Examination of Witnesses (Questions 240-259)
PROFESSOR SIR
MICHAEL RAWLINS
AND PROFESSOR
DAVID NUTT
1 MARCH 2006
Q240 Bob Spink: This would not require
waiting for one of your biannual meetings?
Professor Sir Michael Rawlins:
No.
Q241 Mr Flello: Having listened to
your evidence this morning, I am left with the impression that
these things seem to be very ad hoc. You can have magic
mushrooms where I understand there has been one death but fresh
mushrooms were pushed into class A on a precautionary principle.
On a similar precautionary principle cannabis is class C and on
a similar precautionary principle some of the amphetamines are
class A and some are class B. It seems complete nonsense, does
it not?
Professor Sir Michael Rawlins:
I have sat on government advisory committees for 25 years, mainly
in terms of medicine but others as well. There is a misunderstanding
around in the world that scientific advisory committees just make
their decisions purely on the science. They have to take judgments
too and judgments are very important in scientific advisory committee
meetings. Sometimes people do not realise they are making judgments
but they are. It is very important to realise that we all have
to do it. I think your Committee also understands that scientific
advisory committees look at the science and then they have to
make a judgment.
Q242 Chairman: Our frustration this
morning is that time and time again you seem to have responded
to Members of the Committee that there is a lack of evidence or
you have agreed that there is a lack of evidence to make certain
decisions. We want to know why the ACMD has not done more to promote
research in those areas where there is a lack of evidence. Do
you think it is your job to do it or have we misjudged what the
purpose of the committee is?
Professor Sir Michael Rawlins:
It is arguable whether it is our job. This is an area in which
it is extraordinarily difficult to do research, not just for legal
reasons but for real reasons. Would I, for example, be prepared
to do volunteer studies with Ecstasy? Would I be prepared to give
volunteers Ecstasy? I could probably get the Home Secretary's
approval. It is schedule one and it is possible. I am not sure
I would. I do not know what an ethics committee would think about
it but how would I think about it? We start getting into very
real problems of doing research in this area. It is all very well
people saying, "You should promote research" but you
have to promote research that can be done, not research that we
would just like to see.
Q243 Chairman: Could I ask whether
the Council has ever formally asked the Home Secretary for permission
to carry out research in any of the areas that we have talked
about this morning?
Professor Sir Michael Rawlins:
Yes, and it does commission research.
Q244 Chairman: You could give us
some background?
Professor Sir Michael Rawlins:
Yes. We can let you know of areas we have asked for research to
be commissioned in.
Q245 Dr Turner: When questions fall
outside the massive expertise you already have in the committee,
who do you look to and how do you choose specific people to go
to for advice?
Professor Nutt: Essentially in
the scientific arena we look for people who publish in the field.
The methylamphetamine review brought in people like Charles Marsden
who is a world expert on the effects of amphetamines in the brain.
We make searches of the published literature to find people.
Q246 Dr Turner: Do you ever set up
sub-committees to pursue specific issues?
Professor Nutt: Sometimes.
Q247 Dr Turner: Do these report separately?
Do those reports reach the public domain?
Professor Nutt: They come in through
the committee structure with the technical committee.
Professor Sir Michael Rawlins:
They form the report that goes to the Council and it is published
on the internet.
Q248 Chairman: Do you mean original
research, or is this a review of existing research?
Professor Nutt: The ACMD does
not have a budget that could remotely fund proper research in
the sense of original, primary research. The average research
grant that the MRC funds now is about a third of a million and
I think the whole ACMD is run on much less than that. It does
not have any resources to commission primary research.
Q249 Chairman: It has no mechanism
to ask somebody else to commission it?
Professor Nutt: We have worked
with the Department of Health who do have a research budget.
Professor Sir Michael Rawlins:
And the Home Office sometimes.
Q250 Chairman: When we are talking
about magic mushrooms, could you say, as a simple yes or no, when
the government decided to put magic mushrooms in class A, was
that evidence based? Yes or no?
Professor Nutt: Magic mushrooms
contain the active substances which are in class A.
