Thursday, 1 August 2013

How can government fight everyday sexism?

Thanks to the work of some admirable women, many of us are becoming increasingly aware of the extent to which women are harassed, groped, and intimidated in their everyday lives. Social networks and blogs are becoming spaces where people can share disturbing experiences, find solidarity, and open the eyes of men to just how odious other men can be.

My eyes have been opened, and having been disgusted by what I've been seeing, I did what I do these days when I find an aspect of our culture or society that needs changing. I reached for my laptop to start writing a policy motion*, trying to think of the things that government could do to spare people harassment and trauma.

I included three things I thought government could do to change our culture:
1) Improve relationship and sex education.
2) Develop rape prevention classes and advertising campaigns.
3) Develop public information campaigns to promote appropriate responses to sexual assault or harassment in victims and witnesses.

1) Improve relationship and sex education

When David Cameron delivered his speech on internet pornography last month he described many ways that children could theoretically be prevented from accessing pornography, but completely ignored the thrust of the major report "Basically... porn is everywhere." produced in May of this year. In the accompanying press release Dr Miranda Horvath, Senior Lecturer, Middlesex University said:

"It is clear that children and young people want and need safe spaces in which they can ask questions about, and discuss their experiences with pornography. The onus must be on adults to provide them with evidence based education and support and help them to develop healthy, not harmful relationships with one another."

I'm not surprised our Conservative Prime Minister has baulked at the idea of adults talking to children about pornography, but I am disappointed. It seems likely that preparing children for what they might encounter in pornography and helping them develop healthy attitudes towards relationships, sex, and gender roles through education is going to be far more effective in changing our culture than placing all the internet porn in a cookie jar and putting it on a high shelf.

2) Develop rape prevention classes and advertising campaigns.
This part of the proposal doesn't need much explanation beyond a recommendation that you read this excellent blog post by Christin Bowman. On the issue of advertising, Police Scotland already have a campaign "We can stop it", though to me it stops well short of communicating the same level of derision and stigma as the Canadian "Don't be that guy" campaign. On rape prevention classes, if they work - and they certainly appear to - then we should use them. We need to ask ourselves when we should use them though. Do we deploy them in the later school years, in colleges and universities, or even in work places with high numbers of young people? Could we even develop targeted delivery for those identified expressing sexist attitudes or harassment. If we could identify transgressors who stop short of a criminal offence, could we perhaps compel them to attend a Commission for the Dissuasion of Everyday Sexism (with an acronym that could be pronounced as the suitably stigmatising "seedies")? 
3) Develop public information campaigns to promote appropriate responses to sexual assault or harassment in victims and witnesses.

And so to the final proposal, and I think the one that - if it works - has the greatest potential to transform our culture and people's safety from assault in public places. This idea stemmed from something that I was picking up from many of the blogs and articles that I was reading on the subject. It makes me very uncomfortable to know that a very common response to being harassed or assaulted in a public place is to freeze, to try to ignore the assault and to hope it stops. It's quite sickening to think that I might have been in the presence of a sexual assault and not have known, that I could have prevented distress and trauma if I had been more aware or had heard or seen a sign. The freezing response might be due to a reluctance to make a fuss, or a lack of confidence in society to come to their aid. Regardless of the reason we have to consider how we might change attitudes and behaviours in both victims and bystanders so that we can create a genuinely hostile environment for the perpetrators of sexual harassment and assault.
I think a public information campaign could be developed, like this one in which Vinnie Jones intervenes to save a life. But for this campaign you'd have clear instructions on what to do in case of assault or harassment for the victim, the witnesses, and the perpetrator.
For the victim, there might be key words or gestures that could be used to indicate that they were uncomfortable to witnesses. Words for quieter public places, and gestures for noisy environments like pubs or clubs, or whichever is easiest at the time. Perhaps a clear warning could be issued before deploying these words or gestures when the victim is unsure of whether to escalate.
Witnesses, on hearing or seeing these words or gestures, should feel obliged to intervene, firstly with an audible or physical gesture warning, then perhaps by deploying technology to make a record of the perpetrator's identity and behaviour (over 50% of adults have smartphones now), before passing them to the police. And by witnesses, I mean all witnesses should engage in this behaviour if they can. If witnesses have been exposed to the public information campaign their perception of their behaviour would hopefully convert from having to be brave/stupid to intervene, to having to be cowardly or to neglect their duty to not intervene.
Perpetrators will be given the simple message that they can walk away at any point and any delay in walking away, any attempt to return to that behaviour or follow their victim, or any violence against the victim or witnesses will rapidly escalate the actions that might be taken against them.
I'm not pretending that this is the answer. I'm sure there will be many ethical, psychological and practical questions to consider concerning this approach, but I think we have got to a point where people are more aware something needs to be done to help people enjoy themselves without fear of assault, and the technology appears to be ready to support such an environment.
The ubiquity of smartphones provides society with a potentially excellent tool in the fight against sexual harassment and criminality generally. We can't be far off having the necessary technology to be able to beam live feeds and geographical locations from smart-phones into police control rooms.
The greater question perhaps is whether society is ready to step up. Are we ready to be inspired into rescuing our fellow citizens from distressing experiences? Or are we cowards who would resent feeling obliged to interfere with a lecherous asshole's enjoyment of his evening?

