House of Commons - Science and Technology

Select Committee on Science and Technology Fifth Report

4 Incorporation of advice into policy

41. As noted above, the ACMD makes recommendations to the Home Secretary regarding the appropriate classification for individual drugs but although the Minister must seek the Council's views prior to making any changes, he is under no obligation to implement its recommendations. In order to illustrate the way in which the Government has used the Council's advice in developing its policies, we examined the classification of three types of drugs—cannabis, magic mushrooms and amphetamines, including ecstasy and methylamphetamine. In each case, our primary interests were the processes used for, and the role of scientific advice and evidence in, decisions regarding classification.

Cannabis

42. Cannabis comes from Cannabis sativa, a plant which is found growing wild in many parts of the world and readily cultivated in the UK. The three main forms of cannabis are: resin, which is scraped and compressed from dried plants; herbal cannabis, comprising chopped dried leaves; and cannabis oil, made by percolating solvent through the resin.[66] Cannabis is mainly used as resin or in herbal form in the UK, with cannabis oil accounting for less than 1% of usage.[67] Herbal cannabis is available in two forms. 'Traditional' herbal cannabis imported from overseas comprises a mixture of leaf, flowering tops and seeds. 'Sinsemilla' is a higher potency preparation, either imported or home-grown, made from the flowering tops of unfertilised female cannabis plants.[68] The primary psychoactive agent in cannabis is delta 9-tetrahydrocannabinol (THC). Preparations of cannabis vary considerably in their potency and there may be wide variation between different plant varieties in the amount of THC that can be derived from them.

43. There has been a long running debate over the appropriate classification for cannabis. The ACMD recommended that cannabis should be reclassified from Class B to Class C as early as 1979, on the grounds that cannabis was less harmful than other drugs in Class B and police resources could be deployed more effectively.[69] This view was endorsed by the Runciman report in 2000.[70] In October 2001, the then Home Secretary David Blunkett asked the ACMD to provide advice on the appropriate classification for cannabis. In March 2002, the ACMD presented its report to the Home Secretary, recommending that all cannabis products be reclassified as Class C. The report made reference to concerns about a possible link between chronic use of cannabis and mental illness, but concluded that "no clear causal link has been demonstrated". It also acknowledged that "cannabis use can unquestionably worsen schizophrenia (and other mental illnesses) and lead to relapse in some patients". The report did not address possible increases in cannabis potency.[71] The Government indicated that the recommendations of both the ACMD and the Home Affairs Committee had influenced its decision to support the reclassification of cannabis.[72]

44. Although the Home Office announced the decision to reclassify cannabis as Class C in July 2002, the change did not come into effect until January 2004. In the meantime, three new studies were published which examined the link between cannabis use and mental illness. The charity Rethink expressed concern about the time lag between the start of the ACMD review in 2001 and the implementation of reclassification in 2004: "In this period, a significant amount of new evidence emerged about cannabis and mental illness, but the cannabis decision was not revisited in the light of this".[73]

45. The weeks leading up to and following the implementation of reclassification saw a media maelstrom of reporting about cannabis. Many argued that the changes had caused widespread confusion about the legal status of cannabis and there were reports that this was being exacerbated by the fact that different approaches were being adopted by police in different areas.[74] Sir John Stevens, the then Metropolitan Police Commissioner, was quoted as saying: "We do need to clarify where we are in terms of drugs law", adding that junior officers in his force had told him they were "muddled" about the drug's status.[75] The Government defended its actions, saying that it had initiated a £1 million advertising campaign targeted at teenagers and later arguing that survey results indicated that the message had been widely understood by young people.[76]^,[77] However, the mental health charity Rethink criticised the fact that "the public health campaign that accompanied reclassification did not mention the possible mental health effects of cannabis, but instead concentrated solely on the physical health effects of use and its continued illegality".[78]

46. Moreover, Charles Clarke, who succeeded David Blunkett as Home Secretary in December 2004, deviated from the Government line and, in an implicit criticism of his predecessor's actions, said: "The thing that worries me most [about the decision to move cannabis to Class C] is confusion among the punters about what the legal status of cannabis is".[79] He also said he was "very worried" about emerging evidence suggesting a possible link between cannabis use and mental illness.[80] Changes in drug policy, especially classification decisions, must be accompanied by a comprehensive information campaign. We recognise that the Government did undertake a campaign when the reclassification of cannabis came into effect but in view of the subsequent confusion, which was publicly acknowledged by the Home Secretary, we can only conclude that these efforts were insufficient.

