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There is no intrinsic logic to the legality and illegality of drugs so why do we criminalise the use of some drugs and not others, asks Professor David Nutt, former chairman of the advisory council on the misuse of drugs
For many people, drug taking is pleasurable and for a significant minority, it is indirectly beneficial because it reduces pain and suffering (as with cannabis in multiple sclerosis). For a proportion, drug taking becomes a habit that, though once pleasurable, may end up being a compulsion devoid of any enjoyment; this latter state we call addiction. Drugs vary greatly in their addictive potential with tobacco, heroin and cocaine being at the top of the list with up to 40 per cent of all users becoming addicted. For alcohol, the proportion is about 15 per cent followed by cannabis (about 10 per cent) with the MDMA and the psychedelics at the bottom with little evidence of addiction.
Some drugs such as alcohol and tobacco are legal and sold as commodities. Others such as heroin and ketamine are medicines that become illegal if used in recreational ways without a prescription. Some, such as mephedrone and crack cocaine are just illegal. In some Islamic countries, alcohol is also illegal and has been for centuries. This shows there is no intrinsic logic to the legality or illegality of drugs, so why do we criminalise the use of some drugs and not others? The justification for the UK drug laws [the Misuse of Drugs Act 1971] is that they are designed to reduce personal and social harms from drug use.
It would therefore be presumed that illegal drugs are more harmful than those that are legally sold. However this is clearly not the case as our research has shown. We performed a systematic analysis of more than 20 drugs on a nine-point scale that covers personal and social drug harms and found that heroin was the worst but alcohol scored fifth worst in terms of harm and tobacco ninth. Ecstasy and LSD both scored lower than cannabis.
Critics of this approach say that it is the legality of these drugs that leads to their greater use and therefore greater harms. While this is undoubtedly true to some extent, this does not negate the fact that reducing deaths and chronic illness from alcohol and tobacco is a major and urgent need for the UK.
Would other drugs that scored low on our assessment such as MDMA (ecstasy) and LSD become more harmful if they were not illegal? We cannot say for certain, however, cannabis though illegal is used by up to 50 per cent of young people and seems to cause much less harm than alcohol. MDMA and LSD might be used little more than they are now if they were not illegal. One reason for this is that alcohol is more addictive than these other drugs and addiction drives dangerous use. Moreover, alcohol removes insight and self control so leading to excessive binge intake. However, there is a real risk that if more drugs were legal then heavy marketing of them might lead to excessive and dangerous use and I would not welcome this. Rather, I think a regulated access to drugs such as the cannabis coffee shops in Holland is a more sensible way forward.
The current situation of banning most recreational drugs is therefore not evidence based but does it matter? Does precautionary banning of a drug do any harm? In my view, it does for many reasons. It is unjust and therefore undemocratic. Why should someone who prefers cannabis over alcohol run the risk of criminalisation especially if they are doing less damage to themselves and the country than if they were using alcohol? The previous government's policy to deter cannabis use by forceful policing increased convictions for cannabis possession from 88 thousand in 2004 to 160 thousand in 2008. As well as ruining many lives through getting a criminal record, this added massive costs to taxpayers in extra policing and prison costs.
Another flaw in the current criminalisation-based drug policy is that it doesn't work! The MD Act was brought into law in 1971 yet since then cannabis use in the UK has increased 20 times despite heavy sanctions of up to five years in prison for possession for personal use. Yet cannabis harms have hardly increased, despite media coverage to the contrary, and current figures for hospital admissions for cannabis related illness suggest about a thousand per year. In contrast, alcohol use which has about doubled in the same 40 year period is associated with a rising epidemic of harms leading to over one million hospital episodes in 2009. There is some evidence that heavy enforcement of stimulants such as ecstasy may be moving young people from illegal drug use to alcohol which could explain the rapidly rising epidemic of liver deaths we are now experiencing.
It is now time for a change in policy to better reflect drug harms. There is growing evidence from a number of countries, eg the Netherlands (cannabis in coffee shops), Australian states (decriminalisation of cannabis for personal use) and Portugal (abolition of criminal sanctions for personal use of all drugs) that less punitive approaches are more just and have major public health benefits.
For 10 years, I worked in unpaid roles for the government trying to bring evidence and balance to the drug law debate. Last year I was sacked for criticising government policy that ignored the major problem that alcohol has become and for saying cannabis, ecstasy and LSD were less harmful drugs. The then Home Secretary Alan Johnson famously said in the House of Commons that he was "big enough, strong enough, bold enough" to sack me. We need public servants as well as the general public to make it clear that policies that are not evidence-based are unjust and so, unacceptable.
Many of these issues are discussed in more detail on the website of the new committee I set up – the Independent Scientific Committee on Drugs (www.drugscience.org.uk).
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