I'm hopeful for the former.

*The motion I describe was submitted to Scottish Liberal Democrat conference as part of a larger motion that also covered reform of laws regarding sex work and sex workers. It was not selected for debate, but I intend to separate the motion in two motions and resubmit them in the future. 

I'd welcome any comments on these measures in order to guide what eventually makes it into the motion for next time.

Saturday, 13 July 2013

When prohibitionists lie, we have to call bullshit

My latest letter to The Herald, this time taking a former chief constable over my knee:

I'd like to praise The Herald for shedding further light on the deadly effects of fake ecstasy pills (headline of 13th July 2013), but I'd also like to raise concerns about some of the counter arguments to the 'regulation of a legal market' proposals I outlined in my letter of July 8th, both in Christopher Gilfedder's letter of July 10th, and in Dr Ian Oliver's appearance on BBC's Newsnight Scotland programme on July 11th
Both offenders peddle the ridiculous notion that the illegal drug industry would in some way be successful in fighting back against a legal, regulated market. They forget that the risk premium on drug supply is absolutely enormous, escalating exponentially the cost of drugs as they progress from grower or manufacturer, through distributors and local gangsters to the drug user. Without that risk premium, the government-regulated market could sell cannabis or MDMA at similar prices to herbs or aspirin if they wished to. Instead the government would tax the products, filling as much of the gap between the small manufacturing costs and current illegal market prices as they thought suitable. They would have to pile on an awful lot of tax to cause customers to disregard the guarantees of quality, dose predictability, personal safety and ethical considerations and give their money to criminals.
That tax would be wisely invested in the education and treatment services that would help both prevent and treat the problematic drug use that blights Scotland more than any other western European nation.
To see what such policies can bring about we need look no further than Portugal. Though they have not legalised and regulated the drug market, decriminalisation has allowed them to divert resources from policing to health and education interventions. Rather than the massive increases in drug use and significant increases in drug deaths that Ian Oliver asserts, the latest statistics indicate that past month use of cannabis, cocaine, ecstasy and heroin in Portugal have at least halved between 2001 - when their reforms were introduced - and 2012. (I can send the full document to you or recommend you speak to Alex Stevens of the Uni of Kent to verify this). Portugal's Special Registry of the National Institute of Forensic Medicine estimate that there were 19 drug-related death cases in 2011. In 2008 that estimated number was 94. There were 584 drug-related deaths in Scotland in 2011 for a population half the size of Portugal's. From where I'm sitting it looks like we have a lot of catching up to do, and it greatly saddens me that a former chief constable would commit heinous crimes against statistics in an attempt to hinder that progress.

Thursday, 2 May 2013

The speech I couldn't finish

It's been seven weeks now since I broke down about a third of the way through my speech in the Scottish Liberal Democrat conference mental health debate. It was a debate characterised by quite astounding bravery from almost all of those who got up to speak. Each brave speaker independently chose to disregard the stigma surrounding the issue and relate their own experiences of mental ill health in the hope that those present could learn from those experiences and help to bring change. I am especially grateful to Christine Jardine for abandoning her prepared speech in order to deliver the rest of my own. It was an extremely kind and compassionate gesture that reflected the remarkably supportive and familial atmosphere in the hall.

I have been holding the emotions behind this speech inside me for about 15 years now, so it's perhaps unsurprising that I couldn't get to the end. Even siphoning off that emotion to drive my drug policy work for the last 5 years clearly wasn't sufficient to prepare me for confronting the one thing more than any other that drives me in my political activity.

I hope in publishing my speech in blog form it can reach a wider audience, and maybe cause some people to think about how we can make things better.

"Good afternoon conference. This is very much the second draft of my speech. The first one was basically me taking the opportunity to confront my brother's mental illness and how I feel about it. There was no way I could have delivered that speech. A good friend described it as very touching and very raw, so if you're into that kind of thing I'll probably put it up as a blog early next week*.

I have a brother with schizophrenia. It has been a hugely traumatic thing for my family to deal with over the last 17 years, and I sadly don't see anything in this motion that might have spared us that trauma. This is a fairly solid, well-meaning mental health motion and I'm sorry I couldn't have engaged earlier in an attempt to improve it.

But I'm here now, so I have to take this opportunity to encourage the party to additionally focus its efforts on the key issues of prevention and early intervention.

Schizophrenia is a condition that can render young people a traumatising burden for the rest of their lives. It usually first appears in someone's late teens or early twenties, and it affects approximately 1% of the population. Why, why are we not preparing school children for the distinct possibility themselves, a family member, or friend, might start to lose their grip on rationality and reality. Why are we leaving families open to this devastating impact, that sets off a chain reaction of pain, anguish and mental ill health that ricochets wildly through our society.

I've said this to a UK government health minister's face and I'll say it again to you today. I would have given all my As for the knowledge to identify the warning signs of my brother's impending deterioration. The knowledge that could allow me to do the right thing in good time to allow him to cling on to reality and eventually return to a chance at happiness and fulfilment. Why do we spend hours teaching the fictional breakdown of Hamlet or the poems of Philip Larkin, when we could be teaching our children how to safeguard their real life mental health and how to look out for - and respond appropriately to - the deterioration of their friends and family.

