Prof Dave Nutt talk, 25 January 2012

Picture of neuropsychopharmacologist David Nutt Long ago and far away, I worked at the University of Bristol in the Department of Psychopharmacology. At that time, Professor David Nutt was the department head. It was a real shame that I couldn’t get excited about any of the projects he had on the go at that point, as I would have loved to do my degree under his direct supervision – he treated even lowly grad students well! Life happened and I found myself taking the different, though strangely parallel path that I’m still walking.

Meanwhile, he’s now gone from being merely an eminent and highly-respected scientist to a household name. I was out of the country when the big row over his dismissal from the Advisory Council on the Misuse of Drugs (ACMD) in 2009, and was therefore a little unprepared when I’d tell someone I once worked for a psychiatrist called Dave Nutt and people would respond, “THE Dave Nutt? So when I got the chance to hear him speak about it all, I jumped at the chance to get the story from the source.

Here are some of the highlights from the talk:

From his vantage point of 30 years as a psychiatrist and researcher, Prof Nutt has had plenty of opportunity to see the aftermath of how drug addiction ruins lives – but he’s also been able to observe how the misguided War on Drugs has done even more damage. The original Misuse of Drugs Act, passed in 1971, was designed to keep politicians from trying to enact tougher and tougher prohibitions to score points with the electorate – it took the classification of drugs out of their hands (assigning it to a panel of experts, eventually to become the ACMD) and acknowledged that there were different levels of risk associated with various substances. Even Margaret Thatcher backed needle-exchange programmes once her advisors explained that it was a choice between that or a rampaging AIDS epidemic.

But this period of relative sanity regarding drugs law started to tail off in the mid-1990s and reached an end during the Blair years, when that PM’s close association with then-US president George Bush Jr. started to affect his policy decisions. From the liquor industry’s scare tactics (making Leah Betts the poster child for the alleged dangers of Ecstasy) to the criminalisation of magic mushrooms in 2004 to recent pressure to outlaw khat, anything like a balanced or evidence-based drugs policy seems a distant memory. Policymakers tend to freely admit that the drug laws are badly broken only once they’re no longer in a position to do anything about it; Prof Nutt got into trouble because, when asked to provide a comparative scale of harm from various drugs, he did so with complete and total honesty: among other things, he said that if alcohol were discovered tomorrow, it would be Class A (highest harm potential and no medical use), and that Ecstasy was less dangerous than riding a horse.

The repercussions were fast and brutal. The media divided along predictable lines: the respectable papers were very supportive, whilst the tabloids demonised him. The Sun went so far as to hack his children’s Facebook sites and post images of their alleged drug taking. The pressure to recant must have been intense, but Prof Nutt didn’t back down. Instead, he and other eminent members of the ACMD formed their own drug harm evaluation organisation, the Independent Scientific Committee on Drugs (ISCD), which continues to agitate for sensible, evidence-based drug classification guidelines.

The sheer weight of evidence against alcohol is staggering. Alcohol is responsible for more health problems in 15 – 24-year old males than anything else in the world, according to the World Health Organisation (WHO); some 8,000 people die of alcohol poisoning every year in the UK. The news doesn’t reflect this because the media are largely supported by money from the drinks industry – fewer than 1% of all alcohol deaths make the papers, while nearly every death involving ecstasy does so. Therefore, ecstasy is perceived as much more dangerous than alcohol, even though its actual death toll is far smaller. Alcohol has become cheaper and cheaper over the last 30 years, contributing to the epidemic of binge drinking and its casualties.

In contrast, cannabis use has increased more than 20-fold, but there hasn’t been a corresponding increase in either cannabis-related deaths or schizophrenia. Yet recent legislation has made it illegal for even those with legitimate medical need to use cannabis in the UK, doing away with the longtime defense of necessity only for cannabis. Prof Nutt called this ‘outrageous’.

Meanwhile, evidence for the medicinal value of currently proscribed drugs is mounting. Prof Nutt’s own recent research has shown that psilocybin, the active ingredient in magic mushrooms, may be able to shut off parts of the brain that are overactive in depression. This is only one of many recent studies, accomplished at great cost and through sheer determination to show that such substances cannot be condemned as useless, that have appeared in recent years (for more, see The Beckley Foundation (UK) and MAPS (US)).

What can be done, though, as long as those in charge seem to be determined to stick their fingers in their ears, close their eyes, and maintain that anything illegal must be dangerous, because it’s illegal? Prof Nutt and the ISCD have a plan:

We will build:

* A media response network involving those who support the ISCD to challenge policy makers when they ignore or distort the evidence base.

* An online presence that engages with tens of thousands of people through social media sites.

* Advocacy networks for drug science in professional occupations.

* A drug science supporters’ network to continue the debate in homes and workplaces throughout the country. We will be producing factsheets to inform and support those involved.

Eventually, the evidence will mount to the point where governments will have to take notice. Until then, Prof Nutt will be there to keep reminding them.

 

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