Friday, March 30, 2007

Supercasinos, drugs and alcohol prohibition: more than a whiff of ministerial hypocrisy

.

The sex industry, the drugs industry, and the gambling industry: Governments have always struggled with how to regulate certain pleasure seeking behaviors, especially when they clash with religious concepts of sin, which sex, drugs and gambling usually do. In law they they tend to come under the general description of 'Vice', which addresses the big three 'morality crimes'.

The problem for governments is that these activities are not always harmful (even though they can be), and in one form or another, they are as old as civilization and haven't shown much sign of disappearing despite the best efforts of our moral stewards. People, it seems, like pleasure and seek it out regardless of whether it is frowned upon, or even specifically prohibited and criminalised, as gambling drugs and sex work have been and remain to varying degrees in different places around the world. In the UK some drugs are legal whilst others not, prostitution is legal but soliciting and brothels not (although 'mini brothels' may be soon), and gambling is legal and licensed in various forms but not others (high street bookies, for example, were legalised and regulated in the 1961).

It is fascinating to see how politicians can tie them selves in knots of hypocrisy when it comes to regulating 'vice', as has recently been brilliantly demonstrated by Tessa Jowell, the UK's Secretary of State for Culture Media and Sport, who is charge of casino policy. The Government is very much in favour of regulated gambling and on the subject Jowell is apparently very clear, and very pragmatic. Regards online gambling:


"Broadly speaking we have three choices: you can prohibit, like the US, do nothing or regulate, like we have”

"I firmly believe we have chosen the path that will do the most to protect children and vulnerable people and keep out crime."

"America should have learnt the lessons of prohibition. The Volstead Act
[which brought in alcohol prohibition in 1919] was meant to stop alcohol from causing harm, but in practice it forced otherwise law-abiding customers into the hands of the bootleggers”

"If it goes wrong , there is a real danger is that off shore sites based in poorly regulated countries will become the modern day equivalent of speakeasies, increasing the risk of exploitation and fraud."



Here she is specifically summoning up the failure of a drug prohibition as an example of why we need to legally regulate gambling, albeit alcohol prohibition in 1930s USA. This wasn't a one off quip either. Jowell and her team have obviously decided this prohibition parallel argument is their strongest card in the gambling debate. She made the same point in the House of Commons last October a few days before the above quote hit the news:


"our approach to gambling regulation is different: to avoid prohibition, to introduce regulation and to avoid the damage that the free market will do".

Indeed she was making the exact same argument back in 2004:


‘The House should recognise, however, that gambling is at the boundary between personal freedom and state intervention. On one side of the boundary is the reasonable expectation of adults who, within the law, exercise their right to live their lives as they choose. On the other is the role of the state: to recognise human frailty, and in particular to respect its duty to protect children and the vulnerable. As a Government and a society, we have three options in that respect: prohibition, a free-for-all or regulation. We have no doubt about choosing the regulatory route. The question for the House is how best to apply the regulatory framework for the benefit of society as a whole'
You may be able to guess where I'm going with this...

Is it not obvious that the same logic should apply to currently illegal drugs? Why have we 'learnt the lessons of prohibition' regards gambling and alcohol, but not with the prohibition of other drugs?

Remember that the 2002 updated National Drug Strategy actually refers to itself as a policy of 'prohibition' (page 6). Jowell's self righteous position on gambling and alcohol prohibition is dramatically undermined by the howling contradiction with her Government's own policy on other drug prohibitions. (Also see 'Why this? - but not this?' for another brilliant example of Government double standards). Let’s just change a couple of words in Jowell's above quote and see how it sounds:

"The House should recognise, however, that drug use is at the boundary between personal freedom and state intervention. On one side of the boundary is the reasonable expectation of adults who, within the law, exercise their right to live their lives as they choose. On the other is the role of the state: to recognise human frailty, and in particular to respect its duty to protect children and the vulnerable. As a Government and a society, we have three options in that respect: prohibition, a free-for-all or regulation. We have no doubt about choosing the regulatory route. The question for the House is how best to apply the regulatory framework for the benefit of society as a whole"

eh? EH? EH?

Back in 2004 Jowell wrote a piece for the Guardian titled 'Grown-up politics for an adult world'. She liked it enough to run it a second time earlier this year. In the article (apparently adapted from a Fabian society essay she wrote ages ago) Jowell makes the same prohibition/regulation argument in some considerable detail, again invoking the foolishness of prohibiting drugs to make her point:

“On issues like smoking, drinking and gambling, government has three basic choices: we can prohibit, regulate or leave it to the market. Prohibition does not work - it drives the activity underground ....... Only ideological extremists favour a free-for-all where only the laws of the market hold sway. So the third option is regulation - and regulation with as much emphasis on the quality of the debate as the policy outcome. 'Better regulation' has to mean government engaging people in the decisions that affect their lives and doing so in new and better ways”.



This Guardian article is subtitled 'Voters want choice, respect, dialogue and responsibility. The Government must learn to deliver '. Well Tessa, I am an grown up and I want some grown up politics. I want choice, respect, dialogue and responsibility – so why don't you grow up, and lets apply your obviously sensible arguments to the evident failure of drug prohibition. You know, 'issues like smoking and drinking'.

Just to thrash this point a little further, the current big boss of UK drug prohibition is John Reid, who as health secretary appeared on the Jeremy Vine show (11.11.04) discussing tobacco policy, noting on the subject:

“Prohibition doesn’t work, as the US found out many years ago.”

Aside from this politically-selective analysis of prohibition’s failure, the other glaring problem for Jowell with the new supercasino legislation is that it goes way, way, beyond her alternative proposition of sensible legal regulation.

As the various minister's prohibition analysis correctly demonstrates with alcohol, when demand for illegal drugs exists, and where this demand isn't met legally, criminal supply inevitably fills the vacuum and mops up the extraordinary profits prohibition hands them. These are the inescapable economics of illegal markets, with disastrous effects for all to see; untaxed illicit profits, crime, violence and so on.

However, in contrast to drugs, demand for gambling is being more than met legally, in fact the market is being saturated. There are casinos all over the country and they are not overflowing and turning people away at the doors. People can also gamble online, on the lottery, in bookies on every high street (since 1961), at the horse races, at the dogs, on fruit machines in every pub and kebab shop, even with their mobile phone bookies, 24 hours a day, wherever they are. There is no excess demand for gambling that is not currently being met, which is precisely why there is almost no illegal gambling in this country, bar the occasional cock fight.

That is what is so completely mystifying about the super casinos plan: There was no public demand for them. Sure, once they were proposed and their number limited (initially to one) then certain interests started demanding a piece of the pie. The foreign investors (willing to throw tens of millions into their lobbying efforts) obviously want them, and no doubt some star-struck local government officials think they are good idea too. But before the Government floated the plan in the first place there were no NGOs, grass roots campaigns, policy analysts, or gamblers associations, calling for supercasinos to fill some leisure gap they were being so cruelly denied.

Supercasinos, one assumes, will be allowed to aggressively advertise in the same irresponsible way online casinos already do, including, I think disgracefully, to children via sports sponsorship. The multimillion pound casinos with their multimillion pound marketing budgets will be actively increasing the total amount of gambling that takes place. That is very much not responsible regulation any more than letting alcohol brands aggressively advertise to young people through sports sponsorship is (e.g. The Carling Premiership) when we have the highest youth drinking in the Western World and an exploding problem of alcoholism and liver cirrhosis.