My brothers chances of happiness and fulfilment are all but gone now. This motion is ok, but I humbly ask for your help in preparing the motion or motions necessary for future conferences, that will facilitate genuine early and effective intervention in mental health conditions.

There are a massive number of families like mine who are suffering in silence due to schizophrenia, depression, bipolar disorder, alcoholism, drug abuse or myriad other mental health problems. It is a great pity that we struggle to gather the emotional strength or courage to stamp our feet and shout from the rooftops. But we are out there and we are legion. But because we don't speak up, we are not spoken to. Politicians instead concentrate their messages on jobs and growth. But what is a job without a happy home life. I'd dearly love this party to plant it's flag firmly on this ground. We should be the party that aspires for a society in which it is easier to find happiness, and easier to avoid sadness and trauma.

Voting for this motion is a good start, but we can do so much more."

Having just read this again for the first time in a long while, I'm surprised at how short it is. It doesn't have to be long though. It's a simple request for changes that will be very easy to deliver politically. All it needs is for politicians to do some upper lip loosening exercises and to consider the enormous benefits that better mental health and a more emotionally resilient population could deliver for our society. 

*I'm happy to e-mail copies of the first draft of the speech to anyone who's interested. I'm not comfortable with it being distributed more widely though, so please don't pass it on.

Thursday, 18 April 2013

The proposal of drug consumption rooms is a backward step.

I've just finished listening to a phone-in discussing the issue of drug consumption rooms on BBC Radio 5 live. It was all a bit depressing, and only partially for the fact that every second caller was hysterically describing the concept as an outrage. What is really depressing is that we've already moved beyond drug consumption rooms in the UK.

We already have three centres where heroin is being provided for addicts in secure, medically supervised environments. Discussing drug consumption rooms instead moves the debate back a step from the cutting edge of good practice.

My disappointment stems from the comparative ease of selling each concept politically. It is bizarre to allow addicts to first beg, steal or borrow to raise money to purchase poor quality street heroin, only to allow them to consume whatever it is they have purchased in a clean, clinical environment. The drug itself should be extremely cheap for the state to provide. The major costs of these clinics instead stem from staffing and building costs. Drug consumption rooms require all the costs of staffing and premises, but provide none of the savings of reducing acquisitive crime and undermining the criminal market. The benefits are clear for the addict, but less clear for the community.

Clinics providing clean heroin to addicts should be a much easier sell as they can be easily marketed to locals as assisting both the addicts and the community more effectively, and for only marginally higher cost.

Wednesday, 27 February 2013

Fisking Kathy Gyngell

It's always exciting when I find another link on twitter or facebook to a Kathy Gyngell blogpost on the drug policy debate. I read about drugs policy and come to certain conclusions. Kathy reads the same things and comes to completely different conclusions. I've been wanting to pick all the little non-fact nits out of one of her articles for a while now and I think it's about time I stepped up to the plate. After all, Kathy - having been the major agitator behind The Conservative's drug policy for the last few years – is basically my conservative equivalent. Step aside folks. This battle is mine (though of course if you do feel the need to step in to advise me then your facts and ideas are welcome).

For her latest article Kathy has also rather stumbled on to my territory by having a go at the Transform/Ipsos MORI drug policy poll reported in the media last week. I commissioned a drug policy poll myself in 2010 with the help of Liberal Democrat colleagues, so it's a subject I follow with some interest.

It's a long article, and she has form, so this might take a while to isolate all the little untruths and distortions, but I feel it has to be done.

[I did have a go at the first paragraph, but it has been criticised very ably already (and better than I achieved) by John Robertson at "The Poison Garden" He used 1,000 words on the first paragraph alone so I shall pick up the baton at...]

Paragraph 2:

Gyngell: “Previously commissioned YouGov drug polls (for the Observer) suggest attitudes towards drug use have hardened, not softened”

An interesting assertion, though no link provided so that we can check it our for ourselves.

Gyngell: “The recent Sun YouGov poll hardly found a ringing endorsement for Nick Clegg’s call for a drug policy review either - 50% of his own party members (known for their often off-the-wall views) disagreed and the vast majority of Conservative and Labour members gave it the thumbs down.”

This is where it really gets good/weird. There was a recent Sun YouGov poll  and here's a quote from the YouGov website: “There is majority support for a royal commission across party lines, with 59% of Conservative voters, 62% of Labour supporters and 75% of Lib Dems in favour.” The full results also show a majority in favour of trials of Portuguese-style decriminalisation (a result not replicated by the Ipsos MORI poll using different methodology). And on page 1 there is a trend since June of more people favouring legalisation or decriminalisation of “soft drugs such as cannabis”, such that more people favoured reform than the status quo. Is there another recent Sun YouGov poll that doesn't so utterly destroy Kathy's argument?

Clegg called for a Royal Commission before Christmas, so I assume that's what Kathy refers to when she says “review”. If anyone can point to a poll of party “members” I'd be intrigued to read it, but if 50% of Liberal Democrat members disagree with the call for a review, they must have been outside the walls of the conference hall when my 2011 drug policy motion calling for government to set up an immediate review was passed. It passed “with only one or two votes against” and there were many more than 4 people in the hall.

