Select Committee on Science and Technology Minutes of Evidence


Examination of Witnesses (Questions 120-139)

PROFESSOR SIR MICHAEL RAWLINS AND PROFESSOR DAVID NUTT

1 MARCH 2006

  Q120  Dr Iddon: Thank you, Chairman. Obviously the Home Secretary is looking at the reclassification of drugs at the moment. Was that an idea that came from your Committee? If not, where has the Home Secretary gained the idea that the present system needs looking at?

  Professor Sir Michael Rawlins: Well, I think it is fair to say that I did have a discussion with him about it and I said that if he felt that he wished to re-examine the classification system the Council would welcome it.

  Q121  Dr Iddon: Are you as a committee, Professor Rawlins, commissioning any research into this aspect?

  Professor Sir Michael Rawlins: As to the question of the classification itself?

  Q122  Dr Iddon: Yes.

  Professor Sir Michael Rawlins: No, we are not. What we are doing is using the system that we are asked to use, and that is laid out in the Misuse of Drugs Act. We collect scientific evidence in relation to our responsibilities in that, but, no, we have not commissioned research into how one might classify them. I think that is a more appropriate thing to be done by the Government and the Home Office.

  Q123  Dr Iddon: Because the classification is set out in the 1971 Misuse of Drugs Act, could I suggest that you are perhaps operating within a straitjacket and there is very little flexibility?

  Professor Sir Michael Rawlins: There is some lack of flexibility and that is one of the reasons why we welcome the Home Secretary's decision to review the classification system and come out with a consultation paper.

  Q124  Chairman: Why did you not suggest it?

  Professor Sir Michael Rawlins: I did talk to him about it informally and I said if he felt that he wanted to do that it would be strongly supported by the Council.

  Q125  Dr Iddon: Is it not a fact also that the United Nations Conventions—and there are more than one of them—severely constrain the debate anyhow because they lay out internationally how different countries classify drugs?

  Professor Sir Michael Rawlins: Well, there is a wide range of ways in which the different countries do this and it is summarised quite nicely in the Runciman Report the various systems that are available, and I think it is a matter of what suits us rather than necessarily borrowing somebody else's, but obviously we can learn from their experience.

  Q126  Dr Iddon: I agree that there are cultural aspects we have to take into consideration. Which countries would you advise the Government to look at in particular that might have different systems than ourselves?

  Professor Sir Michael Rawlins: I am not an expert on the international dimension to this, but my advice would be to look at all the systems in developed countries in Europe and in North America and in Australia, look at their strengths and weaknesses, look at their own experience of it, and look at what we ourselves need in this country, but I am not an expert in this area. Professor Nutt might have a comment.

  Professor Nutt: I think we should look across a spectrum. Obviously we have in the past been very interested in the Dutch approach and, as shown in the RAND Report, the Swedish approach is almost diametrically opposite, and other European countries like Spain have gone through quite major changes in the way they regulate drugs in recent years, so there are lessons to be learnt there.

  Q127  Chairman: Bearing in mind that alcohol probably kills directly or indirectly about 32,000 people a year, tobacco 130,000 people a year, and those deaths are far in excess of all the deaths caused by the use of all illicit drugs, why is your committee not enabled to look at tobacco and alcohol as well as all the other substances?

  Professor Sir Michael Rawlins: I think the idea that we would control tobacco and alcohol in the form of the Misuse of Drugs Act (which would thereby render them illegal in terms of possession or supply) the Americans tried in this Prohibition days in the 1930s, and it was a disaster and just encouraged crime, and quite clearly it is not a practicable proposition.

  Q128  Chairman: But, Professor Rawlins, that is exactly what has happened in terms of the drugs classification system. It is exactly what happened with the prohibition of alcohol in the States.

