Wednesday, March 17, 2010

Mephedrone and Methadone - keep calm and review the evidence

There is a two pronged drug panic now in full swing, with the media calling for 'someting to be done' about mephedrone and methadone (Always get the journalist to spell it before you start rabbiting on about the wrong drug...)


I was up at 5.30am this morning in order to prepare for 5Live news at 6.00am to respond to the media furore regarding the deaths of two young people who had allegedly taken mephedrone. By 7.00 am I'd done eight interviews for local radio stations, warning of the dangers of rushing to make it illegal.

As ever the call is being driven by hysterical media hype (for example Telegraph Daily Mail The Sun and Guardian) about deaths of young people, none of which have unequivocally been linked exclusively to the use of mephedrone.

Leah Betts anyone?

Transform's call is three-fold:

  1. Calm down. A knee jerk response to classify may in fact increase harms, rather than reduce them. Mephedrone is not a threat to humanity or even a significant threat to the lives of users (we would have seen far more deaths if that were the case, given the high levels of use). Reduce the threat level to the correct proportions and begin to explore options. Recognise that the media massively over report illegal drug deaths, as opposed to all drug deaths, such as alcohol and tobacco, whose dangers are well known and demonstrably kill many more than mephedrone has (in relative or absolute terms).

  2. All drugs have dangers associated with their use. Put as much harm reduction information out there as we possibly can (knowledge of mephedrone is limited - here is a a decent guide to current knowledge).

  3. Recognise that criminalising drugs causes harms that may significantly outweigh any benefits. Conduct an independent and comprehensive impact assessment to explore all the options: do nothing, criminalise production, supply and posession, legally regulate its production and supply. Until that work is done, we cannot say which is the best option.

However, anecdotal evidence from Guernsey sugggests that the ban on importation there has pushed the price up from £10/gram to £60-80/gram and consequently acquisitive crime is now being committed by heavy users to fund their use/habit. Organised crime has taken over distribution (no guns on Guernsey, so samurai swords are the order of the day for fighting turf wars). This cannot possibly have made things better for the good citizens of Guernsey, and we would hope that (despite the differences between Guernsey and the UK) the Advisory Council take this evidence into account before recommending classification.


I also had a chat with The Times yesterday to try and give some balance to their anti-methadone line. It could have been worse (Leader Here and Feature Here)

What has been forgotten in the drive to turn the rhetoric of 'getting people off drugs' into reality, is  some of the basics.

  1. The vast vast majority of problematic users are not ready to stop using. The question then is how do you we manage that fact and reduce the harm that they cause themselves and the wider community.

  2. Methadone is not just for 'getting people off drugs', even if it can help with that goal for some. It is primarily used to reduce the amount of injecting of street heroin. Its purpose is to improve individual and public health by reducing both offending (acquisitive crime or prostitution to support a habit) and prevalence of high risk injecting behaviours, and thereby reduce transmission of blood borne viruses.
Methadone does not stop people becoming drug free. Anyone on methadone who wants to stop should be supported to do so. But whilst the majority of heroin users remain using, we would be foolish to throw away the medicine that has helped the UK keep its HIV rates amongst injectors relatively low, and reduced the collateral damage of making heroin illegal for non-medical use in the first place.

Transform is working with partner organisations to counter this pernicious move to undermine opiate substitute prescribing in the UK.


Anonymous said...

Wasn't it the case that these deaths were caused by methadone with alcohol?

Synchronium said...

I assume you've seen the stories a while ago about someone ripping their balls off:

Here's some actual harm reduction info too:

mickhumphreys said...

Heard you on Radio 4 World at One. Well done Danny.
Mick Humphreys

Anonymous said...

Nice to hear a balanced view.

Unknown said...

Nice to hear a balanced view this morning.

Tim Scully said...

The graphic from the Guardian about deadliest drugs is wrong. When it says "cannabis fatality figures highly questionable" the author is knowingly not saying the truth, as he knows that those figures are not "questionable", but plain wrong.