47. In March 2005, Charles Clarke asked the ACMD to revisit the classification of cannabis, also asking for advice on the extent to which the potency of cannabis products had increased—a response to anecdotal evidence that higher potency cannabis was being used more frequently. The ACMD reported its findings to the Home Secretary in December 2005, making a number of recommendations but not advocating any change in the classification of cannabis. The Council found that although cannabis had "real and significant" effects on mental health, "the consumption of cannabis is neither a necessary, nor a sufficient, cause for the development of schizophrenia".[81] The Council was not able to reach a definitive conclusion on the extent to which the potency of cannabis products had increased in recent years but noted that material seized by law enforcement officers suggested that while the potency of 'traditional' herbal cannabis and cannabis resin had stayed the same, the average potency of the less widely used sinsemilla had more than doubled.[82] The Home Secretary accepted the ACMD's recommendations in full in January 2006, simultaneously launching a fundamental review of the classification system itself. We recognise that the Home Secretary followed due process in asking the ACMD to review the classification of cannabis in response to concerns about the link between cannabis use and mental illness and perceptions that cannabis was becoming more potent. However, the timing of the second review against a backdrop of intense media hype and so soon after the change in cannabis classification had come into effect gave the impression that a media outcry was sufficient to trigger a review.

48. The Government has argued that the reclassification of cannabis has had the desired effect, with arrests for cannabis possession falling by one third in the first year since re-classification, saving an estimated 199,000 police hours.[83] Furthermore, British Crime Survey data suggest that reclassification has not led to an increase in the use of cannabis: the use of cannabis in the general population (16-59 year olds) has remained stable since 1998 while cannabis use among young people (16-24 year olds) has gradually declined since 1998.[84]

49. Nonetheless, the decision remains controversial. The 2006 World Drug Report published by the UN Office on Drugs and Crime (UNODC) devoted particular attention to cannabis. The report stated that it was used by an estimated 162 million people at least once in 2004, equivalent to 4% of the global population aged 15-64, making it the world's most abused illicit drug. UNODC Director, Antonio Maria Costa, speaking at the launch of the report, made a number of comments, including the assertion that "Many countries have the drug problem they deserve", which were widely interpreted as criticism of the UK stance on cannabis. He also argued that "the harmful characteristics of cannabis are no longer that different from those of other plant-based drugs such as cocaine and heroin" and that "Policy reversals leave young people confused as to just how dangerous cannabis is".[85]

50. Recent media reports have suggested that the Home Office is to drastically reduce the quantities of drugs that people can carry before the charge of possession is upgraded to the charge of possession with intent to supply. In evidence to this inquiry, Home Office Minister Vernon Coaker confirmed that the Government was reviewing this but said that no decisions had yet been taken regarding the limits to be set. According to The Guardian, the draft regulations would put the threshold for cannabis at 5g: "a sharp reversal from David Blunkett's decision 18 months ago to ensure that cannabis possession was normally to be dealt with by confiscation and an informal warning".[86] Jan Berry, Chair of the Police Federation, said in response: "The constant changes only add to public confusion".[87] Having already caused confusion by failing to adequately communicate the implications of the reclassification of cannabis to the public, the Government must be careful that any additional changes to policy relating to cannabis do not further cloud the picture.

Gateway theory

51. The 'gateway theory' refers to the concept that cannabis use in some way predisposes individuals—and is therefore a gateway—to subsequent use of 'harder' drugs. The theory is predicated on the observation that many users of Class A drugs have used cannabis before moving onto these drugs. Professor John Strang, Director of the National Addiction Centre, emphasised the importance of establishing whether the relationship between cannabis use and Class A drug use was causal. He told us: "It is a correct observation that people who are using heroin went through gates on the way to where they are now. The crucial question is: if you had had the power to stop them going through that gate would it have altered their subsequent journey?". He pointed out that "going to primary school is a gateway to being a heroin addict but you are not implying there is a causal relationship between the one and the other".