  Professor Sir Michael Rawlins: I would not disagree with that. I think it is important that the Council does not exclude alcohol and nicotine entirely. One of the very important things the Council does—and it is nothing to do with classification—is it has a Prevention Working Group looking at prevention aspects of the misuse of drugs and its current programme, which is looking at the pathways to misuse of drugs by children and adolescents, is particularly also looking at nicotine and alcohol because we know that the early use—and Professor Nutt may want to talk about this—of nicotine and alcohol is a much wider gateway to subsequent misuse of drugs than cannabis or anything like that.

  Professor Nutt: Yes, I think it is important for you to realise that we are aware of the harms of tobacco and alcohol and we do bear them in mind, both in terms of the issue, as Michael has said, of the gateway but also in terms of the interactions. There are some drugs which by themselves are not necessarily very dangerous or harmful but when used with alcohol can become very much so.

  Q129  Dr Iddon: I am not asking for an ACMD view on this but a personal view. If you were to put alcohol and/or tobacco in one of the present classifications, bearing in mind the harm that they cause not only to individuals but also to society, which classes would you put them in?

  Professor Sir Michael Rawlins: When the Runciman Committee looked at this it was very clear that alcohol was at the border of A and B and tobacco was at the border of B and C.

  Q130  Dr Turner: Sir Michael, the point has already been made about the defects of prohibition and many senior police officers have told me that, in their view, the way in which we operate the Misuse of Drugs Act is actually counter-productive as far as dealing with drugs misuse is concerned, particularly with its emphasise on criminalising personal possession and use. Do you have a view on this?

  Professor Sir Michael Rawlins: Yes, I think the question of possession versus trafficking is very much the criminal justice and the public health elements, and I think for possession the public health issue should be paramount, and I am particularly thinking of vulnerable sections of society. Professor Nutt is much more expert on this than me, but we are very conscious that people with schizophrenia may relapse very readily if they use cannabis, and that cannabis consumption amongst people with schizophrenia is extraordinarily high. The worst thing you can possibly do with somebody with schizophrenia is to send them to jail for two years or five years or any time, particularly in relation to something like possession of cannabis. It is totally inappropriate and I do not think that happens very much, but we want to be helping them not to use it rather than punishing them if they have a spliff in their pocket.

  Professor Nutt: I have a lot of sympathy with your view. I think the evidence base for classification producing deterrence is not strong and we see that with a number of drugs.

  Dr Turner: Do you agree that there is also a problem with the way in which we handle, for instance, heroin addicts in that the substitutes could be as bad if not worse than the primary product if they had access to a pure source?

  Q131  Chairman: I would really like to move on if you do not mind, Des, on this. Could I just finalise with you, Sir Michael, you said you had an informal conversation with the Home Secretary so there has been no formal recommendation from your Committee that he should re-visit the classification at all?

  Professor Sir Michael Rawlins: No.

  Q132  Chairman: It was just an off-the-cuff conversation between yourself and the Home Secretary?

  Professor Sir Michael Rawlins: It was.

  Chairman: Margaret?

  Q133  Margaret Moran: Can I pursue the issue of your work programme and how it is determined. What proportion of your work is in response to Home Office or government departments and what proportion is proactive from yourselves, and what processes do you use to decide what issues you will pursue proactively?

  Professor Sir Michael Rawlins: I will start off and Professor Nutt will follow. I cannot give you a breakdown in quantitative terms. Occasionally it is the Home Secretary himself who asks us, but it has not happened very often. Sometimes it is officials in the Home Office who may propose things. Quite often it is also intelligence that we gather through the Police or the Forensic Science Service that stimulates an inquiry or a serious examination, but David?

  Professor Nutt: Yes, my Committee is called the Technical Committee and it incorporates individuals with an expertise and knowledge of drug toxicity but also people interested in the epidemiology, the natural history of drug use. In the last few years we have initiated reviews of drugs such as khat, based on, I suppose, public concern about sections of society being distorted by the use of khat. Ketamine was driven by concern from Customs & Excise about the very big increase in the importation of ketamine, which was certainly mislabelled as certain products. Basically we are reactive to social concerns, I suppose.

