Towards the end of January, “mostly supine” MPs passed a bill after a “clueless debate.” The Psychoactive Substances Act which is intended to ban “legal highs” (novel psychoactive substances – NPSs) is “one of the stupidest, most dangerous and unscientific pieces of drugs legislation ever conceived.” “Watching MPs debate…it was clear most didn’t have a clue. They misunderstood medical evidence, mispronounced drug names, and generally floundered. It would have been funny except lives and liberty were on the line.”
Not my words but those of an editorial in New Scientist (30 Jan 2016) and a report by Clare Wilson. The act came into force on 26 May, meaning that previously legal “head shops” must cease selling NPSs. The banned drugs will only be available from illegal drug dealers.
The story starts with the panic about “legal highs,” chemicals with similar effects on mood to banned drugs such as ecstasy, cocaine or speed, hence the term “psychoactive.” Legal highs were not covered by drug laws that banned named compounds but not new ones with similar effects.
If history tells us anything, it is that humans take drugs. Sometimes, these drugs cause harm to those who take them or to society in general. Banning specific drugs makes their use more dangerous. A logical approach would be to reduce the harm by controlling purity, taxing their sale, and educating users instead of criminalising them. Drug users would prefer not to break the law, providing a considerable incentive to synthesise new drugs that mimic banned drugs but aren’t on the banned list. But these new drugs will have unknown side effects and there is no control on dose and purity. In contrast, the effects of many “traditional” drugs are known.
The rationale for banning NPSs was that they were dangerous. Legal highs were mentioned in coroners’ reports for only 76 deaths from 2004 to 2013 (Office for National Statistics). Despite the government’s banning of NPSs as fast as it could, the number of mentions was increasing (23 in 2013). Reliable data are extremely difficult to obtain and mere mention of a drug in a coroner’s report is not evidence that the drug caused the death.
As each NPS was banned, more were synthesised. There were 24 NPSs in 2009 and 81 in 2013, making the government’s actions futile, so some bright spark came up with the idea of banning the production and supply of all substances which produce “a psychoactive effect in a person … by stimulating or depressing the person’s central nervous system [thus affecting] the person’s mental functioning or emotional state.” A bill was proposed by the new Conservative government and specified that anyone producing or supplying (but not merely possessing for personal use) the previously legal NPSs could be sent to prison for up to seven years.
The proposal soon ran into problems. Firstly, what is meant by stimulating or depressing the central nervous system? Secondly, what constitutes an effect on a person’s mental function or emotional state? Thirdly, how could it be proved that any suspected substance was psychoactive? After all, placebos can be psychoactive. Fourthly, what about alcohol, nicotine, caffeine, many medicines, and foodstuffs such as nutmeg and betel nut (or, in my case, cake)? Finally, would bona fide scientific research on psychoactive substances be outlawed?
Criticism poured in from scientists. Respected medical researchers said the bill was “poorly drafted, unethical in principle, unenforceable in practice, and likely to constitute a real danger to the freedom and well-being of the nation” (letter to The Times). The Royal Society, the Academy of Medical Sciences, the Wellcome Trust, and others wrote to Home Secretary Theresa May that “Many types of important research could potentially be affected by the Bill, particularly in the field of neuroscience, where substances with psychoactive properties are important tools in helping scientists to understand a variety of phenomena, including consciousness, memory, addiction and mental illness.”
Even the government’s Advisory Council of the Misuse of Drugs (ACMD), more in line with politicians’ wishes since the shameful “firing” of Professor David Nutt (see box), produced a list of objections. The government’s omission of the word “novel” made the bill apply to a vast number of other substances in addition to legal highs. It would be impossible to list all exemptions so benign substances, such as some herbal remedies, might be inadvertently included. Also, proving that a substance was psychoactive would require unethical human testing, since laboratory tests might not stand up in court.
The government changed the bill to exempt scientific research but otherwise remained obdurate. An example of the inevitable confusion concerns alkyl nitrites (poppers). Known since 1844 and used to treat heart problems, they have a short-acting psychoactive effect and are generally safe. However, the government referred to several non-specific risks and claimed that poppers had been “mentioned” in 20 death certificates since 1993 (far fewer than for lightning). After a Conservative MP appealed for poppers, which he used, not to be included, the government said they would consider the arguments later.
Another example concerns nitrous oxide (laughing gas), included in the ban despite its long history of use in medicine and recreationally. Discovered in 1772, laughing gas was greatly enjoyed by Sir Humphry Davy and friends, including the poet Shelley. It has an impressive safety record and has been used in dental and childbirth anaesthesia and sedation since 1844.* Nevertheless, the government referred to “the harms” of recreational laughing gas and included it in the bill. In fact, the deaths “caused” by nitrous oxide result from incorrect methods of inhalation which could be eliminated by education.
The Act was finally implemented on 26 May. Independent expert David Nutt described the government’s policy as “pathologically negative and thoughtless.” He predicts that deaths from drugs will increase as people turn to illegal drug dealers in the absence of legal “head shops.” Einstein defined insanity as “doing the same thing over and over again and expecting different results.” This just about sums up successive governments’ policies towards drugs.**
**But not all drugs. Nicotine and alcohol are legal, despite their addiction potential, toxicity, and role in causing accidents. See, for example, http://www.tobaccoinaustralia.org.au/3-18-smoking-motor-vehicle-crashes-and-other-injur …………………………………………………………………………………………………………………..Labour’s problems with scientific evidence
Tories don’t have a monopoly on cluelessness. Expert neuroscientist Professor David Nutt was “sacked” from his position as chair of the Advisory Council on the Misuse of Drugs by the right-wing press’s favourite Labour politician, former Home Secretary Alan Johnson. This was after Nutt showed that cannabis, then being upgraded to Category B (the same as codeine, ketamine, mephedrone or speed) was less harmful than alcohol or tobacco. This wasn’t an ordinary sacking since Prof Nutt gave his time and expertise freely, believing that it was important to present the evidence to improve the quality of the debate. Three members of the ACMD resigned in protest.
Nutt stated in a lecture to fellow academics that the evidence showed that cannabis was less harmful than alcohol and tobacco. Johnson called this “campaigning against government policy” and “starting a debate in the national media without prior notification to my department.” Johnson was then accused of misleading MPs since Prof Nutt had given prior notice of the content of his lecture and no journalists were invited. Further, as an unpaid advisor, Nutt was not subject to the same rules as civil servants. Other ACMD members who resigned said that they “did not have trust” in the way the government would use the ACMD’s advice and that Johnson’s decision was “unduly based on media and political pressure.”
Shamefully, PM Gordon Brown backed Nutt’s removal, saying that the government could not afford to send “mixed messages” on drugs. Both Brown and Johnson (some people’s favourite to replace Jeremy Corbyn) were quite happy to send the wrong message.
Supported by other scientists, Nutt was awarded the John Maddox Prize for standing up for science by the pro-evidence charity Sense About Science. The government subsequently accepted a new ministerial code allowing for academic freedom and independence for advisers, with proper consideration of their advice. Under this, Nutt would not have been dismissed.
Nutt now works with DrugScience. http://www.drugscience.org.uk