Paragraph 3:

Gyngell describes Transform's mission as “To persuade understandably wary politicians to throw caution to the winds on drugs”

This is of course entirely unfair to Transform, as their efforts recently have mainly been directed at achieving a wide-ranging, government-initiated independent review of all options for reform (including stricter prohibition). They do this presumably because they think their position in advocating a regulated legal market for drugs is in fact the most cautious means of dealing with drug use in respect to reducing the harms to individuals both from drugs and from criminal sanctions. If Gyngell is as confident in her solutions to the drug problem, then she should surely support their examination alongside the alternatives proposed by Transform. She doesn't.

Later on:

Gyngell: “Ipsos Mori, the pollster, it seems took Transform’s biased portrayal of UK drug policy as contrasted with ‘decriminalised regimes’ at face value.”

And here is that “biased portrayal”:

Is this not a fairly rigorous description of the reality in Portugal, the decriminalisation model which I certainly favour, and which would likely be the route that Britain would follow it politicians gathered the courage?

Gyngell: “And like the rest of the media, it swallowed Transform’s fallacious presentation of the impact of decriminalisation in Portugal.“

Ok, I'm not sure you could call Ipsos MORI part of the media for starters, but here's what was presented:


The results of Portuguese decriminalisation have been disputed, but the best way to resolve this dispute is to turn to someone who has addressed it and published peer-reviewed journal articles on the subject. If interested, please read Professor Alex Stevens (introduction here) The only potentially biased aspect of this description is therefore the reporting of a fall in use among school-age children, which from Hughes and Stevens' work appears to be a trend also seen in Italy and other EU countries (see British Journal of Criminology article).

What Gyngell fails to mention is that the polled group was split. Half of those polled saw the description of what decriminalisation meant. Half additionally saw the description of what happened in Portugal. So the presentation of the facts on Portugal was not an attempt to skew the poll, but an exploration of what presentation of those facts - or their absence – would mean for public opinion.

Gyngell: “This was what they gave their na├»ve subjects to consider before the second set of questions they were asked about their preference for a drug policy review.”

I shall repeat, half of the group saw just the decriminalisation description, and half additionally saw the largely accurate (though perhaps slightly biased) reporting of what occurred in Portugal. These separate groups were reported separately for the subsequent polling questions (though their answers were pooled for the press release).

