Select Committee on Science and Technology Minutes of Evidence

Examination of Witnesses (Questions 440-459)


26 APRIL 2006

  Q440  Dr Iddon: I would like to go into a bit more detail as to what each of you think the home secretary should be looking at. Could I put it to you that there are drugs available over the counter and there are drugs that are prescribed by doctors that are equally dangerous as some of the drugs that are already in the classification system? Have we not got it all wrong with this classification system and should we not start from a zero place and build up a new system?

  Mr Barnes: I think the fact that the home secretary has announced a review is very welcome and we do not yet know the full detail as to how the consultation is going to happen, but obviously the wider, the more clean slate it starts the better. I think there is an opportunity there to address those issues of over the counter medicines but also there substances that are not currently classified that can be bought on Camden High Street or on the Internet. People looking at the Internet in terms of those substances do not get terribly accurate information about the possible harms so there is a gap and a potential anomaly there as well that I think should be looked at, but it is an extremely complex subject and I do not think there is a simple answer.

  Mr Rolles: I agree that we should start with a clean slate and I also welcome the fact that the home secretary has announced this inquiry and I also welcome the fact that this Committee is looking at this issue. It is very welcome to have the light of science pointed at this rather murky corner of policy making which seems to have been fairly unbothered by science historically. In terms of what they need to be looking at, I think we need to go beyond just determining and ranking the harm of drugs because that debate can go on forever. It is important up to a point but more important they need to look at the outcomes of this policy: is the policy effective at doing what it is supposed to do? If it is actually doing the opposite of what it is supposed to do if it is increasing harms and under the auspices of this policy use is increasing and availability is increasing, then you have to question the validity and utility of that policy more generally. What I would like to see is the entire scientific base of the policy itself examined. I would like to see some examinations of outcomes historically and consideration of possible alternatives to classifying drugs. We are talking about public health policy in terms of drug harms but significantly that is then transferred into criminal penalties. We have the classic category error here where you have a lot of excellent science in terms of determining harms of drugs which is then transferred into criminal justice penalties which have incredibly poor science in terms of determining the impact of the criminal justice penalties on outcomes from public health. There is great research at one end of the spectrum and a total absence of research and science at the other end. I think that is where we need to focus and hopefully the Committee and Home Office consultation will do that.

  Mrs King-Lewis: I agree with Steve, we need to close that link between having the research there and very little output because it is based on those outcome measures which then inform policy. That is the area that is missing. I also agree with Steve to make it more of a public health agenda as well. It is very much focused on the criminal justice element but really looking from the start at what is the purpose of it? What are the objectives? What are we trying to reach? Certainly the public health agenda and advising the public as what the different harms of the drugs are it is very limiting just by classifying it A, B or C. We are not really giving the public much information. To my knowledge I do not think we have ever done any public survey. We do not even know if the public see that if a drug is in Class A is that more of a deterrent or is it actually an attraction? We cannot even answer those simply questions.

  Q441  Dr Iddon: I asked the previous panel if there are any other countries that get it better than we do. I put it to you that the United Nations conventions are the limiting factors because they do not encourage countries to develop best practice.

  Mr Barnes: I think it is true that the UN conventions are a limiting factor but there is flexibility within that. Look at the Netherlands, for example, which for certain drugs—by no means all—takes a more liberal approach to issues of possession. There are countries, for example, that have been piloting safe injecting rooms but there is a view that that is against the letter of the UN conventions, so the UN conventions are a potential stumbling block to very radical reform but I think the parameters within which domestic policy can operate are reasonably broad. I agree that we do need to look at the effectiveness of the way the current legal enforcement of drugs operates. Steve and his organisation come from the view point and are very clear on this that they want to see a system of legalisation. I do not think we are talking about science evidence base, that there is the evidence to say that legalisation is going to be the way to significantly reduce related harms. It is na-­ve to believe that if we had a system of legalisation it is going to take it out entirely of the harms of criminals. There was an interesting document published alongside the Budget this year looking at tobacco smuggling. If we did a word replacement and instead of "tobacco" put "cannabis" (assuming we have a situation where cannabis is legal) I suspect very similar problems of smuggling and criminal gang involvement would apply. Yes, we need to look at radical reform; the problem is that it is very difficult to have a debate about even cautious changes in drugs policy.

