cannabis policy's in no more chaos than usual

I'm not accustomed to find myself in agreement with anything the Government does, but today I must laud their decision to finally rid themselves of Professor David Nutt.

Until Friday 30 October, Nutt chaired the Advisory Council on the Misuse of Drugs, a body set up by the Misuse of Drugs Act 1971 to do what it says on the tin: advise the Government on drug-use and strategies to control it.

Nutt is no stranger to controversy, most famously this January when he published a paper in the Journal of Psychopharmacology called Equasy - An overlooked addiction with implications for the current debate on drug harms, in which he described a group of symptoms in a woman

who had suffered permanent brain damage as a result of equasy-induced brain damage. She had undergone severe personality change that made her more irritable and impulsive, with anxiety and loss of the ability to experience pleasure. There was also a degree of hypofrontality [lower metabolic activity in the frontal regions of the brain causing impaired concentration] and behavioural disinhibition that had lead to many bad decisions in relationships with poor choice of partners and an unwanted pregnancy. She is unable to work and is unlikely ever to do so again, so the social costs of her brain damage are also very high.

Equasy turned out to be Equine Addiction Syndrome - horseriding (does the author have a Jilly Cooper habit?); and Nutt showed a little later in the paper why he had been such an ideologially beautiful choice for the Labour Party to head a quango: "Violence is historically intimately associated with equasy – especially those who gather together in hunting groups; initially, this was interspecies aggression but latterly has become specific person to person violence between the pro and anti-hunt lobby groups."

He was forced to apologise by then Home Secretary Jacqui Smith for trivialising the dangers of ecstasy, but has continued to insist it is relatively harmless in the face of damage caused by other drugs, particularly alcohol.

I don't know any drugs worker who would disagree with this. One question commonly used in training is to ask what would be the major cause of substance-related conditions you'd see if you sat in a busy Accident and Emergency Ward (or Casualty, Emergency Room, etc) from Friday night to the wee hours of Monday morning. The answer, duh, is alcohol - with maybe a few heroin overdoses and overheating/dehydration and heart palpitations caused by ecstasy and other stimulants - hence the current debate about how to control alcohol consumption by people prone to binge-drinking.

What seems to have done for Nutt, however, is his allegation that Prime Minister Gordon Brown reclassified cannabis from a class C to a class B drug, after it was taken down from class B to C by former Home Secretary David Blunkett under Tony Blair in 2004, for political reasons.

Nutt's gotten hold of the wrong end of the stick. That first reclassification, in my view, was the political move. Votes were perceived in easing up on cannabis smokers and so, in the teeth of opposition from the police, the drug was placed into the lowest class of illicit substances. Almost immediately, people were popping up all over the place saying that cannabis had been legalised. Shortly afterwards, public and professional concerns about the link between cannabis and mental illness began to mount.

This was no knee-jerk reaction. In the early 1970s, when Nutt graduated from medical school, cannabis contained 1-2% THC (tetrahydrocannabinol, or to give it its Sunday name, Δ⁹-Tetrahydrocannabinol), the drug's main euphoriant. Now, the "super-strong" version of the weed called skunk, which has been selectively bred to increase the THC present, has up to 15% of the stuff. Skunk started appearing on British streets in the early 1990s, long after Bill Clinton did not inhale or some future British politicians did, as they used to push each other out of the way to tell us.

The thing is, if you increase the amount of one substance in the plant, other substances will be present in smaller proportions - one being Cannabidiol which, asserted Zuardi et al in a 2006 paper, actually functions as an antipsychotic. So people whose genetic trigger predisposes them to developing a psychotic condition are more vulnerable to having it pulled by cannabis.

And there's the rub. The UK Cannabis Internet Activists association resuscitates the uncaring utilitarianism of Mill Senior that Mill Junior had tried so hard to kill by looking at the number of people who would have to be discouraged from smoking cannabis to prevent one case of psychosis, concluding that "around 3,000 heavy cannabis users, or 150,000 light users" would have to be prevented to achieve this goal. [Update 2 Nov: they were quoting research from various universities - see their comment at bottom; my apologies.] If they want to use the NNT (number needed to treat) measure, though, it shouldn't be considered solely for a single issue: perhaps it might shed light on the effectiveness of the HPV vaccination, or the medicines being thrown at the swine flu. Or, indeed, we might look at the number of arrests needed to turn one burglar onto the straight and narrow, and conclude that theft should be legalised. And I suppose it's sweet that the Government doesn't persecute and slander every group denying establishment orthodoxy - in the UKCIA's case, that cannabis can cause schizophrenia.

But psychosis isn't the only risk of cannabis use. There's also the phenomenon - whose existence is admittedly disputed - of amotivational syndrome, where somebody feels a reduced desire to work or sometimes even get out of their chair - indeed, government drugs helpline Frank used the tagline "Have you become an expert of antique furniture, gardening and daytime cookery programmes?" on one of its posters raising awareness of the amotivational effects of cannabis. There was, it's true, a famous study on labourers in Jamaica who smoked "ganja" heavily that dismissed amotivational syndrome by showing that they did more work when on cannabis; but what's less often mentioned that the work done in between using cannabis was often found to have been carried out with impaired concentration and not quite finished. My own experience of middle-aged people who had used cannabis since their teens was of blank faces asking "what have I done with my life?"; and their partners, if they'd stayed, asking "what have you done with my life?"

I don't know why Nutt ignored all this in his demands for cannabis to be legalised - perhaps for ideological reasons, or possibly he wanted to be perceived as being "down with the kids". This chocolate teapot of a functionary fails to deal with the fact that only a government set on populating psychiatric wards and prisons would legalise skunk, therefore the cannabis "factories" - houses where every square foot possible is dedicated to growing strong cannabis, which can pull in £20,000 per month with overheads diminished if the "gardeners" are trafficked children instead of adults paid with the drug - would have no impetus to close down.

Ultimately, despite claims to the contrary, British drugs policy is in no more of a state of chaos than it usually is for Nutt's departure. The hiring and firing of senior public servants is a function of government, and if we don't like a government's choices, then we change the government at the soonest possible opportunity. As Daniel Hannan MEP states in a Telegraph article entitled Perhaps we should abandon democracy and be ruled by Prof David Nutt, "Have we really lost confidence in our ability to govern ourselves through the ballot box? What fools our fathers were if this be true."

Related post: Rizla - a smoke or a toke?