost of opioid dependence to individuals, their families and society at large by reducing heroin use, associated deaths, HIV risk behaviours and criminal activity. Substitution maintenance therapy is a critical component of community-based approaches in the management of opioid dependence and the prevention of HIV infection among injecting drug users (IDUs).” (p.2)

“Methadone maintenance treatment is also an extensively researched treatment modality. There is strong evidence, from research and monitoring of service delivery, that substitution maintenance therapy with methadone (methadone maintenance treatment) is effective in reducing illicit drug use, reducing mortality, reducing the risk of spread of HIV, improving physical and mental health, improving social functioning and reducing criminality.” (p. 14)

“Substitution maintenance treatment is an effective, safe and cost effective modality for the management of opioid dependence. Repeated rigorous evaluation has demonstrated that such treatment is a valuable and critical component of the effective management of opioid dependence and the prevention of HIV among IDUs.” (p. 32)

World Health Organization, UNAIDS, United Nations Office on Drugs and Crime Policy Brief: Provision of Sterile Injecting Equipment to Reduce HIV Transmission (2004)

online here (pdf)

“The provision of access to sterile injection equipment for injecting drug users and the encouragement of its use are essential components of HIV/AIDS prevention programmes, and should be seen as a part of overall comprehensive strategies to reduce the demand for illicit drugs.” (p. 1)

United Nations High-Level Committee on Programme Preventing the transmission of HIV among drug users: A position paper of the United Nations System (2001)
online here (pdf)

“Several reviews of the effectiveness of syringe and needle exchange programmes have shown reductions in needle risk behaviours and HIV transmission and no evidence of increase into injecting drug use or other public health dangers in the communities served. Furthermore, such programmes have shown to serve as points of contact between drug abusers and service providers, including drug abuse treatment programmes” (para 10)

Commonwealth Department of Health and Ageing (Government Of Australia) Return on Investment in Needle & Syringe Programs in Australia: Summary Report (2002) online here

"By the year 2000, approximately 25,000 HIV infections are estimated to have been prevented among injecting drug users since the introduction of NSPs in 1988, and by 2010 approximately 4,500 deaths are projected to have been prevented.” (p.i 10)

“By the year 2000, approximately 21,000 HCV infections are estimated to have been prevented among injecting drug users since the introduction of NSPs in 1988, (of which approximately 16,000 would have developed chronic HCV); while by 2010 approximately 650 fewer injecting drug users are projected to be living with cirrhosis and 90 HCV-related deaths would have been prevented.” (p. 10)

“Overall, total treatment costs avoided over the life of the cases of HIV and HCV avoided by NSPs are approximately $7,808 million.” (p. 13)

“The results demonstrate that NSPs are effective in reducing the incidence of both diseases [HIV and Hepatitis C] and that they represent an effective financial investment by government... The results demonstrate that, across all measures of effect used in the study, NSPs have yielded a significant public health benefit, and that continued investment will result in further financial savings to government and improvements in both the quantity and quality of life of injecting drug users accessing NSPs.” (p. 21)

ends

Before moving on to the next commentary, it is worth pointing out that IHRA, the leading independent centre of expertise on harm reduction, in the world, were not approached for a submission to the working group. Given the reports repeated critique of the approach (as they define it - or in fact fail to define it) this seems like a stunning oversight. IHRA do, however, warrant a brief mention in the online version of the report. The mention comes within the rambling 130 page submission/rant from former headmistress Mary Brett that is included in toto, suggesting they are part of some global drug promoting / legalising conspiracy (which rather disappointingly Transform are not identified as being part of). Of IHRA, Brett says this:

"The IHRA (International Harm Reduction Alliance), of which the UKHRA is an offshoot and The Drug Policy Alliance are to a large extent funded by George Soros"

These 27 words have the dubious achievement of containing an impressive 3 factual errors: They are mistakenly called the International Harm Reduction 'Alliance' (it is 'Association' ), UKHRA is mistakenly described as an offshoot of IHRA (there is no formal link), and IHRA are mistakenly described as being funded 'to a large extent' by George Soros. They currently receive no funding from George Soros (although there are some Soros funded scholarships to attend the annual IHRA conference). In fact they are 'to a large extent' funded by the sinister 'Department for International Development'.

Right then, next:

Secondly, a press release from the UK Drug Policy Consortium, which, as well as making similar assertions to IHRA, is noteworthy because it is the UKDPC's first commentary on an external policy document (they have, up until now, been keen to state that they are collecting evidence rather than making recommendations, or offering commentry on other peoples)

Conservatives risk adopting flawed drug policy

Although the Social Justice Policy Group have spent much time and effort gathering opinions, anecdotes and case studies for their recent weighty report ‘Breakthrough Britain’, they have not taken sufficient account of the scientific evidence of ‘what works’ to tackle the UK’s drug problems.

This has led to some distorted analysis using selected and partial evidence, particularly in two key areas: methadone prescribing and drug treatment.

Despite a cursory acknowledgement that methadone prescribing can have a positive role, overall the report vilifies such programmes (dubbed ‘methadone madness’) and concludes they have “contributed to the growth of the problem rather than lessened it”. In doing so they ignore the robust body of evidence which demonstrates that harm reduction and treatment programmes including methadone prescribing have over many years contributed significantly to reducing deaths and other drug-related harms in the UK.(1)

In looking at drug treatment programmes the Group notes that one size does not fit all, but again contradicts itself by putting far too much reliance on abstinence, claiming: “abstinence is the most effective method of treatment and the only appropriate one for many addicts”. This sidelines some of the best available research. For example, NICE has comprehensively endorsed a range of treatment programmes including substitution drugs such as methadone and buprenorphine as well as residential rehabilitation.(2)

Roger Howard, chief executive, said:

“The UK Drug Policy Commission urges the Conservative Party to look carefully again at the scientific evidence before accepting the proposals outlined in the Social Justice Policy Group’s report. The Addiction’s Working Group which produced the proposals has been selective and partial in its analysis and interpretation of significant research findings across many areas of its work. Consequently, the Conservatives risk adopting flawed drug policy advice.”

(1) As noted in the independent report we commissioned: An Analysis of UK Drug Policy written by Professor Peter Reuter and Alex Stevens, April 2007. The full report and executive summary can be downloaded at the UKDPC website: www.ukdpc.org.uk.

See also NICE technology appraisal (2007) Methadone and buprenorphine for the management of opioid dependence.

(2) In draft guidance published by NICE and currently being consulted on, they state: “Opiate misuse is often characterised as a long term, chronic relapsing condition with periods of remission and relapse, so although abstinence may be one of a range of long term goals of treatment, it is not always achieved.” [National Institute for Health and Clinical Excellence – Drug Misuse: Psychosocial management of drug misuse: Draft guidelines January 2007].

NICE has also undertaken rigorous studies of the available evidence, which endorse a variety of treatment approaches.

Thirdly, an excoriating piece from Johann Hari in the Independent titled the very worst policy to combat drugs in which Danny Kushlick, Transform's Director, is quoted: "The report's authors avoid the science and the evidence like the plague". Hari, as ever, takes no prisoners and tears the report apart.