  Chairman: I do not really want to go down that road so I am not going to invite you in on that. Our Committee is basically asking where is the scientific evidence to justify the current policy. That is what we are looking at.

  Q442  Mr Newmark: Would you be in favour of using a scientifically based scale of harm to determine a legal status of drugs? Why or why not? In view of the fact that drugs policy is a politically sensitive area, what role should scientific evidence play in influencing decisions? I am asking the question in the context of David Nutt's analysis into which I think Lesley had some input. Steve?

  Mr Rolles: I think in terms of a classification system as a public health tool then I think the simple ABC classification is almost completely useless; I do not think it is any use as a public health at all or it has very little, it is marginal. I think in terms of young people and the classification system I do not think it makes any difference really; it is must more based on their personal knowledge and information they get from their peers about risks and so on. I certainly do not think that young people are leafing through Hansard before they go out on a Saturday night. If anything they will ignore it completely. In terms of a criminal justice tool I think it is actively counter productive. I think criminalising drugs increases the harm associated with those drugs. Not only does it create the secondary harms associated with illegal markets, it also increases the harms of the drugs themselves.

  Q443  Mr Newmark: You are not answering my question. My question has to do with a scientific base scale of harm in determining drug policy.

  Mr Rolles: The problem with the ABC system is that it hugely over-simplifies quite a complex series of drug using behaviours and the vectors of drug harm are far more complicated than just ABC. There is a series of determinates for any particular drug and any particular user.

  Q444  Mr Newmark: You are moving to classification again; I am not talking about classification, I am looking at scientific evidence.

  Mr Rolles: Obviously I believe that you should have scientific evidence for any policy. In terms of ABC I think that is a different area.

  Q445  Mr Newmark: I am mainly focussing on scientifically based evidence in determining harm and having got that scientific evidence from a public platform then articulating that this is the science behind the decisions we are making as public policy makers.

  Mr Rolles: I think I have answered that. It is great to have good science in terms of deciding what drugs are in which category, but there is no science for determining the fact that the classification system itself is effective in doing what it is supposed to do. I would just reiterate that point really.

  Mrs King-Lewis: I think if we had the scientific evidence and used it appropriately we would not have the anomalies in the system today. It has already been mentioned about magic mushrooms being a Class A drug and the classification of other drugs. We have either ignored the evidence that exists or have not used it or other priorities have come into play.

  Q446  Mr Newmark: How can government improve its approach in making policy decisions on drug classification where evidence is inconclusive?

  Mrs King-Lewis: Identify the research gaps, fund it and get it funded by an independent body. The amount of money invested in this country is £3 million to £4 million. That is the average R&D budget for a small public company.

  Q447  Mr Newmark: Which is Professor Strang's point.

  Mrs King-Lewis: Absolutely.

  Mr Rolles: I think we would all agree with that and with the previous panel that there is not enough research into drug policy issues and drug harm issues generally, but I think it is both of those. It is not just research into harms and addictive behaviours and so on, it is also research into outcomes specifically. Whilst we can identify holes in the research with regard to magic mushrooms or ecstasy or whatever, there are also huge holes in the research with regards to some of the things Andy Hayman was talking about such as the deterrent effect. The concept of the deterrent effect is central to the entire classification system and indeed the whole prohibition is paradigm specifically the idea of a hierarchy of deterrents associated with a hierarchy of penalties, but there is no research at all—not a single piece of research ever done by the Home Office that I am aware of—into the effectiveness of the classification system as a deterrent and the independent research that we do have—what little there is—suggests that at best it is a marginal impact on drug taking decisions. To me that is a striking gap in the knowledge that we have in terms of determining this policy.