Catch'm young. Totally inappropriate regulation in action: baby football kits sponsored by drug brands (Rangers), and online gambling (Villa)


The idea that these new casinos will help regenerate inner cities is a particularly perverse justification. They are going to be built in deprived areas, earning a significant proportion of their revenue from those low income populations. They wont be bringing money into these areas, they will be bleeding it away from the populations most vulnerable to their illusory promise of a quick buck. What's more, most of the the profits will largely be leaving these areas anyway, flying off to the overseas investors. Supercasinos bring the same level of culture and enhanced well being to communities as ‘The Mint’ phone-in ‘quiz’ brought to our television schedules.

I have to confess: I’ve visited some supercasinos in Vegas and Reno USA, for my sins, and I can report that (*personal bias warning*) they were pretty vile. Nothing like those swanky places in Bond films, these were grotesque industrialised / warehoused gambling spruced up with lots of tacky flashing lights and full of lonely rather glum looking people losing money. If I had a couple of hundred million pounds to spend on enhancing a deprived community I can think of a couple of hundred million better way to spend it than the financial, spiritual and cultural black hole that is a supercasino.

For organisations such as Transform, arguing for sensible legal regulation of currently illegal drugs, it all sets a strikingly bad precedent. The equivalent in drug terms would be to let Colombian cartels build a glitzy new heroin and crack mega-mart in the middle of Moss Side. And then let them sponsor Manchester city.

The Cocaine Premiership anyone?


No. Of course not. If you want to learn about how it should be done please read:

'After the War on Drugs - Options for Control' (2004) by Transform

'A Public Health Approach to Drug Control (2005) by the British Colombia Health Officers Council (Canada)

Effective Drug Control:Toward A New Legal Framework' (2005) by The King County Bar Association (USA)

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Wednesday, March 28, 2007

A New Approach for Afghanistan

Pakistan's Daily Times here discusses a report from the German Spiegel that NATO governments are finally debating the legalisation of the Afghan opium trade which has so far flourished under attempts to prohibit it. The Taliban insurgency has drawn strength and popularity from Western attempts to eradicate this profitable crop and Western governments and NATO command are to be congratulated for belatedly debating their counter-productive eradication policies. Apparently critics of the legalisation plan fear that venal politicians who currently accept backhanders from the drug barons would only increase their income with legalisation although no reason is given as to why opium producers of sound mind would continue to pay politicians at all under legalisation.

Monday, March 26, 2007

Annual celebration of limited supply-side success

The Home Office’s ‘Annual Tackling Drug Supply Awards 2007’ were distributed to a number of hard working and relatively successful police forces recently. These units had managed to break up a few criminal drug gangs and seize millions of pounds (sterling) of illegal drugs, which in the world of prohibition is a measure of success.

By the sound of things they will have the drugs ‘problem’ sorted out by teatime. However, this is not the case. As we have documented in our Fact Research Guide drug seizure statistics are often misunderstood and misused:

Defenders of the drug war status quo frequently use increases in seizures as evidence of a successful enforcement policy or, conversely, that a decrease in seizures is evidence that drugs markets are reducing. Neither represents a correct interpretation of the statistics, and in reality drug seizure data are of little use for policy makers – aside from achieving arbitrary and equally un-useful seizure targets.

Drug seizures primarily reflect activity of the enforcement authorities and do not provide any useful indication of the scale of actual drug markets, as they can rise or fall entirely independently from drug availability or usage levels. A single large drug-bust can dramatically shape annual year on year stats. It is entirely inappropriate for seizures statistics to be used (as they are in the UK national strategy) as a measure of drug availability, as there is quite simply no correlation whatsoever.

Trumpeting seizures as a success on availability targets has been one of the more shameless and wilfully dishonest activities of Government in recent years
[1]; they know full well that drug availability is increasing and drug prices are falling and have acknowledged as much on the Home Office website and in other reports.[2]

The awards ceremony did uncover one real cause for celebration. It is important and encouraging to note that both Vernon Coaker (Home Office Minister) and Chief Constable Tim Hollis (Association of Chief Police Officers Chair of Drugs) emphasised the necessity of reducing harm and providing treatment. This is a very welcome step on the path towards a rational evidence-based drugs policy.

Sunday, March 25, 2007

The Independent's born-again drug war: Round Two

The Independent on Sunday have followed on last week's Cannabis panic front page splash with another front page splash. This time it is 'The Great Cannabis Debate'. Inside we get more news coverage revelling in the faux-controversy they have stirred up, scary brain scans showing how cannabis 'may' melt your brain, two opinion pieces; one by the head of the UN drug agencies Antonio Costa, another by child psychotherapist Julie Lynn Evans, and another leader defending their retraction of support for cannabis law reform (on the basis that it is more dangerous than they thought).



Jonathan Owen from the Independent on Sunday, who is apparently taking the lead on this latest salvo of cannabis coverage, rang me on Friday. He had read the Transform blog critique on last weekend's IOS cannabis 'apology' and wanted a response for this weeks 'Great Debate' follow up piece. This is what I sent in:

"The IOS makes the mistake of confusing their legitimate concern with the health impacts of cannabis misuse amongst a small group vulnerable young people, with support for the failed ideological policy of prohibition. Rather than supporting an evidence-led regulatory response based on public health and harm reduction principles, they advocate a policy that has not only failed to address the problems they describe (and has arguably created many of them), but also one that offers no prospect of sorting them out. The blanket criminalisation of millions of non-problematic occasional users that the IOS has now re-stated its support for, cannot be justified on the basis of a relatively tiny vulnerable population, especially of teenage heavy users, who have serious problems with the drug (even if this group has grown proportionally with the overall population of users over the last three decades). This is akin to prohibiting cars because of a small population of teenage joy-riders.

Cannabis use undoubtedly involves risk, as does all drug use, legal or illegal. But these risks have been well documented and well understood for generations. The debate around our response to cannabis use is not well served by hype and misrepresentation of statistics on potency, impact on mental health, or treatment and addiction – all of which last week’s IOS coverage was guilty of. This was scaremongering in the cause of an attention grabbing headline, very much in the pattern of many previous cannabis scares and precisely the sort of moral-panic the recent RSA report criticised for historically distorting policy priorities. The IOS also perpetuate the misunderstanding that the cause of cannabis law reform is predicated on the fact that cannabis is harmless. On the contrary – the exact opposite is true: Is precisely because drugs are dangerous that the need to be appropriately regulated and controlled by the State rather than be left in the hands unregulated criminal profiteers. This remains true however harmful a particular drug is shown to be.”

Whilst they have printed some similar-ish sensible comments from others in the follow up (in micro print, beneath the massive banner-headlined UN propaganda fest), they haven't included my comments in their 'great debate', which is mildly annoying since they actually asked for them.

