Sunday, November 1, 2009

cannabis policy's in no more chaos than usual

David Nutt - click to read BBC report
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.

Natural in Cambridge - click to read about the head-shop in the Cambridge NewsI 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 pyou don't know what you're getting without an electron microscopeoliticians 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.

Frank poster campaign arond cannabis - click to see its interactive websiteBut 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.

Daniel Hannan MEP - click to read his article on Frank NuttUltimately, 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 articleclick to go to the Advisory Council on the Misuse of Drugs homepage 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?


  1. Off on a bit of a tangent: My dad likes to give the following reasoning on legal alcohol vs. legal street drugs. He says (and I agree) that he enjoys a glass of wine or a beer, just for the taste, and does not drink to become inebriated, while the only reason he knows of for using street drugs is to become intoxicated, or "high". I myself am pretty partial to a glass or two of Merlot or a half-pint of Bass or Sam Smith's, but I really dislike the sensation of being tipsy.

  2. I agree with your Dad entirely. Also, in order to have a drink or a (tobacco) cigarette, you don't need to perform illegal acts to buy and/or fund the buying, which pulls you into a whole subculture.

  3. Now then Frugal Dougal, you wrote

    "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."

    Actually it was a comment on a report by researchers at Bristol, London, Cardiff and Cambridge Universities, including one Stanley Zammit, no exactly a friend of cannabis law reform judging by his previous writings.

    The use of the "NNP" term was described thus on the UKCIA blog: "Now in all honesty when terms like NNP start getting used the UKCIA “Cod science” alarm bell starts ringing and it’s fair to say it hasn’t really stopped, despite us quite liking the results."

    Fact is though this is an authoritative study by respected academics, not the ramblings of pot head denial freaks as you seem to imply.

    As regards the potential to cause psychotic illness I'm afraid the science doesn't support the claims of a causal link. Indeed, if there were any real chance of it so doing, Prof Murray wouldn't have been allowed to pump people full of THC as he has been doing, it wouldn't have been allowed for ethical reasons.

    In any case the profile of psychosis sufferers hasn't changed over time and the rates of psychotic illness haven't increased. Again, not UKCIA research...

  4. Thanks for pointing that out, I've inserted a correction and apoloty into the text.

    I stand by my comment over at your place - many doctors will not give cannabis users experiencing mental health problems a diagnosis until they can see a picture of the mental state without cannabis, which the patients are unable to do because they are addicted to the cannabis.

  5. Thanks for that FD. All the claims I make on UKCIA are gleaned from research studies though, I don't make them up.

    But I do agree - and have said often enough - that cannabis is bad for people with severe mental illness (or some of them anyway). That is not in dispute and neither is the fact that they often use cananbis and many other drugs very heavily. However, what is cause and which is effect I wouldn't like to say...

  6. OK, fair point, and also: do, for example, people with psychiotic illnesses use, say, cannabis with high THC-content for the effect, or because it provides a gateway to meeting people who, when using cannabis, experience the same things that they do, ie psychotic symptoms?

    What I was trying to say over at your place is, none of us knows whether we have a predisposition to developing a mental health problem and, if so, to what degree.

  7. I think all might be surprised on how many hard working, clear thinking and otherwise 'good citizens' smoke the stuff. It affects people differently. Surely, while high, a person is amotivated, but the long term effects are questionable.

  8. OK, I agree that many people who use the stuff aren't affected by it outside of when they use it. However, in my last drugs agency, when you took the needle exchange out of the picture, the number one drug about which people were contacting us for help was cannabis. What worries me is that folk who need help are being sacrificed to the crumbling establishment orthodoxy that cannibis cannot cause addiction.

  9. OK, it was 30 years ago, but I used it briefly myself. What I've remained impressed with was, that the folks who wanted to hang around with me then, weren't hanging around with me because they liked me, but because I was using it. How I knew was, when I stopped using it, a lot of people I'd thought were my friends (the vast majority) didn't want to hang around with me anymore. And it wasn't because I was preaching to them, because I didn't. Not one tiny bit. (I was a mousy teenager who didn't talk much.) All this made a big impression on me.

