Like master, like man?

When it comes to scientific advice, New Labour acts like George W. Bush.

The Advisory Committee on the Misuse of Drugs is an example of the role of scientific advice in British government.  ACMD, which consists of thirty-one experts who are not themselves officials, has no formal power but historically has wielded enormous authority; by tradition, its advice is not ignored.  The U.S. has always been more comfortable with politicians over-ruling experts.

That has changed under the New Labour government, which has also taken a number of other steps to “Americanize” British governmental practice, for example by building up the power of the Prime Minister’s office vis-a-vis the ministries, in which the ministers are famously captives of their civil-service officials.  In some ways, this is a “democratizing” step, elevating the importance of the beliefs and values of elected politicians over those of unelected experts.  But that doesn’t mean that those of us in the business of being, and training, experts have to like it, and insofar as expert beliefs track objective reality more closely than do voters’ prejudices, it also means making decisions with a weaker connection to the actual phenomena.

When the head of the Advisory Committee on the Misuse of Drugs gave a careful, analytic lecture arguing that cannabis and LSD were over-controlled compared to more harmful drugs such as alcohol, the Home Secretary promptly sacked him on the grounds that for a scientific advisor to express an opinion touching policy made it impossible to have confidence in the adviser’s objectivity.   This is, not to put too fine a point on it, bullsh*t.  What the Home Secretary clearly means is that the Government is committed to the War on Drugs and isn’t interested in any advice that might get in the way.

This clash had been brewing for some time.  Under pressure from law enforcement, the Government, having acted on ACMD’s advice to downgrade cannabis, then reversed itself and upgraded it again.  The status of MDMA (ecstasy) is another point of tension. Reportedly, the strong personal anti-drug sentiment of bothh Tony Blair (or, more precisely, Cherie Blair) and Gordon Brown have played a strong role in driving policy.

New Labour, after siding with GWB over Iraq, seems to have picked up rather Bushian attitudes about the role of scientific advice.   From this side of the Pond, we can only look with admiration at a political system where the forced resignation of a scientific adviser makes headlines.

Author: Mark Kleiman

Professor of Public Policy at the NYU Marron Institute for Urban Management and editor of the Journal of Drug Policy Analysis. Teaches about the methods of policy analysis about drug abuse control and crime control policy, working out the implications of two principles: that swift and certain sanctions don't have to be severe to be effective, and that well-designed threats usually don't have to be carried out. Books: Drugs and Drug Policy: What Everyone Needs to Know (with Jonathan Caulkins and Angela Hawken) When Brute Force Fails: How to Have Less Crime and Less Punishment (Princeton, 2009; named one of the "books of the year" by The Economist Against Excess: Drug Policy for Results (Basic, 1993) Marijuana: Costs of Abuse, Costs of Control (Greenwood, 1989) UCLA Homepage Curriculum Vitae Contact: Markarkleiman-at-gmail.com

6 thoughts on “Like master, like man?”

  1. In the third paragraph, don't you mean "a more harmful drug such as alcohol"?

    You're right. Corrected. Thanks! – MK

  2. FWIW, the Shadow Home Secretary, Chris Grayling, supported the Nutt sacking. (No pun intended.)

    There is, of course, something to be said for scrupulousness about the line between positive & normative advice. It's one thing to tell people what the state of things is, or what trade-offs are possible, or what the likely consequences of an action are, & quite another thing to tell them what is good & right. Audiences may resist even the former if they suspect it disguises the latter.

  3. Thanks for flagging this, Mark. As a lefty Brit, it makes my blood rise to see the Home Office flouting good scientific advice. "Evidence-based policy? We've heard of it"

  4. "New Labour, after siding with GWB over Iraq, seems to have picked up rather Bushian attitudes about the role of scientific advice."

    In an article about drug policy, it's hardly fair to call ignoring the scientific evidence a Bushian attitude. It has long been politically expedient for elected officials in the US to ignore the evidence about both the harmfulness of many illegal drugs and the harmfullness of the war on drugs. Pols on both sides of the isle are guilty of this, notwithstanding Obama's first gesture toward tolerance of medical marijuana (how about removing it from the Schedule-I list if he is going to acknowledge its use as a medicine?).

  5. Removing marijuana from Schedule I would do nothing to change the legal status of the drug; it may (or may not) make it easier to research however.

    Nutt's sacking isn't all that surprising. He likely did step over the line, and his comments about those drugs were questionable. Here's what a well-respected British scientist (kept his name out of it since he doesn't know I'm posting this) said in response:

    "I remain perplexed as to how Professor David Nutt can be so inaccurate in his statements about the damaging effects of cannabis and Ecstasy/MDMA.

    Below I have listed a few of his statements – followed by my brief summaries of the research evidence. They start with some direct quotations from Professor Nutt’s published papers.