Gyngell: “The first page of the actual poll read quite something else than the press release. Despite the encouragingly negative portrayal of British policy that prefaced the first question, it found:
  • 60 per cent support for our drug laws as they are
  • 60 per cent support for possession of illegal drugs remaining a criminal offence.
  • 68% of Conservative supporters, 56% of Labour supporters and 61% of Liberal supporters – all clear majorities – backing this status quo
  • And finally 74% of Asian and 77% of Blacks backing all the above (a headline of its own surely?).
Far from heralding a dramatic liberalisation of attitude, the poll showed only 14% of the population favouring the decriminalisation of possession, only 21% prepared to back a limited decriminalisation trial in a specified area.”
I fail to see how “POSSESSION OF ILLEGAL DRUGS IS CURRENTLY A CRIMINAL OFFENCE IN THE UK.” is an encouragingly negative portrayal of British policy. Gyngell also fails to mention that the first page of the poll data was from the group not exposed to the information/propaganda on what had happened in Portugal. So after railing against the exposure of poll participants to this bias, she presents the numbers from those who were not exposed to this bias. Sneaky.
I'm not sure why she feels she has to use the 60% figure twice. She's reporting the same answer to the same question. And on what race-obsessed planet would the opinions of 37 Asian and 12 black people make a worthwhile headline? There was no significant difference between these groups and the rest. The numbers of black people in the survey were so small they didn't even test for significance. And why not report the fact that only 36% of mixed ethnicity participants backed the status quo? Is it because that didn't fit into her narrative, or because that was only 3 people out of 7? And by "all of the above", she is still referring to one answer to one polling question.
Gyngell: “Could my reading be correct? I checked with an academic colleague. His reply restored my faith in my sanity as well as my eyesight:
The results are as you have interpreted them not as have been presented by Transform, the majority remain in favour of legal barriers (to drugs possession)”, he said.”
It's fun to consider this exchange as that between a crazy person and an unfortunate passing colleague desperate not to feed the loony troll, but the chances are he was presented with incomplete information in much the same way as the readers of her blog. The poll question asked by Ipsos MORI on cannabis regulation, decriminalisation, or prohibition was accurately reported by Transform. They did include the results on decriminalisation of general drug possession in their press release under the heading "Additional survey findings include...", and they let people look at the full results of the poll for themselves on their website. I'd say this was good practice. Much better than writing an epic blog whinge with no links to evidence provided whatsoever.
Gyngell: “So how come then did two thirds of those polled, decide, against their prior answers, that a review of the drug law was in order, how did roughly half back the idea of either legalising or decriminalising cannabis?
They were doped - metaphorically speaking – duped by the great Portuguese drug fallacy”
Were they though Kathy? Half of them weren't exposed to the factual information on what has happened in Portugal, and what did that half have to say?
Support for a review (those without info on Portugal) 64%
Support for a review (those with info on Portugal) 70%
So even among those not doped up on propaganda, 64% support a full independent review of all drug policy options.
Support for cannabis legalisation or decriminalisation (not exposed) 51%
Support for cannabis legalisation or decriminalisation (exposed) 54%
So only a maximum of 6% of the sample were corrupted by what were facts presented in good faith.
Gyngell then launches into an effort to disprove the information provided about successes in Portugal. And in some of this writing she is occasionally correct. If Baroness Meacher is claiming in the media that less people are taking drugs in Portugal than before then she probably shouldn't be.
Then something remarkable happens. Gyngell introduces a source of information which is new to me and which might actually disprove the one shaky assertion in the Portugal information in the poll.
School age use data, however, which has been monitored recently shows a steady rise in Portugal since 1999 (by contrast with a 30% downward trend in school age use since 1999 here) rising rapidly in the last 5 years from 10 -16%. My source was the well reputed and reliable, comparative ESPAD monitoring studies. All this I explained.”
It's a shame she has to tarnish this good work by using the word steady in describing the rise in drug use among school-age children that happened in Portugal. In fact both use of cannabis and of other illicit drugs fell in the data from 2003 to 2007. Generate these graphs for Portugal using this website and you see clearly very wavy lines rather than the straight ones Gyngell implies with the word "steady". This pattern of lifetime use in teenagers is entirely consistent with investment in prevention and treatment alongside decriminalisation decreasing teenage experimentation, and subsequent removal of this investment due to economic circumstances leading to experimentation rising again. It's also a shame that she says that there has been a rise from 10-16% in the past five years. In 2011 cannabis use was at 16% (pats Kathy on head), but the only other data points since 1999 were 2003 (15%), and 2007 (13%). I'm going to be generous and suggest Kathy Gyngell can't read graphs.
Gyngell then gets nasty
Baroness Meacher is by no means the first to have been taken in by pro drugs advocates. Their campaign of disinformation has intensified since they lost the cannabis classification debate in the UK – the focus of their creeping effort to normalise cannabis use - from which neither of the main parties is likely to retract now the serious risks of cannabis use (especially by adolescents) for mental health are known.”
The pro-drugs line is a simple smear. I'm no more pro-drugs than Gyngell is. I want the harms that drugs cause to society to be lessened. I think that goal can be achieved by regulating them. I wouldn't suggest anyone take any drug if they want a better life, unless of course that drug has been recommended to them by a doctor. Organisations like Transform and Release are harm reduction organisations, not pro-drug organisations.
The serious risks to mental health are also paramount in my consideration of cannabis regulations. This is how I explain why in the upcoming issue of AdLib magazine: “Those who worry about the message sent about drugs should be able to recognise that the government message on drugs can be far better delivered by a government-approved vendor than a distant government's messy classification system. As a response to important concerns about psychosis and cannabis, the person selling legal cannabis can be trained and compelled to instruct users on the early warning signs of the illness. Far from endangering young minds, cannabis regulation should be seen as the missing piece of our otherwise excellent mental health policy.” The risks of psychosis are a reason to regulate, not the other way round.
Gyngell: “When the Home Affairs Select Committee, under Chairman Keith Vaz, decided it was time for another drugs policy inquiry, it tuned its terms of reference to theirs [the Global Commission on Drug Policy] and went on to give its prime platform to its main advocate, the self confessed dope smoking Virgin Boss, and Commission backer, Richard Branson.
This revelation hardly discredits the Committee's report any more than the fact that Kathy Gyngell herself later appeared before the committee to give evidence.
Gyngell: “ one, least of all those best informed, seriously maintains that either decriminalisation or the longer term goal of legalisation would reduce drug use. (Reuter & McCoun 1999). They all agree it would increase it (possibly from the minority habit it is today to a majority habit like drinking and smoking).
Perhaps Kathy might like to have a read at the Release document A Quiet Revolution: Drug Decriminalisation Policies in Practice Across the Globe” The authors, following a considerable amount of research, certainly wouldn't agree that decriminalisation would increase drug use. “The main aim of the report was to look at the existing research to establish whether the adoption of a decriminalised policy led to significant increases in drug use - the simple answer is that it did not.
I'm sure others will be able to find omissions, mistakes, and slurs in Gyngell's writing that I have not. It's important that they don't go unrecorded. Gyngell after all appears regularly in the media to provide "balance" in the drug policy debate. I'm not sure how active she remains in Conservative circles regarding drug policy, but if there are any Conservative members reading this, it might be best to ask yourself, and more senior party members, whether her opinions are worth any more of the party's attention.

Sunday, 23 December 2012

A legal high for your loved one at Christmas?

We live in a curious world. I was out doing my Christmas shopping yesterday and came across a legal high stall right in the middle of Glasgow's Buchanan Street. The packaging and brand title were lurid, the stall was huge - much bigger than any I'd seen before in a similar spot - and they were brazenly giving out free samples  of their highly addictive product to anyone who was curious.