  Q448  Mr Newmark: Lesley, you have said you have reflected on what Professor Strang has also said, that there needs to be more funding, but how responsive do you feel government has been to your concerns? Have you had a chance to articulate those previously? What needs to be done is more funding, but should the primary responsibility for funding addiction research in your view lie with the Home Office, health or research councils?

  Mrs King-Lewis: You have made a very interesting point; it is not just with drugs. There are different departments: alcohol is a department, sport and education; nicotine is a separate department; drugs. We almost need one body who has the accountability and responsibility for pooling research into all the different drugs, the legal and the illegal drugs. Obviously we are missing a trick there because there is no joined up thinking.

  Q449  Mr Newmark: Do you think that as a result of that there would be more efficient use of limited resources, ie money, by pooling it together so there would not be competing groups effectively doing the same research?

  Mrs King-Lewis: Exactly. There are cases where the Home Office has actually commissioned research which the Department of Health did not even know about and were commissioning a similar issue. There is a frustration there.

  Q450  Chairman: What was the issue?

  Mrs King-Lewis: I will have to get back to you on that. It is so frustrating when the little amount of money that has been allocated is then duplicated or, as has happened in the past when we have responded to a call, information can be sat on for a long time or never published.

  Q451  Margaret Moran: We have heard the assertion that ACMD should be looking at the research gap. Leaving that aside what other weaknesses do you see that there are in ACMD? How could its effectiveness be improved?

  Mrs King-Lewis: I have had personally very little dealing with it but from my objective point of view there seems to be very little transparency and it seems to be reactive and not proactive so I think the opportunity to be proactive would be great and would make a big difference.

  Mr Rolles: I would agree with both those points. There is a lack of transparency although I did note that Professor Rawlins said that the minutes of meetings would be made available and hopefully we will get to see those at some point. Certainly the work that the ACMD actually produces is first class and no-one is questioning the good intentions of the ACMD. The problem is that the ACMD is set up within the framework of the Misuse of Drugs Act so it exists within a system that is signed up to the prohibitions paradigm and a criminal justice approach to managing drug problems in this country and as such it is very limited within that remit. It can question things within a criminal justice system but it cannot question using the criminal system per se as an effective tool in terms of dealing with drug problems even though there would appear to be a mountain of evidence to suggest that the criminal justice approach to managing drug use has not historically been effective given that the problem has got worse and worse over the last 45 years. I think the main problem is the political framework within which the ACMD operates, not the work that it actually does. The questions that they are asked they answer very well; it is the questions that they do not ask which is the problem.

  Mr Barnes: As you probably know I am here as DrugScope Chief Executive but I am also a member of the ACMD which is possibly why I was not asked to comment on the previous question. I am concerned when I hear words like "lack of transparency" and "not reactive". The ACMD does do proactive work. To give you an example, it published a report three years ago on the issue of children living with parents who misuse drugs, a report called Hidden Harm. It took the Government two years to publish its response to that report; it took 18 months to two years for a fantastic piece of agenda setting work. On the issue of research one of its recommendations was that we need more research into the issue of the effects of drug use amongst parents of young people. The Government's response was that we have enough research on that issue. The ACMD's report on cannabis re-classification, the recent one, it did call for more on-going research into the effects of cannabis on mental health problems. As we have touched on, should it be the role of the ACMD to commission research? Perhaps it could be more assertive with government in terms of saying where the gaps are and what needs to happen, but given the ACMD's role that it is there to reach a judgment on the research, to gather it together, to look at its robustness, to reach a conclusion from that, there could be a tension between it being a commissioning body and also a body that then has to take that evidence into account and reach its judgments on the evidence it is looking at.

  Q452  Mr Devine: How did you become a member of the ACMD and what do you see as your role?

  Mr Barnes: I sit in a personal capacity but I would not have been appointed, I do not think, had I not been Chief Executive of DrugScope. As Chief Executive of DrugScope I hopefully bring to the Committee with all its range of expertise of its members particular knowledge or perspectives. Saying that, if I did not feel that the ACMD was a credible body, as Chief Executive of DrugScope I would not have applied to become a member.