Anyway, there's various things that jump out from the coverage deserving of some sort of response:
  • Owen refers to 'outrage on pro-cannabis websites and blogs' in response to the IOS's cannapology. Read our blog post: it is not outraged and it is certainly not pro-cannabis, any more than advocates of drug policy and law reform generally are 'pro-drug'. They are pro effective evidence-based public health responses to the obvious failings of prohibition. As the late Eddie Ellison, former head of the met drugs squad and Transform Patron, liked to point out, being anti-drug is entirely compatible with a rational pragmatic position on drug law reform (see here and here). Pro drug / anti drug is a false binary that the IOS deploys as part of its own self justification: drugs are bad, we are anti them, we must be right. Once again, they totally miss the point.
  • After last weeks 'drugs bad for you' scoop, the big scoop this week is that the UN agrees with them: 'The United Nations has issued an unprecedented warning to Britain about the growing threat to public health from potent new forms of cannabis, saying there is mounting evidence of "just how dangerous" the drug has become'. Actually this is in no way 'unprecedented', and to suggest so is just poor journalism. Costa, his predecessors, and the UN drug agencies saying exactly this, loudly and frequently, for years, especially since UK cannabis reclassification in 2004. Almost every comment in Antonio Costa's article is copy and pasted from these earlier statements.
  • It is hardly surprising that Costa would say what he does. The UN drug agencies oversee the UN drug conventions to which most countries in the world are signatories. These conventions (1961, 1971 and 1988) enshrine the IOS's beloved criminal penalties for drug production, supply and use into domestic law of over 150 states. They are the legal foundation and ideological bedrock of global drug prohibition. So its hardly surprising that Costa has come out in support of the IOS 's born again war-on-drugs stance. Costa is like prohibition's end-of-level-boss, he is literally the last person on earth you would expect to get a balanced position on drug policy from. Its a bit like an IOS scoop that the Pope sensationally backed their new position on the virgin birth. Indeed, Peter Cohen, in an essay for the International Journal of Drug Policy, titled 'The drug prohibition church and the adventure of reformation', makes a telling comparison between prohibition and religious dogma:
Whatever the origin of the UN Drug Treaties, and whatever the official rhetoric about their functions, the best way to look at them now is as religious texts. They have acquired a patina of intrinsic and unquestioned value and they have attracted a clique of true believers and proselytes to promote them. They pursue a version of Humankind for whom abstinence from certain drugs is dogma in the same way as other religious texts might prohibit certain foods or activities. The UN drug treaties thus form the basis of the international Drug Prohibition Church. Belonging to that Church has become an independent source of security, and fighting the Church's enemies has become an automatic source of virtue

  • Picking apart what Costa and prohibition's other high-level evangelists have to say has been done a million times. The UN drug agency's drug war propaganda is as tediously repetitive as it is economical with the truth. He repeats the myth that legalisation advocates claim cannabis is harmless, and blanket misrepresents all of the theory and practice of alternative policies to absolute prohibition as 'vague, laissez fare' or 'libertarian'. He uses a crackpot quote from a random online head-shop as a source of 'truth' regards the real dangers of cannabis, and has a charming line on not being swayed by 'misguided notions of tolerance'. Anything but tolerance!

  • We then get the utterly ridiculous: "People who drive under the influence of cannabis put others at risk. Would even the most ardent supporter of legalisation want to fly in an aircraft whose pilot used cannabis?" OK. Deep breath... Look, no one, literally no one calling for legal regulation and control of cannabis (or any other drug) is saying driving whilst competence is compromised by drug intoxication is OK or should also be legal. I'm also not aware of anyone ever suggesting that flying planes whilst stoned was acceptable. Decriminalising drug use does not give license for secondary offences committed whilst intoxicated - these will obviously remain criminal, as they should. To suggest different is pretty desperate, and from the rational reformers perspective actually quite offensive.
  • The most egregious nonsense in the Costa piece is where he claims: "drug control works. More than a century of universally accepted restrictions on heroin and cocaine have prevented a pandemic. Global levels of drug addiction - think of the opium dens of the 19th century - have dropped dramatically in the past 100 years. In the past 10 years or so, they have remained stable. The drug problem is being contained and our societies are safer and healthier as a result." Seriously, what can you say to that? How can you argue against that sort of statement that crosses the boundary from shaky institutional propaganda into full-blown Orwellian 'ministry of drug truth' delusion. At this point, I could produce a torrent of graphs, from official government and even UN sources, exposing this statement to be the polar opposite of reality, but hopefully if you are reading this blog, in fact if you can read at all, graphs wont be necessary as you will appreciate that such claims for the success of drug control over the past century are a total joke. It would actually be quite funny - if this man wasn't in charge of global drug policy. If the IOS is relying on this sort of analysis to bolster its case they really have blown it. To find out more about the UN drug policy see this excellent page of TNI publications on international drug policy. See also the recent blog: UN INCB is 'obstacle' to HIV prevention and drug treatment programs
  • The other prominent drug 'expert' the IOS pull in is none other than music / TV / airline /cola mogul Richard Branson. He talks about 'genetically engineered skunk' suggesting that skunk - the ill defined catch-all term for smelly indoor-grown cannabis - is in fact some sort of sinister new species of franken-pot. Actually it's no more 'genetically engineered' than any other farmed plant, flower or vegetable that has been bred to develop certain properties - i.e. everything in your fridge. Rosie Boycott on Radio Four's Today programme last week, despite elsewhere talking a lot of sense, got it even more wrong when she described 'skunk' as 'genetically modified', which is just flat out incorrect. Breeding plants is very different from inter-species DNA splicing. The worst thing about this is that both Branson and Boycott seem to be buying into the hype of the potency panic (explored in last weeks blog and also examined in this week's Guardian Bad Science column by Ben Goldacre). The Independent also seems to imply that Branson is backing their born-again prohibitionist stance when in fact he is not. He specifically only calls for a debate on the harms of cannabis, and also says that people with drug problems should get help on the NHS 'free from blame'.
I could pick more holes in the coverage but I grow weary. Apologies to Julie Lynn-Evans then; its not that your plan to make 'skunk' posession punishable with 14 years in prison, but legalise 'the old stuff' doesn't warrant annihilating, just that I think the point has been made well enough now, and I can't be bothered.

To be honest I'm incredibly bored with the endless recycling of the cannabis debate, the endless retreading of exaggerated claims about the drug itself (either its dangers or its safety). If there is one small mercy in the IOS coverage it is that they spared us the dreaded 'gateway theory'. Most of all I'm bored of the myths, misrepresentations and misunderstandings about people who call for reform of a policy that has manifestly failed on each and everyone of its stated objectives to reduce supply, use or harm associated with the drug.

This has all been going on for literally decades now, in fact generations; bear in mind the original reefer madness film was made in 1936, several decades before the 'good old days' of the flower power era (as Costa calls it) when cannabis was apparently a nice harmless drug used by hippies.



This endless tail chasing has been fuelled by lazy journalists looking for an easy headline and populist politicians looking for a way to score points against opponents. Its just too easy: hype the danger then sound all righteous by coming up with a tough new way to fight it - evidence of effectiveness not required.

At some point we will have to get off this pointless merry-go-round. If nothing else the cannabis debate is a massive distraction from far more pressing issues in drug policy around heroin and cocaine in particular, and the catastrophic impact that those illegal markets have here as well as in Afghanistan, Colombia and elsewhere.

the Independent have changed their position from 10 years ago, and will probably change it again when they realise how the call for a war on pot really isn't the answer to the problems they identify, even if they were half as bad as the make out. Maybe the cycle-time for them changing their minds again will be a bit less than ten years. Maybe next time they will not confuse the debate about drug dangers with the debate about how to deal with them. You live in hope, but this week's spade work suggests they are determined to dig themselves into an ever deeper hole.

It was only last month that the IOS leader was arguing:
"It is true that there is a growing body of opinion that says some of the varieties of cannabis available today, in particular "skunk", are more dangerous than they were in the past. But this does not alter the fact that heavy-handed prohibition is failing."
and
"There are strong signs that the public is far less one dimensional in its attitudes than parts of the media and the political establishment believe. Almost a third of adults in this country have taken some form of illegal drug. There is a growing awareness that present policies are not working."
Just three weeks ago stablemate, the (daily) Indepedent with whom the Sunday version shares a website, had a leader about the RSA drugs report which argued that:

"Of course, the reason ministers are clinging on to the crude policy of prohibition is that there is still a wide-spread mindset in this country, stoked up by the populist press, that all drugs are "evil" and that, by extension, so are those that take them. The summersaults performed by ministers over the downgrading of cannabis demonstrate just how in thrall to this popular prejudice they remain. The RSA report argues that: "The evidence suggests that a majority of people who use drugs are able to use them without harming themselves or others. The harmless use of illegal drugs is thus possible, indeed common." One can already predict the shrieks of alarm that will emanate from the prohibitionist lobby at this eminently reasonable statement."