52. Professor Blakemore, MRC Chief Executive and Professor of Physiology at the University of Oxford, said he could not "think of a chemical or physiological basis" for a causal relationship. He also dismissed the idea that "If you are buying your first drug from a person who then tries to persuade you to use a 'better' one and a stronger one then there is a causal relationship which is determined by the supplier" on the grounds that "cannabis supply is, to a large extent, rather different from the supply of harder drugs". In addition, Professor Blakemore noted that in the Netherlands, while "the attitude to cannabis use is even more relaxed than it is in this country and […] cannabis use amongst the population is a little less than it is in this country", "hard drug use is about one third of the rate in this country".[88]

53. The ACMD considered the gateway theory in its 2002 report on cannabis. The report concluded that proving any causal relationship between cannabis use and later use of Class A drugs was "very difficult due to the many confounding factors that might also act as gateways", including the individual's personality and their environment and peer group.[89] The report also stated that "Even if the gateway theory is correct, it cannot be a very wide gate as the majority of cannabis users never move on to Class A drugs".[90] In addition, Sir Michael Rawlins, Chairman of the ACMD, commented in evidence to us that "the early use […] of nicotine and alcohol is a much wider gateway to subsequent misuse of drugs than cannabis or anything like that".[91] The RAND report also concluded that "the gateway theory has little evidence to support it despite copious research".[92] We note that recent results from animal models have suggested a possible biological mechanism for a gateway effect, at least in rats,[93] but in the course of this inquiry we have found no conclusive evidence to support the gateway theory.

Magic mushrooms

54. Magic mushrooms contain psilocin and psilocybin, naturally-occurring compounds with hallucinogenic properties. Psilocin and psilocybin were designated Class A drugs under the Misuse of Drugs Act 1971, apparently on account of their hallucinogenic properties. Psilocin is also listed under Schedule I, the highest level of prohibition, under the UN's Convention on Psychotropic Substances 1971.[94] Sir Michael Rawlins, Chairman of the ACMD, told us: "I have no idea what was going through the minds of the group who put it in Class A in 1970 and 1971 […]It is there because it is there".[95] The Home Office has admitted that it has never conducted any research into psilocin use and that there is "no clear evidence of a link between psilocin use and acquisitive or other crime".[96]

55. In the past a legal loophole meant that fresh magic mushrooms were not treated as controlled drugs, providing that they had not been 'prepared' (i.e. dried, packaged, cooked etc.). Section 21 of the Drugs Act 2005, which came into force on 18 July 2005, makes it an offence to import, export, produce, supply and possess with intent to supply magic mushrooms in any form.[97] Because the decision to place magic mushrooms in Class A was a clarification of the law rather than a reclassification decision, the Government was not obliged to seek the advice of the ACMD in the usual manner. Nevertheless, the Government told us that it "did write to the ACMD, and ask for its views on [its] proposals before the Drugs Bill was introduced".[98] The ACMD endorsed the move, telling us: "in March 2004 the Technical Committee heard that, over recent years, there had been a substantial increase in the number of retail outlets selling 'fresh' magic mushrooms. In fact HM Customs and Excise estimated the importation of 8,000-16,000 kgs during 2004".[99] However, the ACMD did not conduct a full review of the evidence in arriving at its decision. The Government's use of a clarification of the law to put fresh magic mushrooms in Class A contravened the spirit of the Misuse of Drugs Act and meant that the ACMD was not given the chance to consider the evidence properly before responding. We also note the admission by the Home Office Minister Paul Goggins that "the Home Office received no submissions in favour of the clarification of the law in respect of magic mushrooms prior to the Drugs Act 2005 being granted Royal Assent on seven April and four submissions against".[100]