  Q453  Margaret Moran: We have heard evidence both in the previous session and in written evidence that the ACMD is supposed to be a scientific body therefore the question is why do you have campaigning organisations on there? What does that bring to it? Also there are significant gaps even in the science that should be on the ACMD. What would be your response to that?

  Mr Barnes: Firstly I think if you are referring to DrugScope in particular we do campaign but we are not just a campaigning organisation. We have the largest library of drug information in the world; we do conduct research; we try to inform policy; we have a membership of around 900 organisations that represent the broad spectrum of people working in the drugs sector. So to have non-scientists if you like on there does bring value to the work of the ACMD. There are also people who work in treatment organisations and also people who work in education and they do bring that broad perspective to the issues. I think if the ACMD's role was simply to look at the narrow issue of the scientific and medical evidence as to what harms drugs do to individuals I think its role would be much clearer and easier, but its role is to look at the issue of a drug related harm in the wider context of wider harms, the harms that drugs can do not just to individuals but to their families, to the community, et cetera. That is what makes its role more challenging and, if you like, more complex where the research itself does not necessarily give you the answers—certainly not the easy answers—as to what the policy response to drug harm actually should be.

  Q454  Mr Newmark: Lesley, you expressed concern following the decision to re-classify cannabis as Class C in 2002 that this could lead to an increase in the use by young people in particular. What conclusions do you think we can draw from the apparent decrease in the use that has actually occurred?

  Mrs King-Lewis: I think it is very interesting but again we did not measure it. We missed a vital opportunity. The belief was that if we actually decreased it we expected usage—especially amongst young people—to increase. Actually what happened was that we saw a decrease. But that is all we know. What we do not really know is anything more than that so again we missed the opportunity to evaluate the effect of that change in policy.

  Q455  Mr Newmark: There must be a reason behind your concern.

  Mrs King-Lewis: Yes, because we had not expected the decrease. We expected that if we de-classified it the message being sent out to young people would be that it is okay, it is legal, we are no so concerned about the health messages, it is okay for you to use cannabis. We were concerned about the messages we were sending out to young people and we were actually very surprised to see the overall trend—and the trend has been dropping for the last few years—continued to decrease but we do not know whether it is because of an existing trend, what other factors or because of the re-classification. We are still left in that same ignorant position so if we want to make another change on the cannabis policy we have not built a body of information to make an informed decision.

  Mr Rolles: There is a lot of talk about sending out messages and the classification system being used to send out messages, but firstly there is no evidence to suggest it is effective at doing that at all which I think is something which needs to be borne in mind.

  Q456  Mr Newmark: It goes back to your argument that in fact it should not really influence our thinking; classification is a red-herring.

  Mr Rolles: There is a bigger point really. Why are we using the criminal justice system to send out public health messages at all? It is not the role of law and order to send out public health messages.

  Q457  Mr Newmark: If something is illegal and is deemed illegal by Parliament there has to be a mechanism for enforcing the law and that is the whole point of deciding what is legal and what is illegal and therefore—going back to what Andy was talking about—you then have to have some form of classification to decide where should the resources be put in enforcing the law.

  Mr Rolles: Transform's organisational position is that drugs should not be illegal and that making them illegal has actually increased the harm associated with those drugs. Just because something causes harm does not mean that you necessarily criminalise it. We do not criminalise pork scratchings or running with scissors. There are all sorts of things which are potentially risky but if you want to reduce harm associated with them you educate people and encourage them to make more responsible decisions; you do not criminalise them or put them in prison. That is not ethical and historically it has been completely ineffective. Drugs are a superb example of that. Drugs are quite anomalous in all of UK law and social policy where you use the criminal justice system to send out a public health message. We do not do that with tobacco or alcohol; we do not do that with glue sniffing or prescription drugs or dangerous sports or all sorts of potentially risky activities, but for certain drugs for reasons lost in the mists of time we have decided that we are going to send out a message using the criminal system which is quite bizarre.