Weeks later another leader makes big play of unambiguously calling specifically for prohibition (its an absolutist position, there is only one kind and its always heavy handed), and also stating that the present policy is 'about right'. Its all a bit confused, why, its almost a bit...schizophrenic. Actually I don't really know what they're thinking, and to be honest, I don't think they do either.

Saturday, March 24, 2007

The Lancet and drug harms: missing the bigger picture

The Lancet this week published the long awaited paper on drug classification: ‘Development of a rational scale to assess the harm of drugs of potential misuse’ by David Nutt, Leslie A King, William Saulsbury, Colin Blakemore. Whilst the Lancet publishers will make you register to read it, those nice folks over at MAP have been good enough to put the complete text on their website for your reading pleasure.

This is the abstract:

Drug misuse and abuse are major health problems. Harmful drugs are regulated according to classification systems that purport to relate to the harms and risks of each drug. However, the methodology and processes underlying classification systems are generally neither specified nor transparent, which reduces confidence in their accuracy and undermines health education messages. We developed and explored the feasibility of the use of a nine-category matrix of harm, with an expert delphic procedure, to assess the harms of a range of illicit drugs in an evidence-based fashion. We also included five legal drugs of misuse (alcohol, khat, solvents, alkyl nitrites, and tobacco) and one that has since been classified (ketamine) for reference. The process proved practicable, and yielded roughly similar scores and rankings of drug harm when used by two separate groups of experts. The ranking of drugs produced by our assessment of harm differed from those used by current regulatory systems. Our methodology offers a systematic framework and process that could be used by national and international regulatory bodies to assess the harm of current and future drugs of abuse.

and this is the graph of harm rankings for the drugs they have considered:




The paper has had loads of media coverage focusing on the graph above (rather than the more interesting material about how they came up with it), mostly along the lines of 'alcohol more dangerous than ecstasy', or variations thereof. This minor media furore (‘Alcohol worse than ecstasy on shock new drug list’ blurted the Guardian on its front page) is a bit odd because it must be one of the most heavily trailed Lancet papers in history. Not only were the draft contents discussed in detail by the Science and Technology Select Committee drug classification inquiry report (see page 70), and ‘the graph’ published by them, but ‘the graph' has actually appeared as one of those jazzy front page tabloid splashes in the Independent. Last year. If you missed all that the Lancet paper was also discussed - in even greater detail - by the more recent RSA report which includes an entire section on ‘the Blakemore / Nutt hierarchy of harm’ (not sure what King and Salusbury think about that), and ‘the graph’, around which much of the recommendations are built. Some journalists either have short memories or they are banking on us having short memories - if you can get a 'shock' twice with the same story, why the hell not eh?

Anyway, the finished paper is undoubtedly a fine piece of work. It has very usefully put legal and illegal drugs on the same harm continuum (obvious really, but good to see it being said in the Lancet) and in doing so exposing the contradictions, lack of logic, and false assumption that underpin much drug policy thinking here and around the world. The matrix system they propose for ranking drug harms is definitely a good start. Clearly any system of regulation, be it sensibly based on established legal controls and public health principles, and stupidly based on criminal penalties and prohibitionist ideology, will require some sort of ranking system to make distinctions and policy decisions for different drugs.

I actually think it’s too simplistic, although to be fair, the authors do not claim it as the be all and end all. As discussed in more detail in the Transform briefing on drug classification:

Drug harms are mediated by the nature of the user, the dose of drug consumed and the method of consumption – making a system based upon broad sweep single classifications for each drug fundamentally unscientific, and meaningless in most practical terms.

So the whole idea that drug x is ‘more dangerous’ than drug y is only useful in the broadest population analysis. For an individual it’s fairly meaningless because, obviously, it depends how much of given drug you use, how often you use it, how you use it, whether you have a heart problem or mental health issues, and so on. There are still some oddities in the ranking (solvents, for example, seem too low to me), but it’s a massive leap forward from what we have at the moment which the authors politely describe as having ‘evolved in an unsystematic way from somewhat arbitrary foundations with seemingly little scientific basis’. If they were writing in a blog, not the Lancet, I suspect they would have said: 'it's a total joke'.

However, I take more substantive issue with the paper, not for what they covered, but for what they left out:

Firstly, the harms of a given drug will depend upon its legal status. The best way to demonstrate this point is with heroin, which is placed at the top of the Lancet-scale as the most harmful of all drugs. For street heroin this may well be the appropriate placing, but, if we are being scientific here, it is imperative to separate out the harms that follow from use of the drug per se, and the health and social harms exacerbated or created specifically by the drug's use within an illegal market. These, lets call them 'prohibition harms', include:

  • Contaminated/cut product (poisoning, infection risks)
  • Dirty/shared needles (Hep C / HIV risk)
  • Vast quantities of low level acquisitive property crime to support a habit: illegal markets inflate the cost of an essentially worthless agricultural product to one that is worth more than its weight in gold. People on prescriptions don't have to nick stuff.
  • Street prostitution (see above)
  • Street dealing, drug-gang violence and turf wars
  • Drug litter (needles in the gutter etc)

More useful would have been to rank both illegal street heroin, associated with the above harms which aren't going to help its ranking much, and prescribed pharmaceutical heroin, associated with none of the above harms. The latter would certainly be considerably further down the scale. Luckily, we can theoretically do this with heroin as both legal and illegal markets exist simultaneously in the UK, although the number of prescribed users (approx 400) is rather eclipsed by the number of illicit users (approx 250,000+). It’s a great shame the authors of this study failed to make that comparison (we do, confusingly, get 'street methadone' in the ranking, but not the prescription variety). It would have helped policy makers untangle the harms created by drug misuse from the harms created specifically by prohibition and had far wider implications for the future of the dominant criminal justice paradigm.

Some policy makers are wise to this legality/harm equation. During the Science and Technology Committee inquiry evidence sessions there is a revealing section where they are discussing the harm matrix with Proffessor Nutt and Sir Micheal Rawlins, Chair of the ACMD (at this point, 2006, it is still unpublished and available only in draft). Dr Harris MP raises the point that the classification a drug is given will impact on the level of social harms it is associated with:

Q188 Dr Harris: In this matrix you include under “social harms” intoxication, health care costs, and other social harms. Included under “other social harms” do you include the harm that stems from criminalisation itself?

Professor Sir Michael Rawlins: Yes.

Q189 Dr Harris: You do not spell that out but that is understood?

Professor Sir Michael Rawlins: Yes and whether it leads to acquisitive crime.

A couple of questions later…

Q 195 Dr Harris: Your recommendation recommending classification into a particular class creates social effects, does it not?

Professor Nutt: Indeed it does.

Q196 Dr Harris: Because obviously it brings criminal justice along with it and that affects the price and availability and so forth. Do you recognize that? Your own actions impact on the evidence. Did you feed that back in before you made the recommendation?

Professor Nutt: We know it might happen but you can never be sure how big an effect that might have.

When translated through the prism of the Misuse of Drugs Act the harm rankings become, to a significant degree, strangely self-fulfilling, as is evident in the case with heroin: The more you criminalise the drug (by moving it up the rankings) the more risky you make its use and more social harms you create associated with its illegal supply. Given there is no evidence that these increased harms are offset by any deterrent effect associated with classification the whole system seems even more bizarrely unscientific and unsustainable.