You'd imagine I'd be furious at this attempt to ensnare the Glasgow Christmas punter, but I wasn't. I was quite content, and later on I was cursing my failure to pick up some samples for a couple of my good friends.

The legal high in question was of course nicotine, and the samples being handed out were of a particular e-cigarette brand whose name I don't remember. The arrival of e-cigarettes - and I suspect this is the first Christmas they'll be under more than a few Christmas trees around the country - is going to cause a great many people to do a great deal of head scratching as they ponder a great many difficult questions.

I keep writing the word 'great' perhaps because e-cigs are certainly great news for existing tobacco addicts. Cigarettes are hideously unhealthy. Nicotine for the most part really isn't (though I learned in a past life that high doses can turn mice temporarily into cute, immobile hand warmers). If we've found a way to deliver nicotine - and nothing else of concern - into the lungs of those who are addicted to it in a manner that is safe and appealing than we should be celebrating and promoting it's use to all those who are unable to quit their cancer sticks.

But who should be promoting their use, to whom, and how? This question needs to be asked with urgency. It's all very well weaning people off cigarettes with a cheaper, healthier alternative, but how do we as a society feel about non-smokers becoming smokers (vapourers?) of these new products.

This question is made more pressing by the observation of the promotional activity that is occurring across the pond. Here's 'movie star' Katherine Heigl puffing on an e-cig with David Letterman and using the words, 'But it's not bad for you. It's a fun addiction!' :
And here's a television advert telling people to "Take back your freedom with blu"

Nicotine is one of the most addictive of all drugs, so many people seduced by the likes of Heigl and the attractive blu man to use e-cigs as their first smoke/vapour experience will be surrendering their freedom and submitting themselves to an expensive habit. Maybe it's not as expensive as tobacco, but it'll still be an unnecessary and persistent financial pressure.

Should a substance with such addiction potential be marketed in such ways? I believe not. It's a harm reduction product that should be prescribed and sold in pharmacists or on regulated websites, after appropriate agencies have subjected the devices to rigorous safety tests. The stall on Buchanan Street should be an NHS, anti-smoking stall, helping people to start the new year "smoke" free, not a private company pushing unregulated, addictive legal highs to all and sundry.

But e-cigs do have to be available to the general public, and they should be more available than cigarettes. If I'm offered the trade of e-cigs being available in corner shops if tobacco products no longer are, that is a deal I would happily embrace.

Like so many drugs, the availability of safe nicotine might also be an excellent opportunity to better treat or prevent some very costly and traumatic medical conditions.

This is where the neuroscientist in me comes out. Schizophrenia and psychosis in alzheimers have been linked to the alpha-7 nicotinic receptor gene, nicotine improves attention and reduces impulsivity in schizophrenia, and might even be protective against later development of the disease:

Regardless of whether nicotine is therapeutic in schizophrenia, smoking certainly isn't. People with the condition die much earlier on average than the rest of the population, and they generally smoke like chimneys. Their health needs to be protected by diverting them to e-cigarettes as soon as possible.

Nicotine might also help memory in early dementia, but there is a long way to go in researching nicotine's therapeutic or even cognitive enhancement potential.

For the moment, it's worth remembering that legal or illegal, you can't protect people from the harms of drugs if they are insufficiently regulated. Government needs to step up and get to grips with this issue.

Monday, 17 December 2012

Concerned parents need to take up arms for the new 21st century War on Drugs

The vital drug policy debate that is increasingly occurring worldwide is encountering some difficult obstacles. The passage up the lower slopes of the political mountain is getting increasingly smoother, as can be seen in the substance of the Home Affairs Select Committee report that was published last Monday. But when the arguments reach the political pinnacle, they are met with the usual intransigence and a gentle nudge off the nearest cliff-edge, only to resume their long ascent back to the top table.

Much of the problem faced by the arguments for reform is created by the language used to characterise those arguments. These arguments are sometimes deployed by reformist advocates themselves, and sometimes by the clumsy journalists that report them, but each mention of “ending the war on drugs” or “liberalising the drug laws” creates a narrative in which drugs are winning a war or winning their freedom. In a policy debate that follows this narrative, the figures at the political pinnacle are being asked to admit defeat in a war, failure of their policies and to announce tolerance of the existence of what is widely regarded as a social evil. Even on a good day it is hard to imagine political leaders doing one of these things, never mind all three.

The slogan “end the war on drugs” has to go. Like the “Robin Hood tax”, it may have been good as a rallying cry to raise the profile of the cause, but it is essential that it gets ditched before the final push.

In my speech to last year's Liberal Democrat conference proposing the Liberal Democrat's new policy I suggested we adopt new weapons for a new, 21st century war on drugs. The 21st century war should continue to be a war on drugs, but the goal of eradication of drugs from society was always unattainable and has to evolve into a different, and potentially achievable goal.

The 20th century war was ugly and imprecise, effectively carpet bombing large areas of our cities with myriad harms. It was a war in which collateral damage appeared to be an explicit goal rather than an accident best avoided. In a war on drugs, why were humans going to jail? The 21st century war on drugs should instead take inspiration from ancient history and adopt a distinctly Roman style of capture and enslavement. It should be defined by the goal that drugs can be be our slaves but never our masters.