56. In fact, we encountered a widespread view that the Class A status of magic mushrooms does not reflect the harms associated with their misuse. The RAND report concluded that the Government's decision "was not based on scientific evidence", noting that "the positioning of them in Class A does not seem to reflect any scientific evidence that they are of equivalent harm to other Class A drugs".[101] The RAND report pointed out that "National Statistics show that for deaths in which drug poisoning (listed on the death certificate) was the underlying cause of death, between 1993 and 2000 there was one death from magic mushrooms and 5,737 from heroin" and that "The lethal dose for humans is about one's own body weight in mushrooms".[102] Professor Blakemore was also of the view that "if one could look at all the evidence for harm available now, including social harms, one would say [the classification of magic mushrooms] is wrong".[103] The Government's own 'Talk to Frank' drug information website states that "Magic Mushrooms are not addictive in any way".[104] The drugs charity Release told us that "There was little transparency as to the reasoning behind this policy", describing it as "an unacceptable situation".[105] Paul Flynn MP was also of the view that "The policy appears to have been driven by something other than evidence" and warned that "other more dangerous mushrooms, not covered by the current law, could be substituted for those that are prohibited".[106] Recent press reports, and data from the European Monitoring Centre on Drugs and Drug Addiction (EMCDDA), suggest that substitution with legal hallucinogens - including potentially lethal mushrooms of the Amanita family - is already happening.[107]^,[108]

57. We were, therefore, surprised and disappointed to hear Sir Michael Rawlins, Chairman of the ACMD, tell us that "it was not a big issue" whether magic mushrooms were in the right Class. In Sir Michael's view: "there are bigger, more important issues to worry about than whether fresh mushrooms join the rest of the other things in Class A".[109] The Chairman of the ACMD's attitude towards the decision to place magic mushrooms in Class A indicates a degree of complacency that can only serve to damage the reputation of the Council. Martin Barnes, Chief Executive of DrugScope and a member of the ACMD, did not share Sir Michael's nonchalance. He told us that he was "not aware that the full council were asked to deliberate on this" and that "it was wrong for the Home Secretary to seek to enact [the change] in primary legislation without properly consulting the ACMD and giving it time to deliberate on it".[110] Mr Barnes was also of the view that "the evidence has indicated that [magic mushrooms are] in the wrong classification".[111] The ACMD should have spoken out against the Government's proposal to place magic mushrooms in Class A. Its failure to do so has undermined its credibility and made it look as though it fully endorsed the Home Office's decision, despite the striking lack of evidence to suggest that the Class A status of magic mushrooms was merited on the basis of the harm associated with their misuse.

Ecstasy and amphetamines

58. Amphetamines fall into Class A or B according to their method of preparation. Ecstasy or MDMA (3,4-methylenedioxymethamphetamine) is a so-called 'substituted amphetamine' and, along with the other substituted amphetamine MDA (3,4-methylenedioxyamphetamine), is a Class A drug. Amphetamine and its derivatives are collectively known as 'phenylamphetamines' and include methylamphetamine, also known as methamphetamine. Phenylamphetamines have common properties but can also differ in their effects. Amphetamines are classified in Class B if orally administered, but Class A if injected, on the grounds that intravenous administration produces a more pronounced effect and carries additional risks (e.g. through needle sharing).

59. Professor Nutt, Chairman of the ACMD Technical Committee, was adamant that it was appropriate to make this distinction for amphetamines because "The method of administration clearly determines the risk to the individual and to society".[112] However, Transform Drug Policy Foundation pointed out that "the classification system makes no distinction between coca leaf chewing and smoking crack, because they are both cocaine use", despite the fact that "coca chewing is low dose and slow release and is not associated with significant health harms".[113] When we asked the ACMD why this was the case, Professor Nutt told us: "That is a very good question" and reflected the fact that "We are not as sophisticated with cocaine in terms of the law as we are with amphetamines".[114] We see the logic behind the differential classification of amphetamines depending on the method of administration but regret the fact that the same rationale has not been applied, where appropriate, to other drugs. We recommend that a consistent policy be developed as part of the forthcoming review of the classification system.