    1. Nutt (2009) ’Cannabis use does not lead to major health problems’. In contrast, the actual empirical evidence shows that cannabis is damaging to health in various ways. Cannabis smoke contains a similar cocktail of damaging chemicals as tobacco smoke – and so can lead to various cancers and heart disease/death. In a review of the adverse health effects of cannabis, Hall and Degenhardt (2009) wrote: ‘Epidemiological, clinical, and laboratory studies have established an association between cannabis use and adverse outcomes. We focus on adverse health effects of greatest potential public health interest-that is, those that are most likely to occur and to affect a large number of cannabis users. The most probable adverse effects include a dependence syndrome, increased risk of motor vehicle crashes, impaired respiratory function, cardiovascular disease, and adverse effects of regular use on adolescent psychosocial development and mental health. In another review, Khalsa et al (2002) noted: ‘The use of marijuana is not without significant health hazards. Marijuana is associated with effects on almost every organ system in the body, ranging from the central nervous system to the cardiovascular, endocrine, respiratory/pulmonary, and immune systems. Research presented in this special supplement will show that in addition to marijuana abuse/dependence, marijuana use is associated in some studies with impairment of cognitive function in the young and old, foetal and developmental consequences, cardiovascular effects (heart rate and blood pressure changes), respiratory/pulmonary complications such as chronic cough and emphysema, impaired immune function leading to vulnerability to and increased infections, and the risk of developing head, neck, and/or lung cancer’.

    2. Nutt (2007) ‘In contrast to alcohol, ecstasy is less toxic in overdose because it does not cause respiratory depression’. This is another bizarre statement by Nutt, since MDMA is a stimulant drug which increases heart rate and breathing. Respiratory depression can only occur with sedative drugs – such as alcohol. For a professor of pharmacology to suggest that respiratory depression is a potential cause of death with a stimulant drug such as MDMA – is rather absurd.

    3. Nutt et al (2007) rated ecstasy/MDMA as less pleasurable than either cocaine or nicotine. Indeed MDMA was given one of the lowest pleasure scores for any drug – in the infamous Lancet article – which contains various incorrect statements abut MDMA. Nutt was correct in noting that the most powerful drugs were both the most pleasurable and the most damaging. So by giving MDMA a low pleasure score, Nutt et al also gave MDMA a surprisingly low harm score. Yet Nutt must be one of the few people to think that ecstasy is less pleasurable than smoking a cigarette. MDMA is one of the most euphoric of all drugs, but it can lead to depression, irritability, aggression, memory loss, weight loss, poor sleep, sexual dysfunctioning, reduced immunocompetence (i.e. more coughs and colds), and various other problems (Parrott, 2001, 2006).

    4. Nutt (2009) ‘Cannabis wouldn’t have killed anyone because cannabis does not kill’. Yet again this is incorrect. Just as with cigarette smoking, cannabis can kill smokers through heart and respiratory disorders. Aldington et al (2008) reported that: ‘The risk of lung cancer increased 8% for each joint-year of cannabis smoking, after adjustment for confounding variables including cigarette smoking’. Cannabis also leads to car accidents, with innocent bystanders sometimes being killed.

    5. Nutt (2009) ‘Equasy.. the equine addiction syndrome’. In his most bizarre pronouncement to date, David Nutt stated that horse riding was more dangerous than taking Ecstasy. Natural pleasures are real and long lasting. Those who ride horses, cycle, canoe, climb mountains, dance, or play football, have genuine natural pleasures which can benefit health and happiness during the working week. Furthermore these pleasures can last for a lifetime, they naturally boost the brains pleasure systems, and often increase physical health. It was bizarre that Nutt did not recognize the fundamental difference between a natural healthy pleasure such as horse riding, and drug-induced short-cuts to pleasure – which paradoxically lead to greater distress. For instance, weekend ecstasy users suffer from rebound mid-week depression, so that over the whole week they report being less happy than non-users. Occupational and interpersonal difficulties are also increased by MDMA (Topp et al, 1999), while MDMA also reduces social intelligence (Reay et al, 2006).

    I could add many further quotations…..indeed most of Professor Nutt’s statements about MDMA have been factually incorrect.

    This leads to an intriguing question….why has Professor Nutt been so keen to underplay the damaging effects of cannabis and MDMA ? In a recent BBC programme I was surprised to see Professor Nutt giving an unnamed pleasure-drug to a volunteer. Was this part of a ongoing research project – and if so, was it funded by the pharmaceutical industry? If so, then this might help to explain why Nutt wants to downgrade other pleasure chemicals such as cannabis and Ecstasy.

    If this suspicion is correct – then did Professor Nutt declare this as a ‘conflict of interest’ – when he was or appointed Chair of the ACMD?"

  6. Removing marijuana from Schedule I would do nothing to change the legal status of the drug; it may (or may not) make it easier to research however.

    Nutt's sacking isn't all that surprising. He likely did step over the line, and his comments about those drugs were questionable. Here's what a well-respected British scientist (kept his name out of it since he doesn't know I'm posting this) said in response:

    "I remain perplexed as to how Professor David Nutt can be so inaccurate in his statements about the damaging effects of cannabis and Ecstasy/MDMA.