And that goes for all drugs. When a hard-working citizen returns from work on a Friday night and demands a soothing head massage from their servant drug, who are we to dictate whether that drug be a glass of red wine or a cannabis joint. The state has a role in educating on how a drug best be handled, and if a drug looks like it has ambitions to become a citizen's master, the state and citizen need to be able to work together to put that drug back in its place, or to help the user dismiss the drug if the situation becomes too perilous.

There are far too many citizens around the world who's lives are currently ruled by drugs. Where heroin or crack is master, many are compelled to steal, deal or prostitute themselves to unsavoury men on dark streets. Where cannabis becomes master, all too often the instructions coming from the drug are mutating into the bizarre and isolating orders from the voices of psychosis. There are many drugs whose power over their users becomes so great that the other things of importance in their lives are neglected. Partners, children, jobs, cherished pastimes, all falling by the wayside because of the unchecked power of illegal and unregulated psychoactive drugs.

And it is not just users that fall victim to the power that drugs hold. When greed and ambition are combined with the presence of drugs and a dearth of other opportunity for achievement another kind of victim is frequently created. With the heady combination of greed and drugs as master, those who get involved in the drugs trade have been drawn into a life fraught with danger of incarceration or extermination at the hands of their peers.

So how do we achieve this drug war victory in which drugs are our servants and never our masters?

Well, I'm going to set an example by shifting abruptly from metaphor into clear description of what policies and procedures a post-reform UK could employ. Despite the pro-reform debate in the media being dominated by extremely sensible advocates such as Tom Lloyd - the former chief constable for Cambridgeshire - and representatives of the charities Release and Transform, the media still throws up daft speculation. Will class A drugs will be available at corner shops? Will legalisation lead to widespread cannabis experimentation and increased incidence of psychosis resulting from that?

The positions of these prominent reformers and myself have come from careful consideration of evidence and the utilisation of logic and reason. All combined with a determination to reduce the harms that drugs and the laws governing their use cause to individuals and society.

For me the evidence and logic points to the immediate adoption of the Portuguese system in full. Their addicts are getting treated, heroin addiction is much less prevalent and their jails are less crowded. Their investment in drug services combined with their decision to decriminalise possession of drugs for personal use have been a resounding success for drug users and their families. Rather than tolerating drug use, anyone found in possession of drugs is referred to a Commission for the Dissuasion of Drug Addiction. The message being sent is not that drug use is ok, but that the government cares and wants to help users find health and happiness.

I am in no doubt however that Portuguese services could be better still. In Switzerland and a growing number of European countries that have followed their lead, heroin assisted recovery clinics are being utilised as means of engaging addicts with treatment services. Heroin is far more effective than methadone at reducing street drug use, drug-related criminality and retaining users in treatment so that their other social, economic and medical problems can be addressed. Heroin clinics, where the drug is provided for use inside secure premises under medical supervision, can reach those chaotic individuals for whom methadone is at best a stop-gap between hits of the real thing and at worst just another deeply unpleasant prescription inflicted upon them by the state.

Heroin assisted recovery clinics provided with much broader eligibility criteria than at present could really help users and their families to find hope that they need not live a life of criminality and squalor. But such a policy can also reach those victims of greed that decriminalisation does not. The more heroin addicts are attracted to new clinics and other means of rehabilitation, the more the requirement for criminal suppliers to fill that gap in the market is undermined. Only by effectively treating as many existing addicts as possible can we have a fighting chance at removing the dealers from communities and preventing them recruiting another generation into the same grim lifestyle.

Please excuse the return to metaphor but pharmaceutical heroin really is the slave that nurses the stricken addict and protects him or her against the domineering master that is the heroin available outside the clinic's walls.

As effective as decriminalisation was in Portugal, it can not be a policy endpoint in itself. Why would you take away the intended deterrent of criminalisation of possession but still leave the manufacture and supply in the hands of criminals with all the negative consequences that entails? Without consideration of the international context any rational examination of Portugal's decriminalisation policy would find it to be utterly bizarre.

Legal regulation of drugs was not considered as a policy solution in Portugal only because they were a signatory to the UN drug conventions. Yet in recent weeks Uruguay and the US states of Washington and Colorado have announced their intention to introduce regulated supply of cannabis for recreational use in direct defiance of these well-meaning, but utterly misguided documents. If Uruguay can do it they why should the UK not be a pioneer, perhaps devising a middle way between Uruguay's state monopoly and the American free market model, a carefully designed model that will have the best chance at public and international acceptance.

The British public are rightly concerned about the potential for cannabis to compromise the mental health of young people. Having lived with the traumatic presence of a psychotic family member in my own life for the last 15 years, I have long been driven by a desire to prevent other families having to navigate the distressing events and uncertainty my family has been forced to endure.

Cannabis legalisation does not have to be a blind leap of faith into an unknown, chaotic free market. Why would we take cannabis out of the hands of immoral criminal profiteers and place it into the hands of immoral corporate profiteers? Doing so would likely imperil the mental health of the population and we should resist such a model as fervently as we should rail against the status quo.

Instead we should seek to design a model for which capture and enslavement would be an eminently suitable metaphor.