Colin Blakemore, one of the authors and chief executive of the Medical Research Council is quoted in the guardian saying:

"We face a huge problem. Drugs ... have never been more easily available, have never been cheaper, never been more potent and never been more widely used".

"The policies we have had for the last 40 years ... clearly have not worked in terms of reducing drug use. So I think it does deserve a fresh look”

This leads us to the second, arguably more serious problem with the paper. The rankings of drugs, with the anomalous exceptions of alcohol and tobacco, are defined within the Misuse of Drugs Act 1971 and primarily intended to determine the accompanying hierarchy of criminal penalties, and not to provide public health information to potential drug users.

The evident problem is that there is no meaningful evaluation of the outcomes of this unique criminal justice approach to public health regulation. We can have excellent science ranking drugs public health harms, as this paper presents, but then no science at all regards the outcomes of these rankings when they are implemented as criminal policy. As the authors have noted, the use and availability of illegal drugs has risen steadily under the current system. A more scientific ranking of harm is not enough: the whole prohibitionist legal framework needs to be reassessed as well. To immodestly quote myself in the oral evidence I gave to the Sci-tech Committee:

"I have been trying to think of a metaphor for this and the best one I can come up with is that it is like arguing over what colour to paint a square wheel. Even if all the experts agree it should be blue it does not matter because that wheel does not turn. The classification system does not do what it is supposed to do, it does not reduce harm, it does not reduce misuse, it does not reduce mental health problems. In fact it seems to do the exact opposite so the whole thing is an exercise in distraction"

In the short term I despair that anything at all will happen. The Government give the pretence of supporting evidence based policy on drugs, but when it clashes with their ‘political judgements’ or 'beliefs' that all goes straight out of the window.

In a follow up oral evidence session to the publication of the Science and Technology Select Committee’s devastating 2006 critique of the classification system, the committee re-interviewed Sir Micheal Rawlins, Proffessor Nutt, and the minister with responsibility for drugs, Vernon Coaker.

It’s a truly remarkable interrogation, with the Minister not having a leg to stand on when he is repeatedly challenged on the lack of evidence base for the classification system's effectiveness, or the justification for certain howling anomalies within the system. He falls back on evasion, changing the subject or the excuse of decisions being ‘political judgements’ , or worse, merely that it is his ‘belief’ that the system works. There is not even the pretence that the system is evidence based. I recommend you read it all (or look forward to other choice quotes popping up on the blog in the future), but for the time being here are some low-lights, just so you know what you're up against.

First is a section about the reclassification of ecstasy:

Q109 Mr Newmark: If the ACMD discovered new evidence when it undertook the review, would you consider reclassifying ecstasy?

Mr Coaker: We would consider their evidence. As I say, we have no plans to reclassify ecstasy. The ACMD is independent of government, we obviously respect what they say, and they will bring their report forward, but the Government has no plans and no intention of reclassifying ecstasy.

Q110 Dr Harris: You say that you do not propose to move ecstasy and it will remain a Class A drug. Is that an evidence-based policy?

Mr Coaker: That is a judgment the Government makes on the basis of what we believe to be something that is in the interests of the public at large to keep ecstasy as a Class A drug.

Q111 Dr Harris: Is it an evidence-based view?

Mr Coaker: It is a judgment that we make based on all the evidence we have had no recommendation from anybody to reclassify ecstasy from an A to a B. We think it is a drug which is harmful. There is no safe dose of it. We were talking about alcohol earlier on and one of the problems you have with alcohol is there probably is a safe dose. Like many here, I have a drink now and again, but there is no safe dose of ecstasy, we think it would send out totally the wrong messages and, as I say, we have no intention of reclassifying ecstasy.

Q112 Mr Newmark: Because it kills unpredictably?

Mr Coaker: As I say, there is no safe dose. This is the point, just half a minute—

Q113 Dr Harris: There is no safe dose of tobacco.

Mr Coaker: It just does make the point very well, the exchange that we have just had between two members of the Committee, quite rightly, about the difficulties that there are in this area and the different views and opinions that people have. I think what we all wrestle with is using evidence and using science and also trying to think about it from a non-scientific point of view in the social judgments and the individual judgments and the community judgments that we make. We wrestle with that and, as I say, as a Government we have no intention of doing anything with respect to ecstasy because we do not believe there is a safe dose, it is harmful, it kills unpredictably, as Brooks has said, and we just think that it is a very important way to use the classification system.

Q114 Dr Harris: If the ACMD reviewed the evidence and that review made recommendations to you, are you saying now it is not worth them doing it because your decision on this will not be evidence based, it will just be a reassertion of your "no intention to reclassify ecstasy"? Even if they said there will be fewer deaths, for whatever reason, if it is reclassified, are you saying that you will never consider an evidence-based decision on this drug?

Mr Coaker: I am not saying that at all. What I am saying is the ACMD, of course, can conduct research and look at whatever they wish to with respect to drugs and make recommendations to the Government. What I am saying quite clearly is that we have no intention of reclassifying ecstasy.

Q115 Dr Harris: I am keen to pursue this one. I understand you have no intention and I assume that is current because I do not think you could bind your successors if the evidence changed. Is it your view that all drugs for which there is no safe dose should be in Class A or is there something special about ecstasy which means it is one of the drugs for which you say there is no safe dose which means it must be in A?

Mr Coaker: In talking about ecstasy, it kills unpredictably, we do not believe that there is a safe dose; we will not reclassify ecstasy.

Q116 Dr Harris: Does that apply to all drugs that meet those criteria?

Mr Coaker: What we try to do where we have evidence and where people come to us with recommendations is make individual judgments, as we will do whenever people come to us. All I am saying with respect to ecstasy is that we have no plans and no intention of doing so.

Q117 Dr Harris: So do you think you are wasting your time, Professor Rawlins, if you end up doing a review in this area?

Professor Sir Michael Rawlins: No, I think we will give advice on whatever we feel is appropriate but perhaps in a way more importantly we will also be able to, I hope, give better advice on harm reduction, which is actually rather important, and on what further research is needed in order to understand the dangers of it.

Q118 Dr Harris: Will the fact that the Minister has said quite categorically that he is not going to change the classification have any bearing on whether you follow through and do a report?

Professor Sir Michael Rawlins: None at all because we are going to do it.

Now here is a second section from slightly earlier in the session. Creationism gets a mention in reference to the Minister's scientific discourse; it seems an appropriate comparison (and couldn't help but remind me of this).

Q45 Chairman: Vernon, in response to us, you said that the Government "fundamentally believes that illegality is an important factor when people are considering engaging in risk-taking behaviour . . . It believes that the illegality of certain drugs, and by association their classification, will impact on drug-use choices". Where is the evidence for that?

Mr Coaker: That is the belief and the judgment that the Government have.

Q46 Chairman: I did not ask you that. People believe in creationism and they are entitled to do that, though I do not agree with that, but I am asking you, where is the evidence?

Mr Coaker: To be fair to the response that we tried to make in response to the Committee where the Committee has challenged us, we have ourselves said that we need to do more research into the deterrent effect, that we need to establish a better evidence and research base for that, so we have accepted the point of the need to actually do something about it, but we do believe, and strongly believe, that the classification of drugs in the current system, A, B and C, with respect to Class A does act as a deterrent system. That is a judgment we make, it is a belief that we have and we have accepted that there is more to do with respect to that.

Q47 Adam Afriyie: If when you carry out and conduct this research the evidence shows that you are completely mistaken in that view, will change your view?