  Q458  Mr Newmark: To take a step back, prescription drugs have to be prescribed before you can take them.

  Mr Barnes: Can I just comment on the cannabis issue and the continuing down trend? I think the home secretary in his interview with The Times before Christmas himself accepted that the Government could have handled the issue of re-classification at the time better. There was ample opportunity to have launched a comprehensive campaign, particularly for young people, to explain why the category was being changed. We are now getting a campaign sometime at the end of May and we look forward to seeing that. One of the consequences of re-classification with all the debate and controversy that it generated, is that I do not think we have ever had a more in-depth public debate about the known risks of cannabis. I can remember a couple of years ago hearing somebody on the radio who advocated legalising cannabis coming out with a statement that the worse that can happen if you use too much cannabis is that you fall asleep. That is patently nonsense.

  Mr Rolles: I do not think Transform would agree with that.

  Mr Barnes: I did not say it was you, did I? You are not the only pro-legalisation body. Let me make it clear, I have every respect for Transform and the work they do. I have no criticisms of that organisation so rest assured that I was not having a go. We do now have a more open debate which is difficult to have through the media admittedly. There might have been some initial confusion but research now shows that the vast majority of people do understand that the drug is illegal. I think the next challenge to get across is that they understand the potential harms that can go with its use. That is still the challenge.

  Q459  Dr Iddon: Is there not still a big problem with the cannabis debate? People say today that the cannabis sold on the streets is stronger than it used to be. We are completely dishonest with young people. There are 23 varieties of the plant and what we are selling on the streets today is not the same plant extract that we were selling ten years ago on the street. We have skunk now which was not available some years ago. Is it not time we became honest with our young people and tried to explain what they are buying on the street?

  Mr Rolles: That is absolutely right. What young people need is honest, accurate information at the place and time that it is needed. Going back to the point I made earlier, I do not think an ABC ranking system provides that kind of detail and nuance for what is a really quite complex set of variables in terms of determining drug related harms. It just does not do that. Class C drugs can be used in very risky ways; Class A drugs can be used in comparatively less risky ways. There are an immense number of determinates like the dose you take or the frequency of use or whether you are using certain drugs with other ones at the same time can amplify harms; your personal predispositions, whether you have pre-existing mental health problems or certain physiological conditions which would put you at risk. For all that complexity and all these different variables of harm, the ABC system does not provide any useful information at all.

  Mrs King-Lewis: I agree; we need to be far more honest. I think there has always been a problem in this country and it is almost like we are reluctant to talk to our young people and give them the information. We almost seem to feel that we are going to create a problem by acknowledging one exists and the information is not out there. They do not know the different types; they do not know what the levels are or who they are buying it from. We need to do a lot more work on educating. We need to do a lot more work on prevention as well. It is interesting because prevention does not come within the remit of the ACMD or the Drugs Misuse Act; it does not seem to fall anywhere but that is what we are particularly interested in, the prevention side: how do we talk to young people and, more importantly, how do we change their behaviour about drugs and alcohol? Information has to be a key factor in that.

  Mr Barnes: Could I just reinforce the point that the system of drug classification within the context as we have it is one response to reducing drug related harm. I entirely agree that we also have to look much more at learning lessons and other areas of research around what works in terms of prevention. There is growing evidence that the link between socio-economic factors and drug use moving from casual into dependency, for example, and why are we not seeing tackling drugs as more of a key potential outcome of that as well? Education in schools. More investment around drug treatment. We have seen record amounts going in but there is clearly more to do in terms of improving the effectiveness of drug treatment. On the role of the ACMD it has looked at work around prevention. It published a report in 1998 that emphasised that if we are talking about genuine prevention we need to address the wider social factors, the upstream factors, and at the moment it is doing a very good piece of work I think in terms of looking at the effectiveness of policy responses in terms of young people's drug use. That work is on-going; they are meeting with officials at the moment to firm up the recommendations and I think it is due to be reported later this year.

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