If cannabis is to be sold in shops it should be sold by trained professionals who have been educated thoroughly on the various risks and harms that the drug presents. Those professionals must then be responsible for educating customers in turn. Of vital importance is that every cannabis user should be able to identify the early warning signs of psychosis in themselves or in their peers. Indeed without that goal, cannabis legalisation loses a lot of its appeal to me. Given the prevalence of psychosis in society, the early age at which it can attack, and its devastating long-term impact, you'd think that teenagers should be being taught about psychosis anyway. To legalise a drug whose users experience psychosis at twice the rate of the general population and not to provide that education as a condition of purchase would be negligence of the highest order.

When a customer does experience signs of psychosis, it is imperative that we learn from that in order to adjust our advice to the rest of the cannabis-using population, and it is with that in mind that I propose an online, structured, consumer support community. When a user takes a particular strain or preparation, they should be strongly encouraged to review their experience with that form of the drug. Much as many online vendors now tailor recommendations to their customers with the phrase “users who purchased x also purchased y”, the cannabis-using community could be given recommendations based upon their enjoyment of particular strains and preparations of cannabis. Such an online space would hopefully be welcomed by users as a means of identifying the strains that they would most enjoy, but would also be very useful in diverting users away from strains that might compromise their sanity or other aspects of their health. The possibility of consumers agreeing to the combination of this data anonymously with medical records would also rapidly advance our understanding of the relationship between cannabis and health, both positive and negative, and help us modify the regulatory model to better serve the interests of users and the community in general.

Cannabis is a dangerous drug. The families of those who have developed psychosis associated with its use are very right to be vocal in highlighting those dangers. What needs to be recognised however is that their child's illness was born in an unregulated illegal market. These families have a choice. They can fight to preserve the prohibition system that so tragically failed their children, or they can fight to create a regulated system in which children are better protected. With adults being served by legal vendors, it will be so much harder for dealers to maintain a worthwhile income by dealing to children. Rather than the paltry fines we see for alcohol resale to minors, concerned parents can lobby for severe punishment for those who deal to under 18s. They can also join me in lobbying for the provision of much improved mental health and drugs education in schools. The skunk they so deplore is a product of the black market profit motive. To fight to preserve the illegality of the drug is to promote skunk's dangerously dominant position in the market and the livelihoods of the hated individuals who corrupted your child's mind.

Reform of drug laws is only going to go one way. Gone are the days in which we can aspire to arrest and charge everyone using cannabis. We can't afford the expense, and society would not tolerate the persecution of children being a priority. We also know from international experience that greater enforcement does not lead to lower use. The deterrent effect is a myth (at least at the population level). Concerned parents have to instead consider how their children would be better protected and start participating in the debate in order to promote their family's interests. The regulatory model that is coming should not be shaped by the concerns of bureaucrats and drug users alone. Concerned parents and families who have fallen victim to prohibition's failings have to be the loudest voices at the negotiation table if the harms of cannabis are going to be effectively restricted.

One issue parents should engage with is the problems that might arise if there were companies who would profit from the artificial promotion of cannabis, or particular strains. It might therefore be wise for commercial interests to be excluded from the market altogether. The best way to prevent advertising and marketing encouraging consumers to make decisions against their interests and those of society is to as far as possible ensure that nobody's wealth would be dependent upon continued use of the drug or of particular forms of the drug.

It is quite possible a state monopoly is the only model that can demonstrate to the voters that legalisation is a process we are embarking upon with appropriate care, with the highest regard for the health and happiness of the nation.

If this proposal works in reducing the harms people experience as a result of using cannabis, and the many harms associated with the illegal trade, then it would be highly responsible to extend the model to other drugs. One by one we can capture and enslave drugs into service of health and happiness, releasing people from the yoke of addiction and the impact of the crime and ignorance that goes hand in hand with prohibition and the illegal market.

While Nick Clegg should be lauded for being the first sitting government minister to demand a change in our approach to drugs, David Cameron is also right to reject a Royal Commission. For too many people 2015 will be years too late. There are teenagers (some even younger) smoking cannabis regularly in all of the UK's cities and towns, blissfully ignorant of the horrible, desperate, psychotic life they are risking. There are young addicts all around the country prostituting themselves to fund their next fix. Putting themselves in harms way because politicians don't have the courage to accept that the best treatment for them and their community is to provide them with a clean preparation of their drug of choice. And the lottery of criminalisation keeps making its daily draw with no-one asking why young, black, and poor seem to be the balls that keep dropping out of the machine, while middle-class, white, cocaine-user, banker and politician keep spinning around and around without a care.

Drug policy reform is not about liberating drugs. It's about liberating people from ignorance, persecution and the drugs that have power over them. Can we please finally declare a war on drugs so that we can capture and enslave them and put them to work easing our pains and helping us smile. Without a proper war on drugs with sensible, realistic goals, too many people will be left to fight and lose their own personal battles without the knowledge, help - and in some cases drugs - that they need to triumph.

It doesn't take courage to call for a two year examination of the available evidence. It does take courage to stride proudly in front of public opinion, call for the adoption of policies that we know have worked elsewhere, and present an innovative model that can finally start to bring dangerous drugs under effective control.

I implore any politician reading this to find that courage.