Mr Coaker: I cannot prejudge what any research is going to tell us. Clearly you make judgments about the research that you receive and that is obviously the point.

Q48 Chairman: Vernon, you have not commissioned any research and nor have the ACMD.

Mr Coaker: No, but what we have said in response to where the Committee challenged us and said, "Where is your evidence base for that?", as we have done with a number of other things, we said that we understand that point, we accept that point and we need to look at establishing a better evidence base for that, but it does not alter the fact or change the fact that the Government believes that the tripartite system, the classification system, does send out a strong message and does impact on, and affect, behaviour.






Thursday, March 22, 2007

UN INCB is 'obstacle' to HIV prevention and drug treatment programs

A report published today by the Canadian HIV/AIDS Legal Network (part of the Open Society Institute Public Health Program), titled 'Closed to Reason: the International Narcotic Control Board and HIV / AIDS' strongly criticises the INCB, the nominal enforcement body for the UN drug conventions. It accuses the INCB of becoming 'an obstacle to effective programs to prevent and treat HIV and chemical dependence' . The bizarre politics and machinations of this strange UN entity make for often shocking reading. The summary findings and recommendations are copied below. They should be of immediate and urgent concern to all members states:





Key findings and recommendations

The role of drug policy has been transformed since the era in which the International Narcotics Control Board (INCB), the 13-member body responsible for monitoring compliance with the United Nations drug conventions, was conceived. In a time when an estimated 30 percent of infections outside of Africa are due to injection drug use, drug policy is fundamental to the success or failure of the international response to HIV/AIDS. A significant body of scientific evidence has shown the importance of measures such as effective treatment for chemical dependence and provision of sterile syringes in preventing HIV. The INCB, which emphasizes its impartiality, independence and reliance on evidence, has an historic opportunity to help stop the injection-driven HIV epidemics now emerging and exploding in much of the world.

Instead, the Board has become an obstacle to effective programs to prevent and treat HIV and chemical dependence. INCB annual reports are rife with omissions and misrepresentations and lack both scientific documentation and justification for legal opinions. Country visits by INCB representatives fail to highlight law enforcement patterns that accelerate HIV transmission and represent clear human rights violations. Although the Board is responsible for ensuring the global availability of legal opiates, it has not acted to help countries accurately estimate their need for the opiate substitution treatment shown to be effective in reducing HIV risk and increasing adherence to antiretroviral medications.

The Board stresses the drug control aspects of its mandate. Its annual report for 2005, however, refers 18 times to the role of drug use in accelerating HIV transmission in various countries. Tellingly, that report, like other INCB documents, fails to urge countries to pursue proven strategies to reduce HIV transmission among people who inject drugs. While the UN drug conventions clearly mandate treatment for drug users, the INCB has remained silent on the shortage of effective chemical dependence programs, and the abuses committed in the name of drug treatment and rehabilitation.

The United Nations system as a whole is committed to reducing HIV among people who inject drugs, to safeguarding the human rights of people who use drugs, and to increasing accountability and civil society involvement. In this context, the INCB is an anomaly: a closed body, accountable to no one, that focuses on drug control at the expense of public health and that urges national governments to do the same.

INCB members contradict or seek to thwart evidence-based recommendations of other UN bodies and representatives.
  • INCB members have spoken out against sterile syringe programs and opiate substitution treatment, despite findings by the Joint United Nations Programme on HIV/AIDS (UNAIDS), the World Health Organization, the United Nations Office on Drugs and Crime (UNODC) and the INCB itself that these measures are effective and important components of HIV prevention.
  • In 2002, the president of the INCB claimed, erroneously, that distribution of sterile syringes contravened the UN drug conventions. In 2005, a memorandum signed by an INCB member from Russia included numerous misstatements of fact meant to discredit the use of methadone as a treatment for opiate addiction.
  • The Board has sought to silence UN representatives who support a fuller range of HIV prevention approaches. In 2006, for example, Stephen Lewis, the UN Secretary-General’s Special Envoy for HIV/AIDS in Africa, commented favorably on Canadian data showing that a Vancouver safer injection facility had reduced HIV risk. The next day, he received an angry telephone call from the INCB Secretariat and a promise that the Board would write to the Secretary-General to urge that Lewis be censured for support of “opium dens.” In that letter, the INCB president expressed disbelief that “any officer of the United Nation [sic] could have made such statements,” and demanded that Lewis recant.

INCB reports praise governments that violate human rights.

  • A Board delegation visited Thailand in 2004, several months after police forces began a “war on drugs” in which human rights experts documented extrajudicial executions, arrest quotas, use of blacklists, and the internment of tens of thousands of people, including many with no history of drug use. In its report issued after the visit, the Board did not condemn the mass arrests; instead, it expressed appreciation for the Thai government’s efforts to investigate the killings, despite findings by human rights groups that the government had failed to allow any independent investigations.
  • In 2004, after Bulgaria mandated imprisonment for possession of any amount of any illicit drug, fear of arrest caused rates of drug injection and syringe sharing to increase sharply. INCB representatives visited Bulgaria in 2005, but the Board’s report made no mention of the harsh drug law or its impact, noting instead that national drug control legislation was “well-developed.”
  • In Russia, authorities in 2005 moved to reverse a reform that had reduced the numbers imprisoned for very small amounts of drugs. Wholesale and prolonged incarceration had been recognized as contributing to both penitentiary overcrowding and the fact that Russia’s HIV epidemic was among the fastest growing in the world. INCB representatives visited Russia during this debate, but the Board’s subsequent report made no mention of any discussion of the issue or of concern about the human rights implications of the policy. Instead, the INCB expressed concern about the extent of drug abuse in Russia, and encouraged coordination and cooperation between HIV and drug treatment services.
  • Since 1990, China has marked the UN’s International Day Against Drug Abuse and Illicit Drug Trafficking with show trials in which drug dealers are sentenced to death, sometimes as crowds chant “kill, kill.” Scores have been executed. Despite professed support for sensitive policing, the INCB has failed to criticize either this practice or the police harassment of those seeking to obtain sterile injection equipment, whether in China or in other countries visited by the Board.

The Board stresses drug control at the expense of public health, expressing concern about diversion rather than praise for scientifically proven measures that reduce HIV and other harms.

  • While acknowledging that WHO added methadone and buprenorphine to its Model List of Essential Medicines in 2005, the Board has made no public effort to promote opiate substitution treatment (OST) in countries where large numbers of people inject drugs. It also has failed to highlight OST as an essential tool in HIV care or treatment. Although Ukraine, China, Malaysia and Iran have moved in recent years to expand OST programs and/or needle exchange programs to contain HIV, INCB reports have not expressed appreciation for or satisfaction with these developments. Instead, the Board has expressed concern about diversion of methadone and buprenorphine, and urged WHO to advocate for tightened controls on these medications.

The Board issues interpretations of law and pronouncements on harm reduction, despite a lack of expertise in international law and HIV policy.

  • According to their published biographies, none of the Board’s 13 members has formal training in international law, despite the importance of such credentials in interpreting treaty provisions. In the case of substitution treatment, needle exchange, and safer injection facilities, the pronouncements of INCB members have contravened the fi ndings of the Board’s own legal advisors and national experts.

  • Despite the centrality of drug use to HIV transmission, none of the Board members has published in peer-reviewed journals on HIV/AIDS, and few list any experience of HIV treatment or prevention in their biographies.

The Board conducts operations in secret, and without mechanisms for accountability.

  • INCB meetings are closed to observers, and no minutes are available.

  • INCB members have used their Board affiliation when making misstatements of fact, yet no public mechanism exists for member states or community organizations to contest claims, seek clarification, or offer amendments.

