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.
Saturday, 13 July 2013
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.
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.
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”:
“POSSESSION
OF ILLEGAL DRUGS IS CURRENTLY A CRIMINAL OFFENCE IN THE UK. SOME
OTHER COUNTRIES HAVE ‘DECRIMINALISED’ POSSESSION OF SMALL
QUANTITIES OF ILLEGAL DRUGS FOR PERSONAL USE.
THIS
MEANS THAT POSSESSION OF A SMALL QUANTITY FOR PERSONAL USE IS USUALLY
PUNISHED WITH FINES (LIKE A SPEEDING FINE), ATTENDANCE AT A DRUG
TREATMENT OR EDUCATION PROGRAMME, RATHER THAN ARREST.
UNDER
'DECRIMINALISATION', DRUGS ARE STILL CONFISCATED. PRODUCTION AND
SUPPLY TO OTHERS REMAIN CRIMINAL OFFENCES THAT MAY RESULT IN
PUNISHMENTS CARRYING A CRIMINAL RECORD,
FOR
EXAMPLE A PRISON SENTENCE, FINES OR COMMUNITY SERVICE. WITH THIS IN
MIND, WHICH OF THE FOLLOWING COMES CLOSEST TO YOUR VIEW OF THE LAW IN
THE UK?
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:
SINCE
THIS WAS INTRODUCED IN PORTUGAL IN 2001, AND RESOURCES WERE INSTEAD
SPENT ON HEALTHCARE, OVERALL USE OF DRUGS ROSE AT A SIMILAR RATE TO
NEIGHBOURING COUNTRIES.
HOWEVER,
THERE WERE HIGHER NUMBERS ACCESSING DRUG TREATMENT, THE JUSTICE
SYSTEM SPENT LESS TIME AND RESOURCES ON DRUG-RELATED CRIME, AND THERE
WERE FALLS IN PROBLEMATIC DRUG USE,
AND
DRUG USE AMONGST SCHOOL AGE CHILDREN ALSO FELL. WITH THIS IN MIND,
WHICH OF THE FOLLOWING COMES CLOSEST TO YOUR VIEW OF THE LAW IN THE
UK?
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 naïve 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:
“...no 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!' : http://www.youtube.com/watch?v=bMLSSK038Vg
And here's a television advert telling people to "Take back your freedom with blu" http://www.youtube.com/watch?v=9pxuBgfbid0
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: http://journals.psychiatryonline.org/article.aspx?Volume=160&page=2216&journalID=13
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.
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!' : http://www.youtube.com/watch?v=bMLSSK038Vg
And here's a television advert telling people to "Take back your freedom with blu" http://www.youtube.com/watch?v=9pxuBgfbid0
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: http://journals.psychiatryonline.org/article.aspx?Volume=160&page=2216&journalID=13
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.
Wednesday, 12 December 2012
Cannabis should be legal BECAUSE it is harmful
Some people have been pointing to this article by Patrick Cockburn http://www.independent.co.uk/life-style/health-and-families/health-news/is-this-the-tobacco-moment-for-cannabis-8349054.html as something that should be read before uncritically accepting the HASC recommendations.
This is the letter I wrote in response to a previous article by Patrick and another by John Rentoul that were published in the IoS last year. I thought it would be worth publishing it again. An edited version was published the week after in the IoS but I can't find it online. I'm very happy the Independent has printed an editorial this week that has called for decriminalisation of drugs despite Patrick Cockburn's articles on the subject. Please understand that I do not criticise Patrick Cockburn in any way and only have sympathy for what he and his family have had to endure.
Dear Editor,
(in reply to the articles of John Rentoul and Patrick Cockburn of the
5th of June 2011)
I last had a letter published in the Independent on Sunday on the 15th
of September 2002. It was a desperate plea for increased education on
mental health issues informed by my deeply distressing experience of
my brother's worsening psychosis. Within that letter I said "We don't
need it to be easier to lock up the mentally ill. We need a society in
which everyone knows how to look after their mental health and can
look out for the health of others." Some 9 years later, and with a
brother sadly still severely limited by his condition, I am now a
passionate campaigner for the strict control and regulation of a legal
cannabis market. I have taken this position because I recognise the
potential within a strictly regulated legal market for that education
on mental illness to be delivered directly to people who have around a
doubled risk of developing schizophrenia. If cannabis was sold from
pharmacists and there was a requirement to undergo education on the
early warning signs of psychosis before people are permitted to use,
then I do hope that John and Patrick can recognise that "legalising"
cannabis can present a marvellous opportunity to intervene early in
psychosis and reduce its impact upon young lives, families and
society. Permitting use by adults should also reduce the viability of
criminal enterprises that deal to children, and increase the ability
of the police to rightly target such enterprises. Prohibition did not
stop Henry Cockburn using cannabis from the age of 14. I desperately hope that
controlling and regulating the market, alongside improved education in
schools, can reduce the level of use in the next generation and reduce
the incidence and severity of the terrible condition that Patrick and
I have had the misfortune to witness first hand.
Sincerely,
Ewan Hoyle.
This is the letter I wrote in response to a previous article by Patrick and another by John Rentoul that were published in the IoS last year. I thought it would be worth publishing it again. An edited version was published the week after in the IoS but I can't find it online. I'm very happy the Independent has printed an editorial this week that has called for decriminalisation of drugs despite Patrick Cockburn's articles on the subject. Please understand that I do not criticise Patrick Cockburn in any way and only have sympathy for what he and his family have had to endure.
Dear Editor,
(in reply to the articles of John Rentoul and Patrick Cockburn of the
5th of June 2011)
I last had a letter published in the Independent on Sunday on the 15th
of September 2002. It was a desperate plea for increased education on
mental health issues informed by my deeply distressing experience of
my brother's worsening psychosis. Within that letter I said "We don't
need it to be easier to lock up the mentally ill. We need a society in
which everyone knows how to look after their mental health and can
look out for the health of others." Some 9 years later, and with a
brother sadly still severely limited by his condition, I am now a
passionate campaigner for the strict control and regulation of a legal
cannabis market. I have taken this position because I recognise the
potential within a strictly regulated legal market for that education
on mental illness to be delivered directly to people who have around a
doubled risk of developing schizophrenia. If cannabis was sold from
pharmacists and there was a requirement to undergo education on the
early warning signs of psychosis before people are permitted to use,
then I do hope that John and Patrick can recognise that "legalising"
cannabis can present a marvellous opportunity to intervene early in
psychosis and reduce its impact upon young lives, families and
society. Permitting use by adults should also reduce the viability of
criminal enterprises that deal to children, and increase the ability
of the police to rightly target such enterprises. Prohibition did not
stop Henry Cockburn using cannabis from the age of 14. I desperately hope that
controlling and regulating the market, alongside improved education in
schools, can reduce the level of use in the next generation and reduce
the incidence and severity of the terrible condition that Patrick and
I have had the misfortune to witness first hand.
Sincerely,
Ewan Hoyle.
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