    Below I have listed a few of his statements – followed by my brief summaries of the research evidence. They start with some direct quotations from Professor Nutt’s published papers.

    1. Nutt (2009) ’Cannabis use does not lead to major health problems’. In contrast, the actual empirical evidence shows that cannabis is damaging to health in various ways. Cannabis smoke contains a similar cocktail of damaging chemicals as tobacco smoke – and so can lead to various cancers and heart disease/death. In a review of the adverse health effects of cannabis, Hall and Degenhardt (2009) wrote: ‘Epidemiological, clinical, and laboratory studies have established an association between cannabis use and adverse outcomes. We focus on adverse health effects of greatest potential public health interest-that is, those that are most likely to occur and to affect a large number of cannabis users. The most probable adverse effects include a dependence syndrome, increased risk of motor vehicle crashes, impaired respiratory function, cardiovascular disease, and adverse effects of regular use on adolescent psychosocial development and mental health. In another review, Khalsa et al (2002) noted: ‘The use of marijuana is not without significant health hazards. Marijuana is associated with effects on almost every organ system in the body, ranging from the central nervous system to the cardiovascular, endocrine, respiratory/pulmonary, and immune systems. Research presented in this special supplement will show that in addition to marijuana abuse/dependence, marijuana use is associated in some studies with impairment of cognitive function in the young and old, foetal and developmental consequences, cardiovascular effects (heart rate and blood pressure changes), respiratory/pulmonary complications such as chronic cough and emphysema, impaired immune function leading to vulnerability to and increased infections, and the risk of developing head, neck, and/or lung cancer’.

    2. Nutt (2007) ‘In contrast to alcohol, ecstasy is less toxic in overdose because it does not cause respiratory depression’. This is another bizarre statement by Nutt, since MDMA is a stimulant drug which increases heart rate and breathing. Respiratory depression can only occur with sedative drugs – such as alcohol. For a professor of pharmacology to suggest that respiratory depression is a potential cause of death with a stimulant drug such as MDMA – is rather absurd.

    3. Nutt et al (2007) rated ecstasy/MDMA as less pleasurable than either cocaine or nicotine. Indeed MDMA was given one of the lowest pleasure scores for any drug – in the infamous Lancet article – which contains various incorrect statements abut MDMA. Nutt was correct in noting that the most powerful drugs were both the most pleasurable and the most damaging. So by giving MDMA a low pleasure score, Nutt et al also gave MDMA a surprisingly low harm score. Yet Nutt must be one of the few people to think that ecstasy is less pleasurable than smoking a cigarette. MDMA is one of the most euphoric of all drugs, but it can lead to depression, irritability, aggression, memory loss, weight loss, poor sleep, sexual dysfunctioning, reduced immunocompetence (i.e. more coughs and colds), and various other problems (Parrott, 2001, 2006).

    4. Nutt (2009) ‘Cannabis wouldn’t have killed anyone because cannabis does not kill’. Yet again this is incorrect. Just as with cigarette smoking, cannabis can kill smokers through heart and respiratory disorders. Aldington et al (2008) reported that: ‘The risk of lung cancer increased 8% for each joint-year of cannabis smoking, after adjustment for confounding variables including cigarette smoking’. Cannabis also leads to car accidents, with innocent bystanders sometimes being killed.

    5. Nutt (2009) ‘Equasy.. the equine addiction syndrome’. In his most bizarre pronouncement to date, David Nutt stated that horse riding was more dangerous than taking Ecstasy. Natural pleasures are real and long lasting. Those who ride horses, cycle, canoe, climb mountains, dance, or play football, have genuine natural pleasures which can benefit health and happiness during the working week. Furthermore these pleasures can last for a lifetime, they naturally boost the brains pleasure systems, and often increase physical health. It was bizarre that Nutt did not recognize the fundamental difference between a natural healthy pleasure such as horse riding, and drug-induced short-cuts to pleasure – which paradoxically lead to greater distress. For instance, weekend ecstasy users suffer from rebound mid-week depression, so that over the whole week they report being less happy than non-users. Occupational and interpersonal difficulties are also increased by MDMA (Topp et al, 1999), while MDMA also reduces social intelligence (Reay et al, 2006).

    I could add many further quotations…..indeed most of Professor Nutt’s statements about MDMA have been factually incorrect.

    This leads to an intriguing question….why has Professor Nutt been so keen to underplay the damaging effects of cannabis and MDMA ? In a recent BBC programme I was surprised to see Professor Nutt giving an unnamed pleasure-drug to a volunteer. Was this part of a ongoing research project – and if so, was it funded by the pharmaceutical industry? If so, then this might help to explain why Nutt wants to downgrade other pleasure chemicals such as cannabis and Ecstasy.

    If this suspicion is correct – then did Professor Nutt declare this as a ‘conflict of interest’ – when he was or appointed Chair of the ACMD?"

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