  • Sources are selectively and inconsistently documented in INCB reports.

  • The INCB does not publicize country visits in advance or convene public hearings or other opportunities for input.

  • Despite the UN Secretary-General’s call for greater transparency and interaction with civil society at the UN, the INCB’s website includes no information on the Board’s budget or staff.

  • The INCB Secretariat — paid for by the UN — is unresponsive to requests for information from affected communities or non-governmental organizations.


Recommendations

  • To improve accountability, address the HIV epidemic, and meet its mandate to assess compliance with the UN drug conventions, the INCB must change.

  • The INCB should regularly assess the supply and adequacy of treatment for chemical
    dependence. It should provide technical assistance to help countries accurately estimate the need for opiate substitution treatment, support governments that are striving to scale up such treatment, and encourage governments that have yet to provide these life-saving therapies to find safe and effective ways to do so.

  • The INCB should cite scientific evidence for its observations about drug use and health, and legal grounds for its interpretation of law. It should provide sources of information for its annual reports, and opportunities for UN member states and civil society groups to offer corrections or additional information.

  • The INCB should provide greater opportunity for exchange with UN member states, UN
    agencies with relevant mandates, civil society, and HIV/AIDS experts. INCB country missions should include greater opportunities for engagement with these groups.

  • The World Health Organization, the UN Economic and Social Council (ECOSOC) and UN member states should ensure that INCB members include persons with expertise in HIV/AIDS policy and international law.

  • The INCB should articulate, and ECOSOC should evaluate, public guidelines to clarify when INCB members are speaking for the Board, and how misstatements of fact can be corrected.

  • The UN Secretary-General should commission an independent evaluation of the INCB, including a scientific evaluation of the Board’s statements on health, and an examination of Board members’ independence and expertise, with particular attention to HIV, international law and human rights.

Wednesday, March 21, 2007

Bizarre 'Bong Hits 4 Jesus' case reaches US Supreme Court

File under: only in America

On Monday, March 19th, the Supreme Court of the United States heard oral arguments in the case informally known as "Bong Hits 4 Jesus." High school student Joseph Frederick was subjected to school suspension for his display of a homemade banner while standing across the street from school property, albeit during normal school hours.


clearly one for the highest court in the land


While initial court rulings held in favor of the Juneau, Alaska school district, the Ninth Circuit Court reversed in favor of Frederick. The Ninth Circuit determined that the school district did not have the right to unduly restrict the public demonstration by Frederick when he elected to unfurl and display his 14-foot banner with the words, "Bong Hits 4 Jesus."

The school district appealed to the Supreme Court. Their case is being led by none other than Kenneth Starr of Clinton impeachment notoriety. the US based Media Awareness project has already archived a number of news clippings covering Monday's oral arguments in Washington, as well as some opinion items. These, and additional clippings during the days ahead, can be found here.

thanks to drugsense

a short fim of news coverage of provided by Student for Sensible Drug Policy (US)

Tuesday, March 20, 2007

Prohibition 'not effective' claims Australian Crime Commission

This well written piece by The Age, reports on the Federal Parliamentary Joint Committee on the Australian Crime Commission. Their recent ‘Inquiry into the manufacture, importation and use of amphetamines and other synthetic drugs (AOSD) in Australia’ has a very interesting intro to the main conclusion: "prohibition, while theoretically a logical and properly intentioned strategy, is not effective".

This didn’t sit easy with the current Australian government. The Age suggests the sensationalised climate that politicians have to work within makes them fearful of entering a rational debate on drugs. A problem we’ve hit on time and time again.

However, there is a glimmer of hope. There is a train bound for a world based on reality and a growing number of politicians from across the political spectrum are happily taking luncheon in the dining carriage.

This is good news because coming soon is a major new document produced by Transform with the sole aim to aid rational debate on drug policy. ‘Tools for Debate’ will be a groundbreaking point-of-reference for anyone wishing to challenge non-rational policy positions, no matter how persuasive the rhetoric.

Watch this space.

Sunday, March 18, 2007

How the Independent on Sunday got it horribly wrong on Cannabis

The Independent on Sunday jumped on the skunk-panic bandwagon this weekend with a brash tabloid headline: 'Cannabis - An apology', above a figure of 10,000 in big red letters - which we are informed is the number of teenagers treated for 'cannabis addiction' last year, apparently ten-fold higher than back in 1997. Inside, along with almost five pages of news coverage, there are opinion pieces by Rosie Boycott (the IOS editor who launched their cannabis legalisation campaign 10 years ago) psychiatrist Robin Murray, and a leader in which the they retract their support for Boycott's legalisation campaign - hence the front page headline.



They've totally missed the point.

1. The facts are all over the place. On the front cover Jonathan Owen informs us that skunk today 'is 25 times stronger than the resin sold a decade ago'. In the main feature this has become 'can be 25 times stronger'. A few paragraphs later we later that a cannabis joint 'may contain 10 to 20 times more THC than the equivalent joint in the 1970's'. Rosie Boycott tells us a few pages later that it is 30 times stronger and Robin Murray that the traditional 2-3 % THC of herbal cannabis in the 70's compares to 15-20% (occasionally as high as 30) in today's skunk. Who should we believe?

Actually they are all wrong. In the 70's, as with today, there was a range of cannabis products - herbal and resin - available on the market and they varied in strength from very weak to highly potent. Drugscope reported just last week that most of what was being sold as 'skunk' today is around 10% and that the stronger varieties were comparatively rare because they took longer to grow (increasing production costs) but commanded the same street price. So compare the 'worst' weed from the 70s to the 'best' today and you'll get your scary '25 time stronger' headline. In reality however the average 'weed' from the 70's was probably more like a third to a half the strength of most of today's skunk.

But the true picture is more complicated than this. Skunk is by no means the entire UK market, a large proportion of which is still 'old school' imported weed of the 3-4% variety and a larger proportion being low grade resin (soap bar etc.) also of low single figure % strength. The strongest stuff from 'back in the day' was way stronger than the low grade resin still widely available today. It depends how you spin it.

So lets be clear - the idea that cannabis was weak and harmless in the old days, and has now morphed into super-potent deadly psychotabis today, is just not true. That is oversimplification and hype for sake of a juicy media or political soundbite. An almost identical misleading potency panic took place in the US in the late 1980's : 'Now perceived as a hard drug, marijuana has increased 1,400 percent in potency since 1970' proclaimed the 1986 flyer for a US national marijuana conference.

More potent hydroponically/indoor cultivated herbal cannabis was also already widely available in 1997 , and whilst it is now unarguably more prevalent, the fact that it is mostly UK grown today rather than imported makes no difference to the consumer (if anything the home grown skunk is actually weaker than the equivalent product formerly imported from Holland).

The change in the market over the last ten years is nowhere near as dramatic as the IOS report seems to suggest, and can certainly not account for the 10 fold increase in 'cannabis addiction' that they attribute to it. Indeed this is another extremely dubious statistic (not to mention the reckless and ill defined use of the term 'cannabis addiction'). Not only does the change from 1000 teenagers being treated for 'cannabis addiction' in 1997, to 10,000 last year all seem to deploy conveniently, almost suspiciously, rounded numbers - but as is acknowledged in the papers leader - this rise is significantly due to changes in service provision. It is also due to the way cannabis related problems are diagnosed and counted: of this supposed 10,000 'cannabis addicts' how many are being treated primarily for mental health problems or misuse of other drugs but have also noted cannabis use (practically universal to both groups), or are in treatment as a result of the new and massively expanded arrest referral schemes? We are not told.