ECSTASY

60. A number of commentators have called into question whether the Class A status of ecstasy is warranted on the basis of the harm caused by its misuse. The RAND report cited evidence suggesting that "ecstasy may be several thousand times less dangerous than heroin, although both are in Class A, as the percentage of deaths among users is very small and there is little evidence that ecstasy users exhibit withdrawal symptoms, with far more evidence suggesting there are no withdrawal symptoms".[115] It also noted that "Recent figures show that there were about 13.5 times more ecstasy users than heroin users in 2004, and deaths caused by ecstasy were around 3% of the number caused by heroin".[116] In oral evidence to this inquiry, Professor Colin Blakemore, MRC Chief Executive, told us that ecstasy was "at the bottom of the scale of harm" and "on the basis of present evidence […] should not be a Class A drug".[117]

61. According to DrugScope, the ACMD was not consulted prior to classification of ecstasy as a Class A drug in 1977 and the Government has resisted more recent calls to refer the matter to the ACMD.[118] David Blunkett, then Home Secretary, rejected the recommendation of both the Runciman report in 2000 and the Home Affairs Committee in 2002 that ecstasy should be reclassified from Class A to Class B, in the latter case on the grounds that reclassification would be "irresponsible".[119] The Government's response to the Runciman report stated: "In the absence of any clear recommendation from the Advisory Council to the contrary, the Government believes that ecstasy should remain a Class A drug", but Mr Blunkett subsequently refused to ask the ACMD to conduct a review of the evidence.[120]^,[121] The Home Office Minister Vernon Coaker told us categorically in evidence to this inquiry that the Government still had "no plans" to refer the classification of ecstasy to the ACMD.[122]

62. What is perhaps more surprising is that the ACMD has not "presented any recommendations on [ecstasy] to the Government of its own volition".[123] Sir Michael gave the following explanation for this in evidence to us: "The difficulty is it is one of these other areas where there is very little research done on it […] Frankly, I do not think we would get anywhere by a review at the present time. This may change. There may be better evidence that comes forward but it is vague and imprecise and I do not think we would get very far".[124] We are not convinced by this explanation and note that there is a substantial body of scientific literature on ecstasy, much of which has been published in recent years. In view of the high-profile nature of the drug and its apparent widespread usage amongst certain groups, it is surprising and disappointing that the ACMD has never chosen to review the evidence for ecstasy's Class A status. This, in turn, highlights the lack of clarity regarding the way the ACMD determines its work programme. We recommend that the ACMD carries out an urgent review of the classification of ecstasy.

METHYLAMPHETAMINE

63. Methylamphetamine (also called methamphetamine) is a derivative of amphetamine which is both produced for medicinal purposes and manufactured illicitly. Methylamphetamine can be produced as a tablet, powder or in a crystalline form commonly known as 'ice'. The latter form tends to be extremely potent and, unlike other types of amphetamines, can be smoked in a similar way to crack cocaine.[125] In addition to the harms associated with methylamphetamine misuse, the toxic chemicals and risky procedures involved in the illicit manufacture of the drug can pose a danger to those who live in the vicinity of clandestine laboratories and to others who enter the premises, including law enforcement officers. Methylamphetamine is the most widely produced illicit synthetic drug in the world.[126]

64. The ACMD recently reviewed methylamphetamine following a request from the Home Office. The Council told us that the request had been prompted by a visit to the US, in late 2003, by the Permanent Secretary for Crime, Policing, Counter-Terrorism and Delivery at the Home Office.[127] We also heard on our visit to the US about the scale and severity of the problems associated with methylamphetamine abuse there. Most memorably, a senior officer from the New York Police Department told us that the highly potent crystalline form of methylamphetamine "makes crack cocaine look like a Hershey bar". According to the World Drug Report 2006, the US dismantles the largest number of methylamphetamine laboratories worldwide—17,199 in 2004 alone.[128]

65. The ACMD report found that methylamphetamine was nearly twice as potent as other amphetamines and although the majority of symptoms were the same as for other amphetamines, the level of dependence was higher and was reached more quickly. However, the ACMD concluded that "there does not appear to be evidence in the UK that [methylamphetamine] is present in the drugs scene to any appreciable extent" and "There does not, therefore, appear to be a firm foundation and rationale for reclassifying [methylamphetamine] under the Misuse of Drugs Act 1971, at least at the present time".[129] Furthermore, the ACMD suggested that "reclassification could have the unintended consequence of increasing interest in the drug amongst potential users".[130] Professor Nutt, Chair of the ACMD Technical Committee, made it clear in evidence to us that this was the driver for the Council's decision not to recommend a change in classification: "The reason I believe we did not recommend it at the time was mostly because there could be a perverse effect. If people saw methylamphetamine as a more dangerous drug, a more Class A amphetamine, we might well have begun to see importation".[131] We put this suggestion to experts and officials involved in drugs policy in the US, all of whom told us they were not aware of any evidence to support this view.