Q251 Bob Spink: They are not in class
A based on evidence. They are there because they were there.
Professor Nutt: That is exactly
right.
Q252 Dr Harris: It is not evidence
based; it is historic.
Professor Nutt: Historic evidence,
yes.
Q253 Chairman: Was the Council split
on that? Do you ever have disagreements about an issue like that?
Professor Nutt: It seemed somewhat
illogical given the fact that we had not done a systematic review
of psilocin et cetera, but we did understand that under the current
Act it was a class A drug.
Professor Sir Michael Rawlins:
The other thing the Council was particularly worried about was
that people who had magic mushrooms perchance growing in their
fields would suddenly be prosecuted. We made the point that in
the fields belonging to the Duke of Northumberland if, by chance,
there were some magic mushrooms growing he was not necessarily
going to have to go to jail.
Q254 Dr Harris: I am very interested
in this risk assessment approach, which is methodical. It is flawed.
Professor Sir Michael Rawlins:
Flawed?
Q255 Dr Harris: It is not perfect
because of the issue of the lack of evidence. I thought you did
very well, Professor Rawlins, in setting that out. When it came
to magic mushrooms where the government asked you in a rush what
your view was, I had the perception that you did not have time
to find an expert. Maybe there was not an expert. You did not
have time to do a full technical review. You were asked for your
opinion: shall we stick this in class A as well? You defended
your decision not to object or to approve by starting in on the
precautionary principle and historically hallucinogens had always
been in class A. Feel free to write but would you consider, after
a review of what you have said, that it might be an alternative
approach to say, "On reflection, we did not really have time
to do this properly and that is not our fault; it is just the
timing. If the government are going to do this they can do it
but we should not have given it the imprimatur to imply that a
full risk assessment model had been given to it by the fact that
we wrote to them saying, `This is fine, people understand that
we do these risk assessments and that might have been the impression
they got'." Would that be a fair way of putting the situation?
Professor Sir Michael Rawlins:
No. If we were to do a review of psilocin now, the evidence base
upon which to make any sort of decision, bar knowledge of the
fact that it is hallucinogenic and causes hallucinations when
you take various preparations of vegetables that contain it, is
about as far as we would ever get. Frankly, I do not think it
is worth it. There are bigger, more important issues to worry
about than whether fresh mushrooms join the rest of the other
things in class A. It is not a big issue.
Q256 Dr Harris: If you get thrown
into prison it is a big issue.
Professor Sir Michael Rawlins:
That is only if you are supplying and trafficking.
Q257 Mr Devine: There have been recommendations
that Ecstasy should be changed from class A to class B. I wonder
if you have given the government any advice and, if you have not,
why not? There have been various committees that have now made
recommendations about the reclassification of Ecstacy.
Professor Sir Michael Rawlins:
It is class A. The difficulty is it is one of these other areas
where there is very little research done on it. We do not even
understand how it kills people. It does. I am afraid the report
from the RAND Corporation managed to mangle up the mechanisms
of its toxicity but perhaps I could write to you separately about
that. The estimates of the mortality rates with it vary some ten
to twenty fold, depending on certain assumptions that you have
to make. They are either half as harmful as road traffic accidents
or they are ten times as harmful. There is a huge, wide variation
in the estimates. 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.
Q258 Mr Flello: Just to pick up on
Dr Harris's point about it being an issue if you are caught supplying
magic mushrooms and you get ten years, what is your view on perhaps
having a twin track approach whereby perhaps all drugs are classified
as class A if you are supplying them and dealing in them, but
if you are using them for personal use it is in the existing category?
Professor Sir Michael Rawlins:
There are various ways in which one could do this. One could change
the whole pattern and disaggregate the supply. That is a very
fair approach to it, to separate possession and supply from trafficking.
Q259 Chairman: When the Home Secretary
made his statement on 19 January he stated that clinical medical
harm is the Advisory Council's predominant consideration in terms
of classification. Would you agree with that?
Professor Sir Michael Rawlins:
We also look at social harms.
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