According to the author, David McCandless, those figures are taking from:
But if you go there and download the spreadsheet, you'll see that 19 is the number of deaths where cannabis was *mentioned* on the death certificate.

It is not the *cause* of death, but it is mention on 19 death certificates - quite different, as in the other drugs the number does indicates fatalities caused by such drugs.

I let the author know via Facebook and he assured me he would change it, but he never did, nor did he reply my following messages.

I find quite sad that Transform is helping to perpetuate the myth that cannabis is a lethal drug. Very sad indeed, as that graphic was published on the wake of Professor Nutt dismissal with the obvious intent to justify Alan Johnson ignorance.

Steve Rolles said...

I agree Tim, that did grate, but the general point being made is still important. I thought the stat was for 'mentioned on death certificate'.

I have written a bit about problems with drug death stats on the fact resaerch guide, and there is some useful discussion in the ACMD report on drug deaths.

Steve Rolles said...

daniel - I think i just deleted your comment by accident, can you repost it

Doobz said...

It is of utmost importance that the sale of this drug becomes regulated as soon as possible.
Prohibition is not the correct tool to achieve this.
Prohibition can achieve little more than inflating the price or decreasing the purity. And at a cost that is generally radically underestimated.
Check out the reasons for prohibition, given to you by our esteemed home office. Most of the ills mentioned are DIRECTLY attributable to prohibition, not the consumption of drugs that happen to have been placed in the Misuse of Drugs Act.

3 questions to ask prohibition supporters:-

1. How many innocent people dying per year is an 'acceptable loss' in your war on drug users?
2. Explain why alcohol and cigarettes should not be banned tomorrow
3. Give an example, either evidentially based or logically deduced, of a benefit to criminalising some drug-users

Q1 is important because it is not only people intertwined with the illegal drugs trade that suffer. Completely innocent people do die and lose loved ones too, both because of the clandestine nature of the trade and the violence associated with the vast profits to be made - due entirely to prohibition.
Q2 will contort the prohibition supporters neurons in unusual ways. It is funny to watch.
And Q3 really is the big one. Unless someone can illustrate ONE example in support of a point of view, their point of view is complete bunk. Agreeing to differ is NOT AN OPTION in this instance.
If the prohibition supporter cannot illustrate a single example of prohibition having a positive effect upon anybody, anywhere, then they are admitting to holding an opinion that is unable to be supported by neither evidence nor logic.

Doobz said...

Thanks for posting my comment. I don't suppose you could be so kind as to edit the glaring error I made in the last sentence replacing the word 'unable' with 'able'.

Great job you and your colleagues are doing by the way. Whenever I have heard Transform give an interview, the individuals do so with great eloquence.

Danny K said...

I don't think we can edit comments, which is probably a good thing : ), so I've posted your follow up message.

Anonymous said...

Brilliant article, excellent interviews. Respect to Transform, I hope you can clear take advantage of this current situation with Mephedrone to show the public that people are not criminals or just druggies and also to change attitudes towards the prohibition of drugs.

Gledwood said...

I heard a story about a guy who bought a gram of meow. Assuming that a gram of meow was equivalent to a g of highly adulterated street "speed" this idiot took an entire 1000mgs 4-methcathinone at once. I mean, how idiotically stupid ARE some people? I snorted a weighed 200mg dose of meow in late 2009, It blew my head off. Excellent stuff. It's not for me, but if someone else wants to take it, that's their business. Or would the govt. rather they use far more expensive, weaker and unreliable cocaine? People will use something. Drugs have become an inherent part of our culture now. Perhaps before those idiot MPs bang on about banning analogue substances they ought to have researched the fact that Ecstasy/MDMA had in fact been illegal in the UK since the mid 70s. Meow is a cathinone derivative and hence not covered by legislation covering ecstasy, which is a psychedelic amphetamine. Why can't these MPs get some elementary facts right before they sound off and make themselves even bigger idiots than they already were? Great post.