66. Sir Michael Rawlins, Chairman of the ACMD, acknowledged that in developing its position the Council had made "a judgment […] as to which would be the least damaging thing to do", but argued that it was a "misunderstanding" to think "that scientific advisory committees just make their decisions purely on the science".[132]^,[133] The recommendation by the ACMD that methylamphetamine should stay in Class B because of the signal that reclassification might send to potential users has given us serious cause for concern. We recognise that the Council often has to make recommendations on the basis of weak or limited evidence, but invoking this non-scientific judgement call as the primary justification for its position has muddied the water with respect to its role. The ACMD acknowledged that there was clear-cut evidence that the harmfulness of methylamphetamine misuse justified a Class A status.[134] It should therefore have conveyed this to the Home Secretary with the caveat that he should consider any unintended consequences of a change in classification. It is highly regrettable that the ACMD took it upon itself to make what should have been a political judgement.

67. The ACMD presented its recommendations on methylamphetamine to the Home Secretary in November 2005. He accepted their recommendations in full, but "given the nature of the drug, and the risk of the prevalence in the UK increasing", asked the ACMD to keep a "watching brief" and provide further advice in 12 months.[135] Following a flurry of media reports about the dangers of methylamphetamine and warnings from the UN, the ACMD decided to reconsider its position on methylamphetamine on 25 May 2006, just six months after the publication of its original advice. Further to these discussions the ACMD recommended to the Home Secretary "that methylamphetamine (and its salts) be re-classified as a Class A substance".[136] The Home Office Minister Vernon Coaker confirmed in evidence to us that the Government would be accepting this recommendation.[137]

68. The ACMD said in its letter to the Home Secretary that it was submitting further advice on methylamphetamine in advance of the 12 month deadline "because of the threat potentially posed by this substance".[138] The letter cited four main reasons for the change in recommendation. Firstly, "there are indications that the use of methylamphetamine is now starting to become more widespread"; secondly, "the police have become aware of the existence of a small number of illicit laboratories synthesising the substance"; thirdly, "over the past 6 to 9 months, there has been considerable media interest in the properties and use of methylamphetamine"; and fourthly, reclassification as a Class A drug would give police "powers to close down 'ice houses' as they currently do with 'crack houses'".[139] All of these could have been predicted and, indeed, were by various observers. The ACMD's decision to revise its position and recommend that methylamphetamine become a Class A substance will be welcomed by many. However, the fact that the ACMD changed its mind so quickly makes it look like the Council either realised that it had made a mistake, or had succumbed to outside pressure.

69. Overall, our examination of the processes used by the ACMD and Home Office to make, respectively, recommendations and decisions regarding the classification of drugs has revealed a disconcertingly ad hoc approach to determining when reviews should be undertaken and a worrying lack of transparency in how classification decisions are made. We address these concerns in the following Chapter.

66 RAND Report, para 90 Back

67 As above, para 2.1 Back

68 ACMD, Further consideration of the classification of cannabis under the Misuse of Drugs Act 1971, December 2005, para 2.2 Back

69 RAND Report, para 98 Back

70 Runciman Report Back

71 ACMD, The Classification of Cannabis under the Misuse of Drugs Act 1971, 2002 Back

72 Home Office, The Government Reply to the Third Report from the Home Affairs Committee, The Government's Drug Policy: Is it working?, Cm 5573, July 2002, p 12 Back

73 Ev 74 Back

74 e.g. Law: Keep off the grass?, The Independent, 16 August 2004 Back

75 Cloud of confusion over cannabis law, The Daily Telegraph, 23 January 2004 Back

76 Home Office press notice 020/2004, 17 January 2004 Back

77 Home Office press notice 183/2004, 17 May 2004 Back