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Penalties for drug use must reflect harm

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Big contretemps in the UK government because the Home Secretary sacked a scientist for delivery findings that didn’t like match current government policy—so two more have resigned. David Nutt, the fired scientist, writes in The Times:

In July this year I gave a lecture on the assessment of drug harms and how these relate to the legislation controlling drugs. According to Alan Johnson, the Home Secretary, some contents of this lecture meant I had crossed the line from science to policy and so he sacked me. I do not know which comments were beyond the line or, indeed, where the line was, but the Government has lost its major expert on drugs and drug harms and may indeed lose the rest of its scientific advisers in the field.

All drugs are potentially harmful and many of the harms can be measured. We can use scientific methods to estimate these and produce a ranking, and compare our scores with their location in the Misuse of Drugs Act. Heroin and cocaine appear to be in the correct place (Class A), whereas Ecstasy (Class A) and cannabis do not (Class B).

The reason for making drugs illegal is to let society reduce harms by punishing their sale and use. The purpose of having the ABC classes is to scale penalties according to relative harms. Possession of a class A drug for personal use can lead to seven years in prison, for class B, it is five years and for class C, two years.

The classes are also important in educating the public about the relative harms of drugs. So it is imperative that the classification of drugs truly reflects their harms, otherwise injustices may occur and the educational message be undermined. Scientific inquiry into drug harms must also be honest and accurate so that the best quality evidence is available to the experts and government. Legal drugs such as alcohol and tobacco are as harmful as many illegal drugs and currently score highly on our ranking list.

What are appropriate penalties for drug use? This question has moral and practical aspects, but the penalties must reflect the real and relative harms of drugs.

My sacking has cast a huge shadow over the relationship of science to policy. Several of the science experts from the Advisory Council on the Misuse of Drugs (ACMD) have resigned in protest and it seems likely that many others will follow suit. This means the Home Office no longer has a functioning advisory group, which is very unfortunate given the ever-increasing problems of drugs and the emergence of new ones. Also it seems unlikely that any “true” scientist — one who can only speak the truth — will be able to work for this, or future, Home Secretaries.

Others have suggested a way forward: create a truly independent advisory council. This is the only realistic way out of the current mess.

Here’s the list of drugs in order by how harmful they are:

Professor David Nutt’s harm index, published in a controversial paper entitled Estimating Drug Harms: a risky business, is based on scores allocated for 20 substances based on physical harms, dependence and social harms.

He identifies three main factors that determine the harm associated with any drug of potential abuse: a) the physical harm to the individual user caused by the drug; b) the tendency of the drug to induce dependence; c) the effect of drug use on families, communities and society.

Within each category there are three components, leading to a nine-category matrix of harm, with scores of zero to three for each category. This is the final list based on that classification. In brackets is the classification given under the Misuse of Drugs Act, with Class A attracting the most serious penalties.

1. Heroin (Class A)
2. Cocaine (Class A)
3. Barbiturates (Class B)
4. Street methadone (Class A)
5. Alcohol (Not controlled)
6. Ketamine (Class C)
7. Benzodiazepine (Class B)
8. Amphetamine (Class B)
9. Tobacco (No class)
10. Bupranorphine (Class C)
11. Cannabis (Class B)
12. Solvents (Not controlled)
13. 4-MTA (Class A)
14. LSD (Class A)
15. Methylphenidate (Class B)
16. Anabolic steroids (Class C)
17. GHB (Class C)
18. Ecstasy (Class A)
19. Alkylnitrates (Not controlled)
20. Khat (Not controlled)

Written by LeisureGuy

4 November 2009 at 11:32 am

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