2. They fail to understand how drugs are used. The implication of the repeated 'fact' that cannabis today is 10/15/20/25/30 (take your pick) times stronger than it used to be is that people are consuming an equivalent increase in the main active ingredient THC. This is also not the case. Robin Murray describes the comparison between the weed of old and modern skunk as similar to comparing lager and whisky (Owen makes a similar comparison with shandy and brandy). But people don't drink whisky or brandy in pints. If a drug is stronger they consume less, weaker they will consume more - to achieve the desired level of intoxication. In the case of stronger cannabis users will put less in the joint, take less drags, inhale less deeply, smoke less joints and so on. This is called auto-titration and is exactly the same effect seen with low nicotine cigarettes which it was found users smoked more of, inhaled more deeply and so on. The effect was discussed regarding cannabis during the last potency panic in a 1988 paper in the Journal of Psychoactive Drugs which concluded that:
"Observations of the real world of marijuana use, where autotitration is the norm, renders the scare tactics of the new marijuana proponents not only inaccurate but irrelevant. There is much published evidence about the availability of highly potent varieties of cannabis from the nineteenth century through the present day"

The idea that cannabis users, even teenagers, are incapable of making rational decisions about the dosage they consume is ridiculous, and the idea that they are getting 25 times more stoned than in the good old days is laughable. This is not to say that increased potency does not equate to any increase in risk, it does, but behaviours adapt surprisingly rapidly and hyping the potency panic or hyping the dangers associated with actual potency changes don't help us come up with rational public health responses that might actually help reduce overall harm. It needs pointing out for example that in Holland where cannabis is effectively (albeit not technically) legal, the licensed premises that sell it offer a wide range of cannabis varieties of differing potencies, and the strongest ones are far from the most popular. And they have a far lower level of youth cannabis use than here in the UK.



3. We haven't suddenly 'discovered' that cannabis is related to mental health problems. The IOS report doesn't 'Reveal' anything new at all. You can look at text books and commission reports from the as far back as the 1920s that document symptoms from cannabis use that are actually remarkably similar to those we have today. They say that for most people the risks of occasional use are low (certainly relative to most other commonly used recreational drugs) but that heavy use, particularly for a small sub-set of users with pre-existing mental health problems or certain other vulnerabilities, presents real dangers of exacerbating existing problems or potentially precipitating new ones. These problems include psychotic episodes (occasionally recurring), schizophrenia and so on. These are the same conclusions that have been reached by innumerable studies and reviews over the last hundred years, most recently two undertaken by the Advisory Council on the Misuse of Drugs which came before and after the drug's UK reclassification from B to C: For most people the risks are minimal, but for a few they are very real, particularly for certain vulnerable groups, and particularly when associated with high levels of use. Guess what? Drugs can be bad for you.

The research into cannabis has continued unabated and our understanding is getting increasingly sophisticated, even though establishing the causal links between certain patterns of use and certain conditions remains problematic. The impression that there has been a sudden emergence of new knowledge is more a reflection of the unprecedented attention focused on the cannabis issue since the cannabis reclassification debate kicked off in 2001. Many opponents of the Government or the reclassification have sought to highlight emerging research in the media, often misrepresenting ambiguous conclusions as direct causal links.

Even if it's all true - what exactly is the IOS recommending? Ignore all other tedious witterings above for a moment and let's assume that cannabis really is 25 time stronger than 10 years ago and this really has led to a ten fold increase in teen cannabis addiction (whatever that might be). What does the IOS then recommend in its leader as a response to the policy disaster under which this skunk apocalypse has emerged?

Nothing: They say the the current policy is 'about right'.


Do we get an exploration of policy alternatives or a consideration of progressive policy in other European countries where the problems are markedly smaller? No. Instead we are told that the 'the fact possession of cannabis - and other drugs - is illegal acts as a important social deterrent'. You have to wonder what they have based this on. Could it be the massive rise in use of all illegal drugs since 1971? Could it be the the Police Foundation report of 2000 that concluded:

"such evidence as we have assembled about the current situation and the changes that have taken place in the last 30 years all point to the conclusion that the deterrent effect of the law has been very limited"
maybe it was the 2006 Science and Technology Select Committee that concluded:

"We have found no solid evidence to support the existence of a deterrent effect, despite the fact that it appears to underpin the Government’s policy on classification"
Perhaps it was Professor David Nutt, Chairman of the ACMD Technical Committee when he said: "I think the evidence base for classification producing a deterrent is not strong"

Maybe it was the fact that when challenged by the Sci-Tech select committee the Government were unable to produce a single shred of evidence for such a deterrent effect, and have undertaken no research to find any. I could go on, but needless to say The IOS has similarly failed to produce anything to back this claim up.

This all points towards to the biggest mistake the IOS makes in this whole sorry piece, which is to confuse their legitimate concern with the health impacts of cannabis misuse amongst a small group vulnerable young people with support for a failed ideological prohibitionist policy - rather than support for an evidence-led regulatory response based on public health and harm reduction principles. They advocate a policy that has not only created many of the problems they describe (lets face it, hype), but also one that offers no prospect of sorting them out.

The IOS seem blind to the fact that the emergence of potent indoor cultivated cannabis is itself a manifestation of the illegal market they are now supporting. In a similar fashion to the prohibition-fuelled emergence of crack cocaine, stronger varieties of cannabis (whilst they have always been available) are more expensive and consequently more profitable for the increasing number of small to medium scale indoor growers.

The IOS, despite noting that: 'the rhetoric of the 'war on drugs' tended to distort priorities', then deems it appropriate to maintain the blanket criminalisation of millions of non-problematic occasional users, because of a relatively tiny population of vulnerable teenage heavy users who have problems with the drug. This is akin to banning cars because of a small population of teenage joyriders. It has no legal precedent or ethical basis, it's inconsistent and makes no sense. They don't call for the mass criminalisation of alcohol because of growing teen drinking issues, so what are they doing? If they are so convinced by the deterrent effect of enforcement and if the skunk problem is so awful, why not call for doubling of sentences or show these young'ns the error of their ways by throwing them all in jail?

The IOS also perpetuate the misunderstanding that the cause of cannabis legalisation/regulation is based on the fact that cannabis is harmless - a misunderstanding arguably due in part to the mistaken approach of Rosie Boycott's initial campaign and its rather romanticised view of cannabis use. No serious advocates for drug policy and law reform do so on the basis that any drug is safe (to her credit Boycott's opinion piece reflects the increasing sophistication of her argument ten years on). On the contrary - reformers argue on the basis that all drug use involve risks and that is precisely why they need to be appropriately regulated and controlled by the State, so as to minimise the harms they cause. The IOS apparently wants the multi-billion pound drug markets to remain in the hands of criminal gangs and street dealers. Because that should help protect the kids.

Nowhere in the IOS coverage do they mention the fact that the authors of the key recent studies linking cannabis and mental health problems are advocates of legal regulation for precisely the reason described above (see Transform's 'cannabis reclassification revisited' briefing for more detailed discussion and references on this point). Perhaps there wasn't room for this discussion because all the space had been taken up with noddy-science cross-sections of brains, and lists of unreferenced cherry-picked statistics.

Cannabis use is a real public health issue, and the growing culture of young people misusing it a real concern, even if total numbers seem to have levelled off or even fallen marginally since reclassification. Hyping the problem for the sake of good story, however, is totally unhelpful, and calling for more of the same when the current policy has been such a manifest failure is even less so.

This was a lazy piece of sensationalist journalism and a pathetically weak and ill thought out leader. Dissapointing and mystifying for a supposedly progressive thinking paper.

Read the follow up here: The Independent's born-again drug war: Round Two