  Q134  Margaret Moran: I do not think you clarified for me the exact process, so you are effectively saying there is an issue that comes from the media or from general public concern, and you think, "Okay, we should formulate that into an inquiry"?

  Professor Nutt: That is what we have to do but we have also done other things. Systematically since I have been Chair of the Committee we have worked through two issues. One is how best to assess the harms and risks of drugs, and you have that report from Sir Michael in front of you. We have done that process; over a series of our meetings we have evaluated across the whole range almost every drug in the Act in a systematic way, given the current level of evidence. So we have set up a system where we can be proactive in terms of individual drugs and also we have reviewed the relative harms and risks of all the drugs.

  Q135  Margaret Moran: That is my next question. Could you give us a couple of specific examples where you have come across something where you think policy practice needs to be changed?

  Professor Nutt: I can give you a couple of good examples from the process that the Technical Committee has done. For instance, buprenorphine was Class C, and based on our harm assessment we thought it should be Class B. The same process was applied to cannabis back in 2002, where we thought it should go from Class B to Class C, so those are two examples of where we have used our expertise, applied the template of risk assessment and come up with what I think are quite sensible solutions, and from what we have seen at least one has been acted on.

  Q136  Bob Spink: I just wondered how the ACMD actually assessed risk, what evidence it took, and how it did the work of collecting that evidence. For instance, on crystal methylamphetamine, did the ACMD go to see the devastating impact of that drug on society and individuals in Thailand or in America, and did it use the evidence that it gathered in that way, if indeed it did gather evidence in that way, in making its decision to hold it as a Class B drug rather than classifying it as an A?

  Professor Sir Michael Rawlins: Can I in general terms answer on the approach we take. When we look into a particular area we usually set up a small working group. That small working group undertakes or usually commissions a systematic review of the public evidence, the chemical, the basic science and the social science evidence. That is supplemented by a search for unpublished material from all sorts of sources, not only from scientists we know are working in the field but through our national and international contacts, and then we interact with experts in the field, seeking their written evidence, seeking oral evidence from them and seeking their views on the systematic review and whether we have left anything out. That then forms the basis of a draft report which is looked at by the Technical Committee and then finally goes to the Council for further discussion and consideration and sometimes a bit of iteration between the Council and the Technical Committee. We have not paid visits to Thailand on the crystal meth business as a Council but Professor Nutt has visited.

  Professor Nutt: The people we worked with to produce the scientific overview—Farrell and Marsden and colleagues—do research in Thailand on crystal meth, they are world experts on it, so we felt very comfortable with their expertise because they were part of our process.

  Q137  Margaret Moran: Obviously your direct relationship is with the Home Office but how often are you consulted by other ministers or other departments or have a dialogue with them about some of the issues that need to be raised?

  Professor Sir Michael Rawlins: I do not think in my time in office we have been approached by other government ministers outside the Home Office. The Act would allow any secretary of state to ask for our views, but that has not happened. We do have very close relationships with the Department of Health. That is obviously very, very important and during the time that I have been in the Chair our relations with the Department of Health have got better and better, and it is very collaborative and they are very, very supportive. We also have relations obviously with the Department for Education and Skills, to some extent with the Department of Trade and Industry, with the Foresight Programme in particular, and we obviously have relationships with the Police—ACPO, the Met, and so on.

  Q138  Margaret Moran: When you say relationships, have you actively gone to discuss issues with ministers or representatives of those departments?

  Professor Sir Michael Rawlins: Yes, ministers in the Department of Health have talked to me about misuse of drugs and the views of the Council in discussion. They have not referred a topic to us but we have had discussions about it, yes.

  Q139  Margaret Moran: Just one quick one. When you are finalising your advice to ministers, for example anything about the reclassification of cannabis, how much has the opinion of that minister helped to form the final policy judgment?

  Professor Sir Michael Rawlins: Not in the slightest. It is a very independent group. There is no way I could persuade them to put something in a report because the Home Secretary might like it. They are a very, very independent group. They would walk out of the room if I even thought about doing it.


 
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