  10. Personally, I can't stand it. I have left a few concerts to keep from smelling the junk.
    I have a problem with anyone using a narcotic or any drug in order to enjoy themselves in a situation. I agree that it is not something to be taken lightly, and am more than irritated at a few relatives for having the 'habit'.
    Further, let's say I am in an auto accident with someone who turns out to be stoned. I might clobber the jerk with my own hands if given the opportunity, just for being truly stupid and driving under the influence. With freedoms comes responsibility.
    However, I might argue that it does have medicinal purposes. In the few cases that it can help a person with the effects of chemo, for example, I would not begrudge someone its use. We are seeing in CA though, how this too can be abused.

  11. Pam and Linda - sorry for taking so long to get back, I was laid up with a bug!

    It's not uncommon to have a bad reaction to a drug the first time one experiences it; for example, often people don't like alcohol the first time they taste it.

    Often cannabis and driving mixed leads to what one former boss of mine called "Mr Magoo Driving" - driving excessively slow and carefully, which can cause its own problems when other drivers are trying to estimate where you will be in so many seconds in the dark, where the only referents are headlights.

    The best comment about cannabis came in a diversity course. The facilitator was in full flow about how Rastafarians smoked it as part of their religion, and didn't sit about all day getting stoned. One chap, whose parents had come over from Jamaica, said "some of them do!"

  12. Hi again FD, just popped back to your fen to see how the reeds have grown.

    I must pick you up on this comment: "Mr Magoo driving - driving excessively slow and carefully". I would never accept the idea that you can drive too carefully and the too slowly element must also be questionable.

    When you drive a car your are responsible for what happens and you should never assume what someone else is going to do. Such an argument would never stand up in court for sure.

    Remember, lots of road users travel slowly, such as bikes, milk floats, beat lorries and pedestrians and everyone has the right to brake suddenly and without warning. It is always your duty as a driver to drive in such a way as to be able to stop.

    By the way I do drive, indeed I've just bought a nice shiny new car actually and neither am I justifying stoned driving. But to be against stoned driving because it makes the driver "too careful" is perhaps not the best of arguments.

  13. Perhaps "driving too carefully" is the wrong phrase - maybe somebody can help me with this.

    People who do get into a car under the influence of cannabis - and I'm not implying that you would do this - have been known to drive more slowly than they otherwise would. In rural areas in the dark, this can cause problems as one might expect a car to be going at such a speed, having glimpsed its headlights, and therefore expect it to be in such-and-such a place when you are due to cross the path it has been following.

  14. I think, what you mean, is that a peson would drive with slow reflexes, and not be focused. That is certainly the case after someone is smoking weed.

    I must say, I have never tried it. I have never smoked anything. The smell of the smoke was enough to send me away.

  15. Cannabis does slow reactions and it also degrades tracking ability, but unlike alcohol it makes the user acutely aware of the fact that he is impaired.

    So it is true that stoned drivers are slow, careful drivers and research by the TRL makes interesting reading

    This study was actually done in preparation for an anti-cannabis use campaign based on the dangers of stoned driving and because of the results they dropped the campaign.

    UKCIA advice goes a bit like this:

    Hard, sharp or fast things

    Maybe it doesn't always feel like it, but the real world carries on as normal no matter how stoned you get.

    When you get stoned your perception of time is changed; you think of other things, you are not at your most alert. That isn't the best state of mind to be in when you're aiming a car or waving a chain saw around for example.

    When you get stoned you're not really up to driving or working any kind of dangerous, fast or sharp machinery.

    To be fair, you'll probably know this to be true without being told, so chances are you'll try to be careful if you do these things, but it's not a guarantee that you will be able to compensate for how stoned you are.

    Some people argue that stoned drivers are safe because they are aware of how stoned they are. Indeed, this is supported to an extent by research - although cannabis does reduce reaction times and tracking ability, stoned driving isn't such a major danger as drunk driving.

    But try telling that to the plod doing the impairment test when you get pulled over, or worse, after a crash...

    Also remember it may not be so easy to understand what's happening around you or how other people are behaving.


    That's the trouble with cannabis, all these claims have been made which simply don't stand up to examination. This leads some to claim it's the harmless herb and god's gift to mankind. In truth, the dangers are fairly mild for the vast, vast majority of (adult) stoners, but that doesn't mean there aren't *any* dangers.

    But compared to booze, cannabis is a pussy cat.


Please feel free to leave a comment - Frugal Dougal.